Blog Archive


Facial Plethora Meaning, Symptoms, Causes, Treatment

Facial plethora means redness of face due to increased level of blood volume or increased blood flow. Basically, the term plethora is used for redness due to increased blood volume, so when it occurs on face, it is known as facial plethora. Hypovolemia is the synonym of plethora. It is considered as a clinical sign for many diseases. Commonly facial plethora is a diagnostic factor for Cushing syndrome. Changes in the appearance of facial plethora shows treatment progress of Cushing syndrome or other diseases.

While treating diseases, facial plethora is cured as blood volume or blood flow is reduced. Face of patient appears red and resembles erythema. Facial plethora appearance is independent of age and gender. Facial plethora itself is the sign of increased blood flow and increased blood volume which indicates the presence of a disease. Cushing syndrome is not the only reason behind facial plethora.


Other causes may include e.g familial polycythemia, drug eruption, erysipelas and skin syndrome due to staphylococcal pathogen. Toxic epidermal necrolysis rosacea, carcinoid tumor and systemic lupus erythematous are also included in main causes of facial plethora. There is no special treatment strategy for facial plethora because it disappears after complete treatment of the leading disease behind it.

Facial Plethora Meaning, Symptoms, Causes, Treatment


Facial Plethora Symptoms


Facial plethora itself is a main symptom of many diseases. It is identified because of red skin color. The color of skin changes because of increased level of blood volume or blood flow. Facial plethora is a visible sign of Cushing syndrome. It may accompany hypertension, vasodilation and increased cardiac output. All these conditions lead towards increased blood flow and causing facial plethora. Flushing occurs on facial skin. It mostly resembles erythema. Patient feels tension on skin surface and facial veins are prominent like lines. The surface of skin becomes sensitive that a minor pressure leaves a mark on skin.


Facial Plethora Causes


Facial plethora is a clinical sign of many diseases. Cushing syndrome is the most common leading cause of facial plethora. Other than Cushing syndrome, polycythemia is a main cause. In polycythemia, excessive RBCs production causes plethora. Familial polycythemia (when there are not enough RBCs) is also responsible for facial plethora. It may be secondary to different drugs. Usually antimalarial therapy includes clofazimine, which causes redness of skin. Erysipelas is an infection around eyes and nose also causes facial plethora. Toxic epidermal necrolysis occurs just below eyes causing redness of skin.


Facial Plethora Treatment


Facial plethora itself is not a disease but is counted as a main sign of many diseases. It is considered a visual diagnostic factor of many diseases like Cushing syndrome. Facial plethora eliminates automatically when the root cause is treated. There is no specific treatment strategy for facial plethora. In case of Cushing syndrome, after surgery some changes are observed in the appearance of facial plethora. These changes show progress of treatment. As facial plethora fades, it means the root disease is treated and the surgery was successful. Facial plethora shows recovery of patient.
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Total peripheral vascular Resistance Definition, Increased, Decreased

Total peripheral vascular resistance which is also known as systemic vascular resistance or an ancient term i.e. total peripheral resistance. In case of resistance in pulmonary systemic circulation, it is known as pulmonary vascular resistance. This condition is described as resistance which is offered by systemic circulation. Vascular resistance is basically a force which opposes blood flow. Blood flow have to overcome this force to create proper flow. This resistance is generated by walls of blood vessels to hinder blood flow. If this systemic resistance increases than usual, then it can cause severe problems related to vital organs of body.

Total peripheral vascular Resistance Definition, Increased, Decreased

Total Peripheral Vascular Resistance Increased


Increased total peripheral vascular resistance causes problems in blood flow. If blood is thick or of increased viscosity, the resistance will also increase. In other cases, when vasoconstriction occurs, peripheral vascular resistance increases and let only a small amount of blood to pass at a time. Opposite to this, when vasodilation occurs, the peripheral vascular resistance decreases and blood flow increases. When this systemic vascular resistance increases, it opposes blood flow and as a result high blood pressure occurs which may lead to further complications like heart failure, angina attack or even death.


Total Peripheral Vascular Resistance Decreased


In case of vasodilation, systemic vascular resistance decreases. Likewise when blood is less concentrated i.e. low viscosity, the peripheral vascular resistance automatically decreases. But blood with low viscosity cause turbulence in vascular system. Low peripheral resistance means large amount of blood passes through blood vessels at a time. It may lowers blood pressure and cause complications. Patient may fall down and go faint. Blurred vision and sweating may occur. In that case blood thinning agents are strictly prohibited as these may cause death of patient.

Total Peripheral Vascular Resistance and Cardiac Output


When blood vessels dilate, the blood flow decreases and ultimately peripheral vascular resistance also decreases. Decreased resistance means larger blood flow. When blood flow increases, according to this cardiac output decreases. As a result blood pressure decreases and heart rate slows down. Contrary to it, when vasoconstriction occurs (narrowing of blood vessels), the peripheral vascular resistance increases and as a result blood flow decreases. Due to decreased blood flow through vessels, the cardiac output increases and as a result blood pressure increases and heart rate speed up. This is all about relationship of cardiac output with total peripheral vascular resistance.

Total Peripheral Vascular Resistance in Pregnancy


During pregnancy, the cardiac demand increases. Increased cardiac output is observed at initial stage of pregnancy and in third trimester, the cardiac output achieves peak level i.e. about 30 to 50 percent above from baseline. The release of progesterone leads to vasodilation and as a result total peripheral vascular resistance decreases almost 20 percent. This reduction in peripheral vascular resistance leads to increased blood flow. Cardiac output is increased due to estrogen secretion. As estrogen increases preload on heart and increases stroke volume leading to increased cardiac output.
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Follicular Conjunctivitis Acute, Chronic, Symptoms, Causes, Treatment

Follicular conjunctivitis is a condition in which pink colored tissues surround eyes or cover the upper and lower eyelid or third eyelid is involved. These red tissues contain numerous follicles. These follicles are responsible for regulating local immune system. It is basically a collection of lymphocytes which are round in shape. Follicular conjunctivitis occurs as a local host in response to an external agent or substance and start producing subconjunctival lymphoid follicles. Some viruses, bacteria and chlamydia are responsible for causing follicular conjunctivitis. It is most prominent in the inferior fornix. Concentration of blood vessels increases in these follicles but are not prominent.

Follicular Conjunctivitis Acute, Chronic, Symptoms, Causes, Treatment


Acute Follicular Conjunctivitis


Acute follicular conjunctivitis occurs due to a pathogen named adenovirus. It appears in two main medical conditions named pharyngoconjunctival fever and epidemic keratoconjunctivitis. Both of these conditions occur due to adenovirus but its serotypes vary. In pharyngoconjunctival fever, adenovirus serotype 3, 4 or 7 is involved and in case of keratoconjunctivitis, adenovirus serotype 3, 7, 9 or 19 is involved. Acute follicular conjunctivitis is symptomatic and non specific. Antibiotics used against this condition involve broad spectrum antibiotics in order to prevent secondary infections. Topical corticosteroids are also prescribed for membrane conjunctiva and photophobia.


Chronic Follicular Conjunctivitis


Chronic follicular conjunctivitis occurs as a result of pathogen invasion named chlamydiae trachomatis. It is mostly secondary to toxic conjunctivitis which appear as a result of topical medications and molluscum contagiosum. In chronic follicular conjunctivitis, follicles appear in inferior fornix large enough to see with naked eye. these follicles are then known as mature follicles. It transmit via conjunctival discharge. Cornea of eye is also affected along with conjunctiva. Fibrosis helps a lot in healing chronic follicular conjunctivitis. Secretions of follicles undergo hyaline degeneration and then calcification. Chronic follicular conjunctivitis is divided into four main stages of its development.

