November | 2024 | Global Treatment Services Pvt. Ltd.

Peliosis hepatis

Nov 23, 2024 Posted by admin vascular 0 comments

Overview

Peliosis hepatis (PH) was first described in 1861. PH is a very rare disease, more common in adults, and when it affects the liver, it comes to the surgeon’s attention only in an extremely urgent situation after the lesion’s rupture with the resulting hemoperitoneum. Peliosis hepatis (PH) is a disease characterized by multiple and small, blood-filled cysts within the parenchymatous organs. The cysts of peliosis hepatis often lack a cell lining and are surrounded by hepatocytes. Some have an endothelial cell lining, accompanied by dilated hepatic sinusoids. The cause is probably damage to the sinusoidal lining cells. Peliosis hepatis is associated with use of hormones (eg, anabolic steroids, oral contraceptives, glucocorticoids), tamoxifen, vinyl chloride, vitamin A and, particularly in kidney transplant recipients, azathioprine. Peliosis hepatis usually affects adults, though may occur in children. Peliosis hepatis occurs equally in men and women.

Causes

Infections: HIV, bacillary peliosis (caused by genus Bartonella, bacteria responsible for cat-scratch disease which are identified histologically adjacent to the peliotic lesions), Staphylococcus aureus
Chronic conditions: End stage kidney failure, kwashiorkor, tuberculosis, and other chronic infections
Malignancy: Monoclonal gammopathies (multiple myeloma and Waldenström’s macroglobulinemia), Hodgkin disease, malignant histiocytosis, seminoma, hepatocellular adenoma, and hepatocarcinoma
Kidney transplants: It can be found in up to 20% patients, can be related to azathioprine or cyclosporine use, and may be associated with increased risk of transplant rejection.
Drugs and toxins: Corticosteroids, androgens, azathioprine, tamoxifen

Signs and symptoms

Often, peliosis hepatis causes no symptoms (asymptomatic). In other cases, it may be identified after blood tests show abnormalities in liver enzymes. Peliosis hepatis may cause abdominal pain, especially right upper quadrant pain, or jaundice.

Diagnosis

Liver function test is enough to diagnose the disease.

Other cystic conditions of liver

Polycystic liver disease
Solitary congenital cysts
Congenital hepatic fibrosis
Hydatid cyst
Von Meyenburg complexes
Caroli disease (type V choledochal cyst)
Type IV choledochal cysts

Treatment

Treatment is usually directed towards management of the underlying cause. Withdrawal of azathioprine leads to remission in kidney transplant; bacillary peliosis responds to antibiotics. In rare circumstances partial resection of liver or transplant may be required.

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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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