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Transcortical Motor Aphasia Symptoms, Causes, Speech Therapy, Treatment

Commissural dysphasia and white motor dysphasia are the other names of transcortical motor aphasia. It is a speech disorder which occurs due to damage in anterior superior frontal lobe. It specifically occurs in language control center of hemisphere (frontal lobe). Usually left hemisphere of brain is involved in controlling language center. In this disease, patient can't speak openly I.e. there is reduced speech output.

It is difficult for patient to maintain his speech and initiation. Watershed region of brain is not involved in the direct harm of language production and comprehension center. Executive functions of language are affected if frontal lobe is damage.

Transcortical Motor Aphasia Symptoms

Transcortical motor aphasia is a speech disorder in which patient cant speak properly. He cannot even start a conversation and further maintain it. Executive functions of language are affected which mainly involve Grammer (Syntex) control, patient can't narrate a story or any thing he wants to and language response center is not properly activated. Other symptoms involve:

  • Patient find it hard to compose a sentence and elaborate it properly. 
  • Patient gets confused and cannot select right words during his speech. 
  • Starting a conversation is a hardest task for patient suffering from transcortical motor aphasia. 

Transcortical Motor Aphasia Symptoms, Causes, Speech Therapy, Treatment

Transcortical Motor Aphasia Causes

Transcortical motor aphasia occurs due to damage in the frontal lobe of brain. Frontal lobe specifically left hemisphere contains language control center. Usually damage in anterior superior frontal lobe is responsible for transcortical motor aphasia. This damage occurs due to cerebrovascular problem I.e. infarction. Prefrontal cortex is the part which involves ideation and initiation of verbal speech. So when damage occurs, it becomes difficult to initiate a conversation. Damage in anterior superior frontal lobe does not affect major language network, Broca's and Wernicke area and arcuate fasiculus. Only infarction is not the reason, damage can also occur due to stroke.

Transcortical Motor Aphasia Treatment

Treatment of transcortical motor aphasia involves speech therapy. Its treatment mainly focus on patients strong hearing conversation and skills of repetition and correcting the reduced speech output of patient. Treatment also covers maintenance of speech and initiation of speech including language. Participation approach to aphasia is a treatment  strategy which have greater success rates. In this treatment strategy, patient is asked to focus on his skills he required to talk with people. He is allowed to talk with people in real life situations like talking to nurse about anything he wants to.

Transcortical Motor Aphasia Speech Therapy

A speech and language pathologist is required for treating transcortical motor aphasia. In this therapy some pictures are provided to patient and ask him to elaborate every single thing or event happening in this picture. Pathologist also provide a vocabulary booklet so that he can easily choose words to start his speech. Other than pictures, pathologist also ask some questions related to current affairs, patients past life, general knowledge and about his experiences. He also ask patient about some cooking recipes like baking a cake and cookies. Repetitive questioning helps in improvement of patients speech.
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Navicular Stress Fracture Test, Symptoms, Causes, Treatment

Navicular stress fracture occurs in foot. It is the most common stress fracture which usually occurs in athletes. Athletes who do jumping and sprinting are at hit list. Navicular is the tasral bone present in foot ankle. It is rightly placed just above the heel bone. Navicular stress fracture results from repetitive strains and continuous use of navicular bone. Guys at gym due to wrong training or weight lifting at wrong angle may suffer from navicular stress fracture. The exact mechanism of injury is not known but it is considered that fracture occurs because of compression of navicular bone within other bones around it due to stress.

Navicular Stress Fracture Symptoms

As navicular bone is present in foot, so symptoms of navicular stress fracture are associated with it. Patient feels unbearable pain in mid foot area. The pain is localized. If patient does not stop exercising or sports, the pain may get worse. Upon applying weight on foot, pain may radiate along the arch of foot and then disappears on rest. Pain will start again as training resumes. Along with pain, patient also feel tenderness in foot if pressure is applied on the top of thumb I.e. N spot.