Follicular Conjunctivitis Symptoms


According to stage division of follicular conjunctivitis, signs and symptoms vary. In active stage of follicular conjunctivitis, mature or large sized follicles are present which can be seen with naked eye. These follicles are expressible. It involves upper palpebral conjunctiva and fornix. Pink colored, finger like large papillae are present which give conjunctiva a velvety appearance. Contrary to it, in healing stage of follicular conjunctivitis, white colored, irregular fibrous patches are present. These fibers may be star shaped or linear. A white colored line of fibrosis is also observed in sulcus subtarsalis. Along with these, numerous white spots are also present.

Follicular Conjunctivitis Causes


Follicular conjunctivitis occurs due to an exogenous pathogen. When this pathogen invades inside body, follicular conjunctivitis occurs as a local host. The follicles are responsible for regulating local immune system, that's why they appear in response to any foreign pathogen. According to its two main types i.e. acute and chronic follicular conjunctivitis, causative agent vary. Adenovirus is responsible for causing acute follicular conjunctivitis and chlamydiae trachomatis is responsible for causing chronic follicular conjunctiva. Some chlamydial infections also lead to follicular conjunctivitis. These chlamydial infections involve trachoma and inclusion conjunctivitis.

Follicular Conjunctivitis Treatment


Follicular conjunctivitis occurs due to a pathogen invasion, so its treatment involves antibiotics. Ciprofloxacin, erythromycin, tetracycline, ofloxacin and azithromycin are most effective against follicular conjunctivitis trachoma. Instillation of Ciprofloxacin or ofloxacin 0.3 percent q.i.d is prescribed. And erythromycin or tetracycline in topical dosage form is prescribed to apply once a day especially at bed time. This treatment should be continued for at least 6 weeks. It will help in controlling infections. This is the treatment outline used for follicular conjunctivitis.
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Blueberry Muffin Rash Symptoms, Causes, Treatment

Blueberry muffin rash is a dermatological disease. In this disease, newborn babies are born with blueberry shaped round nodules or marks on skin. These marks are multiple in number. Because of resemblance of this rash with blueberries, it is termed as blueberry muffin rash. Blueberry muffin rash appears because of accumulation of blood producing cells. Bleeding within the skin and cancer spreading may also appear via blueberry muffin rash. The accumulation of blood producing cells in skin is known as extramedullary hematopoiesis.


It has generalized appearance but usually if affects trunk, head and neck region. Blueberry muffin rash appears round in shape but often it appears oval in shape. It has bluish purple color. This rash appears in various congenital infections like rubella, congenital syphilis, rhesus incompatibility, parvovirus B19, cytomegalovirus, toxoplasmosis and B2 infection. It is a disease that can be observed with naked eye and no diagnostic tool is required.

Blueberry muffin rash appears as a sign or symptom of many diseases. So it itself counted as a diagnostic tool for above mentioned congenital diseases. Likewise treatment of blueberry muffin rash involve management of root cause behind it as this will make its treatment easier.

Blueberry Muffin Rash Symptoms, Causes, Treatment

Blueberry Muffin Rash Symptoms


Blueberry muffin rash is a skin disease. It appears as bluish purple color nodules or marks. These may be round or oval in shape. Anemia is a main symptom with associated liver and spleen enlargement i.e. hepatosplenomegaly. Babies with blueberry muffin rash show some symptoms which involve jaundice, retarded growth of baby during intrauterine development and abnormal central nervous system development. Abnormal development of central nervous system may involve seizures, microcephaly, Deafness, chorioretinitis and cerebral calcifications. All the above mentioned conditions are the visible symptoms of blueberry muffin rash and their presence confirms this rash.

Blueberry Muffin Rash Causes


Blueberry muffin rash itself is a sign of many congenital diseases and these congenital diseases involve neuroblastoma, congenital leukemia cutis, langerhans cell histiocytosis and rhabdomyosarcoma. It may also occur due to blood disorders. These blood disorders involve hereditary spherocytosis, hemolytic diseases like ABO compatibility or rhesus and twin twin transfusion syndrome. Some congenital infections are also responsible for blueberry muffin rash and these infections include parvovirus, syphilis, rubella, herpes simplex, toxoplasmosis, epstein barr virus, cytomegalovirus and coxsackie B2 virus. For these congenital infections, an acronym is used i.e. TORCH. It is abbreviated as Toxoplasmosis, Other infections, Rubella, Cytomegalovirus and Herpes simplex virus.

Blueberry Muffin Rash Treatment


Blueberry muffin rash involves various causes so, treatment is selected according to them. Physicians recommend to manage the leading cause 1st and ultimately blueberry muffin rash heals itself. In case of congenital diseases, there is no permanent treatment but temporary treatment can remove blueberry muffin rash. Diagnosis should be proper for treatment. Skin biopsy is performed to check leukemia and cancer. Bone marrow biopsy is also performed. If congenital infections are the underlying cause, then antibiotics are prescribed. In case of blood disorders, proper blood therapy is recommended.
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Double Teeth Problem Meaning, Symptoms, Causes, Treatment

When a row of teeth starts arranging itself just behind the teeth of jaw line, this condition is termed as double teeth. It most commonly occurs in children. It looks scary but it is completely harmless. They do not cause serious problems and treatment is also very easy. Normally baby teeth fall off at the age of 5 to 7 years and replaced by permanent strong teeth. Permanent teeth start growing just behind baby teeth. These permanent teeth loses the roots of baby teeth and they fall off. Then permanent teeth replace baby teeth.


In case of double teeth problem, the permanent teeth do not grow just underneath baby teeth and find their way just above or behind baby teeth causing double teeth problem. In double teeth problem, baby teeth do not fall off and remain on their position. Usually double teeth appear behind lower and upper front teeth. Children with double teeth problem may face problem in chewing and biting food. Biting with double teeth may cause gums injury. It is a visual problem and can be observed with naked eye. No diagnostic tools are required. Treatment is also very easy as no major surgery is required.

Double Teeth Problem Meaning, Symptoms, Causes, Treatment

Double Teeth Symptoms


Double teeth problem is a visible condition and can be observed with naked eye. In this condition, children have two rows of teeth one behind the other. The front row have baby teeth and 2nd row consists of permanent teeth. Common symptoms related to double teeth problem include drooling, irritability during growth of permanent teeth and after complete growth. Biting may cause excessive touching of double teeth with opposite gums and it can cause redness of gums and soreness of gums. Children find comfort in chewing clothes or plastic stuff and other objects they get.

Double Teeth Causes


Double teeth is not a pathological condition and is completely harmless. It may occur in almost 30 percent of children. It occurs at two points in childhood 1st at 6 years old, when incisors start growing just behind baby incisors and appear in the form of double teeth. Secondly it can occur at the age of 11 years. At this age, like permanent incisors grown behind baby incisors, molar teeth start growing just behind baby molars instead of growing underneath baby molars. It may happen due to late falling of baby teeth, as a result permanent teeth start growing side by side causing double teeth problem.

