Blog Archive

Vesicostomy Definition, Procedure, Complications, Care, Reversal

Vesicostomy is a surgery, in which an opening is made from bladder to directly outside the body i.e. lower belly area. This opening helps in draining urine to prevent urinary tract infection UTI. It is kind of temporary treatment. Vesicostomy can be performed in infants and children under five years of age and only eligible in following conditions.

  • If child is born with bladder outlet obstruction, Vesicostomy helps to drain urine in to diaper.
  • If child is suffering from neurogenic bladder, Vesicostomy is recommended.

In adults, Vesicostomy is performed on temporary basis and is removed when infection is completely treated.

Vesicostomy Procedure

Patient have to stay overnight in hospital, and a drip line is injected to maintain fluid replacement and management of pain. A cut is made in lower belly preferably below belly button. A catheter is placed in the opening of bladder which drains urine directly in to diaper or nappy (in children). After Vesicostomy, there may be blood in urine due to cut freshly made. If Vesicostomy is performed in adults, a clear urine collection bag/ system is attached with catheter to collect urine. It is a removable plastic bag which can be removed after it fills up.

Vesicostomy Definition, Procedure, Complications, Care, Reversal

Vesicostomy Complications

Vesicostomy is a simple and reversible surgical operation. But it also have some unusual complications associated like:
  • Opening made in Vesicostomy may become narrow and results in poor drainage of urine. It is normal that Vesicostomy may become narrow due to natural healing process of skin.
  • Stenosis may occur due to poor drainage and then dilation or periodic catheterization is performed.
  • Bladder tissue may get prolapse due to skin opening made in Vesicostomy. Prolapse may occur due to straining (when child cries or have a bowel movement). Prolapse may extend up to 1 inch and is reversible.

Vesicostomy Care

  • Vesicostomy require special care regarding hygiene. Vesicostomy drains urine directly in to diaper and diaper should be changed regularly.
  • Poor hygiene may lead to diaper rash to skin in contact with diaper. Ointments and creams are recommended for these rashes.
  • The abdominal cut should be avoided from water contact, as excess water contact can cause infection in Vesicostomy. Patent is recommended to take complete rest and avoid walking around.
  • If any obstruction occurs in Vesicostomy, it should be replaced because obstructed Vesicostomy will lead to accumulation of urine inside bladder and cause infection.

All these steps should be followed regularly.

Vesicostomy Reversal

Vesicostomy is a temporary surgical operation which is performed when other treatment options regarding urinary tract infections get failed. It is kind of bypass surgery to drain urine directly outside body from bladder. It is performed in children below 5 years of age when they are born with any urinary tract abnormality. These children can have Vesicostomy again and again reversibly whenever they got urinary tract infection. There are many cases of children having Vesicostomy every year reversibly to avoid infections in urinary tract. Any kind of injury may lead to Vesicostomy in adults and can be repeated.
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Cervicobrachial Syndrome Definition, Symptoms, Causes, Treatment

Cervicobrachial syndrome is also known as cervicobrachalgia. In this condition there is pain and stiffness in the cervical spine region. The term cervicobrachial syndrome is not commonly used now a days but in some parts of the world. Pain and stiffness of the cervicobrachial syndrome is also associated with symptoms of shoulder girdle and upper extremity like tingling, headache, discomfort, and numbness in the arm. Pain in cervicobrachial syndrome radiates into the upper limb i.e. arm. It is a radicular pain pattern which is distributed via ventral branch of a spinal nerve. Cervical radiculopathy can be diagnosed with frank sensorimotor deficits and connected with nerve root territory.

Main reason behind cervicobrachial syndrome is cervical radiculopathy which is caused by lesions produced and effecting the c5/6 and c6/7 motion segments of vertebrae. The most effected muscles are located in the upper portion of trunk because this area is mainly supplied with cervical nerve roots. Common muscles involved in cervicobrachial syndrome are rhomboids, supraspinatus muscles, infraspinatus muscle, serratus anterior, deltoid and latissimus dorsi muscles. Cervicobrachial syndrome can also occur due to neurogenic and vascular compression in the thoracic outlet. Nerves involved are subclavian vein and subclavian artery.

Cervicobrachial Syndrome Definition, Symptoms, Causes, Treatment

Cervicobrachial syndrome Symptoms

Symptoms of cervicobrachial syndrome are associated with upper part of the trunk i.e. arm, chest region, neck and back. There are some of the common symptoms stated below.

  • Patient may feel numbness in shoulder and upper arm region.
  • There may be stiffness and pain which originates from neck region and extend towards arm.
  • Sometimes swelling occurs in upper trunk region.
  • Patient feel itching and pins and needle sensation in both neck and shoulder region.
  • Movement of effected limbs may initiate pain and laterally can intriguer pain in one side of head (migraine) and can cause trouble in sleeping.

Cervicobrachial syndrome Causes

Some of the main causes are described below:

Common root cause reported is traumatic injuries which may occur while playing a sport and injuries happen due to accidents.

  • Dislocated joints and fractures also lead to cervicobrachial syndrome.
  • Sprains and muscle tear are usual causes.
  • Long term stress periods and anxiety periods are considered associated causes.
  • This syndrome may be secondary to diseases related to bones and muscles like rheumatism.
  • Some degenerative diseases like arthritis are also responsible as these diseases can in time cause cervicobrachial syndrome.
  • Some infectious diseases such as tuberculosis are also responsible.

Cervicobrachial syndrome Treatment

Cervicobrachial syndrome involves muscles of upper portion of trunk. So, it demands a highly personalized treatment. Choice of drugs should be accurate and according to condition. Physiotherapy helps in reducing pain of muscles and enables patient to move easily around. Hot and cold therapy is also performed in which patient gets massage with hot water and with hot bags. Sometimes alcohol and rosemary oil massage also helps a lot. Bed rest is recommended along with proper posture. Patient is asked to lie down and rest on his back and rest the effected arm experiencing pain on back side.
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Sensory ataxia Symptoms, Causes, Test, Treatment

Ataxia is a term means dis-coordination and the term sensory ataxia means dis-coordination in senses. This coordination is not caused due to dysfunction of cerebral region but it occurs when there is problem in sensory input towards control center of movement. Sensory ataxia is a different condition from cerebellar ataxia. As in sensory ataxia, normal coordination of nearside is present and is observed visually by the patient himself. Shutting of eyes indicates worsening of sensory ataxia. Associated features like pendular tendon and broken pursuit eye movements are not present in sensory ataxia which differentiate it from cerebellar ataxia.

Sensory ataxia Symptoms

There is loss of sensation in sensory ataxia so patient is not able to move his limbs according to his will and as a result patient have unsteady gait and posture. Sometimes stomping gait also occurs. When patient tries to walk around, there are chances of striking foot hard on ground and this state is sometimes known as “walking on pillows”. Pain may also occur in limbs. With these states mentioned above, patient is more closely dependent on visual information he gets to move around in environment. As a result of unsteadiness and imbalance body becomes more pronounced.

Sensory ataxia Symptoms, Causes, Test, Treatment

Sensory ataxia Causes

Sensory ataxia is the loss of coordination due to problem in nerves providing information to control center of movement. Nerves which are present in spinal cord or nerves which supply information to limbs i.e. hands and feet may get damaged and as a result sensory ataxia occurs. This damage in nerves may also occur due to systemic diseases like multiple sclerosis, diabetes and compression in spinal cord. Damage may also occur due to increased exposure to toxins which include mercury, lead and arsenic. But causes behind sensory ataxia do not end here, there are many other reason along with these mentioned above.

Sensory ataxia Test

Before starting any treatment plan, it should be the 1st priority to confirm disease and its level of severity. For diagnosis of sensory ataxia, past medical history of patient is important. A complete conversation about disease is also of help in diagnosing disease and its root cause. Physical examination is also performed to check the functioning of limbs i.e. hands and feet. A blood test and a nerve conduction study is performed and it is checked that how well these nerves carry signals from limbs to brain and from brain to limbs and conduct them.

