Disease and the cure

Clinical Picture and Treatment of Guillain Barre Syndrome

2013-08-31T13:11:00.000-07:00

A cute infective polyneuritis

"Landry Guillain Barre Syndrome"

Aetiology:

It is due to an allergic or auto-immune reaction secondary to a previous non-specific virus infection.

Clinical picture:

Febrile stage:

it starts with an influenza-like attack with fever, headache, malaise, pains all over the body with no nervous symptoms.

Latent stage:

the above symptoms disappear and the patient is free for 1-4 weeks.

Paralytic stage:

There is acute severe weakness or paralysis starting in the loewr limbs and ascending to involve the trunk and respiratory muscles, followed by the upper limbs muscles.
Contrary to other types of polyneuropathy, the weakness is proximal more than distal.
In spite of severe degree of paralysis, wasting is not present early in the disease.
Sensory impairment may occur resulting in stock and glove hypothesia and deep sensory loss.

Early in the disease there is tenderness of the calves.
The cranial nerves are usually involved specially cranial nerves 7,10 resulting in bilateral facial paralysis and bulbar symptoms.
C.S.F. show cytoalbuminous dissociation.
Prognosis is good in 85% of the cases where recovery occurs in 3-4 weeks.

Treatment:

1)Absolute rest in bed till the heart rate reaches below 100/min.(i.e. return of the vagal tone).
2)Care of the bulbar muscles by:

Frequent suction of secretions feom the pharynx.
Neostigmine 1 mg hourly I.M.
Tube feeding in case of phayngeal paralysis.

3)Care of the respiratory muscles by:

Frequent suction to keep a patient airway.
Tracheostomy may be needed.

4)Corticisteriods(Prednosone or Prednisolone 60 mg/day).
5)Gamma-globulins and plasmapheresis:

the most recent and effective treatment.

6)Vitamins B1,B6,B12(Trivarol,Tri-B),I.M. daily.
7)A.T.P. 25 mg daily I.M.(Adenoplex).
8)Antibiotics e.g. tetracycline to guard against 2ry infection.
9)Physiotherapy:

Massage.
Passive and active exercises.
Proper positioning and electrical stimulation.

vitamin B complex deficiency"Pellagra"

2013-08-31T12:54:00.001-07:00

Pellagra

Definition and Aetiology:

This is a multiple deficiency disease due to vitamin B complex deficiency specially niacin;
this may result from:

Deficient intake of vitamin B or of proteins of high biological value (containing nicotinic acid or its precursor tryptophan).
Deficient absorption as in gastro-enteritis.
Parasitic infestation.

Clinical picture:

1)Cutaneous manifestations:

They start as a bilateral and symmetrical dermatitis followed by hyperkeratosis(rough, scaly and desquamated skin) and pigmentation.

The lesions involve the exposed areas(face, neck, dorsum of the hands and feet) and over bony prominences(trochanters, elbows, knees, heels)

2)Gastro-intestinal manifestations:

Mouth: stomatitis, glossitis with atrophy of the papillae(glazed tongue).

Stomach: dyspepsia, nausia, vomiting, epigastric pain.
Intestines: colic, diarrhoea.
Hepato-splenomegaly may be present.

3)Neuropsychiatric manifestations:

Peripheral neuropathy mainly sensory due to peripheral nerves degeneration.
Paraplegia or quadriplegia(systemic paraplegia) due to pyramidal tract degeneration(pellagral lateral sclerosis).
Mentality changes as anterograde amnesia, depression, dementia and suicidal tendencies due to cerebral cortex degeneration.

Treatment:

Treatment of the cause e.g. parasitic infestation or gastro-enteritis.
Good diet, rich in animal proteins and vitamins.
Vitamin B complex(the cheapest source is yeast) iron supplement(to correct anaemia).
Nicotinamide 500 mg I.V. daily in severe cases, followed after improvement by 200 mg daily I.V. for 2 weeks; maintenance dose 100 mg t.d.s. orally.

Non-pharmacological management of Orthostatic Hypotension

2013-08-31T08:26:00.000-07:00

Orthostatic Hypotension

Definition:

A systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing.

Causes:

Nervous system diseases, such as a neuropathy.
Prolonged bed rest.
Dehydration.
Irregular heart beat(heart arrhythmia).

Symptoms:

Dizziness.
Weakness.
Blurred vision.
Fatigue.
Fainting.

Treatment options:

Treatment for hypotension depends on the cause. For example, the dosage of existing medications may need to be altered, or a bleeding stomach ulcers surgically repaired.If no particular cause can be found, drugs may be used to raise blood pressure . In extreme cases, a lower body pressure suit may be required.

Management:

Non-pharmacologic management:

Slow changes in position.
Stockings: to increase venous return / decrease lower extremity pooling.
Temperature: avoid extremes.
Activities:

                          1.Dorsiflexion several times before standing.
                            2.Before rather than after a meal.
                              3.Afternoon rather than morning.
                              4.Swimming pool.
                            5. Avoid heavy lifting.

Night time: slight elevation of head of bed.
Meals normalize salt and water intake.

Pharmacologic management:

Fludrocortisone:

Mechanism: sodium retention.
Midodrine:
Mechanism: alpha-l-adernoreceptor against increase peripheral vascular resistance.

Degenerative Disorders(Lumbar Disc Prolapse)

2013-08-28T15:06:00.001-07:00

Degenerative Disorders

"Lumbar Disc Prolapse"

Definition:

It is herniation of nucleus puposus of the intervertebral disc through a tear in the annulus fibrosus.

Incidence:

Age:- mostly middle age.
Commonest level L4/L5 followed by L5/S1.
Lumbar disc prolapse:- cervical disc prolapse 4:1.

Aetiology:

Trauma:- lifting heavy objects.
Degeneration:-causing weakness of annulus fibrosis.
Both of the above.

Pathophysiology:

1)Stages of lumbar disc herniation:

Tearing of the ring of annulus fibrosis.

Protrusion of the disc against neural structures.

Extrusion of nucleus pulposis in the neural canal.

2)Direction of the cervical disc prolapse:

Posterolateral>>>root compression>>> sciatica(most common).
Posterior>>> thecal compression>>> cauda equina(in the cervical region posterior protrusion>>> spinal cord compression i.e. myelopathy.

Clinical Picture:

1)Related to stretching of annulus fibrosis:

a)back pain for several weeks or years before leg pain.
Pain increase with straining, coughing, sitting or standing for a long time and leaning forward.
Improves by bed rest.

b)Spasm of paravertebral muscle limits spinal mobility to reduce pain.

2)Related to neural compression:

a)In posterolateral disc herniation:
1)Sharp lancinating leg pain occurs along one of the dermatomal supply of the lower limbs. It is increased and decrease by the same factors mentioned with back pain.
Pain is called sciatica when it occurs along the distribution of the sciatic nerve.
Pain is called femoralgia if a long the distribution of the femoral nerve.
2)Numbness and parethesia may occur.
3)Motor weakness.
4)Straight leg raising test(Lesegue's sign). w hile the patient in the supine position, raising the leg less than 60 degrees>>> elicits the pain, Dorsiflexion of the foot while the leg is elevated aggravates the pain.

b)In posterior herniation(Cauda equina syndrome):
1)Sensory
a. Saddle anaesthesia.
b. Sciatica and low back pain.
2)Motor:

weakness e.g. foot drop.
3)Autonomic:
a. Sphincteric disturbance.
b. Sexual dysfunction.

Differential Diagnosis:

1)Osteoarthiritis of the hip joint:

This can be differentiated by faber test which is Flexion, Abducion, External rotation of the hip.This usually increases pain originating from hip joint.

2)Sacroiliitis:

There is tenderness on the sacroiliac joint and pain does not extend below the knee.

3)Spondylolithesis:

Is anterior subluxation of a vertebra on another.Most commonly at L4/L5 and is due to degeneration of the facet joints.
Back pain is significant. Sciatica, if present, is usually bilateral. X-ray is diagnostic.

4)T.B of the hip joint(rare).

Investigation:

1)MRI:

Is the modality of choice.
Demonstrates the prolapsed disc and any canal stenosis.

2)X-ray(A-P and Lateral)

Has a limited value in diagnosis of lumbar disc. It shows a reduced disc height& osteophytes.
On the contrary it is very useful in

                                                           Spondylolisthesis
                                                            Detects spina bifida
                                                           Detects secondary tumros

3)CT scan is useful but to a less degree than MRI.

4)Myelography is invasive and no longer used.

Treatment:

Conservative(succeeds in 90% of cases):

Bed rest for 2-4 weeks. Boards are placed under mettress.
Analgesics.
Muscle relaxants.
Weight reduction is advisable.

2)Surgical

Indications of surgery:

Failure of conservative treatment.
Intolerable pain in spite of initiation of conservative treatment.
Progressive motor weakness.
Cauda equina syndrome.

Type of surgery:
1)Discectomy: different approaches are used:

After laminectomy or hemi laminectomy.
Interlaminar.
Microscopic.
Endoscopic.
Laser.

2)Chemonucleolysis in some cases.

N.B.

In surgery we remove L4 lamina to gain access to L4/L5 disc which causes compression on L5 root.

Degenerative Disorders (Cervial Disc Prolapse)

2013-08-26T13:36:00.002-07:00

Cervical Disc Prolapse

Back ground:

The cevical spine is very mobile and is liable to osteoarthiritic changes(cervical spondylosis). This affects more than 50% of people above 50 years.
20% of those affected develop symptoms.

Definition:

It is herniation of nucleus puposis of the intervertebral disc through a tear in the annulus fibrosis.

Aetiology:

Degenerative is the most important(spondylosis).
Traumatic is less important.
Both.

Pathophysiology:

Two clinical types of cervical disc prolapse are known: soft disc& hard disc(spondylosis)
The stages are

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       Soft Disc                                                         Hard Disc
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Laceration of annulus fibrosis                     Instability(degeneration)
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Protrusion of nucleus pulposis           Osteophytes formation+_compression

Directions of the cervical disc prolapse:

Posterolateral>>> root compression>>>Radiculopasy.
Posterior>>> spinal cord compression>>> Myelopathy.

Clinical Picture:

1)Related to annulus tearing or spine degeneration and instability:

Neck and interscapular pain of referred type.
Spasm of muscles>>> straight cervical spine.

2)Related to neural compression:

A)IN posterolateral disc herniation:
1)Sensory:

Radicular pain(Brachialgia):which is asharp lancinating pain radiating along one of the dermatomes of upper limbs.
Numbness and paresthesia.

2)Motor(lower motor neuron lesion)

Motor weakness and muscle wasting and fasciculation.

3)Autonomic:

Negligible.

B)IN posterior disc herniation(Myelopathy):
Sensory

Numbness and paresthesia below the level of lesion.
Lhermitte sign:Electric like pain radiating down the spine provoked by neck flexion.

Motor(upper motor neuron lesion):

Hpertonia.
Hyperreflexia.
Weakness of lower limbs.
Babiniski sign.

Autonomic

Precipitancy of urine.