Double Teeth Problem Treatment


As it is completely harmless condition, some patients do not prefer treatment because they feel completely okay with this. But usually its treatment involve removal of baby teeth with dental instruments so that permanent teeth can take their place. Children should try to make their baby teeth fall for easy growth of permanent teeth. If double teeth problem develops, dentist will make a cut and remove baby teeth. Then permanent teeth will be visible on front. A metal wire is fixed on to these permanent teeth for alignment.
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Bronchogenic Cyst Complications, Removal, Surgery, Recovery

Bronchogenic cyst are the type of bronchopulmonary foregut malformation. It is a congenital condition in which malformation of bronchial tree occurs. Bronchogenic cyst involves mediastinum and present in the form of mediastinal mass which in turn causes local compression. It is considered the most common type of foregut duplication cyst. Bronchogenic cyst may involve lobar location or extralobar location. In new born babies compression of vital organs due to bronchogenic cyst present in the form of respiratory distress. In adults, it is presented in the form of recurrent infection with associated symptoms. In most of the cases, bronchogenic cyst are asymptomatic.

Bronchogenic Cyst Complications, Removal, Surgery, Recovery

Bronchogenic Cyst Complications


Bronchogenic cyst if left untreated, will show complications and these complications may become severe if neglected. These complications involve ulceration of the walls of cyst, infection which is superimposed, hemorrhage, fistula may occur on bronchial tree. Bronchial atresia (secondary). Bronchogenic cyst may develop into malignant tumor but it is very rare. If it happens, then it is reported with some primary features i.e. anaplastic sarcoma, adenocarcinoma, pleuropulmonary blastoma, leiomyosarcoma and rhabdomyosarcoma. Bronchogenic cyst if diagnosed, should be treated as soon as possible, otherwise it will transform into more severe form and may complicate the case.



Bronchogenic Cyst Surgery


Bronchogenic cyst if show symptoms, then surgical removal is recommended. In newborn babies, surgery is recommended at the age of 3 to 6 months. Thoracoscopic surgery is performed because it is safe and patient feels less pain. In thoracoscopic resection, there are less or no chances of rib fusion. Normally thoracoscopy is performed but in some special cases, in which patient show symptoms of bronchogenic cyst, other types of surgeries are performed. These surgical procedures involve temporizing or palliative procedures like transbronchial, transparietal, aspiration and puncture in mediastinum. All these surgeries are performed when complete removal of cyst is not possible.


Bronchogenic Cyst Removal


Bronchogenic cyst is removed completely via thoracoscopy resection. In thoracoscopy resection, a cut is made right between the ribs of affected side. It is an open surgery. Bronchogenic cyst is removed directly from lungs via surgery. It is performed only when bronchogenic cyst are showing symptoms. In severe cases, cyst cannot be removed completely due to attachment of cyst with the walls of lungs. In that case, bronchogenic cyst is not completely removed via thoracoscopy i.e. the attached part is left as it is in lungs and other part is removed.

Bronchogenic Cyst Recovery


After Bronchogenic cyst removal, patient may take months to recover completely. Patient have to follow some instructions regarding diet and daily routine for fast and infection free recovery. Patient is allowed to take normal diet but heavy work and exercise is prohibited for about 6 weeks after surgery. Wound of open surgery requires special care. Patient have to clean wound daily to avoid infections. Stitches used are biodegradable which makes healing easier. Some medications are prescribed for pain i.e. tylenol (acetaminophen) and advil (iboprufen). Patient have to call doctor if he experience fever, problem in breathing and worse pain. Follow ups are recommended.
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Granulosa Cell Tumor Symptoms, Causes, Prognosis, Treatment

Granulosa Theca cell tumor is another name of granulosa cell tumor. It is a condition in which tumor occurs in granulosa cells of ovary and testicles. It involves stromal surface of sex cord present in both males and females. Granulosa cell tumor occurs in 2 percent of cases with ovarian tumor. It is actively divided into two main types on the basis of histological findings i.e. adult and juvenile granulosa cell tumor. Both of these subtypes release estrogen and this release helps in diagnosis of granulosa cell tumor. Adult GCT occurs mainly in women having menopause and juvenile GCT occurs in adults usually less than 30 years of age.

Granulosa Cell Tumor Symptoms, Causes, Prognosis, Treatment

Granulosa Cell Tumor Symptoms


Excess mass in pelvic region is observed in patients with granulosa cell tumor. The mass is palpable in texture and is present in about 85 to 97 percent of patients. Rectovaginal and bimanual examination is preferred for mass evaluation. Pain in abdominal region is another symptom. If pain persist for longer time period, then further examinations are performed to check presence of any infection. Women feel excessive vaginal secretions and breast tenderness. Abnormal uterine bleeding in postmenopausal women. Increased production of estrogen also shows presence of granulosa cell tumor because estrogen stimulates breast and vaginal tissues.



Granulosa Cell Tumor Causes


There is not any definite etiology reported yet for granulosa cell tumor. But it may occur due to any kind of infection in ovary. Pathogens involved may be neisseria gonorrhoeae and chlamydia trachomatis. If pelvic inflammatory disease is suspected, then gram stain is used to confirm gram negative diplococci presence. It may occur due to chromosomal anomalies. Autocrine and endocrine abnormalities are also responsible for granulosa cell tumor. There may be various factors involved in etiology of granulosa cell tumor. Other than all these causes, cervicitis is also reported for GCT.


Granulosa Cell Tumor Prognosis


The prognosis of granulosa cell tumor is very good. It is so because of its early diagnosis. It can be easily diagnosed at early stage because of excessive secretion of estrogen hormone in both male and female. Over excretion of estrogen stimulates tissues of vagina and breast in women. Surgical removal is considered a safe treatment option with good success rate. But now a days a more advanced therapy is introduced named chemotherapy. Via chemotherapy the mortality rate as well as morbidity rate is decreased. Medications are also of great help in controlling excessive levels of estrogen hormone.


Granulosa Cell Tumor Treatment


Treatment of granulosa cell tumor involves three main treatment options i.e. surgical removal of tumor, chemotherapy and medication therapy. Surgery is considered safe and in postmenopausal women the ovaries as well as womb is also removed along with tumor. Radiotherapy is another option but the treatment is selected on the basis of severity and stage of tumor. Surgery is recommended at initial stage and radiology is recommended at the stage where surgery is not possible. Medications are used side by side along with chemotherapy and radiotherapy. As medicines help in controlling and managing secretions of estrogen hormone.
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Scimitar Syndrome Definition, Symptoms, Causes, Treatment

Hypogenetic lung syndrome is another name of scimitar syndrome. In this syndrome, the lung is hypoplastic which drains via an anomalous vein into systemic system. The anomalous venous return appears as a scimitar in chest X-ray that is why this syndrome is named as scimitar syndrome. It is the clinical finding of congenital disease named pulmonary venolobar syndrome. Scimitar syndrome is a type of partial anomalous pulmonary venous return.


Basically scimitar syndrome is the combination of two main conditions i.e. partial anomalous pulmonary venous return and pulmonary hypoplasia. This syndrome usually involves left sided lung. Blood shows movement from left to right side of lung. The vein involved in scimitar syndrome drains into portal vein, right atrium and most commonly inferior vena cava. Scimitar syndrome has various associations like localized bronchiectasis, vertebral anomalies, horseshoe lung, congenital heart diseases, tetralogy of fallot, diaphragmatic abnormalities i.e. diaphragmatic hernia, abnormalities of genitourinary tract, anomalies of vertebral column and last but not least pulmonary sequestration.

Scimitar syndrome can be easily diagnosed because of these associative problems. Transthoracic and transesophageal echocardiography are used to diagnose this syndrome. Two types of angiography are also used i.e. CT angiography and MR angiography.

