Retinoblastoma is cancer of the eye which begins in the retina. Retina is a layer of nerve cells
that lines the back of the eye. It happens when the cells form a tumor when nerve cells in the retina
change and grows in size and number. Cells usually spread in and around the eye. They can
also spread to the brain and spine. Retinoblastoma usually occur in young children below the
age of five though it appear in adults as well. Children with an inherited gene from their parents
tend to get retinoblastoma at an earlier age, and in both eyes.The early symptoms of
retinoblastoma is a cloudy white pupil(leukocoria). In bright light, the pupil can look silvery or
yellow.
Other symptoms are :
● Poor and blurred vision
● The coloured part of the eye (Iris) appear cloudy
● Crossed eyes (Eyes that appear to be looking in different directions)
● Eye redness
● Eye swelling

There are two types of retinoblastoma.

● Heritable retinoblastoma
This is the most common type of retinoblastoma. It occurs when a child inherits a
mutation (change in a gene) from a parent. Such babies will be born with retinoblastoma.

● Sporadic retinoblastoma
Occurs when a gene mutation happens in early childhood, usually after 1 year of age. It
affects just one eye.

TREATMENT

Treatment involves chemoreduction and focal treatments without the use of external beam
radiotherapy. This allows preservation of the eye in some cases, often with visual function.

Have you ever been without your mobile phone for a few hours? What goes through  your mind when your phone is not within your reach? Irritated?,tensed? or restlessness?.If yes, then probably you are undergoing a state called nomophobia. Nomophobia or “no–mobile-phone phobia” is the irrational fear of being without your mobile phone. This happens when your are not able to use your phone for some reason, such as the absence of a signal or running out of minutes , battery power or credit. Today it’s increasing among high school and college students. A person with this syndrome may be tensed, stressed ,or anxious when he cannot use his mobile phone . It can also be an addiction when such people cannot go to sleep with or next to their smart phone or never switch off their phone or cannot take a break from it.  However, there is debate among the medical community on its classification; is it a phobia, anxiety disorder, lifestyle disorder, or addiction?. But it is commonly perceived as a phobia. Nomophobia preoccupies an individual with his phone and turn to it if they are depressed, anxious, and lonely. It not only affects the mind, but also relationships, where a person is physically present but psychologically absent. It can affect job performance, academic performance, impairs concentration and mental health in a long run. The various symptoms of this condition include,

•  Elevated heart rate, sweaty palms, shallow breathing.
• Keep checking the phone every now and then for battery life and/or messages.
• Plug and connect regularly.
• Use of phone even at inappropriate places .
• Health and mental well being suffers in the absence of mobile phone.

The treatment of nomophobia often does not require medical interventions.  The best remedies for this phobia includes  taking control over phone ,interpersonal counseling, cognitive behavioral therapy, addiction therapy, gradual exposure therapy and systematic desensitization. Exposure therapy is, first exposing the individual to their phobia in therapy (ie, not taking the phone in the room with them) and gradually moving to real-life scenarios (ie, moving the phone to another room for gradually increasing amounts of time). For worst cases of this phobia, anxiety medication may be required.

Breast milk is the primary nutrition source  for the newborn. According to WHO, newborn babies should be fed exclusively with breast milk for the first six months. It is the complete nutrition source till six months of age. The rich composition of the breast milk protects the baby against infections, diseases and illness. Bless fully, the benefits of which continue even long after breast feeding has ended.

STAGES OF BREAST MILK

Breast milk is typically studied under three stages. The colostrum, transitional milk and mature milk.

Colostrum is the thick yellow sticky breast milk produced during the end of pregnancy and during the first few days after delivery. It is high in protein, low in fat and has abundant amount of immunoglobulin(IgA) and white blood cells to fight infections. It also act as a natural laxative by helping to prevent jaundice and clearing meconium from the baby’s body.

Transitional breast milk comes in as a combination of colostrum and mature milk three to five days after birth of the baby.

Mature human milk contain fat (3%-5%), protien (0.8%-0.9%), carbohydrates (6.9%-7.2%),  calculated as lactose. The energy content of breast milk is 60-70kcal//100ml. The protein content is more than the carbohydrate content in the colostrum than the matuem milk. There is no consistent compositional difference between milks from the two breasts unless one is infected.