Sensory ataxia Treatment

Every treatment plan is designed to lower the symptoms of regarding disease, increasing chances of independence, stop progression of damage to nerves and reduce the associated risks. Sometimes treatment is required to treat the root cause behind disease. For treatment of sensory ataxia a specialist or occupation related therapist is needed. Routine life of patient is made better with some life style modifications and physical therapy. Physiotherapy helps in increasing mobility of limbs i.e. hands and foot according to patients will. Some medications are also prescribed to reduce the pain occurring in nerves (damaged nerves).
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Perineal raphe in Female and male, Irritation, Bump, Cyst

Perineal raphe is a tissue line or ridge which originates from anus through the perineum. It is basically the fusion point of urogenital folds and present in both males and females. This tissue line continues through the center portion of scrotum and runs upward through the posterior side of penis right from midline aspect. Perineal raphe develops during fetal development inside mother’s womb. Starting stages of fetal development looks same but at 7th week of pregnancy, fetal genital tissues change and form male reproductive organs i.e. penis and scrotum. At this point, perineal raphe is formed.It is completely common and normal physiological tissue line.

Perineal raphe in Male and Female

Perineal raphe is present in both males and females. In females, perineal raphe originates from anus and continues running upward to female genitalia i.e. passing through vagina till clitoris. In males, perineal raphe originates from anus and extends in upward direction to scrotum and then through posterior side of penis. Perineal raphe on scrotum, also divides it into two portions from inside which is known as scrotum raphe and when this line of tissues runs through midline aspect of penis posteriorly, it is known as penile raphe.

Perineal raphe in Female and male, Irritation, Bump, Cyst

Perineal raphe Irritation

Perineal raphe itching is most common in men than women and the reason behind this difference is unknown. Person feels itching and discomfort. It occurs occasionally due to sweating and cause burning and soreness along with irritation. This irritation and burning may extend up to anus and is called as pruritus ani. Person overwhelmed to scratch raphe and over scratching may lead to injury due to removal of upper protective layers of skin. Moisture, clothing, sweating and pressure upon sitting are other causative factors. Usually perineal raphe itching increases at night time and after every bowel movement.

Perineal raphe Bump

Perineal raphe bump is a lump formation on the line of tissues i.e. perineal raphe. These bumps can occur anywhere on perineal raphe most commonly around anus. These bumps are present inside skin and are not visible on surface. Person can feel it on touching and it hurts on wiping the area, sitting or moving around. These bumps may be 1 or 2 to 3 in number. Sometimes these bumps are painful. Pain is not unbearable, it’s tolerable. Sometimes it is itchy if it occurs due to an infection. Perineal raphe bumps most commonly occur in females.

Perineal raphe Cyst

Cyst may form anywhere on perineal raphe and genital organs i.e. penis and scrotum in males. Main structures involved are glans penis, penile shaft, scrotum or perineum. These cyst are common benign lesions. These lesions most commonly form in adolescence and childhood. In childhood, these cyst are asymptomatic and are unrecognized. These cyst only show symptoms when these get worse due to trauma and infection. Perineal cyst have an epithelial lining which may be urethral type, epidermoid type, mixed type and glandular type epithelium. The most rarely found cyst are median raphe cyst with ciliated epithelium.
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Uterine synechiae Meaning, Symptoms, Causes, Treatment

Uterine synechiae is a condition related to uterus in which adhesions are formed. The word synechiae means adhesion. These adhesions are like fibrous scars which are formed inside the cavity of uterus. Adhesions in uterus may occur due to uterine trauma like curettage and is also known as Asher man syndrome. Other causative factors involve caesarian section and myomectomy. Uterine adhesions during pregnancy are also referred as amniotic sheets and amniotic folds. These adhesions during pregnancy may lead to amenorrhea, hypo menorrhea, habitual abortion and secondary infertility. The diagnosis of these uterine synechiae is incidental during normal ultrasound evaluation during pregnancy.

Uterine synechiae do not cause any complications and also do not interfere in development and growth of fetus. These adhesions appear as thick bands attached to walls of uterus. A single synechiae have 2 parts i.e. 1 attached base and 1 free end. It is a combination of fibrous adhesions. Fetal membranes wrap the synechiae completely. Uterine synechiae have a complete classification according to its location and extension. Sometimes these lesions become worse and covers the whole cavity inside uterus causing the walls to stick together. Diagnosing the frequency of synechiae is not easy because it is asymptomatic in most cases.

Uterine synechiae Meaning, Symptoms, Causes, Treatment

Uterine synechiae Symptoms

Uterine synechiae are asymptomatic and only show symptoms when it gets worse with passing time because with every passing week, these adhesions covers the whole cavity inside uterus containing fetus. It often diagnosed during routine ultrasound checkup during pregnancy. These lesions may lead to various abnormal conditions like amenorrhea or really opposite condition i.e. loss of menstruation. Hypomenorrhea or scanty menstruation may also occur. Sometimes these uterine adhesions may cause infertility. Worse condition of uterine synechiae may cause recurrent abortion of fetus. All these conditions are secondary to adhesions in uterine walls.

Uterine synechiae Causes

There may be many causes behind formation of uterine synechiae. Some of the main causative factors are listed below.

  • Any kind of infection which may lead to fibrous adhesion in uterine walls.
  • Long term use of intra uterine devices lead to infections due to aseptic conditions and these infections cause synechiae formation.
  • These may be secondary to caesarian delivery of fetus and myomectomy.
  • Surgical removal of myomas and polyps also lead to formation of adhesions in uterus.
  • Any kind of trauma in uterus like curettage is the leading cause of uterine synechiae in females during pregnancy or after delivery.

Uterine synechiae Treatment

Uterine synechiae can be treated with some surgical processes. Hysteroscopy is a diagnostic as well as surgical procedure with a camera placed ahead and used rarely to treat these uterine synechiae. Fertility is rarely effected by uterine synechiae but women are advised to take treatment option of in vitro fertilization. Especially after the age of 35. Uterine adhesions may alter transit of sperms during sexual intercourse and these will be no or abnormal pregnancy that’s why in vitro fertilization is recommended. Hysteroscopy should be performed as a minor surgery to continue with in vitro fertilization.
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Heliophobia Definition, Symptoms, Causes, Test, Treatment

Heliophobia is a specific phobia towards light. Light means sunlight or any bright light. It is an irrational phobia towards sunlight and should not be mix with photophobia. People having heliophobia are also obsessed with anxiety disorder intriguer intense fear to sunlight or bright light. There may be various causative factors behind the origin of heliophobia. Some patients have a strange psyche of having skin cancer in response to direct contact with sunlight. There are many information awareness programs to educate patients about skin cancer and its main reasons behind it leading to increase fear in person.

Heliophobia Causes

Heliophobia causes vary according to the type of anxiety disorder. Scientists reveal that there may be three possibilities behind the origin of phobia i.e. classical conditioning, vicarious acquisition and instructional/informational acquisition. Sometimes some negative events in life intriguer this phobia. Sunburns may also lead to fear towards sunlight. The most common reason is informative seminars regarding skin disease and cancer and blindness. Obsessive compulsive disorder along with intensive fear towards sunlight can also cause heliophobia. It may be secondary to some medical conditions like keratoconus, migraine (which originates mostly from bright light) and polyphyria cutanea tarda (makes skin sensitive to bright light).