Scimitar Syndrome Definition, Symptoms, Causes, Treatment

Scimitar Syndrome Symptoms


Scimitar syndrome occurs in lungs associated with a specific vein named anomalous vein. So symptoms of scimitar syndrome are all related to lungs. At initial stage scimitar syndrome is asymptomatic and patient remains unaware of its presence. But in severe cases it show symptoms. These symptoms are cyanosis, shortness of breath, fast breathing, respiratory distress and retraction of rib cage muscles. These symptoms show the presence of scimitar syndrome without diagnosis. There are some minor symptoms which do not clearly show presence of this syndrome. These symptoms involve simple cough, bloody cough, fever and infection in lungs. Hypertension in pulmonary artery and hemoptysis are also included in symptoms.

Scimitar Syndrome Causes


Scimitar syndrome is a congenital disease which occurs during fetal development within womb of mother. The exact cause behind this syndrome is still unknown. It may transfer from generation to generation. So it is concluded that occurrence of scimitar syndrome is totally related to family history. If one of the parent is suffering from this syndrome then there are fifty percent chances that it will occur in their baby. Its occurrence is also associated with some hereditary factors. There is no external cause reported behind scimitar syndrome.

Scimitar Syndrome Treatment


In case of blood flow from left to right side and pulmonary hypertension, surgical correction is selected as treatment option. Other treatment options of scimitar syndrome involve Inter-atrial buffer which is created to make the flow towards left atrium instead of pulmonary venous return. There is also an option of implanting anomalous vein directly into the left atrium. The selection of treatment option is totally dependent on the condition of patient and the amount of blood flowing through anomalous vein. The level of shunting from left to right side is another factor affecting selection of treatment.
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Pseudohermaphroditism in Female and Male Symptoms, Causes, Treatment

Pseudohermaphroditism is a term used to describe a condition in which person born with primary sex characteristics of one sex and develop secondary sex characteristics different from what expected. In simple words, person develop a different sex characteristics from one which is expected on the basis of gonadal tissue. This term is different from true hermaphroditism because in true hermaphroditism, person have both male and female sex characteristics i.e. testes and ovaries respectively. It is divided into two main terms on the basis of sexual characteristics. If ovaries are present then it is termed as female pseudohermaphrodite and if testes are present then the term male pseudohermaphrodite is used.

Pseudohermaphroditism in Female and Male Symptoms, Causes, Treatment


Pseudohermaphroditism in Males


Male pseudohermaphrodite involves male gonads in combination with 46 XY karyotype. The male genitalia appear different from usual one because of a hormone named dihydrotestosterone. It is synthesized via testosterone which in turn synthesize with the help of an enzyme i.e. 5 a reductase. When mutation occurs, this enzyme is blocked and there will be no more synthesis of testosterone. As a result structure deformity occurs leading to male pseudohermaphrodite. Men with pseudohermaphroditism develop feminine external sex organs and behaviour which is a clear symptom of male pseudohermaphrodite.



Pseudohermaphroditism in Females


When pseudohermaphroditism occurs in females, it appears with ambiguous external genitalia along with 46 XX karyotype and ovaries. It occurs due to exposure of androgens to developing fetus during 1st trimester of pregnancy. And this exposure have a reason of congenital suprarenal hyperplasia, tumor in suprarenal gland or ongoing androgen therapy in pregnancy. The external appearance of female genitalia involves large clitotis, and scrotum is missing. Sometimes an obliterated vagina is formed in female pseudohermaphroditism. The internal organs of female genitalia i.e. ovaries, vaginal internal structure and fallopian tubes are normal and there are chances of pregnancy.


Pseudohermaphroditism Symptoms


Pseudohermaphroditism is a congenital problem in which person have secondary sex characteristics. People with this condition may have sexual structural deformity and develops an abnormal external genitalia. Patient with pseudohermaphroditism may either have deformed testes or deformed vagina. In rare cases, person may develop a new external genitalia which is the combination of both penis and vagina. In female pseudohermaphrodite vagina may develop with enlarged clitoris and an empty scrotum. Obliterated vagina may form. While in case of male pseudohermaphrodite, penis is not much enlarged and testes are smaller in size than usual. Male patient may suffer feminine behavior and external sex structure.

Pseudohermaphroditism Causes


As it is divided into two main types on the basis of gender. So both the types have different leading causes behind them. In male pseudohermaphrodite, mutation occurs and 5 a reductase is missing. So there is no more testosterone synthesis. Due to this dihydrotestosterone do not synthesize and leads to sexual structure deformity. Well in case of female pseudohermaphrodite, it occurs due to androgen exposure to developing fetus during 1st trimester of pregnancy. Other causes may include congenital suprarenal hyperplasia, androgen therapy during pregnancy or tumor in suprarenal gland.

Pseudohermaphroditism Treatment


The symptoms of pseudohermaphroditism appear at the age of puberty. And when external sexual organs fully grown or mature than a surgery may be performed for the correction of structure deformity of external genitalia. Surgeries in number are performed on intersex people. In female pseudohermaphrodite, only the external structure is deformed but the internal sex organs are proper so mostly women do not prefer surgery because of normal feminine functioning. The intra abdominal testes should be removed via surgery because there is increased risk of tumor formation in abdomen. Hormonal therapy is also effective if treated on time.
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Microangiopathic Hemolytic Anemia Symptoms, Causes, Treatment

Microangiopathic hemolytic anemia which is abbreviated as MAHA is a type of anemia. It occurs when erythrocytes get destructed because of physical shearing. Basically physical shearing occurs when microthrombi in systemic circulation blocks passage of small blood vessels. In microangiopathic hemolytic anemia, there is no problem in blood coagulation but thrombocytopenia accompany MAHA. Microangiopathic hemolytic anemia have two main prototype MAHA’s i.e. hemolytic uremic syndrome HUS and thrombotic thrombocytopenic purpura TTP.


These two prototype continuum disease with different etiology insults. Microangiopathic hemolytic anemia have variety of etiological insults which may be inherited or acquired. But the common cause of microangiopathic hemolytic anemia is blockage of small vessels due to platelet plugging in systemic circulation. This platelet plugging leads to formation of microthrombi in various micro circulation of different vital organs. Shiga Toxin E.coli is responsible for causing hemolytic uremic syndrome.

This toxin damages epithelial cells and results in platelet aggregation. Ultimately microthrombi deposition occur. There are various pathogens which are responsible for causing microangiopathic hemolytic anemia. Not only bacterias but drugs, inherited defects and malignancies may also cause microangiopathic hemolytic anemia. In diagnostic tests, platelet aggregation and thrombocytopenia  confirms presence of microangiopathic hemolytic anemia.

Microangiopathic Hemolytic Anemia Symptoms, Causes, Treatment

Microangiopathic Hemolytic Anemia Symptoms


Microangiopathic hemolytic anemia is a type of anemia and its symptoms resembles all other types of anemia. Common symptoms include physical fatigue, the skin and eyes of patient show discoloration and turn yellow due to lack of oxygenated blood. Urine may also show discoloration and dark colored urine is observed. Physical examination of microangiopathic anemia shows jaundice and conjunctiva usually pale conjunctiva as symptom. When diagnostic results of microangiopathic hemolytic anemia are checked there will be anemia, increased concentration of indirect bilirubin, reticulocyte count increased, haptoglobin concentration decreased, lactate dehydrogenase also increased and increased concentration of urine urobilinogen.

