Parkinsonism

Parkinson’s disease (PD) is the most common neurodegenerative cause of parkinsonism, a clinical syndrome characterized by lesions in the basal ganglia, predominantly in the substantia nigra.
As a rule, PD begins between the ages of 40 and 70 years, with peak age onset in the seventh decade. The prevalence of PD is approximately 160 cases per 100,000 population, and the incidence is about 20 cases per 100,000 population. The pathological changes of PD may appear as early as three decades before the appearance of clinical signs. The cause of PD is probably multi factorial, with contributions from hereditary predisposition, environmental toxins, and aging.

 Symptoms can take years to develop, and most people live for many years with
the disease. The symptoms caused by Parkinson’s include an ongoing loss of  motor
control (resting tremors, stiffness, slow movement, postural instability) as well as a
wide range of non-motor symptoms (such as depression, loss of sense of smell, gastric problems and cognitive changes).
Parkinson's disease can cause varying and progressive symptoms throughout its course. Some of the most common symptoms associated with the disease include:

• difficulty showing facial expressions
• muscle stiffness
• slowed, affected movements
• speech changes
• tremor, especially of one hand

A person with Parkinsonism may have some, but not all, of the symptoms listed above. This is because they also have an additional disorder that affects the brain's functioning.

For example, people with Parkinsonism often do not have the hand tremor that affects many people with Parkinson's disease.

Other symptoms associated with Parkinsonism include:

• dementia
• issues with the autonomic nervous system, such as problems with controlled movements or spasms
• early problems with balance
• rapid onset and progression of symptoms

Treatment should always be advised by an expert and a qualified medical practitioner.

Alzheimer's Disease

Alzheimer's disease is a progressive disease that destroys memory and other important mental functions. At first, someone with Alzheimer's disease may notice mild confusion and difficulty remembering. Eventually, people with the disease may even forget important people in their lives and undergo dramatic personality changes.

Alzheimer's disease is the most common cause of dementia — a group of brain disorders that cause the loss of intellectual and social skills. In Alzheimer's disease, the brain cells degenerate and die, causing a steady decline in memory and mental function.
At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer's disease that you notice. But over time, the disease robs you of more of your memory, especially recent memories. The rate at which symptoms worsen varies from person to person.

If you have Alzheimer's, you may be the first to notice that you're having unusual difficulty remembering things and organizing your thoughts. Or you may not recognize that anything is wrong, even when changes are noticeable to your family members, close friends or co-workers.

Everyone has occasional memory lapses. It's normal to lose track of where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer's disease persists and worsens, affecting your ability to function at work and at home.

       People with Alzheimer's may:

• Repeat statements and questions over and over, not realizing that they've asked the question before
• Forget conversations, appointments or events, and not remember them later
• Routinely misplace possessions, often putting them in illogical locations
• Get lost in familiar places
• Eventually forget the names of family members and everyday objects
• Have trouble finding the right words to identify objects, express thoughts or take part in conversations

Brain changes that occur in Alzheimer's disease can affect the way you act and how you feel. People with Alzheimer's may experience:

• Depression
• Apathy
• Social withdrawal
• Mood swings
• Distrust in others
• Irritability and aggressiveness
• Changes in sleeping habits
• Wandering
• Loss of inhibitions
• Delusions, such as believing something has been stolen
• Many important skills are not lost until very late in the disease. These include the ability to read, dance and sing, enjoy old music, engage in crafts and hobbies, tell stories, and reminisce.

  This Disorder is progressive and takes time to show it's Symptoms.

Anorexia Nervosa

 An eating disorder characterized by an abnormally low body weight, an intense fear of gaining weight and a distorted perception of weight.To prevent weight gain or to continue losing weight, people with anorexia usually severely restrict the amount of food they eat. They may control calorie intake by vomiting after eating or by misusing laxatives, diet aids, diuretics or enemas. They may also try to lose weight by exercising excessively. No matter how much weight is lost, the person continues to fear weight gain.

