Thoracic outlet syndrome (TOS) is a condition whereby symptoms are produced (such as numbness in fingers, pain in shoulder, arm, and neck) due to compression of nerves and/or blood vessels in the upper chest. The passageway for these nerves and blood vessels to exit the chest and supply the upper extremities is referred to as the thoracic outlet. Muscle, bone, and other tissues border the thoracic outlet. Any condition that results in enlargement or movement of these tissues of or near the thoracic outlet can cause the thoracic outlet syndrome. These conditions include muscle enlargement (such as fromweight lifting), injuries, an extra rib extending from the neck (cervical rib), weight gain, and rare tumors at the top of the lung. Often no specific cause is detectable.

Thoracic outlet syndrome is a condition whereby symptoms are produced from compression of nerves or blood vessels, or both, because of an inadequate passageway through an area (thoracic outlet) between the base of the neck and the armpit.

Thoracic outlet syndrome symptoms include

• neck pain,
• shoulder pain,
• arm pain,
• numbness and tingling of the fingers, and
• impaired circulation to the extremities (causing discoloration).

An inadequate passageway for nerves and blood vessels as they pass through an area (thoracic outlet) between the base of the neck and the armpit causes thoracic outlet syndrome. This can be constant or intermittent. Thoracic outlet syndrome can be caused by weight lifting, obesity, tumors in the chest, and extra ribs extending from the seventh cervical vertebra at the base of the neck.

Risk factors include occupations that involve heavy usage of the upper extremities against resistance, including jack-hammer operators and dental hygienists, weight lifting, pregnancy, and obesity. Any condition that causes encroachment of the space for the brachial plexus at the thoracic outlet can lead to thoracic outlet syndrome, including poor posture.

Symptoms include neck, shoulder, and arm pain, numbness in the fingers, or impaired circulation and flushed sensations to the extremities (causing discoloration). The involved upper extremity can feel weak. Often symptoms are reproduced or worsened when the arm is positioned above the shoulder or extended. Patients can have a wide spectrum of symptoms from mild and intermittent to severe and constant. Pains can extend to the fingers and hands, causing weakness.

Doctors who treat thoracic outlet syndrome include general physicians, such as general-medicine doctors, family medicine doctors, and internists, as well as rheumatologists, physical-medicine doctors, and chest surgeons.

What is the prognosis for thoracic outlet syndrome?

Most people with thoracic outlet syndrome can have complete resolution of symptoms with conservative measures, including exercises specific for thoracic outlet syndrome, physical therapy, and avoiding stressing the tissues of the thoracic outlet. It can be helpful to avoid sleeping with the arms extended above the head. Rarely, surgical intervention can be necessary to take pressure off of involved nerves and blood vessels. Complications include embolization to the hand and nerve damage to the extremity involved.

Is it possible to prevent thoracic outlet syndrome?

It’s possible to prevent thoracic outlet syndrome by maintaining relaxed tissues of the upper chest. This can involve prevention exercises, stretches, and therapies designed to loosen the tissues around the shoulders and neck. 

Sarcoglycanopathy: A form of limb-girdle muscular dystrophy involving abnormalities of the sarcoglycan protein which results in progressive muscle weakness. The severity is greatly variably from wheelchair confinement at the age of 9 years to asymptomatic adults. Most tend to live to their third decade. More detailed information about the symptoms, causes, and treatmentsof Sarcoglycanopathy is available below.

What Is Trigeminal Neuralgia?

Trigeminal neuralgia (TN), also called tic douloureux, is a condition that is characterized by intermittent, shooting pain in the face.

Trigeminal neuralgia affects the trigeminal nerve, one of the largest nerves in the head. The trigeminal nerve sends impulses of touch, pain, pressure, and temperature to the brain from the face, jaw, gums, forehead, and around the eyes.

Signs and Symptoms of Myopathy:

Although symptoms depend on the type of myopathy, some generalizations can be made. Skeletal muscle weakness is the hallmark of most myopathies, with some noticeable exceptions, such as myotonia and paramyotonia congenita. In these two inheritable muscular disorders, the muscles become enlarged, rather than weakened and atrophied, and do not relax after contracting.In most myopathies, weakness occurs primarily in the muscles of the shoulders, upper arms, thighs, and pelvis (proximal muscles). In some cases, the distal muscles of the hands and feet may be involved during the advanced stage of disease.

Other typical symptoms of muscle disease include the following:

1. Aching.
2. Cramping
3. Pain
4. Stiffness
5. Tenderness\
6. Tightnes

Initially, individuals may feel fatigued doing very light physical activity. Walking and climbing stairs may be difficult because of weakness in the pelvic and leg muscles that stabilize the trunk.
Patients often find it difficult to rise from a chair. As the myopathy progresses, there may be muscle wasting.

Treatment for Myopathy:

Treatment for myopathies depends on the cause. The goals of myopathy treatment are to slow progression of the disease and relieve symptoms.