Microangiopathic Hemolytic Anemia Causes


Causes of microangiopathic hemolytic anemia may be inherited or acquired. Basic etiology of microangiopathic hemolytic anemia is blockage of small vessels due to platelet aggregation and thrombocytopenia. If malignancy is the cause identified, then acute myeloid leukemia and mucinous adenocarcinomas may be responsible. During pregnancy, HELLP i.e. hemolysis, elevated liver enzyme and low platelet, placental abrasion and acute fatty liver during pregnancy may be responsible. Other causes include rheumatologic diseases and cardiovascular diseases. Microangiopathic hemolytic anemia may be drug induced and usually drugs involved are immunosuppressants and chemotherapeutic drugs. Other causes of microangiopathic hemolytic anemia involve march hemoglobinuria.

Microangiopathic Hemolytic Anemia Treatment


Microangiopathic hemolytic anemia have two main prototypes i.e. hemolytic uremic syndrome HUS and thrombotic thrombocytopenic purpura TTP. So treatment is selected according to the type. Emergent plasma exchange is performed in case of TTP HUS. It is the 1st line therapy for TTP HUS. For typical HUS, therapy include hemodialysis. Antibiotics are used only when there are chances of sepsis. For thrombocytopenia, anti platelet therapy is recommended. 2nd line therapy involve plasma exchange twice or thrice a day.Corticosteroids are recommended with plasma exchange therapy. Rituximab is prescribed with or without cyclophosphamide.
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Hyponychium Definition, Problems, Overgrowth, Extended, Treatment

Hyponychium is the epithelium which is present just below the free edge of nail plate of nail. It is the particular thickened portion of epithelium. The proximal border of hyponychium have an immediate distal end connected to the distal end of nail bed. The point where distal end of nail bed and distal end of nail plate joins is named as onychodermal. It is a normal physiology of nail that hyponychium extends whenever nail grows and due to this extension, hyponychium is termed as extended hyponychium. It is not a pathological condition, but considered as a part of nail anatomy.



Hyponychium Problems


Hyponychium is the component of nail anatomy, some changes in its shape and morphology may cause problems. Hyponychium may attach closely and firmly to nail edge causing problems. This may occur due to 3 main reasons systemic lupus erythematosus, scleroderma and repetitive use of acrylic nails. Contrary to this condition, hyponychium may get apart from nails and is termed as onycholysis. It may occur due to psoriasis, frequent use of artificial nails, yellow nail syndrome and bacterial infections. Some environmental factors also contribute to onycholysis. Extended hyponychium is another problem if it extends beyond limit. All these problems show distinctive symptoms.

Hyponychium Definition, Problems, Overgrowth, Extended, Treatment

Hyponychium Overgrowth


In hyponychium overgrowth, hyponychium develops beyond limit and attach to nails firmly. This may occur due to poor hygienic conditions and environmental factors. Hyponychium overgrowth creates problems regarding nail cutting. Because overgrowth of hyponychium makes nail cutting difficult. Some dermatological conditions like psoriasis, scaling, eczema and erythroderma may make skin dry and complicate the pre-existing hyponychium overgrowth. People reported that hyponychium overgrowth do not occur on all fingernails. People say that they feel fuller finger buds with overgrowth of hyponychium. Hyponychium overgrowth do not cause any severe problems and can be treated easily with proper hygiene.

Extended Hyponychium


Extended hyponychium is a condition in which hyponychium extends with growth of nails. People with this problem have to cut down their nails and keep them shorter. If people are fond of having longer nails, then they have to follow some tips. As people with extended hyponychium have to apply cuticle oil on it to make it soft. When it becomes soft, it can easily be pressed down and make it on place. It will help a lot. Care is required because a minor cut or sharp touch of stick may cause pain and infections. For this purpose, a specific orange stick is used.

Hyponychium Treatment


All the problems related to hyponychium are not actually problems. People are okay with extended hyponychium and overgrowth of hyponychium and do not require treatment. Some care tips should be followed to manage it. Nail care tools are available in market. Cuticle oil is recommended for extended hyponychium to make it soft and push back to its place.  But if there is any pathological condition behind these, like psoriasis, fungal infection, scaling, eczema and last but not least erythroderma, then treatment is necessary. Treatment is selected according to the leading cause behind extended and overgrowth hyponychium.
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Chondroma Periosteal, Pulmonary, Juxtacortical, Soft Tissue

Chondroma is a rare type of tumor which occurs in cartilage of bone. It is a slow growing tumor. It is composed of cartilage and is totally non cancerous (benign) i.e. does not spread. Benign chondroma is not harmless and distortion of bone may occur via slight compression. In some cases only, it may convert in to cancerous tumor and then it is termed as chondrosarcomas. There are two main types of chondroma tumor i.e. periosteal chondroma and enchondroma. Usually enchondroma tumor occurs in people but periosteal chondroma is rare. Periosteal chondroma may show no symptoms other than pain and slight swelling.

Chondroma Periosteal, Pulmonary, Juxtacortical, Soft Tissue

Periosteal Chondroma


Periosteal chondroma is a rare type of chondroma tumor. It occurs on surface of bone. It does not have a list of symptoms but ends on dull pain and sometimes swelling. It is composed of mature hyaline cartilage. It arises from the surface of bone and the inner layer of periosteum is involved. It does not spread and covers medullary cavity. It is found more cellular than enchondroma. It has only limited symptoms but these symptoms persist for longer duration. It may occur at any age but usually people less than 30 years are more prone to it.



Juxtacortical Chondroma


Periosteal chondroma is also known as juxtacortical chondroma because both of these arises from the surface of bone and core of the bone is not involved. It is present at juxtacortical position of bone and arise from periosteum. It has same features as periosteal chondroma. It mostly occurs in hands and feet. But sometimes it may occur in metaphyseal region of long bones and often appears in proximal humerus. It shows same symptoms as periosteal chondroma shows because of its location. It is usually 3 cm or less. It commonly occurs in males in teen age and after twenties.

Pulmonary Chondroma


It is a rare type of chondroma tumor. It is composed of cartilage and can affect lungs. In lungs bronchus is mostly affected by pulmonary chondroma. It is solitary and can affect both males and females. Carney triad is considered a cause behind pulmonary chondroma. If carney triad is the root cause, then stomach cancer named gastric epithelioid leiomyosarcoma and non cancerous adrenal gland tumor named functional extra adrenal paraganglioma accompany pulmonary chondroma. Symptoms of pulmonary chondroma involve chest pain, cough and fever which may further lead to pneumonia, airways obstruction and other complications.

Soft Tissue Chondroma


Soft tissue chondroma have many synonyms and most common of them is extraskeletal chondroma. It is called as soft tissue chondroma because it occurs in vicinity of bones and joints. It is mainly composed of hyaline cartilage. It usually occur in Middle age people. It appear as lumps at the point of joints in hands and feet especially. Head and neck region is also involved. It is painless type of chondroma. With a simple surgery, people can get rid of these non cancerous benign lumps. Male gender is more prone to this type of rare chondroma.
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Overriding Aorta Symptoms, Causes, Fallot, Treatment

Overriding aorta means aorta is wrongly positioned over a ventricular septal defect instead of ventricle i.e. left ventricle. It is a congenital defect of heart and present in infants by birth. When this condition appears, it results in mixing of oxygenated blood and deoxygenated blood within aorta. Blood mixing occurs because aorta receives some blood from ventricle in overriding aorta. When oxygenated blood get mixed with deoxygenated blood, the oxygen concentration in blood decreases and as a result less oxygen is transferred to body tissues. Overriding aorta is considered one of the four findings of tetralogy of Fallot.