COMPOSITION OF BREAST MILK

The nutrient rich complex composition of breast milk include water, protien, carbohydrates, fats, immunoglobulins, vitamins, minerals, enzymes and hormones. The composition may varies among mothers and within the same mother throughout a day. This variation over time helps to meet the needs of a growing child.

The principal protein of human milk is casein. It is homologous to bovine beta- casein, alpha lactalbumin, lactoferrin, immunoglobulin IgA, lysozyme and serum albumin.

The principal sugar of human milk is lactose. Apart from lactose 30 or more other oligosaccharides are also present. These amount is the aggregate to as much as 1g/100ml in mature milk and 2.5g/100ml in colostrum. Some of them has the ability to promote growth of certain strains of lactobacilli.

The principal fat elements in human milk are palmitic acid and oleic acid.

The principal mineral constituents are sodium, pottasium, calcium, magnesium, phosphorus, and chlorine. The iron, copper and zinc contents of human milk varies considerably.

BENEFITS OF BREAST MILK

• Water: Water which makes up 90% of the breast milk keeps the baby hydrated and help to regulate body temperature , lubricate and protect internal organs.
• Carbohydrates: Apart from being the energy provider , it is also linked to greater brain development.
• Lipids: lipids or fats play a major role in the baby’s weight gain as he grows.
• Protein:  It helps to build, strengthen and repair the body. Protein lactoferrin in the milk is associated with the iron transport in the body.
• Immunoglobulins/ antibodies: They are baby’s first vaccine. It helps fight off germs, bacteria, fungi, viruses, parasites and diseases.  IgA ,the main immunoglobulin  prevents germs from entering the nanbab body and blood.
• Vitamins protects the baby from scurvy, rickets,and other deficiency diseases.
• Minerals helps to build strong bones, produce red blood cells and helps in the proper functioning of muscles and nerves.

Acidity or acid reflux is the back flow of stomach acid to the chest cavity. It is a very common medical condition among people. It is often caused by one or multiple factors. The gastric acid which aids digestion in stomach rises up to the chest cavity or food pipe. This happens when  the lower oesophageal spincher (LES) that regulates the flow of food from oesophagus to stomach doesn’t close or opens too long.

CAUSES

• Hiatal hernia: This is a stomach abnormality that occurs when gastric acid builds up or fills the oesophagus as the lower part of the stomach and lower oesophagus moves above the diaphragm.
• Excess production of acid in the stomach.
• Excess consumption of spicy and oily foods.
• Irregular eating patterns and habits.
• Side effects of medices.
• Consumption of alcohol.
• Being pregnant.
• Snacking just before bed time.
• Lying on the back or bending over at waist just after a heavy meal.

SYMPTOMS

Acid reflux is generally characterised by a  burning sensation in the stomach throat and heart. The person with acidity may face difficulty in swallowing, indigestion, constipation, restlessness and prolonged sour taste in mouth. Nausea and bad breath are other common symptoms of acidity.

DIAGNOSIS

Acidity is usually self diagnosable with its symptoms. If it doesn’t help, a doctor may ask you to undergo,

a) an X-ray of stomach and oesophagus.

b)an endoscopy of gastrointestinal tract

TREATMENT

• Antacids: It helps neutralise the stomach acidity
• H2  receptor blockers/ histamine blocking agents like nizatidine, famotidine, cimetidine.
• Home remedies include consuming mint leaves, ginger, clove cardomom, banana , cucumber etc.
• Drinking a glass of milk every day helps reduce acidity.
• Follow regular eating patterns.

Choking is a medical emergency where in a foreign body obstructs the air passage to lungs. It is often life threatening caused due to inhalation or ingestion of food or another object .This obstruction can be partial or complete.Partial obstruction allows some air passage to lungs and compete obstruction prevents air passage to lung. It prevents normal breathing and thus body is deprived of oxygen delivery leading to asphyxia. It can be fatal.

SYMPTOMS

• Difficulty in breathing ,gasping and wheezing
• Difficulty to speak.
• Clutching, and grabbing of throat or mouth.
• Person’s face turns blue and may become unconscious.

CAUSES

It occurs when a foreign body blocks the air passage to lungs. The object may block either the upper or lower air passages. The most common causes of choking are food and toys. Nuts, seeds, peanut butter are the causes of choking in children.Toy and toy parts also have high potential to completely block the airway in children.