Differential Diagnosis:

Amyotrophic lateral sclerosis(mixure of upper and lower motor neuron lesions).

Investigation:

1)MRI:

Is the modality of choice.
Demonstrates the prolapsed disc and any canal stenosis.

2)X-ray(A-P and Lateral)

Has a limited value in diagnosis of lumbar disc. It shows a reduced disc height& osteophytes.
- On the contrary it is very useful in

Spondylolisthesis
Detects spina bifida
Detects secondary tumros

3)CT scan is useful but to a less degree than MRI.

4)Myelography is invasive and no longer used.

Treatment:

1)Conservative:

Neck collar and traction.
Analgesics
Muscle relaxant.

2)Surgical:

Indications of surgery:

Failure of conservative treatment.
Intolerable pain in spite of initiation of conservative treatment.
Progressive motor weakness.
Cauda equina syndrome.

Surgical procesures

1)Soft disc:

Discectomy by anterior approach via incision.

2)Hard disc:

Discectomy by anterior approach via neck incision+removal of the osteophytes+fusion of vertebrae by a bone graft.

Milk and Medications For Treatment of Hypertension

2013-08-25T13:26:00.002-07:00

Hypertension
"A Silent Killer"

Definition:

Persistance elevation of arterial blood pressure above normal limit under normal basal condition.

Symptoms:

Hypertension is called silent killer because it rarely causes symptoms.when blood pressure is very very high, these symptoms may occur:-

Headache.
Nosebleeds.
Palpitations.
Dizziness.
Numbness or tingling in the hands or feet.
Confusion.
Blurred vision.
Vomiting.

Management:

STEP 1

The four main choices for initiating therapy of essential hypertension(HTN):
A)Diuretics.
B)Beta adrenergic blockers.
C)Calcium channels blockers.
D)Angiotention converting enzyme.

A)Diuretics:

Effective alone or adjunct to other antihypertensives.
Considered as(prefferd) starting agent for most patients, and an impotant part of multidrug HTN therapy.

>>>>The diuretic chioces for HTN:
Thiazides(oral diuretics)used most _prototype is hydrochlorothiazide:

ACTION:-

Modest renal Na+ loss seems ti decrease vascular responsiveness to vasoconstrictors such as norepinephrine, peripheral vascular resistance falls.
Reduction of circulating fluid volume(diuresis) probably contributes to initial antihypertensive action in some patients, however the diuretic effect is usually short-lived but blood pressure control usually persists.
Flat dose-response curve : markedly insrease antihpertensive effect(but often does increase number, severity, of side effects).

Main side effects:-

Hypokalemia (Thiazides are potassium-wasting).
Risk of hyper uricemia, gout(Thiazides elevate serum urate).
Hyperlipidemias, hyperglycemia:
thiazides increase blood lipids and glucose, yet these drugs shouldn't be absolutely avoided in patients with hyperlipidemias and/or frank diabetes mellitus.
Risk of hypovolemia(a particular concern in pregnancy: maternal volume depletion may>>> hyoperfusion of placenta)
Loop agents(e.g. furosemide__LASIX); NOT often a chioce for HTN , rarely chosen goal is to use diuretic for uncomplicated HTN.

B)Beta-blockers (e.g. propranolol; INDERAL)

All orally effective B_blockers are approved for HTN.

Action:-

Reduce cardiac contractility.
Reduce renin release.

Uses:-

Effective alone or as adjunct(mainly to inhibit reflex tachycardia caused by some other antihypertensives).
May be preffered for patients who also have angina (not vasospastic),tachycardia, myocardial infarction,hyperthyroidism, migraines.
Reduction exercise tolerance may take these less than ideal chioce for some patients who are very physically active.

Contraindication:-

Asthma, emphysema.
Insulin-dependant diabetes mellitus.
Atrio-ventricular block or bradycardia.
Vasospastic angina.
Severe congestive heart failure.
Peripheral arterial disease.

N.B.

B_blockers raise serum triglyceride levels and lower HDL.
Discontinuing B_blockers Tx:

never stop abruptly(to avoid risk of rebound increase heart rate).

C)Calcium channels blockers:

Block slow voltage gated (L-type) Ca channels >>> decrease calcium influx to heart, blood vessels.

Types:-

1)Nondihydropyridines:Prototype verapamil(ISOPTIN):

Action:-

Reduce contractility.
Reduce vasoconstriction(i.e. cause vasodilatation).

Uses:-

Mainly as alternative to B-blocker, antoanginal& antiarrhythmics as well.

Side effects:-

Contipation is most common side effect.

Contraindication:-

any situation in which depression of cardiac contractility, rate, automaticity, impulse conduction, would be dangerous(never combine with B-blocker).

2)Dihydropyridines: prototype nifedipine(ADALAT):

Selective vasodilator.
No verapamil-like cardiac depression, thus...
Might be chosen when cardiac depression from anondihydropyridine is to be avoided, or when the mild cardiac "stimulation" from dihydropyridine might be beneficial(e.g. concomitant bradycardia).
Produces ankle edema.

D)ACE inhibitors (and other angiotensin"modifiers"):

Propotype ACE inhibitor is captopril(CAPOTEN).

Actions:-

Inhibit Angiotension 2 synthesis(hence consequent vasoconstriction and aldosterone release).
Inhibit breakdown of bradykinin, avasodilator(ACE = bradykininase).

Uses:-

Hypertention:

often cosidered suitable for hypertensive patient who also has congestive heart failure|(CHF) and/or diabetes mellitus w/o evidence of severe kidney diseases, and/or hyperlipidemia.

Tx of CHF.
Help delay progression of renal disease in patients with diabetic neuropathy.

Side effects:-

Most common : cough esp. with captopril(due to bradykinin)
Taste loss; allergic skin rash; drug fever.
Rare but serious: angioedema(to bradykinin).
May lead to excessive hypotention when used with diuretics(synergistic effects).
Aldosterone levels may indirectly>>> hyperkalemia, so K-sparing diuretics or oral K supplements cautiously.
Acute renal failure (in patients with bilateral renal artery stenosis).
Proteinuria with captopril.

Contraindications:-

Bilateral renal artery stenosis >>> acute renal failure.

Angiotensin 2 receptors blockers (ARBs):

>>>prototype Losartan(COZAAR):

Alternative to ACE inhibitor, fewer/no typical ACE inhibitor side efeeccts (e.g. cough&angiodema)
Action:-
only block A-11 receptors(>>>decrease mediated vasoconstriction and decrease aldosterone release.
Lack effects on bradykinin metabolism.
Share same pregnancy contraindication as ACE inhibitors.

STEP 2

Alternative initial agents(sympathetic inhibitors)

A)selective peripheral alpha-blockers:

Prazosin:

Actions:-

Block sympathomimetic-induced vasoconstriction in periphery via postsynaptic(alpha-1)blockade, with no effect on presynaptic alpha-receptors(alpha-2)
Usually 2nd line, but may be turned to as first choice in some cases e.g. patients with:
Hyperlipidemias.
Benign prostatic hypertrophy, as smooth muscle relaxing effect in GU tract(also due to alpha-blckade).

Side effects&Contraindication:-

Most important:Orthostatic hypotention(first dose faint effect)
Long term hypotention may trigger

Reflex tachycardia(may need to add B-blocker to control it)
Compensatory renal Na retention(may need diuretics).

B)Centrally acting Alpha-Agonist: Clonidine(Catapress)

Actions:

Central alpha-2 agonist reduces "sympathetic outflow" to periphery (e.g. to blood vessels& heart).

Side effect & Contraindications:-

Sedation, dry mouth and impotence(in men)common.
Little or no reflex tachycardia.
Danger: rebound increase blood pressure and heart rate with abrupt discontinuation; never stop abruptly

Related drugs:

Methyldopa(ALDOMET)
Preferred drug for managing HTN during pregnancy.
Risk of hepatotoxicity.

C)Catecholamine Dopletor: Reserpine(Serpasil)

Actions:-

Depletes peripheral neuronal norepinephrine>.>decrease vasoconstriction and heart rate.

Uses;-

mainly when any of above drugs are ineffective (even in combination) or high cost is factor, otherwise this drug is seldom used.

Side effects&Contraindication:-

Bradycardia,possible CHF.
Peripheral autonomic: parasympathetic predominance,not used in peptic ulcer.
CNS: fatigue,drowsiness, suicidal depression,parkinsonism.

STEP3

Hydralazine:oral administration

Actions:

Direct acting vasodilator(dilate arteries& not veins)
Relatively rapid response.

Uses:-

For HTN when Step 1/2 drugs ineffective
After load reduction for severe CHF .

Side effects,need for adjuncts:

Reflex tachycardia(may necessitate B-blocker).
Renal Na retention(might have to add diuretic).
Lopus like syndrome(facial "rash"; joint pain, fever, characteristic blood tests)
Peripheral neuritis(hydralazine interferes with vitamin B6 metabolism).

Related drugs:

Minoxidil:-

Seldom used because of side effects (only in life threatening severe hypertention),used topically in Tx of hair fall.

Side effects of Minoxidil:-

Hirsutism
Tachycardia
Fluid&salt retention
SO used with B-blocker and diuretic.

STEP4

Other oral antihypertensives:(RARLY USED)

Mao inhibitors
Guanethidine(acts like reseprine that also>>> mor complete NE depletion than reseprine).

Importance of MILK in Treatment of Hypertension:

recent studies at the "American Heart Association's" and confirmed that addition of milk a few calories to the diet reduces the risk of developing high blood pressure, and proved that drinking milk for long periods of time decreases their systolic blood pressure, so decreasing the likelihood of hypertension in the future. In previous studies were detected multiple health benefits of eating yogurt repeated with regard to maintaining the body mass index (BMI) and body weight.

Milk consists of a high concentration of calcium and other essential nutrients easily be affixed to the daily diet, is also a source of protein and imparts a feeling of fullness for a longer period of time.

Underwent the study of nearly 2,000 volunteers proven safety diagnosed with high blood pressure at the beginning of the study, which lasted for 15 years during which fill a questionnaire to three times to check their consumption of milk, and the results confirmed the decreased likelihood of developing " high blood pressure" for approximately 31% of the volunteers were a daily consumption of milk for at least 2% of daily calories equivalent to 4.53 g of low-fat yogurt every three days as the rate of high systolic blood pressure decreases compared to those who did not rely milk part of their daily diet.

Contribute to a diet with few calories and physical activity in reducing the incidence of chronic diseases such as high blood pressure, which causes delay in treatment in the damaged arteries and torn and works as a network picks up cholesterol and moves through the bloodstream to accumulate on the vascular wall.

Prophylaxis and Treatment of Gout

2013-08-25T12:54:00.001-07:00

Gout

" Kings disease"

Definition:

Gout is a metabolic disease charactrized by recurrent episodes of acute arthiritis due to depositis of ureate crystals in joints and cartilage. it is usually associated with high serum levels of uric acid.

Smptoms

Gout causes sudden severe pain, and is usually at the base of the big toe, but it may affect another joint, especially joints damaged by other conditions such as osteoarthritis inflammation.