Heliophobia Definition, Symptoms, Causes, Test, Treatment

Heliophobia Symptoms

Heliophobia is a phobia (fear) to direct light i.e. sunlight or any bright light. So the symptoms totally depends upon severity and person suffering from it. Mild fear shows following symptoms:

  • Patient may feel uncomfortable, may have nauseatic feeling, be shaky, and sometimes numb.
  • Patients with severe heliophobia may have extreme panic attacks and feel anxious all the time. 
  • Increase in sensitivity i.e. heightened senses, patient may have lack of focus, trapped feeling, patient may experience tachycardia or irregular heartbeat, air hunger is common, rapid breathing, excess sweating and muscle cramps.

Heliophobia Test

Heliophobia is a phobia which can be self-tested or via checking behavioral changes of patient. There are some online tests available on internet which consist of a questionnaire regarding phobia. Patient have to fill it as he feel about going out in sunlight. There are also some behavioral observational test. Some tests can be performed at home via ADHD home test kit and concentration home testing. These are some home based test for children. Adults also have some home based test for heliophobia named adult ADHD home testing. All the above mentioned tests help in accurate diagnosis of heliophobia.

Heliophobia Treatment

As heliophobia is totally a psychological state so it need some talking therapy to recover. Sideways exposure therapy is also needed, some self-help techniques can help in recovering patient from heliophobia. Support groups therapy which involve some members who support patients courage help him to go through this phobia. Cognitive behavioral therapy is most commonly used therapy for heliophobia. Relaxation techniques are required to make patient relaxed by body and mind. Meditation is another way of treatment i.e. anxiety meditation is used to treat severe heliophobic patient. Along with all these therapies, patient response really matters a lot.
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keratoderma blennorrhagica Pictures, Symptoms, Causes, Treatment

Keratoderma blennorrhagicum K.B is also known as keratoderma blennorrhagica. As the name indicates, kerato means keratinized, derma means skin, blenno means mucousy and rrhagia means discharge. Skin lesions are formed on palms and soles of feet which may further spread to the scrotum, scalp and trunk. Psoriasis is a condition resembling keratoderma blennorrhagicum. It is a main symptom of reactive arthritis occurring in 15 % of patients. Lesions on palms and soles of feet appears as a waxy vesico-pustular of brownish yellow in color. These small sized lesions are may join together to form larger crusty plaques.

These lesions can spread to other parts of body on contact. These can be diagnosed with complete diagnostic test of reactive arthritis. Sometimes it does not require any diagnosis because it is a visible skin condition. Keratoderma blennorrhagicum appears differently in males and females with reiter syndrome. Abdominal discharge from the urethra indicates presence of keratoderma blennorrhagicum. Complete blood count CBC test is performed to detect presence of keratoderma blennorrhagicum in the form of inflammation in body. In advanced stages of this condition X-rays are recommended for diagnosis. Clinical examination is considered most important method used to confirm the diagnosis.

keratoderma blennorrhagica Pictures

keratoderma blennorrhagica Pictures, Symptoms, Causes, Treatment

keratoderma blennorrhagica Pictures, Symptoms, Causes, Treatment

keratoderma blennorrhagica Symptoms

Keratoderma blennorrhagicum is a skin disease so its signs and symptoms are visible. Some of the main symptoms are as follows:

  • Lesions appear as a waxy texture.
  • Lesions have a great tendency to spread other parts of body on contact.
  • Color of these lesions can be yellowish brown.
  • It appears as pustules or vesicles on the surface of the skin.
  • Upon clustering the patches may become crusted or scaly.
  • In some cases, these lesions may transform into nodules.
  • These nodules are hard and tender on touch.
Sometimes these lesions may be painful and may make patient uncomfortable.

keratoderma blennorrhagica Causes

The exact cause behind keratoderma blennorrhagicum is unknown. But some scientist state that it occurs due to genetic predisposition. It appears in the genito urinary variant of the reiter syndrome or reactive arthritis. Main cause stated is infection in urethra which may occur due to a microorganism named chlamydia trachomatis. This biological agent may transfer from one person to another through sexual contact. Basically it is a reaction to the infection caused by chlamydia trachomatis. This reaction is named as reactive arthritis. Keratoderma blennorrhagicum is a primary symptom of reactive arthritis diagnosis appear along with other symptoms.

keratoderma blennorrhagica Treatment

Keratoderma blennorrhagicum is the primary symptom of reactive arthritis or reiter syndrome. There isn’t any treatment of reiter syndrome but its symptoms can be treated with success. If the patient is active, he can be treated with course of antibiotics. It is considered primary course of treatment for this skin disease. Antibiotics are preferred because the urethral infection requires treatment 1st to treat keratoderma blennorrhagicum. Other medicines that are prescribed may involve anti-inflammatory drugs to reduce other related symptoms of disease i.e. pain and inflammation. Treatment of psoriasis is also effective which includes topical corticosteroids and other creams.
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Prostatomegaly Size, Grade 1, Grade 2, Grade 3, Mild to Moderate

Prostatomegaly is defined as enlargement of prostate gland. Normally prostate gland in men start increasing in size after 40 years of age. Prostatomegaly is also known as benign prostate hyperplasia. Prostate is an important gland in male reproductive system. It is small in size and have muscular texture. Prostate surrounds urethra and makes fluid in semen. The cells of prostate gland start to multiply these growing and multiplying cells makes prostate gland swell. Due to increase in size of prostate gland, urethra get squeeze or compress and as a result flow of urine become limited. It is not a cancerous condition and does not spread like it. Even it does not lead to cancer.

Prostatomegaly Size

The size of prostate gland usually increases in size after the age of 40 or 45. It is normally small in size and surrounds urethra. When men reaches at the age of 40 or 45, it starts increasing in size due to multiplication of cells. Radiographic images shows enlargement of prostate gland if its size increases from 33 cc i.e 30 grams. The increase in size divides it into different grade sizes i.e. grade 1, grade 2 and grade 3. Each grade size show different symptoms and require different treatment plans according to condition. The symptoms become severe from grade 1 to grade 3.

Prostatomegaly Size, Grade 1, Grade 2, Grade 3, Mild to Moderate

Prostatomegaly Grade 1

The very early stage of growing prostate gland show mild symptoms. Like decrease in urine flow or increase in urination time. Patient have to wait for urine to flow. These mild symptoms do not cause any harm and generally do not require treatment but just some life style modifications. The grading system is according to the increase in size of prostate gland. In grade 1 Prostatomegaly, the size of prostate gland increases up to 25 % of the original size. Some patients use medications as a treatment for grade 1 Prostatomegaly.

Prostatomegaly Grade 2

When size of the prostate gland increases up to 50 % of original size, this is the grade 2 prostatomegaly. It show symptoms on moderate level. The frequency of urination increases and volume of urine passing out decreases. Patient feel hindrance during urination and do not get satisfy because he can feel bladder full even after urination. For grade 2 prostatomegaly, medication therapy is used. Alpha 1 blockers are used like doxazosin, prazosin, alfuzosin, terazosin and tamsulosin. Some medications are also used to reduce the level of hormones like dutasteride and finasteride. These medications can reverse the size of prostate gland.

Prostatomegaly Grade 3

When symptoms of prostatomegaly get severe or worse and causing other problems in normal life routine. This level is grade 3 prostatomegaly. In grade 3 prostatomegaly, medications are of no use and last option i.e. surgery is recommended. Urine flow get totally blocked and this cause severe and unbearable pain in bladder. Patient get uncomfortable. Surgical removal is recommended. Removal can be done by various techniques like transurethral nasal ablation, transurethral microwave therapy and water induced thermotherapy is used in outpatients and transurethral resection of prostate, simple prostatectomy and transurethral incision of prostate are used in inpatients.