  The physical signs and symptoms of anorexia nervosa are related to starvation. Anorexia also includes emotional and behavioral issues involving an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat

.

Physical signs and symptoms of anorexia may include:

• Extreme weight loss or not making expected developmental weight gains
• Thin appearance
• Abnormal blood counts
• Fatigue
• Insomnia
• Dizziness or fainting
• Bluish discoloration of the fingers
• Hair that thins, breaks or falls out
• Soft, downy hair covering the body
• Absence of menstruation
• Constipation and abdominal pain
• Dry or yellowish skin
• Intolerance of cold
• Irregular heart rhythms
• Low blood pressure
• Dehydration
• Swelling of arms or legs
• Eroded teeth and calluses on the knuckles from induced vomiting

   There is no guaranteed way to prevent this but the treatment regime can be designed as follows.

Diabetes

  Diabetes, a metabolic disorder, in which there is a disturbance in the glucose metabolism in  our body.Glucose is vital to your health because it's an important source of energy for the cells that make up our muscles and tissues. It's also our brain's main source of fuel
  The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems.Chronic diabetes conditions include type 1 diabetes and type 2 diabetes.
      Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Some of the signs and symptoms of type 1 and type 2 diabetes are:

• Increased thirst
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin)
• Fatigue
• Irritability
• Blurred vision
• Slow-healing sores
• Frequent infections, such as gums or skin infections and vaginal infections

To understand diabetes, first you must understand how glucose is normally processed in the body.

How insulin works
Insulin is a hormone that comes from a gland situated behind and below the stomach (pancreas).

• The pancreas secretes insulin into the bloodstream.
• The insulin circulates, enabling sugar to enter your cells.
• Insulin lowers the amount of sugar in your bloodstream.
• As your blood sugar level drops, so does the secretion of insulin from your pancreas.

The picture shown below, in my opinion is the most comprehensive way to sum up this disorder and it's prevention.

Diarrhea

  Diarrhea can be simply explained as lose, watery, and frequent movement of the bowel and stool.
In most cases, diarrhea lasts a couple of days. But when diarrhea lasts for weeks, it can indicate a serious disorder, such as a persistent infection, inflammatory bowel disease, or a less serious condition, such as irritable bowel syndrome

 As for the symptoms, these can be stated simply as:

• Loose, watery stools
• Abdominal cramps
• Abdominal pain
• Fever
• Blood in the stool
• Bloating
• Nausea
• Urgent need to have a bowel movement

  If your diarrhea persists for more than two days with severe pain then you should consult your doctor, either wise it may lead to dehydration and other complications which may be life threatening.

A number of diseases and conditions can cause diarrhea, including:

   Viruses. Viruses that can cause diarrhea include Norwalk virus, cytomegalovirus and viral hepatitis. Rotavirus is a common cause of acute childhood diarrhea.

   Bacteria and parasites. Contaminated food or water can transmit bacteria and parasites to your body. 

   Medications. Many medications, such as antibiotics, can cause diarrhea. Antibiotics destroy both good and bad bacteria, which can disturb the natural balance of bacteria in your intestines. This is a major reason why antibiotics should be taken carefully and by the prescription of a doctor as self medication is always harmful.

  If your diarrhea is not controlled it may lead to dehydration and the symptoms of dehydration are as follows:

• Excessive thirst
• Dry mouth or skin
• Little or no urination
• Weakness, dizziness or lightheadedness
• Fatigue
• Dark-colored urine

In infants diarrhea presents with the following symptoms:

• Not having a wet diaper in three or more hours
• Dry mouth and tongue
• Fever above 102 F (39 C)
• Crying without tears
• Drowsiness, unresponsiveness or irritability
• Sunken appearance to the abdomen, eyes or cheeks

  By taking simple steps we can easily prevent diarrhea and these simple steps are:

• Wash your hands frequently
• Use sanitizer regularly
• Vaccination
• AND WATCH WHAT YOU EAT

These foods can help control diarrhea

Coronary Artery Disease

    Coronary artery disease develops when the major blood vessels that supply your heart with blood, oxygen and nutrients (coronary arteries) become damaged or diseased. Cholesterol-containing deposits (plaque) in your arteries and inflammation are usually to blame for coronary artery disease.