Overriding Aorta Symptoms


Overriding aorta does not occur alone because it is considered one of the four findings of tetralogy fallot. Other findings involve pulmonary wall stenosis, right ventricular hypertrophy and ventricular septal defect. So collective symptoms appear involving discoloration of skin due to less oxygen supply via blood. Skin color turns blue and is known as cyanosis. Tachycardia with rapid breathing. Shortness of breath during exercise. Weight loss and poor weight gain. Irritability, mood swings, murmur sounds of heart. Patient may get tired soon with walk and minor exercise. Clubbing of fingers occur and Shape of nail bed appear abnormal.

Overriding Aorta Symptoms, Causes, Fallot, Treatment

Overriding Aorta Causes


Overriding aorta is a congenital heart abnormality which occurs during fetal development within womb of mother. During heart development, this abnormality occurs and aorta misplaces itself over ventricular septal defect. Other findings of tetralogy of fallot also present with overriding aorta and cause behind tetralogy of fallot is still unknown. There are some factors which can make overriding aorta more complicated and sometimes worse. These factors involve illness due to virus invasion, genetic disorders and poor maternal nutrition. It is a congenital abnormality and any external factor is not responsible for this tetralogy of fallot.


Overriding Aorta Fallot


Basically overriding aorta is the clinical finding of tetralogy of fallot. Tetralogy of fallot have four main findings involving overriding aorta, ventricular septal defect, pulmonary valve stenosis and right ventricular hypertrophy. These four problems occur side by side collectively during fetal development. In pulmonary valve stenosis, narrowing of pulmonary valve occurs. In ventricular septal defect, a hole occurs in the septa (membrane which separates lower two chambers of heart). In overriding aorta, aorta place directly over the ventricular septal defect. In right ventricular hypertrophy, walls of ventricle become thick and stiff due to over pumping of blood.

Overriding Aorta Treatment


There is only one treatment option of tetralogy of fallot i.e. surgery. Surgery is the only solution to this condition. Intracardiac surgery or a temporary procedure is performed. In children and small babies intracardiac surgery is performed preferably. In intracardiac surgery, an open heart surgery is performed to do various repairs. It is performed during 1st year of birth. In temporary procedure, some temporary solution is performed to wide up the veins for good blood flow. These two surgeries are safe and have greater success rate but there are some long term complications which can occur after surgery.
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Risus Sardonicus Meaning, Symptoms, Causes, Treatment

Rictus grin is the other name of risus sardonicus. In this condition, facial muscles constrict in an abnormal way and remain sustained in that texture. Basically it is a muscle spasm occurs near eye and produces grinning. This condition is named so because of its appearance. The eyebrows appear abnormally lifted and an open grin. This grin appears sardonic to a common man. This condition occurs in people suffering from muscle spasm. Risus sardonicus has its roots in mediterranean island present in sardinia.


It is commonly known as a main sign of tetanus. Not only tetanus is its root cause but it can also occur as a result of strychnine poisoning and sometimes due to wilson’s disease. In university of eastern piedmont some workers discovered a plant which is responsible for causing sardonic grin. People with risus sardonicus appear abnormal because of their facial appearance. Contraction of muscles normally occur around eyes leading to small grin eyes and elevated eyebrows.

These are the symptoms of risus sardonicus. Most of its symptoms resemble symptoms of tetanus. Risus sardonicus is also described in various drama serials and movies like sherlock holmes as hero of a famous novel describe risus sardonicus to explain facial features of victim.

Risus Sardonicus Meaning, Symptoms, Causes, Treatment

Risus Sardonicus Causes


Risus sardonicus is considered a main sign of disease named tetanus. As in tetanus, clostridium tetani enters in flesh via wound and start growing. This pathogen leads to release of tetanospasmin and causes stiffness in muscles and muscle spasms. If this spasm occurs in facial muscles then it is known as risus sardonicus. It can also occur as a result of strychnine poisoning and Wilson’s disease. Some workers in university of Eastern Piedmont discovered a plant named Oenanthe crocata which is also responsible for sardonic grin appearance. This sardonic herb was used anciently for ritual killing.


Risus Sardonicus Symptoms


Risus sardonicus is a sign of tetanus in which muscles of face constrict and show spasm around eyes. So due to muscle constriction, eyes appear small in size. Eyebrows get abnormally lifted and grin appearance. People with risus sardonicus look abnormal and sometimes horrible. Muscle spasm may also occur on jawline and neck muscles. If muscle constriction occurs near jaw line, then this condition is defined as trismus. Due to muscle constriction, nerves supplying blood to that area may also got disturbed and change in blood pressure occur. Spasm may hurt sometimes.

Risus Sardonicus Treatment


There is no specific treatment for risus sardonicus but it can be managed with care and medication therapy. As tetanus is counted as a root cause of risus sardonicus, so its treatment involves anti toxins to regulate the toxin named tetanospasmin. Because this toxin is responsible for risus sardonicus. Some antibiotics are also prescribed.
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AV Nicking Hypertension, Symptoms, Causes, Treatment

AV nicking which is also known as arteriovenous nicking is a condition or phenomenon in which a small artery crosses small vein causing vein compression in eye. It is a microscopic phenomenon which can be seen with a microscope only. When artery compresses vein, it results in vein compression and blood pressure increases on either side of vein. This increase in blood pressure leads to bulging of vein which appears prominently in microscopic examination of eye. AV nicking commonly occurs in an eye disease caused by high blood pressure named hypertensive retinopathy. It occurs because both arteriole and venule share a common sheath.



Av Nicking Hypertension


When arteriole crosses venule with its thicker walls it leads towards compression of venule and as a result blood pressure rises on either side of venule. This causes hypertension in eye. The vein bulge out due to hindrance in blood flow and causes hypertension. This hypertension can cause damage to arterioles present in other organs of body like heart, kidney and brain. The phenomenon of AV nicking causes hypertension and on other hand chronic hypertension is the commonest cause of AV nicking. So, AV nicking is closely related to hypertension related diseases.

AV Nicking Hypertension, Symptoms, Causes, Treatment

Av Nicking Symptoms


As AV nicking causes high blood pressure (hypertension). This high blood pressure remains sustain until the problem is solved. So the symptoms of AV nicking resemble symptoms of high blood pressure (if any). Symptoms of AV nicking may involve severe headache, pain in eye, pain in vital organs where hypertension may spread, problem in vision, blurry vision, confusion, vertigo, fatigue, dizziness, difficulty in breathing, irregular heart beat normally tachycardia. There may be blood in urine, pounding at the site, neck, chest and ears. Only few of the above mentioned symptoms occur in case of AV nicking in eye.


Av Nicking Causes


Hypertensive retinopathy is considered the commonest cause behind AV nicking. Research states that venules and arterioles share a common sheath. Arterioles have thicker outer walls as compare to venules. These thicker boundaries compress venule upon crossing. Compression of venule makes it appear in the shape of an hourglass around the arteriole. Some scientists believe that AV nicking does not occur as a result of venule compression but occurs due to sclerotic thickening of venule or due to glial cell proliferation at the site (site at which arteriole crosses venule in eye). These above mentioned phenomenon are the only causes reported till now.