Prostatomegaly Mild to Moderate

When cells of prostate gland start multiplying and start growing in size it show some mild symptoms. This is the mild state of prostatomegaly. Symptoms appearing in mild state do not cause harm to patient and require some life style modifications to reduce symptoms. When symptoms get a bit severe and start causing problems in life style of patient this is the moderate state of prostatomegaly. Some life style modifications are not enough and patient require some medications which include alpha 1 blockers and some hormone stabilizer medications to maintain hormones.
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Galactocele Definition, Symptoms, Causes, Treatment

Galactocele is a kind of cyst present in breast. Galactocele contains milky substance or sometimes milk. As the name indicates, galactea means milky white and coele means pouch. Galactocele are formed in the sub-areolar region of breast. The occurrence of galactocele is very rare. It occurs most commonly in pregnant women, lactating women or have just stopped lactation. It feels like a lump in breast. Galactocele are formed as a result of a kind of blockage in ducts of breast. These lesions may be uni or bilateral and nodules formed may be single or multiple. It mostly resembles breast cancer or clogged ducts. As these two conditions have symptom of lump formation.

Galactocele may be painful and sometimes it is not painful at all. The size of galactocele varies, when they get filled with milk or milk like substance its size increases and when it gets empty, its size shrinks. Galactocele may be as large as the size of kiwi. Diagnosis of galactocele is important and can be diagnosed with ultrasound and tissue biopsy. Mammogram is 1st diagnostic tool in diagnosing galactocele lumps. Galactocele are not dangerous at all. Patient do not feel comfortable with these lumps. It takes about a few weeks to months to develop galactocele.

Galactocele Definition, Symptoms, Causes, Treatment

Galactocele Symptoms

Galactocele have a main visual symptom i.e. lump formation in breast. These lumps can be felt during lactation. Sometimes these lumps are painful and sometimes it’s not. Galactocele closely resemble breast cyst or blockage of ducts. Milky discharge occur from nipples and sub-areolar mass. Galactocele may be 1 or more in number. Patient feel physical discomfort. Fatigue and fever are not the symptoms of galactocele. If these occur, there may be infection secondary to it. Galactocele are not dangerous. There may be abscess formation secondary to galactocele and cause an infection.

Galactocele Causes

Galactocele have many causes behind its formation. Galactocele may form secondary to any infection inside breast and can occur postpartum. The basic etiology is lesion in ducts of breast. Lactiferous ducts are present in breast. When these ducts get obstructed, distension occurs which lead to accumulation of milk and epithelial cells in these obstructed ducts. As a result, lumps filled with milk are formed. Oral contraceptive pills administration leads to the formation of galactocele. Galactocele are not infected as milk is produced inside breast ducts and is completely sterile. It do not have any way out except lactation.

Galactocele Treatment

Galactocele are a kind of cyst, so its treatment resembles cyst treatment. If infection is the root cause then antibiotics are prescribed to treat infection. Normally galactocele are not dangerous or fatal, so treatment is not required. But patient feel uncomfortable and need treatment. Excision is performed as in case of cyst. Excision is performed by making a little incision on breast and tumor is excised. If patient want to treat it herself, then she have to do regular breast massage to unclog the blocked ducts. Mostly galactocele resolve itself after lactation if it occurs due to weaning process.
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Truncal obesity Meaning, Definition, Symptoms, Causes, Treatment

Abdominal obesity, central obesity are other names of truncal obesity. In obesity, body of patient looks like an apple. It is also called apple shaped body. In truncal obesity, excess fats are accumulated in truncal or abdominal region and leads to many health problems. As heart lies in chest or truncal region, so obesity in truncal region may also causes some cardiovascular diseases. Truncal obesity do not only occur in elder and obese patients but it may be secondary to other diseases like Alzheimer disease.

It may be secondary to metabolic diseases and various vascular diseases. In truncal obesity, the body mass index of patient is equal or greater than 30. In this condition, fats start accumulating around abdominal region primarily. Patients with apple shaped body or truncal obesity have greater risk of severe health problems as compare to persons having fats around hips, thighs and arms. When fat start accumulating in truncal region, it can also effect closely lying organs and cover them in fats. This can lead to diabetes mellitus type 2 and excess fat can also cause back strain. Women are more susceptible to gain weight and fats as compare to men due to hormonal changes.

Truncal obesity Meaning, Definition, Symptoms, Causes, Treatment

Truncal obesity Causes

Truncal obesity occurs due to accumulation of fats around truncal region and fats accumulated as a result of eating too much heavily processed fast foods having high amount of fats. Due to lack of exercise and any kind of physical activity to consume fats it start accumulating in truncal region. Hormonal disturbances in women is the main reported cause of truncal obesity. Truncal obesity may be secondary to many diseases and disorders like it may be secondary to Alzheimer disease and metabolic diseases and vascular diseases. Due to decreased metabolism or impaired metabolism obesity may occur.

Truncal obesity Symptoms

Truncal obesity is a visible condition. Patient can be visibly judged whether he is obese or not. Fats accumulate around truncal region and abdomen comes out. The body of patient looks like apple. Many diseases are linked to truncal obesity like cardiovascular diseases, hypertension, insulin resistance and most commonly diabetes mellitus type 2. The circumference of abdomen increases as compare to the circumference of hip. There may be blood lipid disorders, inflammation and many cardiovascular diseases. Truncal obesity is considered the biggest health risk as it is the most common cause to various fatal health problems.

Truncal obesity Treatment

There are many methods regarding weight loss. Dietary modifications and physical exercise are of great help in losing weight. But patient need counseling from a physician because not all exercises help in losing truncal fat obesity. Crunches and cardiovascular exercises are performed to lose truncal fat. Crunches not only burn fat of stomach but it reduce fat from all over the body. Patient have to skip fast foods and eat healthy fruits and vegetables. Some medications also help in reducing weight along with weight loss plan continued. Gastric bypass surgery also help to reduce weight in morbidly obese patients.
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Prostatomegaly Definition, Symptoms, Causes, Treatment

Prostatomegaly is defined as enlargement of prostate gland. Normally prostate gland in men starts increasing in size after 40 years of age. Prostatomegaly is also known as benign prostate hyperplasia. Prostate is an important gland in male reproductive system. It is small in size and have muscular texture. Prostate surrounds urethra and makes fluid in semen. The cells of prostate gland starts to multiply rapidly make prostate gland swell. Due to increase in size of prostate gland, urethra get squeeze or compress and as a result flow of urine becomes limited. It is not a cancerous condition and does not spread like it.

Even it do not lead to cancer. Symptoms generated due to Prostatomegaly have great impact on quality of life of patient. It most commonly occur in men above 50 years of age. Symptoms are mild but in some cases, if they do not get treated on time, may become worse. The common complications reported are:

There may be total blockage of urine and as a result urinary retention occurs. If small amount of urine pass and some amount of urine remains in bladder every time, this condition is known as chronic retention.

Prostatomegaly Definition, Symptoms, Causes, Treatment

Prostatomegaly Symptoms

Lower urinary tract infections have the same symptoms as prostatomegaly have. Urethra becomes congested and narrow. There is hindrance in urinary flow. Main visible symptoms are:

  • There will be decreased or weak urine flow.
  •  Urination time increases due to reduced flow.
  • Patient have to wait a bit for urine to flow.
  • At the end of urination, there will be slow dribbling.
  • Patient can feel his bladder full even after urination and do not get satisfy.
  • Urine frequency may increases due to weak urine stream.
  • Increased chances of toilet urgency.

Symptoms are mild but if left untreated, may become severe.

Prostatomegaly Causes

The increase in size of prostate gland is natural process in men after the age of 40. It is a normal phenomenon of aging in men. The exact cause is unknown but some scientist say that changes in sex hormones may lead to increase in size of prostate gland. If family history of patient is reported with Prostatomegaly, there are increased risk of occurrence of Prostatomegaly in their young ones. Men who have undergone removal of testicles at very young age do not have any chance of developing Prostatomegaly. All these causes may lead to Prostatomegaly but the exact one is still unknown.