Navicular Stress Fracture Test, Symptoms, Causes, Treatment

Navicular Stress Fracture Causes

The following factors can cause navicular stress fracture.

  • If patient starts athletic activity at a very high level. He does not let his bones and muscles to relax, that's why stress increases and as a result fracture occurs.
  • Patient does not relax for sufficient time and body remains under stress so it leads to navicular stress fracture.
  • Biomechanical abnormality.
  • Relative osteopenia.
  • Wrong fitting of equipment.
  • Training under Non professional trainer
  • Due to weight lifting at wrong angle or wrong training is the common cause.
  • The exact mechanism of navicular stress fracture is not known yet.

Navicular Stress Fracture Treatment

There is poor blood supply in navicular bone, so treatment is difficult. A good blood supply is needed to heal it completely. Casting is preferred usually to treat stress fracture in navicular bone. Patient have to rest for atleast 6 weeks because even slow walking absorbs navicular bone. The success rate of casting is 85 to 90 percent. Other methods of treatment invovle use of bone stimulator. It helps a lot in bone healing but it does not effect healing time. Walk during casting is strictly prohibited because even a little walk will increase healing time up to 25 percent.

Navicular Stress Fracture Test

At initial stage, X rays may show nothing but Magnetic resonance imaging or bone scan will clearly show fracture at navicular bone. Navicular drop test is performed to assess fracture specifically in navicular bone. In this test, the height of navicular bone is checked while patient stand in front of physician. 1st height of navicular bone is checked at rest, and it is again checked after applying stress on both foot. So the difference in measurement is known as navicular drop. Greater than 10 mm is considered in excessive foot pronation.
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Double Red cell Donation Requirements, Side Effects, Recovery, Complications

Double red cell donation is the blood donation which only contains red blood cells with no plasma and platelets. Automation is the process which is used to donate this blood I.e. consist of only red blood cells. In this process, the recipient is provided with double the amount of red blood cells instead of whole blood donation. Red blood cells are the most needed components of blood in patient, so automation helps to transfer only red blood cells. People who have blood type O or people who have Rh negative factor in their blood are preferred to donate blood because their red blood cells are mostly required.

Double Red Blood Cell Requirements

A criteria have been set up to select the people who are willing to donate blood. The criteria is different for both males and females. Following are the requirements:

For Males

Donor should have weight atleast 130 pounds or 65 Kg. His height should be at least 5'1". Taller than this is preferred mostly.

For Females

Donor should have weight atleast 150 pounds or 75 kg. Height should be atleast 5'5". Women taller than this are preferred mostly.

The criteria is different for both genders because blood volume is not usually lower in females as compared to male.

Double Red cell Donation Requirements, Side Effects, Recovery, Complications

Double Red Cell Donation Side effects

Double red cell donation is a beneficial process and automation is the best method of specifically red blood cell donation. But it may have some side effects or we can say some risks. Patient may feel irritation at the site of infusion. Itching occurs due to allergic reaction to iodine present in blood. Bruising or hematoma can occur at the site. Patient feels pain and nerve damage at the site of infusion. Because of blood cells acceptance, patient feels vomiting, nausea, increased pulse rate and cardiac arrest.

Double Red Cell Donation Recovery

Patient recovery time varies from case to case. When blood is transferred to the patient, his body starts generating blood to compensate the list amount of blood. Plasma starts recovering in a quick way in almost 24 hours. Patient is asked to stay calm and does not perform any strenuous exercise until all the blood plasma normalizes. Platelets will restore but takes time of about 72 hours. This is considered the standard time in which blood recovers properly. But symptoms will subside according to the patient's body ability.