TREATMENT

• Alternate back blows and abdominal trust.

a)Five back blows: Stand behind the person choking /kneel down behind a hoking child.Bend the person so that his upper body is parallel to the ground and blow between the shoulder blades using the heel of your hand. Repeat it five times.

b)Wrap the person in your arms at his waist. Position one fist above the person’s navel and hold the fist in the other hand and deliver a hard and quick upward thrust to the abdomen.continue doing this five times.

In case of infants less than one year.

1. Hold the infant face down in a seated position.
2. Support his head and neck with your hand so that the head is lower than the trunk.
3. Blow the infant gently between the shoulder bones using the heels of your arm five times.
4. If the infant is still not breathing,turn him face up n your fore arm resting on your thigh with the head lower than the trunk.
5. Give five chest compressions at the center of breast bone using two fingers.Press down to a depth of 1.5 inches and let the chest rise again between each compressions.

Alopecia areata is a medical condition in which hair falls out in round patches..It is an autoimmune disease which is affected by one’s genetic makeup along with factors such as stress and extremes of dieting. The fall out of hair can be from the scalp or elsewhere on the body. Though the hair re grows, it may fall out again and often the hair loss lasts for years. It can occur in all age groups and otherwise healthy people.

SYMPTOMS

• Hair fall out in patches: Patches of hair are usually noticed on one’s pillow or in shower. Hair fall out may occur on scalp, eyebrows, eyelashes and beards.
• In severe cases some patients go bald
• Nail problems: Nails show pinpoint pitting, white spots and loss their shine often splits.
• Exclamation mark hair: Hair may grow narrow at the end and as round patch at the bald end.

CAUSES

It is an autoimmune disease where the body attacks its own hair follicles. It is not contagious. Alopecia areata patients may have a family history of this disease and are at a higher risk for thyroid disease, vitiligo, asthma , eczema and hay fever.

DIAGNOSIS

• Skin biopsy: A small piece of skin is removed and studied under a microscope by a dermatologist.
• Blood tests: To look for any chances of other autoimmune diseases.

TREATMENT

Currently there is no approved treatment and complete cure so far. Some immunosuppressants and hair regrow medicines are often prescribed by dermatologists to help hair regrow.

Immunosuppressants like corticosteroids and hair regrow medicines such as minoxidil, anthralin and diphencyprone are some other medicines that triggers allergic reactions that help hair regrowth.

Light therapy or photo chemotherapy is a radiation treatment which uses both oral medication called psoralens and UV light.Essential oils like tea rose, rosemary ,lavender, peppermint and oils like coconut, olive,castor and jojoba help reduce symptoms.

The effectiveness of treatment may vary among patients. However hair regrowth may only be temporary. Hair may regrow and fallout again.

Varicose veins are swollen, twisted veins that can be visible just under the surface of the skin. Although it usually occurs in the legs, they also can form in other parts of the body also.Varicose vein is quite a common condition.

Veins have one-way valves that help keep blood flowing toward your heart. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell, which can lead to varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.

Causes

Weak or damaged valves in the veins can cause varicose veins. After your arteries and capillaries deliver oxygen-rich blood to your body, your veins return the blood to your heart. The veins in your legs must work against gravity to do this.One-way valves inside the veins open to let blood flow through, and then they shut to keep blood from flowing backward. If the valves are weak or damaged, blood can back up and pool in your veins. This causes the veins to swell.
Weak vein walls may cause weak valves.If these walls become weak, they lose their normal elasticity. They become like an overstretched rubber band. This makes the walls of the veins longer and wider, and it causes the flaps of the valves to separate.When the valve flaps separate, blood can flow backward through the valves. The backflow of blood fills the veins and stretches the walls even more. As a result, the veins get bigger, swell, and often twist as they try to squeeze into their normal space. These are varicose veins.
Many factors can raise your risk for varicose veins. Examples of these factors include family history, older age, gender, pregnancy, overweight or obesity, lack of movement, and leg trauma.

Associated vein problems

Telangiectasias
Telangiectasias are small clusters of blood vessels usually found on the upper body, including the face.These blood vessels appear red. They may form during pregnancy, and often they develop in people who have certain genetic disorders, viral infections, or other conditions, such as liver disease.Telangiectasias can be a sign of a more serious condition.