Prostatomegaly Treatment

In some cases, treatment of prostatomegaly is not necessary but if symptoms become severe, they do require treatment. But there is not any treatment which totally eliminate all symptoms but can improve them. If treatment is not required, patient have to adopt some lifestyle modifications like drink less water and try to go to washroom frequently. Stop or reduce the use of caffeine. Alpha blockers, 5 alpha reductase inhibitor are prescribed in medication therapy. if medications are of no help to reduce or eliminate symptoms, then surgical removal of prostate gland is recommended.
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Hypochromasia Definition, Symptoms, Causes, Treatment

Hypochromia is another name of hypochromasia. As the name indicates hypo means deficiency and chromia means color. When more than half diameter of cell have central pallor region or the central pallor region increases this is known as hypochromasia. In this condition, there is decreased production of hemoglobin due to deficiency of iron. Due to deficiency of iron, anemia occurs and poikilocytes are frequently present in iron lack anemia which are formed as a result of oxidation of red blood cells membrane.

It will leads to fragmentation. The concentration of hemoglobin is less as compare to the required concentration according to volume of cell. Mean corpuscular volume (MCV) is the evaluation parameter of color of anemic red blood cells and mean corpuscular hemoglobin concentration is the parameter to check effect of size of cell to its color. Hypochromia is defined when its value is less than normal mean corpuscular hemoglobin MCH. The normal range of MCH in adults is 27 to 33 picograms per cell and normal range of MCHC is 33 to 36 gram per deciliter in adults. The size of red blood cell also decreases and can overlap leading to microcytic anemia.

Hypochromasia Definition, Symptoms, Causes, Treatment

Hypochromasia Symptoms

Hypochromasia is a cell disease which have wide range of symptoms all over the body. Tachycardia occurs and may increase up to 100 beats per minute. Due to anemia, blood concentration in body decreases and leads to fatigue and tiredness. Main symptoms of hypochromasia is weakness in body. Hypochromasia disturbs the sleep cycle. When there is decreased concentration of blood it will lead to decreased circulation in veins. Skin becomes pale. When this condition is at peak, sore mouth occurs. Menstrual cycle gets disturb due to deficiency of blood. Pica can also develop due to hypochromic anemia.

Hypochromasia Causes

Deficiency of vit B6 in body and less intake of iron in the form of diet along with less absorption of minerals all these factors lead to hypochromasia. Parasitic infections like in case of hookworm also lead to hypochromic anemia. It may occur secondary to prescribed medications. Lead poisoning is another major reported cause now a days. It may be secondary to diseases like thalassemia and iron deficiency. Heavy periods can cause excessive blood loss and lead to hypochromasia. Ulcers and gastric bleeding can cause Hypochromia. Piles, hemorrhoids and inherited gene mutation are last but not least reported causes.

Hypochromasia Treatment

Hypochromasia can be treated via collection of treatment options. Like carbonyl iron should be administered to fulfil iron deficiency. Eculizumab is also prescribed for it. It is a monoclonal antibody. Cyanocobalamin whose other name is vitamin B6 is also recommended for vit B6 deficiency. Darbepoetin alfa and Epoetin beta-methoxy polyethylene glycol are prescribed. When it occurs due to a parasitic infection, then homeopathic remedy cina is effective. Ferrum met and ferrum phos helps in production of healthy red blood cells via stimulating bone marrow. There are some life style modifications which should be adapted like quit smoking and exercise etc.
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Pulmonary toilet Definition, Therapy, Procedure, Techniques

Pulmonary hygiene is also known as Broncho pulmonary hygiene. It is a set of methods which are used to clean different secretions or mucous from the pulmonary airways. Pulmonary means lungs and toilet means toillete a French word regarding body care and hygiene. Cleanliness of pulmonary airways leads to respiratory health or pulmonary hygiene. Normally, pulmonary airway is cleared via two mechanisms. 1st one is the mucocilliary clearance system and 2nd one is the ability to cough.

If mucocilliary clearance system is impaired, it will lead to poor functioning of lungs along with many diseases and various disabilities. With the help of pulmonary hygiene, many diseases can be prevented like atelectasis (collapse of the alveoli present in the lungs). Excessive secretions can be discarded with pulmonary toilet which is the main cause behind various respiratory infections. Other benefits of pulmonary hygiene are: pulmonary shunting may be decreased and there may increase in functional reserve capacity of lungs. It also helps in preventing respiratory infections normally occurs after chest trauma. Methods of pulmonary toilet include suction technique to remove mucous and excessive secretions and patient is helped to lie in a position in which fluids drain by gravity.

Pulmonary toilet Definition, Therapy, Procedure, Techniques

Pulmonary toilet Techniques

As pulmonary toilet is the set of methods use to drain secretions from lungs and these methods involve deep breathing, incentive spirometry, postural drainage and percussion. Bronchoscopy is a technique in which a long tube is inserted into the airway to view inside lungs and can be a part of pulmonary hygiene. Coughing also helps in initiation of drainage of mucous and secretions. Patient during pulmonary hygiene is not completely sedated so that coughing do not stop. Tracheotomy is another technique helping in pulmonary toilet. In percussion, mucous is loosen and cilia are stimulated to drain mucous.

Pulmonary toilet Therapy

In various lung diseases, pulmonary toilet is performed as a chest physiotherapy. Though physiotherapy is reported with no much efficacy. Chest physiotherapy is important in bronchiectasis and lung abscess. Patient is helped to position in a way that trachea is inclined downward and lie below the chest area which is infected. Postural drainage is considered important and essential in bronchiectasis. Physiotherapy should be received by patient to learn about the position in which draining lobe will be at uppermost position. It should be perform 3 times a day for about 30 minutes in each session.

Pulmonary toilet Procedure

As there are different methods or techniques performed for clearing pulmonary mucous and secretions. So, every method or technique have different procedure. In bronchoscopy, a long tube is inserted inside the pulmonary airway to have inside view. Bronchoscopy helps in performing pulmonary toilet. Patient is not overdosed with sedatives to keep patient coughing as coughing stimulates mucous or excessive secretions. In percussion, secretions are loosened by clapping on backside with cupped hand and cilia are simulated to drain secretions. Positioning is also a technique which is important in draining secretions from pulmonary airways with the effect of gravitational pull.
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Argyll robertson pupil Definition, Symptoms, Causes, Treatment

Argyll Robertson pupil is a type of reflex iridoplegia along with miosis and irregular shape. There is a loss of pupillary reflex to direct light and have normal constriction of pupil while seeing near objects. It is a symptom of tabetic neurosyphilis. Argyll Robertson pupil is a miotic pupil which cannot reflect to direct light but efforts towards accommodate light. Its been more than a century, this condition is describing. This reaction of pupil is a way to confirm the functionality of the optic nerve pathway. It is considered a neurological disorder biomarker like in neurosyphilis, neuro sarcoidosis and multiple sclerosis.

The diagnostic test of Argyll Robertson pupil does not require any special equipment and can be diagnosed easily. The pupil better respond to accommodation as compare to stimulus of light. As miotic pupil occurs due to lesion in dorsally placed fibers which are responsible for light response. This condition was 1st described by a scientist named Douglas Argyll and named this disease after his own name. Pathophysiology behind Argyll Robertson pupil is not clear yet. Some scientist believe that the rostal midbrain in the vicinity of the sylvian aqueduct of the 3rd ventricle is area of damage.

Argyll robertson pupil Definition, Symptoms, Causes, Treatment

Argyll robertson pupil Symptoms

Argyll Robertson pupil shows consistent pupillary findings with the passage of time from months to years. The abnormal functioning of pupil starts with a very sluggish response to direct light and this abnormal response to direct light leads it towards complete loss of reflection to light. Other symptoms reported are iris atrophies along with loss in its radial folds. Crypts are also reported. Vision is effected and patient is not able to see distinct objects but can see nearly placed objects. It is similar to near sightedness in which far vision is blurred and near vision is accurate.