Av Nicking Treatment


AV nicking is related to hypertension so its treatment requires life style modifications to manage hypertension. Along with life style modification, dietary modification is also required to manage high blood pressure problem naturally. If patient do not respond to these natural ways of managing blood pressure then medications are recommended. These medications involve all medicines which are used to control and manage high blood pressure. If it is left untreated, then it can cause further problems in eye like retinopathy, glaucoma and sometimes cause damage to optic nerve leading to vision problems.
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Trichophyton Rubrum Pictures, Symptoms, Causes, Treatment, Life Cycle

Trichophyton rubrum is a fungus (dermatophytic fungus). It belongs to phylum ascomycota of class Euascomycetes. It exclusively colonize in upper most layer of dead skin cells. Trichophyton is responsible for causing athlete foot, nail fungal infection, ring worm appearance and jock itch. Trichophyton rubrum consists of complex of species i.e. morphotypes which are geographically patterned. Mostly of them are described as distinct taxa. like T. Megninii, T. Raubitschekii, T. Soudanence, T. Gourvilii. It is the common cause of dermatophytosis all over the World. Dermatophytosis occurs on skin of feet, and between finger nails. This fungal disease appear in various colors.



Trichophyton Rubrum Symptoms


Trichophyton rubrum causes fungal infection named dermatophytosis. It occurs on the skin of feet and in between finger nails. It may appear in different shades like white, brown, yellow and red. It also have different texture like it may be waxy, smooth or cottony in texture. Dermatophytosis can be observed easily but its accurate diagnosis is very difficult because of its appearance. Trichophyton rubrum can cause athlete foot, ring worm, jock itch and nail fungal infection. So all these conditions show different symptoms according to their texture, site of infection and color of appearance.

Trichophyton Rubrum Pictures


Trichophyton Rubrum Pictures, Symptoms, Causes, Treatment, Life Cycle


Trichophyton Rubrum Causes


Trichophyton rubrum is the main and only cause of dermatophytosis. It is not a life threatening infection. The pathogen i.e. trichophyton rubrum have the ability to secrete and produce proteolytic enzymes which are proved more virulent. Trichophyton rubrum enters in to skin via degrading the keratin of skin. Keratin is a fibrous protein present mainly in skin. Trichophyton rubrum invades through stratum corneum which is the skin outer most layer of epidermis. As a result, dermatophysis occurs in the form of athlete foot, jock itch, fungal infection between fingers and finger nails. It is a painful disease.

Trichophyton Rubrum Treatment


Trichophyton rubrum causes skin fungal infection. It occurs on foot basically so treatment is selected on the basis of severity. Topical medications are used which involve anti fungal agents like miconazole nitrate, clotrimazole, terbinafine hydrochloride, tolnaftate, undecylenic acid and butenafine hydrochloride. Ketoconazole is highly recommended in oral dosage form for severe skin disease. Long term use of ketoconazole in oral dosage form is not recommended because it can harm liver due to its 1st pass effect. Photodynamic treatment, laser treatment, activation of rose bengal dye with light specially by green laser light. Fingernail infection will take about 6 to 8 weeks to fully recover.

Trichophyton Rubrum Life Cycle


Trichophyton rubrum causes skin infection named dermatophytosis. This pathogen can survive in in-vitro conditions i.e. outside the body. Outside the body it exists in the form of a spore. Trichophyton rubrum lets spores desquamate and this is the reason it remains over full in most of the human habitat. This pathogen shows growth in moist conditions that's why it readily grows on skin surface. With moisture, warm conditions are also necessary. It spread with normal flora on stratum corneum of epidermal layer which is the upper most layer of skin.
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Bronchogenic Carcinoma Symptoms, Causes, Prognosis, Treatment

Basically lung cancer is known as bronchogenic carcinoma or bronchogenic carcinoma is considered as an origin of lung cancer. As the name indicates, it is the cancer i.e. carcinoma which occurs in bronchi of lungs i.e. bronchogenic. Bronchi are the largest airways of the lungs. Bronchogenic carcinoma have two main types 1st one is small cell lung cancer and 2nd one is non small cell lung cancer. In small cell lung cancer, cells are observed under microscope and in non small cell cancer, cancerous cells are bigger in size and further divided into large cancerous cells, squamous cell carcinoma and lung adenocarcinoma.



Bronchogenic Carcinoma Symptoms


Symptoms of bronchogenic carcinoma resemble symptoms of other lung cancers. Symptoms of brochogenic carcinoma are related to cancer cell growth in bronchi.  Commonly bronchogenic carcinoma shows blood in cough, airways get obstructed due to tumor and lead to recurrent pneumonia and persistent cough. Now a days lung adenocarcinoma (a type of bronchogenic carcinoma) is found to be most common lung cancer. It is present in about 40 to 50 percent of cases of lung cancer. So symptoms regarding lung adenocarcinoma are frequent weight loss, weakness, fatigue and shortness of breathe specially when patient do workout or exercise.

Bronchogenic Carcinoma Symptoms, Causes, Prognosis, Treatment


Bronchogenic Carcinoma Causes


It is a common awareness that smoking leads to lung and mouth cancer because of presence of tobacco in cigrette. Other than cigrette, there may be many other causes behind like exposure to radioactive materials. Radon exposure is considered a second leading cause of lung cancer in people who are chain smokers but in case of non smokers, it is considered number one leading cause of lung cancer. Pollution in air may also cause lung cancer. People who keeps company of chain smokers can suffer from lung cancer. Carcinogenic material inhalation is another cause of bronchogenic carcinoma


Bronchogenic Carcinoma Prognosis


Unfortunately, bronchogenic carcinoma have poor prognosis. Survival rate is very low that small no. Of people survive with lung cancer. People with bronchogenic carcinoma survive only 5 years. Only a few people (almost 17 percent) with lung cancer survive more than 5 years. Prognostic data varies according to the type of lung cancer and stage of cancer. Chances of survival at early diagnosis of 1st 2 stages are greater. Treatment of lung cancer is still improving for increased survival rate. Chemotherapy is improving day by day to make it more effective even at 4th stage. As 4th stage is deadly stage and no one recover from that stage.


Bronchogenic Carcinoma Treatment


Treatment option is selected on the basis of several factors. These factors involve stage of cancer and type of lung cancer. Diagnosis is really important in selecting treatment. Diagnosis will confirm the type and stage of lung cancer. People who take treatment i.e. chemotherapy and also take care of their health by following precautions have greater survival rate. Other than chemotherapy, surgery of target cancer site, targeted therapies and immunotherapy are involved. Radiation therapy is least recommended because it do harm healthy cells too and can make patient more ill.
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Capillary Refill Time, Sacle, Test, Normal, Slow

Capillary refill is returning of color to an external capillary bed e.g. finger tips. Color returns to capillary bed after blanching (pressure applied). It is done by holding hand above the level of heart and pressing the soft tip of finger with other hand. Pressing should be much hard that skin color turns white. After that pressure is released and check time in which color of finger recovers. It is known as capillary refill. It is a diagnostic test which is performed to check amount of blood flow and dehydration in patients. Basically time of capillary refill tells about problems in heart flow and dehydration.



Capillary Refill Time


Capillary refil time is the time required for refilling capillaries. It is checked by holding hand above the level of heart and pressing the soft bud of fingers and finger nails and then slightly release pressure. Then start recording time that takes to refill capillaries of finger bud. The stopwatch is started when pressure is released and stop recording when color of finger bud recovers. Average time of capillary refill is 2 to 3 seconds. In new born, sternum is pressed for 5 seconds with finger to check capillary refill time.