It can affect lobe of ears and skin surrounding the joint, especially the joints of the fingers or the back of the heel

The symptoms begin with sharp pain in the affected joints with swelling and redness around it,and these symptoms may be associated with high temperature (fever)and in most cases these crises occur in the evening, but the symptoms go away permanently within a week or more to re-appear again at intervals over several weeks or months or years.

Aim of treatment:

To relieve acute gouty attacks.
To prevent recurrent gouty episodes and urate lithiasis.

Treatment of acute gout:

1)Non-steriodal anti-inflammatory drugs(NSAIDs):

All NSAIDs except aspirin, salicylates, and tolmetin can successfully treat acute gouty episodes.
Oxaprozin lowers serum uric acid, it should not be given to patients with uric acid stones because it increase uric acid excretion in the urine.
Indomethacin is commonly used.

>>>N.B.

SAIDs may be given to patients unable to take NSAIDs.

2)Colchicine:

Colchicine relieve the pain and inflammation of gouty arthiritis in 12-24 hours without altering the metabolism or excretion of urates and without other analgesic effects.
It acts by inhibition of leukocyte migration and phagocytosis.

Indications:

Treatment of acute gout(largely replaced by NSAIDs).
Colchicine is now used for the prophylaxis episodes of gouty arthiritis.
Has a mild beneficial effect in sarcoid arthiritis and in hepatic cirrhosis.
Although it can be given intravenously, this route should be used cautiously because of increased bone marrow toxicity.

Adverse effects:

Diarrhea.

Nausia, Vomiting and abdominal pain.

Rarely: hair loss and bone marrow depression as well as peripheral neuritis and myopathy.

A cute intoxication after overdoses is characterized by burning throat pain, blood diarrhea, shock, hematuria, and oliguri. fetal ascending CNS depression has been reported. Treatment is supportive(Colchicine has a small fatal dose).

Prophylaxis:

1)Uricosuric Agents:

Probenecid and sulfinpyrazone are uricosuric drugs(increase urine secretion of uric acid).
In a patient who excretes large amounts of uric acid, uricosuric should't be used.

Advese effects:

Gastrointestinal irritation(should be given with food to reduce irritation).
Rash.
Rarely:aplastic anemia.
Nephrotoxicity may occur with Probenecid.

Contraindications&Cautions:

It is essential to maintain a large urine volume to minimize the possibility of urinary stone formation. Also alkalinization of urine decreases incidence of stone formation.

N.B.

Because aspirin in doses less than 2,6 g daily causes net retention of uric acid, it shouldn't be used for analgesia in patients with gout.

2)Allopuinol:

Mechanism of action:

inhibit synthesis of uric acid (by inhibition of xanthine oxidase enzyme).

Indications:

Prophylaxis of gout: when starting allopurinol, colchicine should also be used untill serum uric acid is decreased to less than 6 mg/dl. Therefore colchicine can be stopped, while allopurinol is continued.
Antiprotozoal agent.

Advese Effects:

Acute attack of gout during initiation of trearment(add colchicines or NSAID prophylactically).
Nusia, vomiting and diarrhea.
Preipheral neuritis and necrotizing vasculitis.
Bone marrow depression and, rarely, aplastic anemia may also occur.
Hepatic toxicity and interstitial nephritis have been reported.
Allergic skin reaction.

Interactions&Cautions:

When azathioprine is given concomitantly with allopurinol, its dosage must be reduced by about 75%.
Allopurinol may increase the effect of cyclophosphhamide.
Allopurinol inhibits the metabolism of probenecid and oral anticoagulants.

3)Febuxostat:

Inhibitor of xanthine oxidase therefore reduces the formation of uric acid.

Adverse Effects:

As with allopurinol, prophylactic treatment with colchicine or NSAIDs should start at the begining of treatment to avoid gout flares.

The most frequent adverse events are liver function abnormalities, diarrhea, headache,and nusia. Febuxostat appear to be well tolerated in patients with a history of allopurinol intolerance.

N.B.

Febuxostat is awaiting FDA approval for the treatment of chronic gout.It is the first new drug for the treatment of gout in over 40 years.

First choice to treat Parkinsonism

2013-08-23T13:55:00.001-07:00

First choice to treat Parkinsonism

L-Dopa

Definition:

Levo-Dopa is the precursor of dopamine that bass blood brain barrier(BBB) to be converted into dopamine and increase its activity in basal ganglia to correct all syptoms of parkinsonism especially bradykinesia.

Kinetics:

L-dopa is administered orally to be absorbed by an active process in intestine(decrease by some amino acids in food), peak concentration in 1-2 hours,t1/2=1-3 hours.

*Most(more than 95%)of ingested l-dopa is metabolized in peripheral tissues by:

DD(dopa decarboxylase) to dopamine, which cannot pass the BBB (pyridoxine"vitamin B6" activate peripheral DD,so decrease the efficacy & increase toxicity of L-dopa).
COMT to 3-O-methyl dopa(3OMD) that complete with L-dopa for active uptake to CNS.

*Only 1-3% of ingested dose reaches CNS to be metabolized by central DD into dopamine to produce the therapeutic effect ,then metabolized br MAO-B enzyme.

Efficacy& brain level of L-Dopa is increased by adding:

Peripheral dopa decarboxylase inhibitor(not pass BBB)as carbidopa or benserazide:-

* Carbidopa(10 or 25 mg)+L-dopa(100 or 250 mg)=Sinemet.
* Benserazide925mg)+ L-dopa(100 mg)=Madopar.

COMT inhibitor as tolcapone (hepatotoxic) or entacapone.
MAO-B inhibitor as selegiline(deprenyl) (slow disease progression).

Side effects of L-Dopa:

Fluctuation of response (on-off phenomenon);may be reduced by use of drug holidays& reserve l-dopa for late severe disease.
CNS effects: dyskinesia, psychological disturbances, hallucination, insomnia, anxiety, agitation& mood changes.
CVS effects: tachycardia, arrhythmia, postural hypotention.
GIT effects: anorexia, nusia, vomiting, peptic ulceration.
Other effects:mydriasis, increaso IOP, hemolysis, brown secretion.

Contraindication:

Psychosis.
Glaucoma.
Peptic ulcer.
Cardiac disease.
Melanoma.
With MAO-A inhibitor.

Neurological manifestations of Diabetes

2013-08-23T09:28:00.001-07:00

Neurological Manifestations of Diabetes

"Diabetic Polyneuropathy"

Pathogenesis:

Diabetic microangiopathy of the vasa nervosa.
Ischaemia of the nerves, 2ry to atherosclerosis of vasa nervosa.
Nutritional 2ry to hypovitaminosis (vit. B1, B6 and B12).
Metabolic due to production of toxic ketonic bodies, leading to nerve damage.

Clinical Picture:

In early diabetes or in the pre-diabetic stage, the neuropathy is of mononeuritic type which may affect the sciatic. femoral, lateral popliteal, ulnar or median nerves or cranial 3,6,7 nerves.
In the frank diabetes, the neuropathy is of the poly neuritic type.
The polyneuropathy is mainly sensory with pain and parathesia specially in the lower limbs followed by superficial sensory loss of stock and glove type. the deep sensations are also lost early in the disease,resulting in loss of deep reflexes and sensory ataxia.
The muscle sense is increased at first resuting in tender calf followed later on by lost muscle sense.
Motor weakness may occur late in the disease.
Autonomic manifestations:

Impotence.
Sensory, motor or autonomic bladder.
Postural hypotention.
Silent myocardial infarction.
Gastroparesis diabeticorum: indigestion and delayed gastric emptying.
Hyperhydrosis.
Trophic skin changes: Ulcers, loss of hair, brittle nails, charcot's neuropathic joint.

Treatment:

Proper management of diabetes: diet, oral hypoglycemic drugs or insulin.
Vasodilator as Piribedil(Trivastal) 50 mg daily.
Capillary modulators: Ca Dobesilate(Doxium).
Vitamins B1 100 mg daily, B6 200 mg daily, B12 1000 micro gram dailyand A.T.P.(Adnoplex).
Carbamazepine(Tegretol) 200 mg twice daily or Gabapentine(Neurontine) 400 mg twice daily for neuropathic pain.
Physiotherapy if motor weakness is present.

Thiamine deficiency disorder

2013-08-22T13:46:00.001-07:00

Thiamin deficiency disorder
"Beri-beri"

Aetiology:

A disease 2ry to thiamine(vitamin B1) deficiency affecting the nervous system(dry beri-beri) or the cardiovascular system(wet beri-beri).

Clinical Picture:

1)Dry beri-beri: peripheral sensory neuropathy:

Subjectively there is pain and paraesthesia in the limbs,espcially distally
Objectively there is:

*Superficial sensory impairment of the stock and glove nature.

*Deep sensory loss specially distally with absence of deep reflexes.

2)Wet beri-beri: congestive heart failure.

3)Cerebral type(werni cke's encephalopathy): amnesia,ophthalmoplegia,nystagmus&ataxia.

Treatment:

1)thiamine 100 mg daily snd vitamin B complex.
2)Diet rich in vitamins and low in salt.
3)Digitalisation and diuretics in in case of heart failure.

Bell's Palsy Prognosis and management

2013-08-22T12:35:00.001-07:00

Bell's Palsy

Definition:

It is an acute paralysis of the face due to non suppurative inflammation of the facial nerve near the stylomastoid foramen . usually unilateral,may be recurrent&sometimes run in families.

Atiology:

1)exposure to air drafts usually preceed the onset:this may lead to ischaemia,oedama&compression of the nerve at the stylomastoid foramen.
2)It may 2ry to a neurotropic virus e.g. Herps Zoster.
3)It may be autoimmune,as evidenced by high levels of immunoglobulins in the patient.

Clinical Picture:

1)the onset is usually acute with pain behind the ear.
2)one or two days later,there is complete paralysis of the facial muscles on the affected side of lower motor neuron lesion nature which are:
*obliteration of naso-labial fold.
*Dropping of the angle of the mouth with dripping of saliva.
*accumulatin of food behind cheek.
*inability to blow the cheek.
*inability to show the teeth properly.
*inability to raise eyebrows with absence of wrinkles of the forehead.
*inability to close the eye: when the patient attempt to close his eye, the eye ball rolls upward(Bell's Phenomena).
3)there may be impairment of taste on the anterior 2/3 of the tongue on the same side.

Treatment:

A)Medical:

1)Prednisolone tablets 30 mg/day or Synacten amp. I.M. for 2-3 weeks.
2)Vasodilators, vitamens B complex & Neostigmine.
3)Protection of the exposed cornea:eye ointment during sleep, sunglasses during day time.

B)Physiotherapy:

1)Massage of the facial muscles.
2)Infrared irradiaton on the face.
3)Galvanic stimulation to the facial muscles.

C)Surgical:

1)Decompression of the facial nerve.
2)facial nerve grafting.
3)Plastic surgery for residual facial asymmetry.