Treatments range from drug therapy for muscular dystrophies and inflammatory myopathies to avoiding situations that work the muscles too hard for metabolic myopathies. Some physicians recommend that patients with myopathy keep their weight down (a lighter body demands less work from the muscles) and avoid overexerting the muscles.
When breathing problems develop, an incentive spirometer can help improve breathing function in some patients. Unfortunately, there is no way to strengthen the breathing muscles.
Treatment for Muscular Dystrophies:
The goals of MD treatment are to slow progression of disease and relieve symptoms. Duchenne MD and Becker MD are the subjects of current medical research and clinical trials may be available for patients with either disease.
Corticosteroids (e.g., deflazacort, prednisone) seem to be the most effective medications. Both improve strength and walking ability for about 6 months in boys with Duchenne dystrophy. Following initial improvement, further progression of the disease may be delayed for 3 to 5 years in some cases.
Prolonged use of corticosteroids can cause severe side effects including the following:

• Bone loss (osteoporosis)
• Depression
• High blood pressure (hypertension)
• Thinning of the skin
• Weight gain

Calcium supplements and antidepressants may be prescribed to counteract these side effects.
Preventive treatment for permanent contraction of a muscle (contractures) includes physical therapy and bracing. There are currently no drugs available to prevent or treat contractures.
Heel cord surgery (also called tendon release) and spine-straightening surgery (i.e., rod insertion) may be necessary in cases of severe contractures. Heel cord surgery is performed when the patient is still able to walk. Braces are usually required following surgery.

Treatment for Endocrine Myopathies:

Often, treating the underlying condition helps relieve muscle weakness and pain associated with endocrine myopathies.
Treatment for Inflammatory Myopathies:

Inflammatory myopathies, such as polymyositis and dermatomyositis, are usually treated with drugs that suppress the action of the immune system. Prednisone is most commonly used to treat inflammatory myopathies. It is used initially in high doses (up to 100mg/day) and then slowly tapered to the lowest possible dose that relieves symptoms. Long-term use of prednisone can cause severe side effects, including bone loss, depression, and high blood pressure.

Treatment for Metabolic Myopathies:

The primary goal in treating metabolic myopathies is to avoid situations that tax the muscles and promote muscle pain and weakness, like strenuous exercise.

Dengue Symptoms and Signs

Primary symptoms of dengue appear three to 15 days after the mosquito bite and include the following:

• high fever and severe headache,
• with severe pain behind the eyes that is apparent when trying to move the eyes.

Other associated symptoms are:

• joint pain,
• muscle and bone pain,
• rash,
• and mild bleeding.

Many affected people complain of high knee pain and low back pain.

Dengue infection is a leading cause of death and sickness in tropical and subtropical parts of the world. Dengue is caused by one of four viruses that are transmitted by the bite of an infected mosquito. Dengue hemorrhagic fever is a more serious form of dengue infection.

Primary symptoms of dengue appear three to 15 days after the mosquito bite and include high fever and severe headache, with severe pain behind the eyes that is apparent when trying to move the eyes. Other associated symptoms are joint pain, muscle and bone pain, rash, and mild bleeding. Many affected people complain of low back pain. The lymph nodes of the neck and groin may be swollen. Young children and people infected for the first time typically have milder symptoms than older children and adults.

Dengue hemorrhagic fever starts with the typical signs and symptoms of dengue as described above. The fever lasts from two to seven days. After the fever begins to abate, symptoms occur that are related to increased permeability of the capillary blood vessels. These symptoms can include severe abdominal pain, prolonged vomiting, and breathing problems. Bleeding tendencies, including easy bruising, nosebleeds, bleeding gums, skin hemorrhages, and even internal bleeding may occur. The disease may progress to failure of the circulatory system, leading to shock and death.

The virus is contracted from the bite of a striped Aedes aegypti mosquito that has previously bitten an infected person. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito bite can cause the disease.

The virus is not contagious and cannot be spread directly from person to person. It is mosquito-borne, so there must be a person-to-mosquito-to-another-person pathway. The full life cycle of the virus involves the mosquito as the vector (transmitter) and the human as the source of infection.

After being bitten by a mosquito carrying the virus, the incubation period for dengue fever ranges from three to 15 (usually five to eight) days before the signs and symptoms of dengue appear in stages.

Which are the food reduce the dengue fever:

• Kiwi fruit, fig, Pomogranates, papaya etc( these will increase the blood count )
• Juice made from young leaves of papaya.(daily have one time 5ml or 3ml- continue for 3-5 days).

A sarcoma is a rare kind of cancer. Sarcomas are different from the much more common carcinomas because they happen in a different kind of tissue. Sarcomas grow in connective tissue — cells that connect or support other kinds of tissue in your body. These tumors are most common in the bones, muscles, tendons, cartilage, nerves, fat, and blood vessels of your arms and legs, but they can happen anywhere.

Sarcoma Symptoms:

Soft tissue sarcomas are hard to spot, because they can grow anywhere in your body. Most often, the first sign is a painless lump. As the lump gets bigger, it might press against nerves or muscles and make you uncomfortable or give you trouble breathing, or both. There are no tests that can find these tumors before they cause symptoms that you notice.