Capillary Refill Time, Sacle, Test, Normal, Slow

Capillary Refill Test


Capillary refill is basically a test which is performed to check pressure of blood and volume of blood flow. It also check level of dehydration. It is a quick test and also known as nail blanch test. In this test a minute pressure is applied on soft bud of finger or finger nails while keeping hand above the level of heart. Slowly release pressure and calculate time in which finger bud or nail gets pink color again. The normal time recorded is 2 to 3 seconds. If more time is recorded, then it shows dehydration, hypothermia, shock and peripheral vascular disease (PVD).


Capillary Refill Scale


Capillary refill test have a scale with readings 1 to 10 seconds. Average capillary refill time is 2 seconds and sometimes 3 seconds is also recorded. It is normal. But if capillary refill time exceeds 3 seconds, then it indicates the presence of an abnormality. If more than 2 seconds capillary refill time is recorded then there may be dehydration, hypothermia, peripheral vascular disease PVD and shock. So this scale helps a lot in diagnosing some major diseases related to heart. If more than 5 seconds are recorded, then patient is in danger and require quick aid.


Normal Capillary Refill Time


Normal capillary refill time means blood take 2 seconds of time to refill capillaries of finger bud or finger nail which were pressed by keeping hand above the level of heart. 2 seconds are normal but if this time exceeds, then it indicates the presence of any abnormality. 2 seconds of capillary refill time shows normal blood pressure and normal volume of blood flow. It also shows good condition of heart activity. It is a quick  and easy test can be easily performed at the spot. No instruments are required.


Slow Capillary Refill Time


Slow capillary refill time means blood takes longer than 2 seconds to refill capillaries of finger soft bud or finger nails which were pressed slightly by keeping hand above the level of heart. More than 2 seconds of capillary refill time means there is an abnormality like dehydration, stroke, hypothermia and peripheral vascular disease. When these problems exist, it hinders the flow of blood towards the site. It indicates low blood pressure and low volume of blood flow moving in veins. When slow capillary refill time is observed, patient need further tests and treatment according to diagnosis.
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Jacksonian Seizure Definition, Symptoms, Causes, Treatment

Jacksonian march is another term used for jacksonian seizures. Jacksonian seizure is a specific type of epilepsy. In this type, seizures occur due to movement or progression of seizures in a specific region of brain and leads to marching of nerves causing seizures. It is a brain disorder associated with small changes in body movements and abnormality in sensory actions and abnormality in electrical impulses conduction. Primary motor cortex is a part of brain from which abnormality in electrical impulses is initiated.


This part of brain (primary motor cortex) have a special characteristic that these electrical impulses pass from this region quickly and effecting all corresponding muscles present in that region. Jacksonian seizures is a type of epilepsy, so its symptoms will correlate with symptoms of epilepsy. Main symptoms involve unintentional limb movement, head turning and some uncontrollable movements. Numbness and tingling are common.

These seizures spread locally in a specific confined area. Patient sometimes become unconsious. Jacksonian seizures are a type of simple partial seizures where simple means patient do not go unconscious and can be in senses and partial means seizures occur in only one part of brain. So it means in jacksonian seizures, patient remain in senses and feel seizures in one side of brain only.

Jacksonian Seizure Definition, Symptoms, Causes, Treatment


Jacksonian Seizure Symptoms


There are two main symptoms which shows the presence of jacksonian seizures. One of them is occurrence of seizures in one part of brain only while patient is not unconscious and second one is its spreading “march action” i.e. it spreads in a specific pattern within minutes. For example if seizures initially occur in a finger, then it may spread to whole hand within minutes like a march. Other symptoms involve muscle cramping, numbness, hallucinations, head turning, migraine, crawling skin sensations, automatism, capsular warning syndrome and last but not least stroke.

Jacksonian Seizure Causes


There are some defined causes behind jacksonian seizures and one of them is mutiple sclerosis. Age is another main cause and risk factor of jacksonian seizures. People above 65 years of age are at greater risk of jacksonian seizures. Other causes that may lead to jacksonian seizures include any kind of head injury or accident, lesion or injury at frontal lobe of brain like atriovenous malformation and reduced or lack of oxygen supply to cells of brain. Due to low b.p, oxygen supply is limited or reduced leading to various problems like epilepsy or seizures.

Jacksonian Seizure Treatment


Treatment option include surgery and medication therapy which is selected on the basis of leading cause and severity of seizures. If seizures are mild, then treatment is not necessary. surgery is preferred when an injury occur to brain specially frontal lobe. Other wise medication therapy is recommended for treating jacksonian seizures. Common anti seizure medications which are recommended include clobazam, zonisamide, topiramate, phenytoin, carbamazepine, divalproex sodium, valproate and vitamin B6 i.e. folate in the form of folic acid. If there is a tumor present in brain, then surgery is preferred to remove that tumor.

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Lisch nodules Pictures, Symptoms, Causes, Treatment

Melanocytic iris hamartomas is another term used for lisch nodules. Lisch nodules is an ocular disease in which hamartomas appear in iris like a sharp appearance. These hamartomas are soft or smooth masses which appear on stromal surface. These hematomas consist of spindle cells which have melanocytic origin. Lisch nodules were named after a scientist named Karl Lisch who 1st recognized them. This condition of eyes is related to severe condition of skin freckles and café-au-lait spots.

Lisch nodules are considered the commonest type of ocular involvement neurofibromatosis NF and said to be neurofibromatosis type 1 NF type-1. These hamartomas are clear yellow to brown in color. It appears as dome shaped elevations on surface. Lisch nodules are not microscopic and can be seen with naked eye. It is also reported that these lesions (hamartomas) have blurred margins. These nodules do not cause any further complication. Lisch nodules are most commonly found in adults above 20 years of age. Lisch nodules have some specific characteristics as follows:


  • Specific for NF-1
  • These nodules appear in 1st decade
  • All people with NF-1 virtually have lisch nodes at the age of 20. 
  • These are benign hamartomas histologically resemble to iris nevi.

Lisch nodules Pictures


Lisch nodules Pictures, Symptoms, Causes, Treatment



Lisch nodules Symptoms


Signs and symptoms are mild to moderate in appearance but these signs and symptoms may vary in severity cases. Common signs and symptoms are as follows:

  • Along with lisch nodules some flat and light brown in color spots appear on skin surface which are known as cafe au lait spots. These spots if more than 6 is considered as a strong indication for lisch nodules.
  • Freckles occur in groin area and armpits. These are smaller in size than café au lait spots. 
  • Small bumps on iris, minor and soft bumps appear on and under skin surface.
  • Patient face learning disabilities. 

Lisch nodules Causes

       
As lisch nodules is the type of neurofibromatosis which is caused by mutation in genes i.e. genetic defects. Specific genes are involved in it. These mutated genes are either passed on by parents or occur later. NF 1 gene is involved which is present on chromosome no. 17. Neurofibromin is a protein which is produced by NF 1 gene. This protein helps in regulation of cell growth. When mutation occur in NF 1 gene, it leads to loss of that protein named Neurofibromin. Due to absence of Neurofibromin, cells grow abnormally and uncontrollably.


Lisch nodules Treatment

       
There is no treatment for lisch nodules but signs and symptoms can be cured with proper treatment. Regular monitoring is required for complete and better outcome. If symptoms become severe then surgery is recommended. Tumors are removed by surgical procedure which might be compressing other cells around them. Stereotactic radiosurgery is another treatment option to treat tumor. In stereotactic radiosurgery, radiations are used to remove tumors and incision is not required. Auditory brainstem implants and cochlear implants are also performed. Some pain medications are also prescribed like amitriptyline which is a tricyclic anti-depressant, gabapentin or pregabalin for nerve pain.
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