Spider Veins
Spider veins are a smaller version of varicose veins and a less serious type of telangiectasias. Spider veins involve the capillaries, the smallest blood vessels in the body.Spider veins often appear on the legs and face. They’re red or blue and usually look like a spider web or tree branch. These veins usually aren’t a medical concern.

Varicoceles
Varicoceles are varicose veins in the scrotum and may be linked to male infertility.

Other types of varicose veins include venous lakes, reticular veins, and hemorrhoids. Venous lakes are varicose veins that appear on the face and neck. Reticular veins are flat blue veins often seen behind the knees. Hemorrhoids are varicose veins in and around the anus.

Diagnosis

Duplex Ultrasound
Duplex ultrasound combines traditional with Doppler ultrasound. Traditional ultrasound uses sound waves to create a picture of the structures in your body, in this case the blood vessels and anything that may be blocking the flow of blood. Doppler ultrasound uses sound waves to create pictures of the flow or movement of the blood through the veins. Duplex ultrasound combined with traditional together gives a picture of the blood flow in your arteries and veins.

Angiogram
Although it is not very common, an angiogram givest a more detailed look at the blood flow through your veins.An angiogram helps to confirm whether you have varicose veins or another condition.

Treatment

Varicose veins are treated with lifestyle changes and medical procedures. The goals of treatment are to relieve symptoms, prevent complications, and improve appearance.For more severe symptoms like pain, blood clots, or skin disorders ,one or more medical procedures may be needed.

Medical procedures

Sclerotherapy
Sclerotherapy uses a liquid chemical which is injected into the vein to cause irritation and scarring inside the vein. It causes the vein to close off, and it fades away.This procedure often is used to treat smaller varicose veins and spider veins.

Microsclerotherapy
Microsclerotherapy  is used to treat spider veins and other very small varicose veins.A small amount of liquid chemical is injected into a vein which scars the inner lining of the vein, causing it to close off.

Laser Surgery
The laser light makes the vein fade away.Laser surgery mostly is used to treat smaller varicose veins. The main advantage is that no cutting or injection of chemicals is involved.

Endovenous Ablation Therapy
Endovenous ablation therapy uses lasers or radiowaves to create heat to close off a varicose vein.A device at the tip of the catheter inserted to the vein heats up the inside of the vein and closes it off.

Endoscopic Vein Surgery
For endoscopic vein surgery, a small cut is made in your skin near a varicose vein. A tiny camera is used at the end of a thin tube to move through the vein and a surgical device at the end of the camera is used to close the vein.Endoscopic vein surgery usually is used only in severe cases when varicose veins are causing skin ulcers.

Ambulatory Phlebectomy

For ambulatory phlebectomy,  doctor will make small cuts in your skin to remove small varicose veins. This procedure usually is done to remove the varicose veins closest to the surface of your skin.

Vein Stripping and Ligation
Vein stripping and ligation typically is done only for severe cases of varicose veins. The procedure involves tying shut and removing the veins through small cuts in your skin.

Bronchiectasis is serious!Bronchiectasis is a form of chronic obstructive pulmonary disease (COPD) .It is a lung condition in which the airways to the lungs are damaged making it abnormally wide,scarred and thickened.This extra space allows bacteria and mucus to build up causing recurrent infections and  leading to the blockages of airways.Bronchiectasis in Detail

When we breathe, air is carried into lungs through our airways, also called bronchi. The bronchi divide into thousands of smaller airways called bronchioles which contain tiny glands that produce mucus.Mucus is a slimy substance that helps to keep airways moist and traps the dust and germs that are inhaled.The mucus is moved away by tiny hairs, called cilia, which line the airways.
In bronchiectasis, airways are scarred and inflamed with thick mucus, also called phlegm or sputum,airways slowly lose their ability to clear out mucus. When mucus can’t be cleared, it builds up and creates an environment in which more bacteria are breathed in.Bacteria grows in the excess mucus, leading to repeated, serious lung infections.Each infection causes more damage to your airways ,the breathing tubes become baggy and holes form in the lungs.. Over time, the airways lose their ability to move air in and out preventing enough oxygen from reaching your vital organs.This can ultimately lead to the loss of lung function over time, as well as serious health problems such as respiratory failure,heart failure and atelectasis.