Double Red Cell Donation Complications

Double red cell donation may cause different blood complications. Sometimes patient's immune system does not accept new blood cells and acts against them. So infection occurs Inside body and as a result patient may die. Cardiac arrest can occur due to non acceptance of new red blood cells. Patient who is donating blood feels nausea, vomiting and light headedness. He feels weakness in his limbs and eyes got blur. So both of the person I.e. the one who is receiving blood and other one who is donating blood have to face complications and various side effects.
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Chloroma Pictures, Definition, Symptoms, Causes, Survival Rate, Treatment

Chloroma is a condition in which leukemic cells start accumulating around bone marrow. These leukemic cells are solid in nature. Basically it is a tumor of immature white blood cells. Chloroma is also known as extramedullary myeloid tumor and granulocytic sarcoma. The immature white blood cells responsible for tumor are called as myeloblasts. Extramedullary myeloid tumor has a tint of green color in it because of myeloid peroxidase. So due to this green color it is known as chloroma. Chloroma is basically derived from chloros meaning green color in Greek language. There is a link between acute leukemia and chloroma.

Chloroma Symptoms

Chloroma is a rare disease. As it has a link with acute leukemia, so their symptoms resemble a lot. So common signs and symptoms involve

  • Severe and continuous nose bleeding.
  • Blood flows out of nose frequently.
  • As bone marrow is involved, so pain in joints and in bones is common symptom.
  • Along with nose, bleeding may also occur via gums.
  • Activation of immune system can cause fever.
  • Lungs are also affected, as patient faces difficulty in breathing.
  • Weakness and fatigue occurs.
  • Skin may turn pale in color.
  • Patient may feel lumps in armpits, groin area and around neck.

Chloroma Pictures, Definition, Symptoms, Causes, Survival Rate, Treatment

Chloroma Causes

Chloroma occurs as a result of abnormal development of DNA in bone marrow cells. This abnormality let cells grow and divide when normal cells stop growing and dividing themselves and eventually die. This may lead to abnormal blood cells production. Bone marrow starts producing immature cells and these immature cells start converting into leukemic cells. As a result, these leukemic cells start accumulating around bone marrow causing chloroma. Scientists discovered that in most cases, it is not inherited from parents to their offsprings. Still the causative DNA mutations are not known which leads to extramedullary myeloid tumor I.e. chloroma.

Chloroma Treatment

Chloroma is considered a systemic disease rather than localized disease. Leukemic chemotherapy is recommended as a 1st line treatment. Chloroma shows response towards chemotherapy because it is quite sensitive towards standard anti leukemic therapy. Allogeneic hematopoietic stem cells are transplanted in patients with good health. If chloroma still persists after chemotherapy, then a localized treatment is preferred I.e. surgery or radiation therapy. These localized treatment processes do not have any impact on survival rate. Chemotherapy is mostly recommended for patients with primary chloroma. In case of relapsed leukemia, treatment outcomes are not good and satisfactory.

Chloroma Survival Rate

There isn't any proper data about success rates of treatment. It has been seen that scientists argue about poor prognosis and survival rate of chloroma. People show less response to chemotherapy and as a result condition becomes worse. So survival rate is down. It totally depends upon the stage of tumor. If patient is diagnosed with last stage chloroma or acute lymphocytic leukemia then survival chances are very low. Contrary to it, if chloroma is diagnosed at its initial stage, then patient will well respond to the chemotherapy and there will be greater chances of patient survival.
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Optokinetic Nystagmus Definition, Test, Drum, Pathway

It is an eye related disease in which eyeball moves along with the moving field. In simple words, eye moves if patient focus on the whole scenery moving or rotating. It is not tracking of a single object placed far ahead but it is the tracking of whole field rotating in front. In moving field, there are different targets, so we can say that smooth pursuit is counted under optokinetic nystagmus. Patient tried to move his eyes with the moving object.

One common example of optokinetic nystagmus is: person sitting in a moving car tries to match his eye velocity (vision velocity) with the velocity of moving object. An optokinetic stimulus is used to check movement of eyes. Stimulus should present things moving in both peripheral and central visual fields. The following methods are used commonly to provide stimulus.

  • Physical drum beat
  • Stripe projector or LCD projector
  • Large screen array
  • And light bar.