Prognosis:

*most patients(80%)recover in 4-6 weeks; the remaining 20% need surgical intervention.
*occasionally aberrant reinnervatin occur where the regenerating facial fibers anastomose with trigeminal fibers. thus when the patient move his jaw while eating or speaking there may be:
_Winking( jaw winking)

_Lacrimaton(crocodile tears)

The Epilepsy, Treatments and its side effects

2013-08-21T16:11:00.001-07:00

Treatment of Epilepsy

A)General Treatment
1.    moderation of the patient's physical activities specially swimming , driving or working near machines or at heights for fear of drowning or injury during a fit
2.    precipitating factors are avioded as photic stimulation(e.g. watching T.V. in thedark) or hyperventilation(e.g. running along distance)
3.    Alcohol intake is forbidden
4.    ketogenic diet,inducing acidosis,used to be given.Acidosis raises threshold of stimulation of brain cells,while alkalosis lowers it

B)Specific Treatment
1.    treatment of the cause in symptomatic epilepsy
2.    Anti-epileptic drugs

Anti-epileptic drugs
for at least 2 to 3 years
1)barbitarates:
•    Luminal(phenobarbitone)
Dose
•    100-600 mg daily
Best indicated
•    broad spectrum anticonvulsant
•    NOT for petit mal seizure

2)Hydontion:
•    Epanutin
Dose
•    200-600 mg daily
Best indicated
•    simple partial motor seizure
•    Grand mal seizure

3)Carbamazepine
•    tegretol
Dose
•    400-800 mg daily
Best indicated
•    Simple partial motor seizure
•    Complex partial motor seizure
•    Grand mal seizure
•    NOT for petit mal seizure

4)Clonazepam
Rivotril
Dose
•    2-6 mg daily
Best indicated
•    myoclonic seizure
•    Grand mal seizure

5)Valproate:
Depakin
Dose
600-1500 mg daily
Best indicated
•    Simple partial motor seizure
•    Complex partial motor seizure
•    Grand mal seizure
•    Myoclonic seizure

6)Succinimide
•    Zarontin
Dose
•    500-1000 mg daily
Best indicated
•    Petit mal seizure

7) New antiepileptics
1.    Gabapentin(Neurontin)
2.    Vigabation(Sbril)
3.    Topiramate(Topamax)
4.    Lamotrigine(Lamictal)
5.    Tiagabine(Gabitril)

1)Gabapentin(Neurontin)
Dose
•    1200-2400 mg daily
Best indicated
•    Refractory partial and generalized seizure

2)Vigabation(Sbril)
Dose
•    2000-3000 mg daily
Best indicated
•    Refractory partial and generalized seizure

3)Topiramate(Topamax)
Dose
•    400-800 mg daily
Best indicated
•    Refractory partial and generalized seizure

4)Lamotrigine(Lamictal)
Dose
•    200-600 mg daily
Best indicated
•    Refractory partial and generalized seizure

5)Tiagabine(Gabitril)
Dose
•    30-60 mg daily
Best indicated
•    Refractory complex partial seizure

Side effects of antiepileptics
•    drowsiness,Ataxia,skin rash and blood dyscrasias; therefore blood pictures should be done
•    Depakin rarely cause hepatic insufficiency;thus frequent liver function tests are needed early in the treatment
•    Epanutin also produce gum hyperplasia and hirsutism
•    antiepileptics have teratogenic effect thus an epileptic woman should postpone pregnancy untill she is fit-free and off medication;however,if achild ia wanted,or she is already pregnant,she should continue her medication,as the fits are dangerous to her and to her foetus
Guidlines for drugs used
1)Always start with one drug to avoid iteracton between antiepileptics
2)If the patient doesn't respond to one drug another drug may be added. the new antiepileptic drugs are mainly used as add-on treatment in case of refractory epilepsy not responding to classical treatment
3)Antiepileptics are discontinued only when the patient has been free from fits foe at least 2 years and his E.E.G. is normal

The end

drug therapy in Diabetes Mellitus

2013-08-21T14:02:00.001-07:00

treatment of diabetes mellitus

types of DM
•    type1>>>> insulin dependent diabetes mellitus(IDDM):
occer during childhood or puberty
beta cells are dertroyed

•    type2>>>non insulin dependent diabetes mellitus(NIDDM):
occur over age 35
beta cells are unable to produce sufficient insulin

Treatment
1.    Insulin
2.    Oral Hypoglyecemic Drugs>>for treatment of patient with type2 DM

1.    Insulin:
is apolypeptide hormone given by subcutaneous injection

Indication of insulin:
1.    IDDM
2.    Diabetic ketoacidosis
3.    NIDDM:with
•    permanent:failed oral hypoglycemic ttt in IDDM
•    temporarily:in some stress situation as infection,surgery,pregnancy

Adverse effects of insulin
1)Hypoglycemia:
most sreious&common in overdose
•    treatment of hypoglycemia
if conscious : sweets or juice
if unconscious : 20_50 ml glucose 50% intravenous or glucagon 1mg intramuscular
2)Lipodystrophy(less common)
3)Allergic Reaction(less common)
4)insulin resistance

2)Oral Hypoglycemic Drugs
for treatment of patient with type2 DM

Types of oral hypoglycemic drugs:
A.    insulin secretagogues as Sulfonylureas>>>increase insulin resistance
B.    insulin sensitizers as Biguanide(metformin) or glitazones>>>improve insulin action
C.    Modify intestinal absrption of carbohydrates as alpha glucosidase inhibitor

A)insulin secretagogues
Sulfonylureas
•    indication of Sulfonylureas
stimulate insulin release from the beta cells of pancreas

•    Adverse effects of Sulfonylureas
1.    Hypoglycemia
2.    weight gain
3.    Sulfonylureas transverse the Placenta(beplate insulin from fetal pancreas)

B)insulin sensitizers
1.    Biguanide(metformin)
2.    glitazones

1)Biguanide(metformin) :
•    Indication of Biguanide(metformin)
1.    increase glucose uptake by target tissues,thereby decreaseing insulin risistance
2.    Euglycemia(no fear of hypoglycemia)
3.    loss of weight(loss of appetite)
N.B
these effects maynot be apparent untill 4-6 weeks of use

Adverse effects of Biguanide(metformin)
1.    Gastrointestinal(anorexia,nausia,vomiting,diarrhea)
2.    longterm use may iterfer with vitamin B12 absorption
3.    Potentially fetal lactic acidosis may occur

2)glitazones
•    Indication of glitazones
increase insulin sensitivity in adipose tissues,liver and skeletal muscles

•    Adverse effects of glitazones
1.    strongly recommended to measure liver enzyme levels of patients on these medications initially and periodically
2.    weight increase(increase subcutaneous fat or due to fluid retention)

C)alpha glucosidase inhibitor
Acarbose(glucobay):

•    Indication of Acarbose(glucobay)
Reversibly inhibiting membrane-bound-glucosidase in the intestinal brush border thereby decreasing glucose absorption

•    Adverse effects
flatulence,diarrhea and abdominal cramping

Afa Klamath - The German kaps

2013-05-17T06:17:00.002-07:00

what is "Afa klamath":

It is a dietary supplement and contains many of the vitamins, proteins, amino acids, fatty acids and minerals.

Produced by: German "raad algen"

Abstract
This compound is a 60 plant material natural and completely free of chemicals, so he does not have any side effects or adverse effects and Nsphasameeh according to tests conducted in the laboratory of America is equal to zero hand the positive effects it is the process of a comprehensive survey of both the needs of the cells in different types and characteristics, which restores functional equivalence, especially the immune system entrusted to resist most pests and diseases, especially the cancer and viral infections and bacterial acute and chronic by converting chlorophyll to interferon naturally within the body and activate the immune cells deadly and diverted into the infected tissue to exterminate the cancer cells and Alverosahopastqra and follow-up tests and studies carried out in Canada America and Cuba, New Mexico and some Egyptian universities show the following:

Movement pharmaceutical and therapeutic effects of this Alakaraly two types:

I. General effects:
The cells to satisfy everything you need from food, which raises theFunctional status and overall efficiency for each device separately.1 digestive system:Increase the activity and the movement of the gastrointestinal tract due to increased energy resulting from the percentagesHigh carbohydrate and fat and it appears in the following:A Fatah and increased appetite and ease of digestion due to increased rotary movement of the stomach and increase the secretion of digestive enzymes and hormones organization as a result of supplyThese cells essential amino acids manufacturers of these materials.To increase the movement of worms in the intestines with the strengthening of the mucous membranes throughAlkolorovil material which reduces gastroenteritis and relieves constipation cases.C reduce the periods of the presence of food in the stomach and intestines, which prevents a lot ofComplications such as infections and ulcers of the stomach and duodenum and disordersColi, such as bloating, cramps and constipation.Nervous system: 2Rebalancing of neurons due to high concentrations of certain vitamins, such as "12" and some minerals organization of neural responses which improves the vulnerability nervous system and peripheral nerve inflammation resulting from shortages of some food or because of high blood sugar.Structural and muscular system: 3Because contain this property to a wide range of metallic materials, it is re-building cells weak bones, so it has an active role in the treatment of osteoporosis and debilitated bone in the elderly as the strengthening of soft tissue Kaladilat Foreign Affairs and heart which increases the efficiency physical and increase the activity of the muscular system and the heart.Circulatory and heart: 4With increasing the efficiency of the heart muscle due to some metal compounds but have other functions such as pacemakers and equations that govern the process of blood clotting and maintain the rate of internal pressure of fluids with ease cases of anemia because it contains basic materials of the components of blood as the substance chromium reducing the percentage of harmful fats and cholesterol, which prevents atherosclerosis, angina and liver fatty deposits.Get rid of toxins and oxidizing substances: 5The presence of vitamin "A e", a powerful anti-oxidant which improves the state of fatigue and general weakness and functional limitations of the cells and re-equalization hardware and MembersArthritis and rheumatoid arthritis: 6The presence of some anti-inflammatory substances, the effect is effective in the treatment of articular stiffness and inflammation and rheumatoid arthritis.Urology: 7An active role in the treatment of chronic urinary tract infections, prostate and dissolve excess salts pipes and kidney stones.Respiratory: 8His extraordinary ability to improve aerobic people chronic infections and sinus allergies bra and get rid of toxins deposited to the lungs due to smoking.Endocrine and hormonal imbalance: 9Has strong effects on re-hormonal system and activate the inactive glands such as the thyroid gland and the ovaries which improves many of the diseases of women such as bleeding delayed childbearing and inflammation of chronic cervical and pipes.Nervous system and mental state: 10This Alakaraly contains the so-called love and next molecule that improves the state of attention, concentration and IQ, it lifts the mood and addresses of depression.General weakness and nerve dysfunction and anemia: 11It is widely door takes all cases with special circumstances or emergencies such as: periods of childhood and old age, pregnancy and childbirth, postpartum and breastfeeding and preparation for surgical operations and periods of convalescence after and during eating Aladuahalkimawih and especially chemotherapy for cancer diseases

Second, special effects:

1 viral infections: either C or B virus of this property's ability to address the super immune system particularly for
By converting chlorophyll to interferon naturally within the body and activate the immune cells combat by destroying the cells exotic whether viral Osrtanih In case of a tie immune system is dissolving Cover Alglicobrotina Ocean cells viral so invalidate the effects of harmful and becomes his presence has no consideration shall be the final outcome of the impact of real estate on the virus either eliminates it altogether and either eliminates impact Aldharoalentijh and one of the practice
Cellular activity and cancer diseases: 2
For this property ingenious power in the pursuit of cancer cells through activation of cells and other combat tools immune assigned for this purpose and it contains vitamin "A", which is one of the strongest factors that prevent cancer morbidity according to the decision of the World Health Organization

the end

Some types of cancer, its symptoms and treatment methods and Prevention

2012-05-16T11:16:00.000-07:00

Definition of brain cancer:

Division is abnormal and irregular brain cell, both in the brain, the cerebellum or spinal cord, which causes compression of the other parts of the brain and therefore the loss of one of the senses or weakness.And primary brain tumors (ie, originating in the original brain) is very rare, unlike the secondary brain tumors that are caused by the spread of the disease from other members of the body all the way to the brain.Symptoms:Brain tumors, whether benign or malignant cause similar symptoms, which vary according to place of occurrence of the brain. One of these symptoms:1. Headache, which affects especially the person in the morning.2. Nausea and vomiting.3. Occurrence of convulsions.4. Weakness of some of the parties Kalaloah or lower.5. Some senses weakness or vulnerability.Causes:Has no known causes so far.Diagnosis:Work-ray scan of the head to make sure that the work of a tumor after clinical examination. Also, examine the nervous system is important in order to find out where in the brain injury.And other tests that can be done is the injection of color in one of the arteries feeding the brain and then photographing the head showing where all the arteries there. This examination is normally if there is an intention to undergo surgery to remove the tumorMethods of Treatment:1. Surgical intervention to remove the tumor if the spot to remove the pressure on other parts. But sometimes it is difficult to carry out the surgery if the tumor is near the site of an important dynamic in the brain.2. Radiation therapy.3. Chemotherapy with him that the benefit is limited as the drugs can not enter the brain through the blood vessels, but the drug can be injected in the cerebrospinal fluid.Prevention:No methods of protection from the lack of knowledge of its causes or the factors leading to it.The most important types of brain tumors:• Gliomata• Glioblastoma Multiform• Astrocytoma• Acoustic Neurinoma• Meningioma• Pitutary Tumours

Definition of oral cancer:

Is the abnormal growth and uncontrolled by the cells lining the oral cavity.
Symptoms:
1. Appearance of ulcers in the mouth does not heal or bleeds easily.
2. The emergence of a tumor or an area of small red or white on a permanent basis in the mouth.
3. Difficulty in chewing or swallowing.
4. Inflammation of the throat.
5. Be selected in the movement of the tongue and jaws, or a sense of distress when wearing artificial dentures.
6. Pain is rarely a symptom of oral cancer in the early stage.
Causes:
1. Smoking and tobacco use (which stores and chewed in the mouth).
2. Eat qat.
3. Drinking alcohol, and since it is often accompanied by excessive smoking, the combination between the two is suspected that it increases the probability of cancer of the mouth.
4. Smoking cigars and pipes, which increases the probability of cancer of the lips.
Diagnosis:
Taking a sample of the tumor or lesion in the mouth and examined under a microscope.
Methods of Treatment:
1. Surgical intervention.
2. Radiation therapy.
Prevention:
1. Stay away from smoking as well as chewing khat.
3. Stay away from drinking alcohol.

Definition of nasopharyngeal cancer:

Is the abnormal growth and uncontrolled by the cells lining the nasopharynx (which is a cavity located in the back of the nasal cavity and Aousel between the nasal cavity and the end of the oral cavity and his delivery of the air entering through the nose to the upper parts of the respiratory system in the process of inhalation and vice versa in the process of exhale). And this growth leads to obstruction of the cavity and then move to nearby parts of the membranes and then move through the lymph nodes in the neck, sometimes spreading tumor in various organs of the body especially the bones and liver.Symptoms:1. Headache.2. Change in vision.3. Obstruction in the nose.4. Bleeding from the nose.5. Numbness in the face.6. Pain in the neck.And not necessarily that the patient complains of these symptoms, but in most cases be a complaint or a shortcut to view presentations. It is also important that these symptoms may also appear in cases of pharyngitis or tonsillitis.Causes:Does not have a specific reason, but smoking and alcohol of the most important reasons associated with this type of cancer.Diagnosis:1. Work-ray scan of the head and neck.2. Taking a sample of the lining of the nasal pharynx.Methods of Treatment:1. Surgical intervention if it is possible to eradicate the infected part.2. Chemotherapy.3. Radiation therapy.4. Should also consult a dentist if necessary to take any precautions.Prevention:No methods of prevention, but abstinence from smoking and drinking alcohol contributes to reduce the incidence.

The definition of lung cancer:

Is the growth of some cells lining of the trachea by a faster than normal and irregularly, which leads to accumulation and the occurrence of interference in the process of directed mucus, and develop some of the cells multiplying rapidly and become malignant. These cells crowd out and kill normal cells, and lead to retention of mucus in the lungs. And make up the mass of cancer cells or a tumor blocking the windpipe, and is one of the leading causes of death for men and women in most industrialized countries.Symptoms:1. Shortness of breath.2. Difficulty in the output of sputum from the trachea.3. Chronic cough.4. Out blood with sputum.5. Pain (rarely).6. A significant lack of weight for no apparent reason with stress.7. Sound in the chest during breathing (zoom).8. Difficulty in swallowing a result of tumor pressure on the esophagus.Causes:1. Smoking, has been proven that smokers are more easily than others for lung cancer.2. High percentage of pollution in the air.Diagnosis:1. Work of the rays of the thorax.2. Examination of sputum under a microscope.3. Telescope of aerobic styles Bronchoscopy.4. CT scan.5. Take a sample of the tumor by needle.Methods of Treatment:1. Alasitsal surgery if possible.2. Radiation therapy and the place to expose X-ray cancer.3. Chemotherapy is important for some types of lung cancer as it is used with other treatments if there are transitions of the cancer outside the lung.Prevention:1. Stay away from smoking.2. Separation plants for the city, where residents live.

Definition of breast cancer:

Is one of the most common cancer among women, which often occurs after the age of fifty, but this does not mean that it may not appear at an early age. Also is possible to the emergence of this disease in men, but by very few compared to women.Causes:Unknown but there are factors that help to visit the possibility of infection including the existence of the disease in a relative (to that of the mothers or their sisters hit in this tumor is getting used to conduct self-examination).There is a possibility to increase the incidence of the disease in women who had their first pregnancy after the age of thirty. Also smoking and excessive alcohol intake is one of the factors which are believed to be associated with the disease.Symptoms:Not every change in the breast is a tumor, but not all tumor is malignant, but must not be neglected any swelling or change in the form of the breasts it is important to check with your doctor if you notice:• the emergence of mass in the breast• an increase in the thickness of the breast or armpit• discharge from the nipple• contraction of the nipple• local pain in the breast• a change in breast size or shapeNote that some of these changes occur naturally when pregnant or breastfeeding, or before and after menstruation in some women.The importance of early detection for breast cancer cure rate that exceeds 95%, God willing, if the tumor is in its early stages .. But delay diagnosis of this percentage drops to 25% only ..Is early diagnosis of breast cancer by following these steps:• Monthly self-examination of the breast for those over the age of forty women• screening mammography Mammography every two years for women who are over the session.Methods of Treatment:There are four ways to treat the disease either surgery or chemotherapy or only radial or hormonal, may the doctor uses one or more of these methods, depending on the nature of the tumor where the treatment plan depends on the type of tumor size, stage and age of the patient and her health,Usually remove the tumor or the entire breast, with or without lymph nodes in the armpit as a first stage followed by the chemotherapy and radiation therapy for some patients or radiotherapy only, depending on the situation.Chemotherapy (chemotherapy): is chemotherapy using a complex set of chemical drugs, which have their effect on cancer cells stronger than on healthy cells, and the treatment is either in the form of injection into a vein or tablets in the mouth, and the effects of treatment side effects hair loss, vomiting, and diarrhea But all these effects are temporary. Also may be due to low number of white blood cells and therefore is usually a blood test on an ongoing basis and are advised to stay away from all complain of infectious diseases such as influenza if the number of white blood cells is low ..Radiation therapy Radiation therapy - Radiotherapy: is radiation therapy using X-ray intense high-energy, and the effect of these rays high on the sorts of cancer, where they are more sensitive to radiation than normal cells and recover more slowly, and the treatment is usually either 20 or 25 sessions of radiation (as the case ) and each session lasts for less than 10 minutes note that the same treatment during the session may not take more than two minutes.Possible side effects of treatment are usually simple, including• inflammation of the skin treatment area, it is necessary not to use soap or any kind of creams on the treatment area during treatment• general fatigue, loss of appetite, all of these effects occur during the hearings and fade, usually after two weeks of the end of treatment.Hormone therapy (Hormone Therapy): This treatment begins after the end of radiation therapy is given for some patients who are over the age of fifty .. Not all patients need treatment for hormonal note that this treatment may continue for a lifetime.

Definition of stomach cancer:

Is the abnormal growth and uncontrolled by the cells lining the internal wall of the stomach.Symptoms:Difficult to diagnose gastric cancer at an early stage and that the length of time between the appearance of cancer and the onset of symptoms, they include:1. Swelling of the stomach.2. Weight loss.3. Anemia and fatigue.4. Persistent pain does not respond to treatment.5. Vomiting.Causes:1. The presence of benign tumors of the stomach.2. The remaining stomach after partial gastrectomy.3. Inflammation of the stomach self-autoimmune.4. Incidence of long-term indigestion.5. The presence of gastric ulcer does not heal.6. Genetic makeup and have found that a higher proportion of gastric cancer occur in people with blood type (a).Diagnosis:1. Work-ray of the stomach after drinking a white colored substance Barium.2. Work of the telescope of the stomach.3. Work of the ultrasound of the abdomen.4. Take a sample of the tumor (through the work of the telescope) and examined under a microscope.Methods of Treatment:1. Orthopedic surgery and be either a partial removal of cancers of the stomach or topical eradication of gastric cancers in the event the full spread.2. Palliative surgical procedures, such as metal work connections, and can alleviate suffering when cases of obstructive heart contagious put plastic tube through the tumor.3. Chemotherapy is used in a limited way to eliminate the transfer of cancer in other organs.Prevention:1. Stay away from the causes of stomach ulcers, that is smoking, drinking alcohol, drinking coffee a lot, constantly eating hot spices, very large number of emotionalism.

Definition of pancreatic cancer:

Is the abnormal growth and uncontrolled when the cells of the pancreas, and be both in the head of the pancreas or the body or tail.
Symptoms:
Has no specific symptoms and for this reason in the difficulty of diagnosis, but may sometimes be hidden in the image of the gall bladder inflammation, and pain in the upper abdomen accompanied by a pebble bitterness.
Causes:
Believes that there is substance in the body play a role in the emergence and growth of cancer cells and the continuation of the pancreas and is the NF-Kappa B. It is also addicted to alcohol and inflammation of the pancreas in the task of the reasons it occurs.
Diagnosis:
1. Work of the ultrasound of the abdomen.
2. The work of a CT scan of the abdomen.
Methods of Treatment:
1. Surgical excision in 10% to 15% of cases only.
2. Bsitapan chemotherapy (Gemzar).
Prevention:
No methods of protection from him.