Causes

Bronchiectasis can be congenital resulting from an abnormal lung development before birth. Bronchiectasis usually begins with some type of  lung damage which might have been caused by a common childhood infection such as whooping cough or measles, or from a lung-related medical condition such as  cystic fibrosis or primary ciliary dyskinesia.There are two main categories of this condition. One is related to having  cystic fibrosis and is known as CF bronchiectasis. CF is a hereditary condition that causes an abnormal production of mucus.The other category is non-CF bronchiectasis, which isn’t related to CF.

Bronchiectasis can develop in the following conditions:

• Humoral immunodeficiency (low levels of infection-fighting proteins in the blood)
• Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
• Rheumatologic diseases (rheumatoid arthritis and Sjögren’s disease)
• Alpha1-antitrypsin deficiency (genetic cause of COPD in some people)
• Chronic obstructive pulmonary disease or COPD
• HIV infection
• Allergic bronchopulmonary aspergillosis (a type of allergic lung inflammation)
• pneumonia
• Whooping cough or measles
• Tuberculosis
• Fungal infection

Symptoms

The most common signs and symptoms of bronchiectasis are:

• A daily cough that occurs over months or years
• Daily production of large amounts of sputum (spit). Sputum, which you cough up and spit out, may contain mucus (a slimy substance), trapped particles, and pus.
• Shortness of breath and wheezing (a whistling sound when you breathe)
• Chest pain
• Clubbing (the tissue beneath the nail thickens and the fingertips become rounded and bulbous)
• Fatigue which is profound

Diagnosis

If your doctor listens to your lungs with a stethoscope, he or she may hear abnormal lung sounds.

We have two kidneys,one brain,one heart. Aren’t the numbers right?Now,can you guess how many uterus a woman can have?Most of you would say ‘one’.But there can be ‘two’ too!In this post,we are discussing one of the  congenital uterus anomaly-uterine didelphys. There are two uterus ,two cervices involved and in many cases two vaginas too.

Formation and malformation

As aforementioned,uterine didelphys is an anomaly and so a result of malformation.

Now let’s look at the formation of uterus,females fetus ofcourse. The development of the normal female reproductive tract is a complex process. It starts in the womb.The mesonephros , principal excretory organ during early embryonic life (4—8 weeks), appears in humans during the 4th week of gestation and degenerates after 8th week. Draining function of this transient kidney is handled by mesonephric ducts(Wolffian ducts).The ‘indifferent’ or ‘bipotential’ gonad (meaning it appears same for both sexes at this stage) differentiates to the ovary.Two paramesonephric ducts called Müllerian ducts form from coelomic epithelium extending from the vaginal plate to lie beside the developing ovary. The wall between these paired tubes breaks down in its lower aspect (fuse from the vaginal plate end), forming the primordial body of the uterus .And the unfused lateral portion of the paramesonephric ducts form the uterine tubes.
Thus,the mesonephros, Wolffian and Müllerian ducts differentiate in an orchestrated manner to form the uterus, vagina and lower urinary tract. Any disordered differentiation can result in congenital abnormalities affecting the female reproductive tracts, renal tract and lower intestines.When the Müllerian ducts do not fuse completely resulting in complete duplication of uterine horns as well as duplication of the cervix, with no communication between them,it is called uterine didelphys or double uterus.

Other anomalies due to the incomplete fusion are

• Uterus bicornis
• Uterus bicornis unicollis rudimentary horn
• Uterus Arcuatus
• Atresia of cervix
• Atresia of vagina

Symptoms and complications

In most women,the condition is asymptomatic.In others,it remains undetected untill menarche,the time when menstrual cycles start in a girl.They can discover this condition as putting a tampon into one of the vaginas does not cause bleeding to stop completely.Since women with uterine didelphys also has vaginal septum or partition in varying degrees,some may present with following symptoms.
Dyspareunia or painful intercourse
Dysmenorrhea or painful periods.This is accompanied by heavy monthly menstrual periods .
In extremely rare cases, genital neoplasms(tumor of the genital system) and renal anomalies are reported.