LCD projector is the stimulus which closely matches with the definition of optokinetic nystagmus. All the above mentioned methods are used for eliciting optokinetic nystagmus. Optokinetic nystagmus is also used as a parameter of assessment of visual system. It is used specially in new borns.

Optokinetic Nystagmus Drum

Optokinetic nystagmus can be elicited with an optokinetic drum. The drum is rotated in front of the patient. Patient is asked to focus on the drum movement. Start rotating that drum in front of patient. In case, if optokinetic drum is not available, a simple paper with black and white strips can be used. The strips are at the distance of at least 2 inch. This paper is moved in front of patient horizontally and patient is asked to focus on it. Nystagmus can occur in both adults and infants with normal vision. Visual pathway can be checked with nystagmus.

Optokinetic Nystagmus Definition, Test, Drum, Pathway

Optokinetic Nystagmus Test

Optokinetic nystagmus is tested with the help of an optokinetic stimulus. The stimulus used can be LCD projector, stripe projector, large screen aray, light bar or physical drum. LCD projector is the stimulus which matches the definition of optokinetic nystagmus. In physical drum stimulus, an optokinetic drum is used. But in stripe projector, a simple paper sheet is used with black and white lines on it. In LCD projector, a proper video is played and fast forward and patient is asked to focus on it. A light bar is also used as a stimulus, in which a light rod is used to move fastly in front of patient and patient tries to focus on its light.

Optokinetic Nystagmus Pathway

The pathway of nystagmus consists of initial smooth pursuits which means patient start focusing on an object placed far ahead in front of patient. That object works as a stimulus for the vision of patient. When smooth pursuit phase ends, it is followed by fast phase or corrective phase known as saccade. The same pathway is followed in case of optokinetic nystagmus but the time period of each phase becomes extremely short. Normally presence of nystagmus shows normal pathway of vision.
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Pericholecystic Fluid Definition, Symptoms, Causes, Ultrasound, Treatment

Gall bladder is an important organ of the body which is present just below liver on the right side of abdomen. When inflammation occurs in the walls of gall bladder it is termed as cholecystitis. Pericholecystic fluid is the severe complication of cholecystitis in which fluid is also found in gall bladder along with inflammation. It is diagnosed upon ultrasound imaging. Basically inflamed walls of gall bladder shows a hypodense layer of sub serosal edema around it. And this layer is known as pericholecystic fluid. It shows the signs and symptoms related to inflammation because of pregnancy existing cholecystitis.

Pericholecystic Fluid Symptoms

Common symptoms of pericholecystic fluid are mainly associated with inflammation of walls of gall bladder. It  involves pain in upper quadrant of gall bladder at right side. Patient may feel temperature because of inflammation. Fever and chills are commonest symptoms of pericholecystic fluid. The amount of white blood cells increases in blood. Other symptoms include no or little appetite, vomiting, nausea and bloating in abdominal area. Patient feels tenderness in the right upper quadrant of gall bladder because of inflammation and pericholecystic fluid. Sweating may occur because of high level of white blood cells in blood.

Pericholecystic Fluid Definition, Symptoms, Causes, Ultrasound, Treatment

Pericholecystic Fluid Causes

It is the severe complication of cholecystitis. So pericholecystic fluid occurs secondary to it. Biliary sludge and stones in gall bladder can cause formation of pericholecystic fluid just because these stones or biliary sludge got stuck in the opening of gall bladder. Other possible causes may include:

  • Longer period of fast.
  • Deficiency in immune system.
  • Vasculitis.
  • Shock
  • Any kind of injury in abdomen at the site of gall bladder.
  • Sepsis or trauma can also cause formation of pericholecystic fluid.
  • Sometimes surgery of abdomen leads to pericholecystic fluid.
  • Any infectious disease or tumor in gall bladder causes inflammation and blockage of out flow of bile.