Argyll robertson pupil Causes

The main mechanism or etiology is still unclear but it can occurs secondary to many diseases like syphilis. The Argyll Robertson pupil results in lesion to the pretectal nuclei in the mid brain. Scientist believe that roastal midbrain present in vicinity of cerebral aqueduct of third ventricle is the main area of damage regarding Argyll Robertson pupil. This area involves pupillary fibers which are responsible for reflecting light. If it occurs secondary to syphilis, then pupil generally appears to be unequal and irregular. Atrophy and depigmentation are also reported as rare causes.

Argyll robertson pupil Treatment

Treatment regarding Argyll Robertson pupil is not discovered yet but its underlying cause must be treated to cure it. Most of the time, its leading cause is syphilis, which should be treated 1st. Medication therapy of syphilis include intravenous administration of penicillin doxycycline and tetracycline can be administered instead of penicillin. When the treatment has started, it is important to perform plasma regain test. This test measures the level of antibodies against cardiolipin but do not calculate level of antibiotics against treponema. Once a person get infected, this test will always come positive because of presence of antibodies against it.
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Duret hemorrhage Definition, Symptoms, Causes, Treatment

Duret hemorrhage is lesion occurred in the central area of brain i.e. mid brain and upper pons of brain stem. This condition is named after a scientist Henri Duret. The lesion in mid brain is appeared as small lineal area of bleeding. Duret hemorrhage occur secondary to increased intracranial pressure which raised due to formation of transtentorial pressure cone which is involved in in the front part of the cerebral peduncles which is known as cerebral cura. When the level of intracranial pressure increases above tentorium it may also involve other structures of midbrain. Due to this increased intracranial pressure, brain stem dislocation occurs and a groove is formed in the cerebral peduncle known as kernohan’s notch.

Duret hemorrhage should be diagnosed with great care. Various test are performed to diagnose Duret hemorrhage like medical imaging technique of computed tomography scan and magnetic resonance imaging. It is found to be difficult diagnosing Duret hemorrhage with other lesions. When brainstem is displaced due to stretching and tearing of branches of the basilar artery connected to pons it will lead to Duret hemorrhage. Duret hemorrhage cause many problems in routine life of patient and is proved fatal for life of patient.

Duret hemorrhage Definition, Symptoms, Causes, Treatment

Duret hemorrhage Causes

Duret hemorrhage is like small lesion occurred in central part of brain which can be caused due to many reasons. The main causes reported are as follows:
It most commonly occur due to displacement of the brain stem in downward direction due to any trauma or injury. Injury may be external or internal leading to Duret hemorrhage. Herniation of hippocampus gyrus also occur along with brain stem displacement through the tentorial notch. Also through the acute hematoma. Edema can also lead to Duret hemorrhage. Other reported causes are trauma, tumor which may be malignant or benign and abscess.

Duret hemorrhage Symptoms

Duret hemorrhage is a fatal condition but people with recovery are also reported. Lesion or small lineal area of bleeding may cause serious problems in body. As it is caused due to displacement of brainstem or its head named pons so all the functions of pons are disturbed. Patient can lose his control over many involuntary functions like breathing, communication and different sensations like hearing, smell, taste and body balance. Patient is not able to communicate with others with no proper language control and cannot even walk with proper balance of body.

Duret hemorrhage Treatment

All the traumatic brain injuries including Duret hemorrhage is irreversible and cannot be cured at once. If treatment therapy works, it takes time to recover. But patient after Duret hemorrhage cannot get fully recover but with some abnormalities. Treatment option do not contain surgery because it is a very sensitive case to operate and get successful surgery. Instead medication therapy is used to reduce the symptoms and control bleeding. Blood thickening agents are prescribed and patient is transferred to intensive care unit. Patients who survive through Duret hemorrhages may recover with some disabilities like inability to talk and walk and breathing problems.
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Hutchinson teeth Pictures, Symptoms, Causes, Diagnosis, Treatment

Hutchinson’s incisor, Hutchinson’s sign or Hutchinson-boeck teeth are other names of Hutchinson teeth. It is a main symptom of syphilis (congenital syphilis). Basically Hutchinson teeth appear as notches on the biting surfaces of teeth. Babies with syphilis have smaller and spaced teeth along with notches on them. Sir Johnathan Hutchinson described them and named it after his name. The distance between teeth is larger than usual. Hutchinson teeth can be congenital and may develop late in life. About 63 % of cases of syphilis are presented with Hutchinson teeth. In this disease, patient have to face problems in biting and chewing food properly.

Hutchinson teeth Pictures

Hutchinson teeth Pictures, Symptoms, Causes, Diagnosis, Treatment

Hutchinson teeth Symptoms

Hutchinson teeth itself is a symptom of congenital syphilis. The appearance of Hutchinson teeth is as follows:

Teeth are distant and have greater spaces than usual. Patient have incisor teeth along with notches on the biting surface of teeth. Basically appearance of notches shows the presence of syphilis in patient. Tooth are tapered from sides. The size of teeth is smaller than a normal teeth size. Incisors of upper jaw placed in center get more effected. These changing occuron permanent teeth rather than deciduous teeth which fall off after 7 years of age.

Hutchinson teeth Causes

Main cause reported behind Hutchinson teeth is congenital syphilis. Baby is born with this disease and take it from his parents. It is considered a main symptom of syphilis. There is not any specific etiology behind Hutchinson teeth but it appear secondary to many diseases like some dental diseases, oral and head diseases. Some of the main diseases leading to Hutchinson teeth are as follows:

  • Acrofacial dysostosis
  • Weyer’s type alves castelo dos Santos syndrome.
  • Ecroption
  • Clefting
  • Deafness onychodystrophy dominant form.
  • Ectodermal dysplasia
  • Gene Weidman syndrome
  • Hay wells syndrome
  • Incontinentia pigmenti.

Hutchinson teeth Diagnosis

There is not a proper test to diagnose Hutchinson teeth but its appearance shows its presence. Whenever parents observe problem in teeth of their children, they should consult a dentist. During examination of teeth, if he observe notches on the biting surface of teeth and distant teeth with smaller size then he will recommend for good and appropriate treatment. But along with checking symptoms of Hutchinson teeth disease, physician will also check for the presence of syphilis and if it exist as a root cause, then the physician will recommend to treat this root cause behind it.

Hutchinson teeth Treatment

As Hutchinson teeth is a symptom of congenital syphilis so syphilis should be treated 1st to treat Hutchinson teeth. Along with treatment plan of syphilis, patient should take good care of oral hygiene. He should use a proper tooth paste and hygienic brush and should clean his teeth two times a day. Braces are also used to decrease distance between Hutchinson teeth and sometimes tooth surgery is recommended to straighten teeth. Along with these treatment options patient is advised to take care of his teeth and do not lose hope as it takes time to get fully recover.
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Ideomotor apraxia Definition, Symptoms, Causes, Test, Treatment

Voluntary automatic dissociation is another name for ideomotor apraxia. It is a movement or action disorder which is related to neurological abnormality of patient. Patient is not able to cope with the instructions he receives. Ideomotor apraxia consist of simple motor tasks like having hand to say good bye and using a hammer to hit something. Patient get confuse while acting on instructions or there is no similarity between his limb movement and his will. This abnormality or disorder occur in patients suffered from stroke. Patient with stroke have already experienced this incompatibility of nervous system with voluntary actions.

Ideomotor apraxia Symptoms

Ideomotor apraxia is a neurological disorder which causes many problems in transmission of impulses and mostly motor neurons are involved. Patient is not able to perform functions properly. There is no similarity in physical actions to the signals he receives in brain. Even he cannot mimic actions performed by a person in front of him. Other symptoms associated with ideomotor apraxia is confusion in performing any physical activity, dizziness and less social activity. Patient cannot move out in public confidently and cannot communicate verbally and physically. All symptoms the mentioned above are related to personality of patient.