The condition is in most cases diagnosed when women undergo frequent miscarriages.It usually do not hinder woman becoming pregnant.One of the uteri is usually bigger and better than the other, which is also composed of stronger tissues and muscles, which can support implantation which occurs once she conceives. That is why, women with double uterus can carry their babies only in the stronger one.
The pregnancy in these women is classified as high risk .The pregnancy complications associated are reccurent miscarriages,late miscarriage,pre term delivery and still births.Term deliveries of untreated didelphys uterus is approximately 45%.
Despite these complications, there are many women that did not exhibit any gestational challenges.Some percentage of women can go on to have full term and healthy babies.The delivery would normally require a C section.Also a very few cases are known where these women delivered vaginally.
For those of women who do not face pregnancy problems,contraception may pose an issue.Often the two uteri are of unequal size, so fitting an intrauterine device to each may not be possible.They will need to use contraceptive pills which can work like for any other normal woman.

Diagnosis

• Hysterosalpingography for Double Uterus Diagnosis: This method of examination make use of a dark colored dye which is filled into the uterus which is followed by taking X rays of the reproductive organs. As the uterus is filled with colored dye, a clear image of the shape of uterus can be observed in the images taken by the X-rays.However, these methods rely on the clinician’s subjective interpretation rather than strict diagnostic criteria
• Ultrasound Test is Conducted to Diagnose Double Uterus: The use of 3D ultrasound is becoming more commonly used for diagnosis as it is not only noninvasive, but it also overcomes the limitation of 2D ultrasound by providing a coronal view that enables examination of both the endometrial cavity and uterine fundus, thus giving all the information needed for morphological classification.Modern ultrasounds make use of advanced transducers that are capable of producing a 3-D image of the tissue. It is more effective than traditional ultrasound.
• Sonohysterogram: This is a special type of ultrasound for diagnosing double uterus in which the uterus is filled with a fluid before carrying out ultrasound scan. Usually a tube is first inserted into the uterus through which the fluid is filled into the uterus. It gives a better view of the vagina to the doctor and helps him in proper diagnoses of condition.
• Magnetic Resonance Imaging (MRI): It is an advanced method of imaging which is more effective than ultrasound for double uterus. It consists of tunnel shaped MRI machine that is open at both the ends. The person to be examined is made to lie on a table that is moved into this tunnel. This tunnel shaped machine produces a combination of radio waves and magnetic waves to produce a 3 dimensional image of the complete body.

Treatment

It is the degree of the müllerian malformation that bears the most important consequences on reproductive outcome rather than the type of malformation encountered.Generally, women with this condition should make sure to work closely with a doctor during pregnancy to watch for signs of pre term or other risks to the baby. These women will likely need an obstetrician who specializes in high-risk pregnancies.
Before conceiving, a woman with a double uterus should discuss her plans to become pregnant with her physician. Doctors may perform surgery to unify the uterus or to remove an underdeveloped uterus if a woman is having health problems.
Surgery is rarely performed for the condition, though. It’s usually reserved for women who’ve had repeated pregnancy problems. A physician may also help such women take additional steps to lower their risk of complications during pregnancy, labor, and delivery.

It is estimated that more than 5 million people are living with lupus worldwide.Lupus is a complex disease which can cause inflammation throughout the body damaging any part including skin,joints,organs-kidneys,heart,lungs- and bodily systems-blood vessels and nervous system.about 90% lupus sufferers are women of child bearing age.The illness is usually aggressive in children and teenagers than in adults.And it is a harsh reality that 20% of lupus diagnosis happens to be in children.
In lupus,immune system is hyper active and produces abnormal antibodies invading bodily tissues and organs.This condition is thought to be triggered by a combination of genetic and environmental factors.Lupus when referred generally means Systemic Lupus Erythematosus (SLE) which is the most common form of  lupus. SLE in its severe cases involve complications to major organ system.Before we analyse SLE in detail, let us have a brief look at three other types of lupus.

Cutaneous lupus erythematosus
This is the form of lupus limited to the skin but is worsened by exposure to sun. Discoid rash which is the most prevalent rash appears raised, scaly and red, but not itchy.In another form namely ‘Butterfly rash’ ,rash appears over the cheeks and across the bridge of the nose.It is to be noted that Butterfly rash happens to be the significant symptom of SLE. Also,10% of people who have cutaneous lupus will develop systemic lupus.

Drug-induced lupus erythematosus
Although ,the symptoms of drug-induced lupus resemble systemic lupus,it rarely affects major organs.It is a lupus-like disease and symptoms generally vanish in about six months once after the  drug intake is  stopped.Lupus inducing drugs include Hydralazine—Treatment for high blood pressure or hypertension,Procainamide—Treatment for irregular heart rhythms and Isoniazid—Treatment for tuberculosis.