   When plaque builds up, it narrows your coronary arteries, decreasing blood flow to your heart. Eventually, the decreased blood flow may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and symptoms. A complete blockage can cause a heart attack.

   Because coronary artery disease often develops over decades, you might not notice a problem until you have a significant blockage or a heart attack. But there's plenty you can do to prevent and treat coronary artery disease.

   

   If your coronary arteries narrow, they can't supply enough oxygen-rich blood to your heart — especially when it's beating hard, such as during exercise. 

• Chest pain (Angina)
• Shortness of breath

These ultimately leading to a heart attack.

   The causative agents or predisposing factors are:

• Smoking
• High blood pressure
• High cholesterol
• Diabetes or insulin resistance
• Sedentary lifestyle
• High stress
• Diabetes
• Unhealthy diet

   The preventive measures are easy to take and prevention is always better than treatment.

The same lifestyle habits that can help treat coronary artery disease can also help prevent it from developing in the first place. Leading a healthy lifestyle can help keep your arteries strong and clear of plaque. 

   To improve your heart health, you can:

• Quit smoking
• Control conditions such as high blood pressure, high cholesterol and diabetes
• Stay physically active
• Eat a low-fat, low-salt diet that's rich in fruits, vegetables and whole grains
• Maintain a healthy weight
• Reduce and manage stress

    

Stroke

   Stroke, normally referred to as the brain stroke, is a medical emergency and occurs when the blood supply to the brain is blocked. Today i shall focus on the signs and symptoms of this condition so you can think "FAST" and act "FAST".
   Nearly 800,000 people have a stroke each year and it is the fifth leading cause of death in the world.
A stroke occurs when the supply of blood to the brain is either interrupted or reduced. When this happens, the brain does not get enough oxygen or nutrients, and brain cells start to die.In the U.S., approximately 40 percent of people who die from stroke are male, with 60 percent of deaths occurring in females.According to the American Heart Association (AHA), compared with Caucasian people, African-Americans have nearly twice the risk of a first-time stroke and a much higher risk of death from stroke.

    I stressed on the word "FAST" so i could hammer in the symptoms by the above depicted diagram.

   A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that doesn't cause permanent damage.
Ischemic stroke:
About 80 percent of strokes are ischemic strokes. Ischemic strokes occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:

Thrombotic stroke:
A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions.
Embolic stroke. An embolic stroke occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus.
Hemorrhagic stroke:
Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels. These include:

Many factors can increase your stroke risk. Some factors can also increase your chances of having a heart attack. Potentially treatable stroke risk factors include:

Lifestyle risk factors:

• Being overweight or obese
• Physical inactivity
• Heavy or binge drinking
• Use of illicit drugs such as cocaine and methamphetamines

Medical risk factors:

• Blood pressure readings higher than 120/80 millimeters of mercury (mm Hg)
• Cigarette smoking or exposure to secondhand smoke
• High cholesterol
• Diabetes
• Obstructive sleep apnea
• Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal heart rhythm
• Personal or family history of stroke, heart attack or transient ischemic attack.

Other factors associated with a higher risk of stroke include:

• Age —People age 55 or older have a higher risk of stroke than do younger people.
• Race — African-Americans have a higher risk of stroke than do people of other races.
• Sex — Men have a higher risk of stroke than women. Women are usually older when they have strokes, and they're more likely to die of strokes than are men.
• Hormones — use of birth control pills or hormone therapies that include estrogen, as well as increased estrogen levels from pregnancy and childbirth.

   Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. If you've had a stroke or a transient ischemic attack (TIA), these measures might help prevent another stroke. The follow-up care you receive in the hospital and afterward also may play a role as well.Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:

• Controlling high blood pressure (hypertension). 
• Exercising, managing stress, maintaining a healthy weight 
• Lowering the amount of cholesterol and saturated fat in your diet. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the plaque in your arteries.
• Quitting tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke.
• Controlling diabetes. You can manage diabetes with diet, exercise, weight control and medication.
• Maintaining a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes. Losing as little as 10 pounds may lower your blood pressure and improve your cholesterol levels.
• Eating a diet rich in fruits and vegetables. A diet containing five or more daily servings of fruits or vegetables may reduce your risk of stroke. Following the Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful.
• Exercising regularly. Aerobic or "cardio" exercise reduces your risk of stroke in many ways.
• Treating obstructive sleep apnea.
• Avoiding illegal drugs. Certain street drugs, such as cocaine and methamphetamines, are established risk factors for a TIA or a stroke. Cocaine reduces blood flow and can narrow the arteries.

Environmental crisis

   Today's ill be blogging off topic. This is a serious problem we are facing in Pakistan, and not only in Pakistan but also, all around the world. Our health is directly related to our environment, a polluted environment always leads to health crisis.
  Today I shall be focusing on "HOW TO PROTECT YOUR BELOVED PLANET AND YOUR ENVIRONMENT".

 Clean Air:

• Painting your house? Use a latex paint. Oil-based paints release hydrocarbon fumes.
• Get a tune-up. Properly maintained vehicles get better gas mileage and emit fewer pollutants.
• Don’t top off your gas tank. Overfilling causes spills that release hydrocarbons and other toxic chemicals into the air.
• Conserve energy. You’ll lower your utility bills and help avoid peak demands on utility plants.
• Don’t burn your yard waste. It’s illegal in many areas of the world because burning yard waste releases mold spores, soot, and other contaminants that can aggravate allergies and cause respiratory problems.
• Plant a tree. Trees absorb carbon dioxide, a greenhouse gas.
• Park the car. Walk, bike or use mass-transit whenever you can. Vehicle traffic is a major contributor to smog.

Clean Water:

• Use less fertilizer on your lawn. When it rains, excess fertilizer runs off into storm sewers and pollutes streams.
• Never pour anything – especially waste oil or leftover lawn chemicals – into a storm drain. It will end up in the nearest stream.
• Don’t trash our streams. Volunteer groups sponsoring annual cleanups find everything from old tires to old appliances in our waterways.
• Water your lawn in the early morning, when the water will soak in and not evaporate in the heat of the day.
• Don’t water more than once a week, and then only if it hasn't rained. Established lawns need only one inch of water a week.
• Don’t water the sidewalk - it won’t grow. Set your sprinkler to keep the water on the lawn.
• Mulch around your landscaping. A three-inch layer of mulch holds moisture and prevents evaporation, reducing the need to water.
• Use a bucket when you wash the car, instead of the hose. Letting the water run while you work costs money and wastes water. Only use the hose to rinse.
• Sweep your driveway and sidewalk instead of cleaning them up by spraying with the hose.
• Don’t do the dishes until you have a full load. Your dishwasher uses 12 gallons of water whether it’s full or half-empty.
• Wash a full load of laundry. Your washing machine uses 40 gallons of water. Run it full, or adjust the water level to the size of your load.
• Don’t let the water run while you shave or brush your teeth. Turn it on only when you need it. Every minute the faucet runs, five gallons of water go down the drain.
• Take a shorter shower. And switch to a low-flow shower head.
• Repair leaky faucets and toilets. You can tell if the toilet leaks by putting food coloring in the tank. If color shows up in the bowl without flushing, there’s a leak.
• Install faucet aerators. You can cut your water usage by up to six percent.