Definition of liver cancer:

Is the abnormal growth and irregular cells to the liver if the tumor is primary, but if it be a secondary spread from another member of the body all the way to the liver.
Symptoms:
1. Yellowing of the body and the eyeball.
2. Pain in the upper abdomen.
3. Loss of appetite and weight.
4. Nausea and vomiting.
5. Rise in temperature.
6. Sense of fatigue and lethargy.
Causes:
1. Incidence of Hepatitis B or C virus.
2. Drink alcohol a lot.
Diagnosis:
1. The work of a CT scan of the abdomen.
2. Magnetic X-ray work.
3. Analysis of blood.
4. Paljaleom radioactive screening, which is important to distinguish between tumors and other diseases that may infect the liver.
5. Take a sample of the tumor and examined under a microscope.
Methods of Treatment:
1. Surgical intervention if the disease is localized or in one of lobes of the liver.
2. Chemotherapy through a vein or artery directly to the main liver.
3. Radiation therapy as a treatment Tlatifi.
4. Treatment of tumor freezing.
5. Liver transplantation.
Prevention:
1. Lack of exposure to hepatitis B or C and by taking precautions when blood transfusion, and not to the use of injection was used before. Most importantly, take the vaccine hepatitis.
2. Stay away from drinking alcohol.

Definition of cancer of the colon and rectum Colon & Rectum Cancer:

Start all types of cancer of the colon and rectum Bslelat benign mucosa. It consists of these non-malignant tumors in the wall of the large intestine and may grow in size and eventually turn into cancer. And eradication of benign polyps is one aspect of preventive medicine that achieves good results.Symptoms:1. A nerve of the rectum.2. Changes in bowel habits such as constipation or diarrhea. (These symptoms also appear when other diseases, so tests should be carried out if there are such symptoms).3. Abdominal pain.4. Underweight and are the symptoms appear late and are usually referring to the possible spread of the disease.Causes:1. The presence of cancer of the colon and rectum polyps and mucous in the family history.2. A person has ulcerative colitis and inflammation Sulailp coli or cancer in other organs, particularly the breast and uterus.3. There is a belief that hemorrhoids lead to colon cancer and is a popular misconception.Note:Hemorrhoids symptoms may appear similar to Balslelat mucous or colon cancer, emerged if such symptoms should go to the doctor for examination and evaluation, preferably down specialist surgery to detect and make some analysis and perspective of the colon.Diagnosis:1. Perspective of the entire colon.2. The work of ultrasound through the anus to the rectal tumors.3. The work of computed tomography of the abdomen and pelvis with the need to use the dye to the vein and intestines.4. Rays Magnatsé work of the basin (if available).Methods of Treatment:1. Colon tumors: the eradication of the tumor and nearby lymph nodes. And after recovery from the process and see the result of microscopic examination of the patient may be given chemotherapy if the tumor has spread to the lymph nodes.2. Tumors of the rectum: Most cases require chemotherapy and radiation the patient may be given chemotherapy after surgery if the tumor spread to the lymph nodes. And the best way to perform the surgery is to eradicate the rectum with the surrounding area, which is the fat surrounding the rectum and are removed as one part after the colon and Aousel anal canal by the tumor site.Regain about 80-90% of the patients well-being in full if the cancer is detected and treated in early stages. But the cure rate drops to 50% or less when diagnosed in a late stage. As a result of the findings of modern technology, less than 5% of all patients with cancer of the colon and rectum need to make anastomosis slot (slot discharge of industrial development of, the colon is surgically).Prevention:1. Removal of benign polyps by colonoscopy, in addition to careful examination and comprehensive of the large intestine.2. Diet may play an important role in preventing cancer of the colon and rectum. And to our knowledge, the low-fat diet rich in fiber is the way in which the only food may protect the rights of cancer of the colon and rectum.3. It should be noted changes in bowel habits and make sure to check out the intestines into the regular medical examination, which is normally once a person became a class of people most vulnerable to the disease.

THE END

Cancer, its types and causes

2012-05-16T11:02:00.003-07:00

What is cancer and what types and methods of treatment?

The human body consists of cells in different forms and functions. In a simple, each cell containing a nucleus and an external casing, and in the nucleus kept the basic information of the cell. This information in fact be found in the DNA molecule DNA - deoxyribonucleic acid. Containing DNA in 26 chromosomes, which are comprised of millions of genes. These genes are determined by the system and the functioning of the cell.

During some of our body's cells die naturally and the body compensates for the lack of cells by division. When the cell division to produce another copy of the DNA and then divided into two cells. This is what happens in the cell in a simple process where the division is more complicated than that. Cell division usually occurs on a regular basis so that our body growth or to replace or repair damaged tissue. When you work cells as planned, we enjoy good health, but when that system breaks down, we get sick. In the case of cancer cells grow unnatural and instead of compensating only damaged cells, these cells proliferate significantly and non-stop Vttgy on a patient and the problem of so-called tumor.
Tumors that result from this imbalance of two types:
Benign (not cancerous Benign): They are usually packed membrane and non-dispersible, but some may cause problems by the patient, especially if the large size and the impact would be clicking on the affected limb or member near them, which prevents them from functioning normally. These tumors can be removed surgically or treated with drugs or radiation to reduce the size and it will be enough to heal them and often do not go back again.

Malignant tumors (cancerous Malignant): that is the subject site. Tumors attack and destroy cancerous cells and surrounding tissue and has a high potential for spreading. They spread in three ways

Spread directly to the surrounding tissue and organs affected by
Through the lymphatic system.
Through the bloodstream, where it separates a cell (or cells) of the tumor's initial Primary and transmitted through the device Allmphoui or blood to other organs far enough to settle in a place - often members of rich blood, such as lung, liver or lymph nodes - causing the growth of cancerous tumors other secondary tumors are called secondary.

Cancer is a group of diseases (more than 100 disease) are similar in some characteristics among them, cancer has been designated as swollen blood vessels around the tumor are similar to the outskirts of lobster. The disease or diseases that result from the cell out of control. Change occurs in a cell, making it out of the control system that controls the work of the cell, as in healthy cells. There are more than theory is attributed to it cause the start of cancer in the body. The first error says that what happened in the DNA at the division which is called the status of "change" or mutation. The incidence of error in the DNA at the growing divide over exposure to carcinogens such as tar in cigarette smoke. Many of these errors occur for different causes in the human body but the body's immune system recognize them because they differ from the rest of the cells and destroy them. Sometimes the immune system fails to recognize the similarity of these cells with other cells, whereupon the presence of division and cause cancer.
One theory says that modern reason is the existence of a simple genetic defect can not be seen from the immune system and the imbalance with time causes the exit of the cell for control and then the emergence of cancer. This theory explains the appearance of some types of tumors in more than one individual of the same family.

Cancer causes Carcinogens:

Whether there was a genetic defect or not, there are known causes of cancer is divided into three sections:Physical carcinogenic particles such as radioactive isotopes, UV radiation and some metal-fiber Mineral fibers. The isotope work holes for DNA when exposed them, causing the imbalance in gene regulation. Radioactive isotopes comes from X-rays, cosmic rays that reach the earth, and radon (found naturally in the earth varying degrees) and so indirectly. The UV radiation that comes from the sun caused the association of some proteins in the DNA at a time should not be as well, causing a defect in the DNA. Some minerals such as asbestos fibers cause direct damage to DNA due to their large size.Carcinogenic chemicals, such as the Benzopyrene found in cigarette smoke and the vinyl chloride used in the plastic industries where fractions associated with DNA, causing the imbalance.Biological carcinogens such as viruses or bacteria which cause an imbalance in the cell to turn into a cancer cell. Examples of viruses with human papilloma virus causes cervical cancer, virus and hepatitis B (hepatitis B virus), which causes liver cancer, the most common cancers among men in Saudi Arabia. The types of bacteria helicobacter pylori, which causes stomach cancer.Cancer passes through its growth in three main phases:Beginning (Initiation): This first step towards the formation of the tumor starts at the level where the cell change in their work and simple way to control the materials in this work that caused this initially called carcinogenic substances (carcinogens).Development (Progression): the tumor is composed by a single cell and have success in growth and division at the expense of other cells, and in this stage can be seen MkroskubiaClinical tumor (Clinical): Here the tumor is large and if not treated will continue to grow and destroy nearby tissue and may spread to distant organs.

Cancer is not one disease, it is a collection of diseases, different for different cells that give rise to. Her difference from each other and they differ in their actions as some fast-growing and one slow, some quick to spread and another does not spread quickly. But all of these types have similar characteristics with different patients.
Is different for different treatment of cancer or type of tumor a patient. In general, roads Home for the treatment of cancer are surgery and the removal of User or infected tissue, radiation therapy using X for the treatment of the tumor, chemotherapy, using drugs, chemical and hormone therapy, using hormones for some types of cancer and're going to these methods in detail in other pages.

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Varicella

2012-05-13T00:47:00.004-07:00

Introduction

Varicella or chicken-Box is a spread of infectious diseases especially among children
Highly contagious and fast transition from infected to healthy
And may be transmitted to all family members or classmates at school during the period of a simple
Cause severe discomfort to the injured because of itching
Let us know more about this disease!

What are the bacteria that cause??

It varicella virus, a virus affecting nerve

And how to move from infected to healthy?

Through the air and spray the outside of the mouth and nose of the patientAnd through contact with infected skin

Be a source of infection the patient before the rash appears two days and that peels off

How much is the incubation period for this virus?

Between 10 to 21 days.

During this period, the virus multiplies in the respiratory tract of infected and then moves into the blood and spreads in the body, causing skin rashes

What are the symptoms and signs of illness?

After contact with the person Bmassab earlier, signs of the disease begin to appear on a new patient within two weeks or threeSigns of disease are:High temperatureGeneral weaknessLoss of appetiteHeadacheAbdominal painsAfter that, start the rash to appear first in the head, face or mutilation, in the form of small red spots turn into a severe itching of the granules and vesicles and then to the waterThese vesicles begin to dry and scaling with new groups made up of them on different areas of the bodyThese vesicles may appear in the mouth or eyelids alsoAfter the vesicles crust, leaving a dark or light spots disappear within days or weeksRarely remain after the effects, if only wounded skin bacterial infections associated with skin rashDisease may be more severe and complicated in people with weak immune systems.

What about the varicella in the newborn??

If a mother's illness during the week before or after birth, the child born to be vulnerable to serious stages of the diseaseMust receive the child in this case an anti-virus inoculated directly

And in the event of illness must be treated with medicines anti-virus

What if a pregnant smallpox water? What will happen to the baby??

25% of the embryos picked up the infection from motherIf the mother of the disease in the early stages of pregnancy, the likelihood of birth defects and Ward

Injection should be the mother of the vaccine virus and treated with drugs for

Is there a cure for this disease??