Pericholecystic Fluid Treatment

The 1st step of treatment of pericholecystic fluid is balanced diet. Patient have to avoid solid food intake and should prefer liquid diet. Hospitalized patients are on intravenous therapy for continuous liquid diet. Doctor prescribes some medications like pain killers and antibiotics in case of an infection. Surgery is another option but there are chances of re-occurrence of inflammation and ultimately formation of pericholecystic fluid due to gall stones.

Surgery is only preferred if there are very less complications. Main complications are gangrene and perforation of gall bladder. Immediate surgery is performed in case of chronic inflammation.

Pericholecystic Fluid Ultrasound

Usually a group of tests are performed to diagnose pericholecystic fluid which normally include blood test, ultrasound, computerized tomography CT scan and hepatobiliary iminodiacetic acid scan HIDA.

In ultrasound, gall stones are visible and the walls of gall bladder are inflamed. Ultrasound clearly shows infection within gall bladder. A free flowing fluid is also seen in the imaging of ultrasound.
All the diagnostic methods are useful in diagnosing pericholecystic fluid but ultrasound is the easiest and accurate way of diagnosing pericholecystic fluid. Mostly doctors prefer ultrasound report for analysis because it shows the severity of disease.
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Cardiac Cachexia Defenition, Symptoms, Causes, Life Expectancy, Treatment

Cardiac cachexia is a condition in which severe weight loss occurs due to cardiac diseases. Like in case of heart failure, patient losses excessive body fat. Not only body fat, he also loses bone mass and muscle mass. Body wasting is another term which describes cardiac cachexia. It is a one way disease, which if begins, can never be reversed. Even eating more and more doesn't help. Basically this disorder is associated with absorption and usage of nutrients and calories which patient consumes. It is a complex disorder and cannot be understand easily because even after eating can't fulfill muscle and bone mass.

Cardiac Cachexia Symptoms

Cardiac cachexia is associated with extreme weight loss. Severe weight loss can lead to death of patient. Common symptoms of cardiac cachexia involves:

  • Patient does not feel hungry any more.
  • Most of the time patient remains weak and tired.
  • Feels nausea most of the time.
  • Patient cannot perform exercise because of weakness
  • Shortness of breath
  • Taste of food changes.
  • Last but not least, constipation.

Some of the above listed symptoms, can make patient lose even more weight. These symptoms cause serious affect on gastrointestinal tract, lungs, mainly heart and other parts of body.

Cardiac Cachexia Defenition, Symptoms, Causes, Life Expectancy, Treatment

Cardiac Cachexia Causes

There are many beliefs regarding causes of cardiac cachexia. Some scientists think that it may occur secondary to imbalance in the nervous system. Because nervous system does not send messages about break down of food in gastrointestinal tract. Some common causes are enlisted below:
Congestive heart failure causes fluid accumulation. Ultimately it disturbs nutrients absorption.
Malnutrition disturbs the production of albumin which is necessary for chemicals transmission.
Body causes break down of muscles leading to fatigue.

This condition makes your body work hard and utilize energy to perform basic functions. So patient burns more calories causing weight loss.

Cardiac Cachexia Treatment

There are no specific medications for treatment of cardiac cachexia. Physician prescribe medications to treat the root cause. As if heart failure is the cause, then treating heart failure will ultimately reduce symptoms. Other than specific medications for the disease, patient is asked to do some physical activity like yoga and exercise. Patient have to follow his diet plan and should try to eat healthy food. Nutrient supplements are prescribed to fulfil the reduced amount of nutrients like vitamin C and vitamin D and folate. Some special medications are also prescribed to increase hunger of patient.

Cardiac Cachexia Life Expectancy

Cardiac cachexia is a life threatening condition. As it causes severe weight loss. Patient may lose his weight in the form of fats, muscle mass and bone mass. This weight loss is not healthy for patient as he loses all of his muscle mass. Excessive weakness will make patient seriously ill. In this condition patient does not feel hungry at all. So even eating more and more can't help gaining weight. After diagnosis this condition should be treated immediately. If it is left untreated, then patient may die due to weakness. So life expectancy is low with no appropriate treatment.
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