Clean Land:

• Recycle. If your community does not offer a recycling program, ask local officials to start one.
• Don’t put hazardous materials in the trash. Save paints, pesticides, lawn chemicals, car batteries, waste oil and similar materials for your local household hazardous waste collection day
• Don’t buy more than you need. When it comes to lawn ,chemicals, pesticides, paints and other hazardous materials, buy a smaller package so you won’t have leftovers to dispose of.
• Paper or plastic? Better yet, take a canvas bag to the grocery and re-use it each time you shop.
• Use both sides of the paper. Set your copier to make double-sided copies and you’ll substantially reduce your paper use.
• Use rechargeable batteries. Many batteries contain metals that are better kept out of landfills.
• Give it away, don’t throw it away. Many charitable organizations accept donations of wearable clothing and gently used household items

Plant Trees:

  Planting a tree is a lifelong investment. How well this investment grows depends on the type of tree selected and the planting location, the care provided during planting, and the follow-up care after planting. Getting your new tree off to a healthy start will help the tree mature to its full size and ensures it will provide environmental, economic, and social benefits throughout its lifetime.

   Ideally, trees are planted during the dormant season – in the fall after leaf drop or in early spring before bud break. Weather conditions are cool and allow plants to establish roots in the new location before spring rains and summer heat stimulate new top growth. Healthy balled and bur lapped or container trees, however, can be planted throughout the growing season if given appropriate care. In tropical and subtropical climates where trees grow year round, any time is a good time to plant a tree, provided that sufficient water is available.

Conserve water:
    Conserve and don't waste water as we are running out of clean water. Take part in activities like social media awareness for building dams. Spread awareness among people.

Protect your environment to give your children a better future and a better life.

Rheumatoid Arthritis

   Gouty Arthritis which was published last week, is a metabolic disorder, Whereas Rheumatoid Arthritis is an autoimmune disorder. This means that the protective or the security system or the immunity of our body starts attacking our own cells specifically present in the joints which progress t this disease ultimately.

   Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition also can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels.An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues.Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities.

 Signs and symptoms of rheumatoid arthritis may include:

• Tender, warm, swollen joints
• Joint stiffness that is usually worse in the mornings and after inactivity
• Fatigue, fever and weight loss
• Early rheumatoid arthritis tends to affect your smaller joints first — particularly the joints that attach your fingers to your hands and your toes to your feet.

As the disease progresses, symptoms often spread to the wrists, knees, ankles, elbows, hips and shoulders. In most cases, symptoms occur in the same joints on both sides of your body.

About 40 percent of the people who have rheumatoid arthritis also experience signs and symptoms that don't involve the joints. Rheumatoid arthritis can affect many nonjoint structures, including:

• Skin
• Eyes
• Lungs
• Heart
• Kidneys
• Salivary glands
• Nerve tissue
• Bone marrow
• Blood vessels

Rheumatoid arthritis signs and symptoms may vary in severity and may even come and go. Periods of increased disease activity, called flares, alternate with periods of relative remission — when the swelling and pain fade or disappear. Over time, rheumatoid arthritis can cause joints to deform and shift out of place.

When you observe these symptoms, then it is probably a good time to visit your doctor.

Gout

    Gout is a common and complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe. An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.
   The signs include:

• Intense joint pain. Gout usually affects the large joint of your big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins.
• Lingering discomfort. After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
• Inflammation and redness. The affected joint or joints become swollen, tender, warm and red.
• Limited range of motion. As gout progresses, you may not be able to move your joints normally.

      Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood.

Your body produces uric acid when it breaks down purines — substances that are found naturally in your body. Purines are also found in certain foods, such as steak, organ meats and seafood. Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle like urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.

    Most likely risk factors include:

• Diet. Eating a diet rich in meat and seafood and drinking beverages sweetened with fruit sugar (fructose) increase levels of uric acid, which increase your risk of gout. Alcohol consumption, especially of beer, also increases the risk of gout.
• Obesity. If you're overweight, your body produces more uric acid and your kidneys have a more difficult time eliminating uric acid.
• Medical conditions. Certain diseases and conditions increase your risk of gout. These include untreated high blood pressure and chronic conditions such as diabetes, metabolic syndrome, and heart and kidney diseases.
• Certain medications. The use of thiazide diuretics — commonly used to treat hypertension — and low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
• Family history of gout. If other members of your family have had gout, you're more likely to develop the disease.
• Age and sex. Gout occurs more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women's uric acid levels approach those of men. Men are also more likely to develop gout earlier — usually between the ages of 30 and 50 — whereas women generally develop signs and symptoms after menopause.
• Recent surgery or trauma. Experiencing recent surgery or trauma has been associated with an increased risk of developing a gout attack.