Ideomotor apraxia Definition, Symptoms, Causes, Test, Treatment

Ideomotor apraxia Causes

Ideomotor apraxia is related to neurological abnormal condition which hurdle in transmitting signals to brain and from brain to target limb. Basically parietal lobe is responsible for controlling voluntary actions like ability to read, ability to write and understanding some spatial concepts. So whenever stroke occurs in parietal lobe it will lead to ideomotor apraxia and is considered the most common cause behind it. Any kind of injury in parietal lobe located in back and top side of head above ears can also cause ideomotor apraxia. The injury may be internal or external both can lead to ideomotor apraxia.

Ideomotor apraxia Test

There is not one defined test for ideomotor apraxia but are so many tests which are performed to diagnose it. A test is performed widely which was developed by George Goldenberg. In this test physician uses imitation assessment of 10 different gestures. Tester perform some actions in front of patient and then he ask him to mimic the same actions he performed. On the basis of his actions performed his condition is evaluated. The tester give scores on right imitation of actions and give no scores on no imitation. Then these scores are counted to check progress.

Ideomotor apraxia Treatment

Ideomotor apraxia is a sensitive case which should be treated or managed with great care. There are some therapies which can be performed to manage it. Occupational therapy is very effective and help patient in regaining the same level of motor functioning he lost. In this therapy, patient is encouraged to beat one task on daily basis like combing hairs etc. 1st separate actions are ask to perform and after getting perfection in it, he is asked to perform series of actions collectively and his performance is checked. This therapy include simple to complex actions.
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Microphilia Meaning, Definition, Psychology, Test, Treatment

Microphilia is a type of paraphilia. In this condition, person have sexual attraction towards small size or micro things or people. Microphilia is an opposite term of macrophilia (sexual attraction towards giant human beings). Microphilia is basically a microphiles thinking in which person assume others shrinking in front of him. Research reported that mostly women are fantasized in microphilia shrinking in small size. Person suffering from this type of paraphilia, is identify as microphiles. Microphiles just fantasize about shrinking of his sex partner and he himself remain unchanged.

A writer resemble microphilia with masochism which is an opposite term of sadism. Microphilia is the most abundantly occurring paraphilia in last few decades. And the main reason behind spreading of microphilia is adult internet surfing and getting attracted towards paraphilia. Internet is spreading this thing all over the world and leading youth towards sexual gratification. The term microphilia is not used in the world of microphiles instead they use term S.W (shrinking women) preferably. There is also a microphiles community consisting of women using term shrinking men and sadomasochism. Microphilia is not publically common type of paraphilia. Some people consider it as a type of fetish sex, dominating sex or bondage sex.

Microphilia Meaning, Definition, Psychology, Test, Treatment

Microphilia Psychology

Microphilia is a type of paraphilia in which person get sexually attracted towards micro sized people. People get this idea or habit from movies like Thumbelina and from internet sites full of microphilia fetish sex. Person with microphilia fantasize about his partner to shrink and become small in size and person feel happy to get sexually engaged with his small sized partner. Person feel relaxed while having sexual activity with minion partner. Minion is an animated character having small height. Most of the people like this character and follow it and also demand a minion partner to fulfil their sexual desire.

Microphilia Test

Microphilia is a visible activity which can be observed at an early stage. Home testing or self-testing helps in diagnosing this type of paraphilia. Parents can observe their child in home based activities. Parents can observe their child in selecting their toys and clothes and their attraction towards small things. If an adult is suffering from microphilia, he can test himself by answering some specific questions available online in the form of a questionnaire. If he is able to answer these questions, then he is under microphilia state and should get a treatment therapy.

Microphilia Treatment

Microphilia is a type of psychology related disorder. It is in their head in the form of a desire or need. There is no such medications for this disorder but there are some therapies like physical and mental therapies which will rehabilitate the patient. Physical therapy consist of some exercises and being healthy. And mental therapies consist of some counseling sessions in which patient is asked some questions about routine life and about their sexual desire and their answers show their progress. These two therapies should be continued side by side to get better and early results.
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Nutmeg liver Definition, Symptoms, Causes, Treatment

A condition in which liver get congested is known as nutmeg liver or congestive hepatopathy or passive congestion of the liver. Congestion of liver occurs due to congestion in venous system. Congestive hepatopathy is named as nutmeg because due to chronic congestion of liver, it appear as grated nutmeg “speckled”. The gross image of congested liver shows small black spots representing the both dilated and congested veins of liver or small hepatic venules. The paler area appeared on the gross image is unaffected which surrounds liver tissues. If congestion of liver persist for long term it will lead to fibrosis.

If congestion of liver occurs due to failure in right heart ventricle then this congestion is termed as cirrhosis. Sometimes the sign and symptoms of congestive heart failure covers the signs of cardiac cirrhosis. Most of the time nutmeg liver results in cardiac failure. And the ultimate cause behind it is chronic alcohol use or viral hepatitis. In congestive liver disease, veins get shrink and become small in size leading to increased pressure. This narrowing of veins leads to increased blood pressure and blockage occurs leading to chronic passive congestion of liver also known as nutmeg liver.

Nutmeg liver Definition, Symptoms, Causes, Treatment

Nutmeg liver Symptoms

Sign and symptoms are totally depend upon the cause behind it. Mainly symptoms occur after 1st lesions which leads to nutmeg liver. Symptoms are also associated with heart and lungs. Patient feel full and tender in the upper right hypochondriac region. Vomiting containing blood or blood vomiting can occur along with gastrointestinal catarrh. Sometimes jaundice is also reported. Due to obstruction in portal vein, ascites may occur. These ascites lead to generalized edema. Presence of bile in urine and stool have a specific color i.e. light or clay colored. The size of liver increases and it becomes tender.

Nutmeg liver Causes

Mainly nutmeg liver occurs as a result of cardiac failure. Due to diseased heart, pressure increases in the sub lobular vein of liver and congestion occurs. Cardiac lesions are also reported as a main cause behind it. Lobules of liver have a red brown colored central portion which stand against non-congested normal tan colored liver. Necrosis also occur in the central portion of hepatic lobules. Lesions in lungs like interstitial pneumonia, pleural effusions and intrathoracic tumors. All the causes mentioned above are directly or indirectly leads to chronic passive congestion of liver or nutmeg liver.

Nutmeg liver Treatment

Treatment therapy of nutmeg liver is based on permanently removing the leading cause behind it. But if removal of cause is not possible, then the procedure is modified along with its effects. So, treatment options are limited. Treating congestive heart failure or right heart ventricle disease will ultimately decrease the chances of congestive hepatopathy or nutmeg liver. Lesions in heart and lungs are treated 1st to treat nutmeg liver. Vasodilators are prescribed to dilate vessels and help in ease of blood flow. There is no proper medication for congestion of liver but for the leading cause behind it.
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Hepatojugular reflux Definition, Test, Mechanism, Pathophysiology

Whenever pressure is applied to abdomen and it is compressed, it leads to distension of jugular vein. Physiology behind distension of hepatojugular vein or hepatojugular reflux is, when abdomen is compressed for 20 to 30 seconds, the venous pressure increases towards right side of ventricle of heart, if the right ventricle is not healthy and not working properly then it cannot handle that increased pressure of blood and as a result lead to distension of jugular vein. This mechanism is known as hepatojugular reflux. Hepatojugular reflux is a historical term used to explain abdominojugular reflux or another name of abdominojugular test. Basically hepatojugular reflux is an indication of right and/or left ventricle disease or failure.