Osteosarcoma can show obvious early symptoms, including:

• Pain off and on in the affected bone, which may be worse at night
• Swelling, which often starts weeks after the pain
• A limp, if the sarcoma is in your leg

Children and young adults get osteosarcoma more often than adults. And because healthy, active children and teens often have pain and swelling in their arms and legs, osteosarcoma might be mistaken for growing pains or a sports injury. If your child’s pain doesn’t get better, gets worse at night, and is in one arm or leg rather than both, talk to a doctor.

Sarcoma Treatments:

How your sarcoma is treated depends on what type you have, where in your body it is, how developed it is, and whether or not it has spread to other parts of your body, or metastasized.

Surgery takes the tumor out of your body. In most cases of osteosarcoma, the doctor can remove just the cancer cells, and you won’t need your arm or leg removed, too.

Radiation can shrink the tumor before surgery or kill cancer cells that are left after surgery. It could be the main treatment, if surgery isn’t an option.

Chemotherapy drugs can also be used with or instead of surgery. Chemo is often the first treatment when the cancer has spread.

Targeted therapies are newer treatments that use drugs or man made versions of antibodies from the immune system to block the growth of cancer cells while leaving normal cells undamaged.

Surviving Sarcoma:
Most people diagnosed with a soft tissue sarcoma are cured by surgery alone, if the tumor is low-grade; that means it is not likely to spread to other parts of the body. More aggressive sarcomas are harder to treat successfully.

The survival rate for osteosarcoma is between 60% and 80% if the cancer has not spread. It is more likely to be cured if all of the cancer can be removed by surgery.

Schwannomas are benign tumors that arise from the nerve sheath (covering) of cranial nerves along-side the cerebellum and brainstem.

The optimal treatment for the majority of symptomatic schwannomas is maximal surgical removal and/or focused radiation therapy (radiosurgery). Fortunately, for patients requiring schwannoma surgery, most large vestibular (acoustic) schwannomas can be removed through a retromastoid keyhole craniotomy while most trigeminal schwannomas can be removed through either a retromastoid approach or an endonasal endoscopic approach.

These tumors are typically benign and arise from the nerve sheath (covering) of cranial nerves along-side the cerebellum and brainstem. The most common schwannoma arises from the 8th cranial nerve (the vestibulo-cochlear nerve) or the 5th cranial nerve (the trigeminal nerve). In some instances, schwannomas are related to a genetic syndrome called Neurofibromatosis. Bilateral vestibular schwannomas are associated with NF-2.

What Are Gallstones?

They aren’t really stones. They’re pieces of solid material that form in the gallbladder, a small organ located under the liver.

You might not even know you have them until they block a bile duct, causing pain that you need to get treated right away.

Types:
The two main kinds are:Cholesterol stones. These are usually yellow-green in color. They’re the most common kind, accounting for 80% of gallstones.

Pigment stones. These stones are smaller and darker. They’re made up of bilirubin, which comes from bile, a fluid your liver makes and your gallbladder stores.

What Causes Gallstones?

There may be several reasons, including:

• Your genes
• Your weight
• Problems with your gallbladder
• Diet

Bile can be part of the problem. Your body needs bile, but if it has too much cholesterol in it, that makes gallstones more likely.

It can also happen if your gallbladder can’t empty properly.

Pigment stones are more common in people with certain medical conditions, such as cirrhosis (a liver disease) or blood diseases such as sickle cell anemia.

What are  Risk factors?

You’re more likely to get gallstones if:

You’re obese. This is one of the biggest risk factors. Obesity can raise your cholesterol level and also make it harder for the gallbladder to empty completely.

You take birth control pills, hormone replacement therapy for menopause symptoms, or are pregnant. The extra estrogen is the problem. It can increase cholesterol and make it harder for the gallbladder to empty.

You have diabetes. People with this condition tend to have higher levels of triglycerides (a type of blood fat), which is a risk factor for gallstones.

You take medicine to lower your cholesterol. Some of these drugs boost the amount of cholesterol in bile, which may increase your chances of getting cholesterol stones.

You lost weight too quickly. Your liver makes extra cholesterol, which may lead to gallstones.

You’re fasting. Your gallbladder may not squeeze as much.

What Are the Symptoms?

You might not notice anything, or even know you have gallstones, unless your doctor tells you. But if you do get symptoms, they usually include:

• Pain in your upper belly and upper back that can last for several hours
• Nausea
• Vomiting
• Other digestive problems, including bloating, indigestion and heartburn, and gas

What’s the Treatment?

Many people with gallstones get surgery to take out the gallbladder. There are two different kinds of operations.

Laparoscopic cholecystectomy. This is the more common procedure. The surgeon passes instruments, a light, and a camera through several small cuts in the belly. He views the inside of the body on a video monitor. Afterward, you spend the night in the hospital.

Open cholecystectomy. The surgeon makes bigger cuts in the belly to remove the gallbladder. You stay in the hospital for a few days after the operation.

If gallstones are in your bile ducts, the doctor may use ERCP to find and remove them before or during gallbladder surgery.