Neonatal lupus
A condition which  affects infants of  whose mothers are lupus patients, but rarely.It is  due to the antibodies of mother acting upon the infant in the womb .Consequently,the baby at birth  may have skin rash, liver problems, or low blood cell counts. Fortunately,symptoms disappear completely  within months leaving no lasting effects. Some infants  can also have a serious heart defect.

Systemic Lupus Erythematosus (SLE)

Symptoms

Lupus range from mild to life-threatening forms.As mentioned earlier,butterfly rash or malar rash is one of the striking feature of Lupus in general.Lupus begin to manifest with a fever, vascular headaches, epilepsy, or psychoses.Several people will have to suffer from cardiovascular disease, strokes, disfiguring rashes, and painful joints.People also experience extreme fatigue, hair loss, cognitive issues and devastating physical impairments. For others, there may be no visible symptoms.
Symptoms also exhibit relapses(symptoms flare up and become worse) and remissions (symptoms settle down).For some,symptoms are seen to be constant.
In the mild variant,sufferers are usually young women.They experience photosensitivity and hypertension.
Symptoms are limited to arthritis-like joint pain,fatigue,sun light induced skin rashes,mild anemia and problems with blood platelet regulation.Moderate lupus inflame skin and other parts of the body,including lungs,heart and kidneys.
Severe SLE may  result in

• Kidney disease called lupus nephritis.
  It can be so damaging that dialysis or kidney transplant may be required.
• Major blood disorders; Inflammation in the brain’s blood vessels can cause high fevers, seizures, and behavioral changes.
• Neuropsychiatric symptoms such as mild cognitive dysfunction, organic brain syndrome,peripheral neuropathies, sensory neuropathy, transverse myelitis, and paralysis and stroke.
• Terrible psychological disorders like personality change, paranoia,mania,schizophrenia,epilepsy , psychosis
• Hardening of the arteries or coronary artery disease—the buildup of deposits on coronary artery walls—can lead to a heart attack.
• Problems with the lung, heart and pancreas.
• Serious form of lupus rash results in “bullous” lupus rash.
• Raynaud’s phenomenon-fingers and toes turning white or blue and feeling numb when a person is cold or stressed

Diagnosis

Diagnosis is challenging as there is no single test specifically for lupus.Tests are usually a combination of blood and urine tests,physical examination findings ,symptom analysis and medical history.

Complete blood count:For WBC,RBC and platelet counts.
Urine analysis: To check for higher levels of protein and RBCs or if  kidney is affected
Blood clotting test:To test for clotting problems.
Biopsy:Tests to check for signs of inflammation by removing a small piece of tissue from different parts of body.(For eg: skin biopsy,kidney biopsy)
Antinuclear antibody (ANA) test. A positive result for the presence of these antibodies  indicates a stimulated immune system. As most people with lupus have a positive ANA test ,if tested positive for ANA, more-specific antibody testing may be advised by rheumatologist.

As symptoms gradually present over time and also varies from time to time,diagnosis may require series of repeated tests.

Treatment

Currently,there is no complete cure for lupus.Treatments are generally used to ease the symptoms and prevent organ damage.Mild forms can turn into severe SLE due to flare ups leading to irreversible damage to the organs.Although still treatable,close monitoring is required to reduce the chances of organ damage.
Treatment must be tailored for individuals.Also,treatment for different forms are different.

Treatment for mild SLE

Nonsteroidal Anti-inflammatory Drugs (NSAIDs):For joint pain and muscle pain are classic early symptoms of mild SLE.
Anti-malarial Agents:The malaria drug hydroxychloroquine (HCQ) for both the muscle and bone pain of SLE as well as the rashes and other sunlight-induced skin problems caused by SLE
Corticosteroids:Low dose corticosteroids are often effective in treating the musculoskeletal inflammation, fatigue, occasional low-grade fever.
The bad news is that for those with mild SLE, the side effects of these conventional treatments outweigh their benefits
Emerging Therapies: Hormone Manipulation
Although it doesn’t mean that estrogen cause lupus,there is evidence that estrogen and prolactin somehow regulate the severity of lupus.This suggests that controlling these hormones through drugs can be groundbreaking treatment for SLE.

Treatment for severe SLE