Dole has an anti-virus is known (Acyclovir)And generally do not require treatment for this disease is a disease that disease is usually severe, and disappears automatically, and an expensive drug available relatively

Drug is given immediately after the first appearance of skin rash on the patient to ensure its effectiveness

Are any complications of the disease??

Usually does not cause complications for people with the disease is already healthy, but it may be dangerous to those suffering from diseases or weakened immunity tumorsSome complications:- Inflammation of the skin secondary bacterial- Bleeding in the blood sacs- Bleeding with blood Alabual - Oazakm God -- Bleeding from the blood of the digestive system- Lurching nervous- Inflammation of the brain- Pneumonia- Alatlhab renal

- And other rare complications

What about vaccination?

There is a vaccine protective against the disease can give to the child at the age of 12 to 18 months, one dose

And for adults (above 12 years old): two doses

Is it because the disease again?

No!After smallpox body of water acquires a long-term immunity against the virusBut the virus remains in hiding in the gangliaIn the case of low immunity in the person, may cause another type of disease: Herpes zoster!

Weakness of the heart muscle, the treatment of heart muscle, heart muscle weakness problems

2012-05-13T00:31:00.000-07:00

Introduction

Heart of the most vital organs in the human body is the most important muscle Tequenath is what this muscle and diseases affecting the causes of these diseases and symptoms and treatment.

Heart muscle is the atria and ventricles of the heart muscle is the main muscle of the left ventricle, which pumps blood from the heart to the whole body.

This can happen twice or sagging muscle in the abdominal left accompanied by "inflation in the wall and can occur at any age, but increases in cases of high blood pressure or chronic cases of drinking heavily with a family history of heart disease in the family and sometimes" happens to a defect in the interactions of the device immune
.

Symptoms of the disease:

Usually the disease at the age of the average 50-60 year where symptoms appear gradually, "although some patients do not complain of any symptoms for long periods of months or years and comes symptoms with the cases that require effort plus of the heart muscle, such as effort, muscle overload or pregnancy or exposure to surgery any microbial infection or severe that the diagnosis is sometimes "mistaken for it is the severe pneumonia not expect to heart disease in this age .

The main symptoms of heart drop in the form of shortness of breath at the effort and the inability of the patient to sleep on his back as suffering from shortness of breath is forced to sleep semi-sitting "on a large number of pillows and often" over this case at night, "as well as shortness of breath without effort and is suffering from swelling feet, nausea, abdominal pain and then comes the symptoms of lack of blood pumped by the heart, which leads to weakness and sometimes "fainting frequent this may happen as a result defect in heart rate may occur symptoms of angina pectoris due coronary appears chest pain with pain in left arm and mid-back or neck .

Diagnosis of the situation:

Must first "examine the patient clinically" good "such as measuring blood pressure and irregular heart rate and the absence of any other symptoms such as swelling foot, edema abdominal or fluid excess at the bottom of the lungs - and then must work a diagram of the heart may show a defect in the electrical impulses or signs of angina ancient or modern.
× rays must be done to the chest, heart, and shows where inflation in the size of the heart in general with evidence of pulmonary congestion or nominated Bllory.
Is the work of Sonograms (echo) may reveal reflux valve and mitral valve trio as well as swelling or sagging in the left heart muscle can also "scan using radioactive isotopes to follow the blood circulation and blood flow to the muscles of the heart failure.
If you require further tests work by the previous results can be if "the work of the heart catheter in order to detect any failure or shortness of the coronary arteries feeding the heart muscle of different.
Improvement that occurs in this condition means the stabilization of the situation and some improvement by 20 to 50% of the disease and that progress depends on several factors, including the early diagnosis of the disease and the lack of impact a large muscle in the heart or in the electrical conductivity of the left ventricle and depends on the treatment of drop of the heart muscle using diuretics and the use of supplements of the heart muscle and the doctor must be advised these patients to avoid excessive physical exertion in proportion to the efficiency of the condition of the heart.
We are interested here recall to avoid salt and reduce tea and coffee to their direct impact on high blood pressure and increased fluid in the body in general.
Advised patients using diuretics to follow up their weight constantly to adjust the amount of medicine if it happened a clear lack of weight because of "the possibility of blood clots or pulmonary periodically and may require anticoagulants sometimes."
This treatment is, of course, be a follow-up of regular physician who is following also "control blood pressure and the importance of losing weight to ease the burden on the heart muscle and also" to control any diseases associated with such as sugar or high fat or any other disease have no effect on the heart muscles are sore the people of the time as a result of smoking for long periods.
Finally, "remember that these cases occur and evolve over a long period must not neglect to reveal the work of the league and the required analysis routine with your doctor to detect any case of early" to avoid all these complications.

Obesity (overweight) and its treatment

2012-05-06T06:52:00.001-07:00

Introduction

Many may consider it as a simple command, was seen by some as a mere stock or unacceptable distortion to the beauty of our bodies, and remembers little to gravity, however stand idly by unable to stop it.

Dear all those and you say - watch out for a serious disease called obesity, and should always be remembered as a disease, not a simple disease, but is a disease of serious diseases, it is a disease of modern times.

What is obesity?

Obesity is increasing the weight of the body alone is the natural result of the accumulation of fat in it, and this accumulation results from an imbalance between energy intake from food and energy consumed in the body.

What are the causes of obesity?

    Kind of food: where it is certain that gorging on food calories with high-calorie non-payment of this leads to the accumulation of fat in human body fat have a note that the higher efficiency of carbohydrates and proteins in the bloc in the fatty tissues of the body. The best example of this that the proliferation of so-called fast food rich in calories in Western countries and other countries have led to the spread of obesity and associated diseases in many parts of the world were not showing before. If we want to be honest with ourselves why it is the first and most important, is the only cause in 90% of cases of obesity
    Lack of activity and movement: It is known that obesity is rare in people Aldaúba movement or activity which requires their constant, but must also know that the lack of volume of activity alone is not sufficient reason for the occurrence of obesity. There is no doubt that the activity and movement of great benefit in improving human health in general and can be summed up activity and movement in one word is a sport. Studies have indicated that the role of sport in reducing the proportion of fat and blood Glicoz They also have a role in the activity of insulin and body tissues receive him, but this percentage is large enough to draw in weight loss? The answer to this question is not, as the studies conducted in this area was mixed to the extent that it can not be recommended for obese sport as a basis for reducing the weight, but it can be helpful, especially to reduce the contouring of body fat, which reduced weight. And the example that if you practiced swimming or running for an hour non-stop, you will spend about 170 calories if then stopped and drank a cup of Pepsi and a small piece of chocolate, it will give you 500 calories.
    Psychological factors: the situation prevalent in women than in men. When subjected to severe psychological problems is reflected in the form of eating too much food.
    Imbalance in the endocrine glands: the reason is always appropriate in cases of obesity, it is usual and common to hear say (I have the doctor said to me it Bgdda endocrine disruption). Once again, To be honest with ourselves, it's very rare and not the reason in most cases.
    Genetics: Also you should know that this factor alone is not responsible for obesity and may not be responsible at all.
From the above it is clear that the most important reason for the occurrence of obesity is eating more food than we need.

Obesity and diseases

Now it is appropriate that we recognize the complications of the disease:

Obesity, heart disease and sudden death

Did you know that it is rare to find Muammra obese!, This theory may be the sort of fallacy, but a general indication of the importance of obese obesity and weight reduction. The weight is excessive overload on the heart and lungs to the setting calls for each effort multiplier.

Despite the lack of knowledge of the relationship between obesity, heart disease and hardening of the arteries, but a relationship exists, although this relationship is also about the nature and type of food you eat fat, where it tends to eat foods rich in fat or fried more of an inclination to take up proteins or carbohydrates, addressing such items raises cholesterol in the blood and this is the first risk factor for heart disease.

Concerning the relationship of obesity, heart disease and sudden death is a relation that depends on the duration of obesity or age of a person. Some studies have found that the persistence of obesity for more than 10 years the percentage of exposure to heart disease and sudden death, especially when obesity in childhood or young adulthood in the first.

Obesity and diabetes

There is no doubt that there is a strong relationship between obesity and diabetes (non insulin-dependent) is not that we should not overlook that there are other reasons such as genetics, gender, geographic locations, etc., but what is the relationship of obesity to diabetes?

That each cell receives the materials, the hormone insulin, which burns to produce energy Alglicoz these substances called insulin receptors and if these receptors are not or less in number, the insulin will not work on this cell and therefore would not be utilized Alglicoz rate rises in the blood. And a fixed rate of these receptors on the cell fatty acids increased the size of the normal cell as is the case in the two countries, the number of receptors may be few

For large area of the cell size. Our advice to all debt reduction and weight as it is the optimal treatment for patients with sugar as the weight reduction leads to improvement of the situation and received insulin secretion in these patients.

Obesity, high blood pressure

Suffice to say that the rate of hypertension among obese up to three times the rate between the ordinary and that weight reduction while minimizing the intake of salt when Mrtfie blood pressure if their pressure well within the limits of up to 50%.

Obesity, joints and ligaments

Obesity also overload the joints of the body and Erbtth and appears in the form of the pain of multiple joints.

Obesity and the skin

Obesity increases the amount of folds in the skin and is therefore the skin is prone to infections and fungal infections and bacterial as well as intolerance to hot weather.

Let's talk now about the means of treatment, and Znserd what is common.

..Diet

The control diet for the obese is the most important and most successful way in which to reduce their weight by reducing caloric intake to less than the limits of the body's need of energy.

As mentioned above, the calories needed varies from one person to another and the application of certain Rigama depends on the body's need for calories and on the basis that the medical advise is to lose weight by 1 kg per week only. Therefore, you should consult your doctor to determine the proper diet as well as educational and behavioral guidance is necessary.

Reduce the use of food

There are three ways for them a real role in preventing the use of food and they are:

     Prevent the utilization of carbohydrates (starch) by preventing the activity of digestive enzymes for carbohydrates and excreted from the salivary glands, pancreas and that by giving the individual materials (found in legumes) to prevent this activity and these materials are of beans and the most famous so-called Carbo-lite These materials do not have a health damage of importance to the gas they are annoying and as a result of non-absorbed carbohydrates that ferment in the colon by bacteria.
     The use of dietary fiber found in bran, vegetables and fruits (so it is advisable to eat without peeling) as they exist in the form of tablets in pharmacies, and these fibers prevent absorption of food from the intestine in addition to that taken before and the food is human satiety, which reduces handling of the food.
     Recently been the use of certain drugs that inhibit the absorption of fat from the intestine and thus reducing the benefit from such a compound called orlistat orlistat.