This reflux occurs in about 70 % of cases with heart disease. Hepatojugular reflux is an early sign of congestive heart failure. It is named as hepatojugular reflux because of increased blood pressure in peripheral nervous system which increases load on liver and ultimately distension of jugular vein occurs which is present in neck. When heart is in healthy condition, it increases the cardiac output due to increased venous return. This will not increase load on liver and as a result there will be no distension in jugular vein.

Hepatojugular reflux Definition, Test, Mechanism, Pathophysiology

Hepatojugular reflux Test

Hepatojugular reflux is also known as abdominojugular test. It is a physical test which is performed to check performance of heart. If the result is positive, it shows problem in pulmonary artery pressure and indicates right heart dysfunction. In this test patient is asked to lie down at 30 degrees and head tilted at 45 degrees to left side. Direct light is applied on neck to see the difference in jugular vein appearance. Patient’s abdomen is compressed lightly for about 20 to 30 seconds and distension in jugular vein will be seen.

Hepatojugular reflux Mechanism

Hepatojugular reflux is an indication of heart failure or many other cardiac diseases. Because it occurs as a result of cardiac failure or diseased state of heart. When a light pressure is applied, abdomen get compress and after 20 to 30 sec of compression the venous return pressure increases, which increases pressure on liver. Increased blood pressure on liver leads to increased blood pressure in cranial vena cava ultimately increasing pressure on jugular veins leading to distension of vein. Jugular veins are present in neck region which can be easily seen on surface after expansion or distension.

Hepatojugular reflux Pathophysiology

Hepatojugular reflux is a normal physical test which is performed to check performance of heart. The pathophysiology behind this reflux is dependent upon the impaired condition of heart. When right or left ventricle is diseased, increased venous return pressure on right ventricle cannot be handled by it. And leads to increased peripheral nervous pressure. This increased pressure start increasing load on liver and liver pass this pressure on cranial nerves and ultimately jugular vein. As a result jugular vein get distended. All this happen due to diseased state or failure of heart. This condition mostly indicate congestive heart failure.
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Brushfield spots Pictures, Causes, Symptoms, Treatment

Brushfield spots is a condition present in eyes. It is the coolest condition of eyes which makes it more attractive and colorful. These spots are arranged in a circular position like ring in the pupil of eye. As the name indicates the presence of spots in the outer brush field boundary of iris. The spots are of greyish or brown in color. Thomas brush field is the scientist who named this condition after his name. These spots occur due to the aggregation of connective tissues which is a normal element of iris. These spots occur in a syndrome named Down syndrome.

It is normal in children. About 35 to 78 percent of children have Brushfield spots with Down syndrome. These Brushfield spots are more common in children who are European descendent with Down syndrome and very rare in Asian descendants with Down syndrome. It is also common in light pigmented irises. Brushfield spots are the focal areas of stromal hyperplasia and surrounded by hypoplasia. It is not only present in patients with Down syndrome but also present in person without Down syndrome. These spots do not have effect on vision and normal functioning of iris and pupil.

Brushfield spots Pictures, Causes, Symptoms, Treatment

Brushfield spots Symptoms

Brushfield spots are not a pathological condition. It is a normal appearance of colored spots in the periphery of iris. The pupil of eye have colored spots mostly greyish, brownish or white in color. These spots are small crescent shaped markings. These spots impart an attractive appearance to the eye of patient. These spots occur as a result of aggregation of connective tissues which normally present in the pupil of eye. The eyes are almond shaped. Children with Down syndrome have these Brushfield spots and other symptoms associated with it like slow growth and short height children.

Brushfield spots Causes

The main cause reported behind Brushfield spots is Down syndrome. Down syndrome is a genetic disorder which is regarding to the retarded growth of children. It is not a pathological condition so the physiology behind appearance of greyish brown spots is the accumulation of connective element of pupil which are present normally in the eye. The pigmentation of eye may also occur due to zellweger syndrome. Other causes behind Brushfield syndrome are roifman syndrome, iris disorder, Yemenite deaf blind hypopigmentation syndrome, osteoporosis oculocutaneous hypopigmentation syndrome, familial progressive hypo and hyper pigmentation and last but not least gradenigo syndrome.

Brushfield spots Treatment

The treatment plan for external eye disorder like Brushfield spots is similar to that for non handicapped patients. In treating Brushfield spots, the medications of cardiovascular disease and respiratory disease should be avoided. Medical therapy of blepharitis is similar to the treatment therapy of Down syndrome to ultimately treat Brushfield syndrome. Some antibiotics and topical scrubs are included in medication therapy. Other precautions include wearing sun glasses when going out in order to avoid other generating diseases like esotropia, aphakia, pseudophakia and refractory errors which causes amblyopia. Starting care is important but with passage of time patient get used to it.
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Ligamentum teres hepatis, hip, Umbilical Vein, Ultrasound, Radiology

Ligamentum teres is a round ligament present in liver. It is also known as ligamentum teres hepatis because of its location. Ligamentum is a collection of string tissues (fibrous in nature) that is present at the edge of falciform ligament present in liver. This round shaped ligament divides the left part of liver into two parts i.e. medial and lateral sections. Fetus Umbilical vein remnant is represented by this round ligament (ligamentum teres) that is why it is only present in placental mammals. After one or two months of delivery, the umbilical vein degenerate to form fibrous tissue i.e. ligamentum teres.

Ligamentum teres Hepatis

Ligamentum teres is also known as ligamentum teres hepatis because it is present in liver. It is located at the edge of another ligament named falciform ligament (dividing liver in left and right side). This ligament is present in left side of liver which divide it into 2 parts medial and lateral. It is a degenerative ligament because it has the same degenerative cells as present in liver. It is composed of fibrous tissues which joins navel part to the anterior side border of liver. It is of great importance as it is remnant of fetal umbilical cord.

Ligamentum teres hepatis, hip, Umbilical Vein, Ultrasound, Radiology

Ligamentum teres Hip

The ligamentum teres present in hip is also known as round ligament of the femur and ligamentum teres femoris. It is not round in shape but appear as triangular shaped or sometimes flattened ligament. It has different strength in different subjects and unsheathed by the synovial membrane. The ligamentum teres femoris get tense when person is in semi flexed or half bended position and get relax at adducted limb position. It provides extra protection to hip and avoid dislocation of hip with great resistance that is why it is also known as hip capsule.

Ligamentum teres Umbilical vein

Umbilical vein is developed during pregnancy for the purpose of development of fetus. It carries oxygenated blood to fetus via placenta. This umbilical vein provide oxygenated blood to very central circulatory system of neonate and restore the actual blood volume in the body of neonate. It also help in administration of glucose and drugs. After delivery of neonate, the umbilical vein start closing and converting into the fibrous rounded cord like structure named ligamentum teres. It is located in liver and cross over the falciform ligament to divide left half of liver into two parts.

Ligamentum teres Ultrasound

The ultrasound report of liver shows the presence of tear ligamentum teres. A survey report containing 100 patients illustrated that about 87 % patient were found with tear ligamentum teres. This calculation was reported after ultrasound examination of liver showing pathological condition of ligamentum teres. The mean diameter of ligamentum teres is 4.5 mm and have a range of 3 to 6 mm. when tear ligamentum teres is present, the diameter of round ligament is increased due to thickness. This increased ligament thickness appear clearly in the reports of ultrasound. Thickening of ligamentum teres is of two types i.e. nodular or smooth.

Ligamentum teres Radiology

Arthroscopy and magnetic resonance imaging are performed to get radiology report. But magnetic resonance imaging is not all the time successful in getting radiology report. But arthroscopy of hip and liver portion have greatly reported pathological findings in ligamentum teres. Pain in hip and instability in patient when undergo from arthroscopy, found to have lesions in ligamentum teres. About 4 % to 15 % cases of ligamentum teres tear are reported by arthroscopy. Lesion in ligamentum teres is found to be the most common cause behind pain in hip portion in athletes.
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