The use of medicines

And divided the drugs used in the treatment of obesity into two groups:
    Inhibitory drugs such as appetite
    Amphetamine and amphetamine Hbheth
    One of the drug lost its appetite through their effects on the activity of the nervous system, have used these drugs already resistant to sleep, and the most important side effects they cause addiction and leaving it may lead to depression, as it prevents their use for people with heart disease and high blood pressure and Aljlakoma, and more amphetamine derivatives used Kvaked of appetite called polyvinyl propanol Secretary-phenyl propanolamine as it is the best effective and safer to use and does not lead to the problem of addiction.
    Serotoninergic Drugs drugs Alserotoninrjk
    From experiments on these drugs found that the impact would be clear at the beginning of use but after a long use of a mild impact, as these drugs are safe and less dangerous than amphetamine, although it does not differ from those in effect on the nervous system and loss of appetite.
    Thermal generation drugs
    There are natural substances of different ownership property generating heat in the body such as Alkvaian and some hormones and minerals, all working to burn part of the food and convert it into heat without the utilization of it, and these compounds group called Bashbhet with 3 or B3-Agonists, which works to increase generating heat without affecting the appetite, and vehicles Hbhet B-2 - Adranerjk or B2-Adrenergic agonists that affect the appetite in addition to his work as a generator heat.

Surgical intervention (liposuction) lipo-suction

The basic principle in the surgical treatment of obesity through liposuction cosmetic significance but it is not recommended for use only in cases of obesity too.

done..

What is alternative medicine and its benefits and its uses

2012-05-06T05:54:00.002-07:00

Introduction to Alternative Medicine

Interest in alternative medicine is increasing in Western countries. In Arab countries, we are still in the first way. There is a significant lack of information and literature in Arabic on alternative medicine, although a number of attempts to take advantage of its benefits is increasing, and the urgent need for it in the Arab world.
This is what makes some people unfortunately take advantage of that need in the mixing piggledy and display methods of treatment as a folk medicine from alternative medicine without a corrective basis. Many of the doctors is posing to themselves the term alternative medicine, even though they are far away from medicine and diagnostics, installation and other human body.
That had to be - as we have seen - we begin to open a window all to alternative medicine the right to introduce it and try to link the various interested by physicians and other doctors, including patients, and to give information sober and to exchange views and to help those who need it.
The Internet has become the platform today, which overlooks the various interested him all over the world. It encouraged me to open a page on the Internet for alternative medicine that I had published a story about alternative medicine in a Fanahalt Web sites on the questions and inquiries from all over the world.
We will try this site, God willing, published several articles on various methods of alternative medicine, such as that published in other journals, including what has not been published. Then open the door for each of Death for information or questions about alternative medicine to be discussed together in this site. We also hope to all colleagues who are interested in alternative medicine that share our in this area may be based on what they offer on the basis of information and references are correct.
I like to mention here that most of the information that I have the same origins and references by a German medical studies and culture. But that is not fanatical or intransigent. The door is open to all other cultures are in this site in the hope that a forum be a link to the various currents of ideas and cultures and to reconcile God.

What is alternative medicine?

Western medicine has spread in the last three centuries in various parts of the world is widespread, and extracted for himself alone recognized medical status on the grounds that a scientific test. The advanced research and discoveries in medicine, which has become the so-called traditional medicine made impressive progress, particularly in the field of diagnosis and surgery. Also, think about the manner in which commercial companies, led by the pharmaceutical industry and medical equipment may be overwhelmed everything else and covered the other possible means for the treatment of diseases, and blind the eyes of many doctors and patients from other types of effective treatment.
However, there are methods and ways of thinking about the other old and new patients and help process them different from traditional medicine, as we called. These methods are found and still find resistance from many of the men of modern medicine, because they differ in the way she thinks or means of treatment of their habitual, and that they were unable to explain the reasons for their effectiveness Bosalipem did not give up traditional scientific thinking about a different way again.
If we look at the various diseases found are divided into two parts, they are either organic or functional. The organic diseases, any changes that occur in various organs, tumors and Kalxwor cuts and changes in the tissues, this is no doubt require surgical treatment or non-surgically to get rid of them. The diseases and functional, disorderly stomach, intestines, and neurological diseases, psychological, headaches, allergies, and most skin diseases and diseases of the joints, muscles, rheumatic and many others, the traditional medicine today did not find her a cure, but all it does is painkillers to relieve the symptoms of the disease means could hurt if many or misused of drugs or surgical interventions be replaced by the suffering or the suffering of diseases other diseases.
; Appeared in a recent call from a new organization to use other means to address these diseases is still functional, including the number of sufferers is increasing in every country and all the doctors' offices. Instead of flooding the patient bags of chemicals, drugs and toxins from antibiotics and hormones to medications for pain and that helped ease the pain, but they do not eliminate the disease, but often lead to problems and the suffering of other new diseases, while described as an argument helpless.
This appeared to advocate the use of other means that do not harm the patient and help him get rid of a lot of suffering, regardless of the economic side, which provides the patient at the same time a lot of money in drugs and toxins may harm him. Alternative medicine is important to emphasize that it does not hurt that did not work. While chemical drugs based on the principle that what does not hurt them at all does not work at all. That is, they after all poisons. While alternative medicine helps the patient to get rid of their suffering in ways more compassionate as long as the membership of that suffering is not in need of surgical intervention can remove.
Alternative medicine should nevertheless be kept in the hands of doctors, which means that it is practiced by a doctor knows both directions and knows the limits of the use of all of them and when to apply this or that or refer the patient to whom it is most skillful in the treatment of that situation.
To this must be away this medicine is quackery and charlatans who are unaware of doctors and diagnostic techniques and knowledge of the limits and potential of each method in the treatment.
There are types of alternative medicine proven to be effective and successful as there are types that have not been successfully clear. There is no type effective in all diseases, but you should know the limits of each type and when to use it and to what extent, and these types of effective all in a particular area Acupuncture Chinese and treatment nervous German, medicine and manual of herbal remedies and other needs to explain each of them to a separate article.

Why alternative medicine?

Diseases of two types: organic and functional, and organic diseases are those that occur because of a clear change in the part of the body fractions or bone tumors or wounds or muscle or hernia rupture or blockage of a blood veins or interruption of the nerve center of the nerves. There is no doubt these diseases need to be addressed through traditional medicine, which has proved successful in this regard is no need for us to give it up. It is also important to know that such diseases are difficult to overcome the body's own completely without medical or surgical intervention. There is no need for us in such cases to search for alternatives to medical treatment.
The disease functionality, which occupies a large portion of the suffering of patients in various parts of the world, most of the inability of medicine to this day to find a clear explanation of them, but they are assumptions and theories appear and disappear are treated on the basis of which, most prominent of these diseases, functional diseases of rheumatism in all its forms Kojaa joints and muscles , and allergic diseases as they call it in the chest, nose, or skin or other, and different types of headaches Kalshqikh and other diseases of digestive disorders, constipation and gas and more. All these and many other people experience and almost no human being but complained that some day one of these diseases, at least for a time in his life.
The traditional medicine, Western scientific experimental day trying to repair the defect arise in various organs of the body if discovered. This applies to organic diseases, where he managed to do very much. The diseases we call functional as the traditional medicine was not able to interpret a clear explanation except in a few cases. It is supposed to put the theories and assumptions are uncertain, in the end, trying to relieve the symptoms with drugs it covers not eliminate the disease. Then that these drugs if they have weakened the body's resistance against the disease is difficult for him transformed into a chronic disease symptoms and change to other symptoms and continue suffering.
In the alternative medicine Attempts and method of treatment does not depend on soothing the symptoms only, but at the same time give the body a chance to fight the disease himself and overcome it and restore balance to the body in ways that simple does not hurt that did not work, other than those massive amounts of drugs, potent and alien to the body that spend all day in the thousands and millions all over the world in the field of traditional medicine or surgery, even those that build on the theories of uncertain and incapable of being an argument do not work temporarily, but that did work, you continue suffering until after the procedure or to turn into symptoms other symptoms.
Functional cure for diseases, including chronic diseases where alternative medicine has proved highly successful filed by the methods of traditional medicine in most cases. It also does not hurt that did not work, or cure for rheumatic diseases, allergies or digestive disorders or Chinese acupuncture therapy nervous German or herbal remedies, for example better and more merciful for the body and lead to results beyond the results of treatment in traditional medicine often.
Has spread alternative therapy in various parts of Europe and America, especially Germany's leading in this field, spread to a large extent increasing, and found responsive and demand of patients who are trying to avoid drugs, chemicals that do not even know today how their negative impact and side effects on the body. The doctors also demand to learn the various types of alternative therapy continues to increase, convinced of its potency and the advantages and the benefit of their patients.
As an example of how the application of alternative medicine back pain suffered by every fifth person in the world today and almost do not know that in most cases causes. Traditional medicine is more than the suffering of the patient to conduct several tests of different types of rays by the coincidence and perhaps find something wrong with the vertebral series of references to the suffering and pain and address without paying attention to the suffering of origin. The Chinese alternative medicine or treatment Kalokhoz nervous German helps the patient to get rid of the pain and leaves the body restore balance and to overcome the change thereto, without side effects of drugs or surgery. All this is just one example of what the alternative medicine that needs to be many details of every kind and condition.

Disease and the cure

Clinical Picture and Treatment of Guillain Barre Syndrome

A cute infective polyneuritis

"Landry Guillain Barre Syndrome"

Aetiology:

Clinical picture:

Febrile stage:

Latent stage:

Paralytic stage:

Treatment:

vitamin B complex deficiency"Pellagra"

Pellagra

Definition and Aetiology:

Clinical picture:

1)Cutaneous manifestations:

2)Gastro-intestinal manifestations:

3)Neuropsychiatric manifestations:

Treatment:

Non-pharmacological management of Orthostatic Hypotension

Orthostatic Hypotension

Definition:

Causes:

Symptoms:

Treatment options:

Management:

Non-pharmacologic management:

Pharmacologic management:

Degenerative Disorders(Lumbar Disc Prolapse)

Degenerative Disorders

"Lumbar Disc Prolapse"

Definition:

Incidence:

Aetiology:

Pathophysiology:

Clinical Picture:

1)Related to stretching of annulus fibrosis:

2)Related to neural compression:

Differential Diagnosis:

Investigation:

1)MRI:

2)X-ray(A-P and Lateral)

3)CT scan is useful but to a less degree than MRI.

4)Myelography is invasive and no longer used.

Treatment:

Conservative(succeeds in 90% of cases):

2)Surgical

N.B.

Degenerative Disorders (Cervial Disc Prolapse)

Cervical Disc Prolapse

Back ground:

Definition:

Aetiology:

Pathophysiology:

Clinical Picture:

1)Related to annulus tearing or spine degeneration and instability:

2)Related to neural compression:

Differential Diagnosis:

Investigation:

1)MRI:

2)X-ray(A-P and Lateral)

3)CT scan is useful but to a less degree than MRI.

4)Myelography is invasive and no longer used.

Treatment:

1)Conservative:

2)Surgical:

Surgical procesures

Milk and Medications For Treatment of Hypertension

Hypertension"A Silent Killer"

Definition:

Symptoms:

Management:

STEP 1

A)Diuretics:

ACTION:-

Main side effects:-

B)Beta-blockers (e.g. propranolol; INDERAL)

Action:-

Uses:-

Contraindication:-

N.B.

Hypertension
"A Silent Killer"