 

 As far as diet is concerned, avoiding beverages especially carbonated and using fresh juices and citrus fruits always help in the prevention of  Gout.

Arthritis

     Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two different bones meet. A joint functions to move the body parts connected by its bones. Arthritis literally means inflammation of one or more joints.Arthritis is frequently accompanied by joint pain. Joint pain is referred to as arthralgia.

   There are many types of arthritis (over 100 identified, and the number is growing). The types of arthritis range from those related to wear and tear of cartilage (such as osteoarthritis) to those associated with inflammation resulting from an overactive immune system (such as rheumatoid arthritis). Together, the many types of arthritis make up the most common chronic illness.

   The causes of arthritis depend on the form of arthritis. Causes include injury (leading to osteoarthritis), metabolic abnormalities (such as gout and pseudogout), hereditary factors, the direct and indirect effect of infections (bacterial and viral), and a misdirected immune system with autoimmunity (such as in rheumatoid arthritis and systemic lupus erythematosus).

      

  Arthritis is classified as one of the rheumatic diseases. These are conditions that are different individual illnesses, with differing features, treatments, complications, and prognoses. They are similar in that they have a tendency to affect the joints, muscles, ligaments, cartilage, and tendons, and many have the potential to affect other internal body areas.

    Many of the forms of arthritis, because they are rheumatic diseases, can cause symptoms affecting various organs of the body that do not directly involve the joints. Therefore, symptoms in some patients with certain forms of arthritis can also include fever, gland swelling (swollen lymph nodes), weight loss, fatigue, feeling unwell, and even symptoms from abnormalities of organs such as the lungs, heart, or kidneys.

      or most forms of arthritis, diets play little or no role in precipitating or exacerbating the condition. However, in general, oils of fish have been shown to have anti-inflammatory properties. Some osteoarthritis suffers benefit from omega-3 fatty acid supplements. Some people with osteoarthritis feel they benefit from the curcumin that is present in curry foods.

    Gout is a particular type of metabolic arthritis that is clearly diet-related. Foods that are high in purines, especially red meats and shellfish, can worsen the condition. Moreover, certain foods elevate the levels of uric acid, including alcohol (especially beer) and those foods containing high amounts of fructose (such as the corn syrup found in soft drinks). For people with celiac disease, gluten-containing foods (wheat, barley, rye) can worsen joint pains.

   

      With the exception of the unique metabolic form of arthritis in gout and celiac disease, there are no universally accepted foods that must be avoided by people with arthritis. Gout can be promoted and precipitated by dehydration as well as fructose-containing foods (corn syrup, etc.), high-purine foods (seafood, shellfish, organ meats), and alcoholic beverages (particularly beer). People with gout should avoid these foods. The arthritis of celiac disease can be worsened by intake of gluten-containing foods (wheat, barley, rye).

    The detail of forms of arthritis will be discussed in the subsequent blogs, so stay tuned.

Tourette Syndrome

   Tourette syndrome (TS) is a neurological disorder characterized by repetitive, stereotyped, involuntary movements and vocalizations called tics. The disorder is named for Dr. Georges Gilles de la Tourette, the pioneering French neurologist who in 1885 first described the condition in an 86-year-old French noblewoman.

   The early symptoms of TS are typically noticed first in childhood, with the average onset between the ages of 3 and 9 years. TS occurs in people from all ethnic groups; males are affected about three to four times more often than females. It is estimated that 200,000 Americans have the most severe form of TS, and as many as one in 100 exhibit milder and less complex symptoms such as chronic motor or vocal tics. Although TS can be a chronic condition with symptoms lasting a lifetime, most people with the condition experience their worst tic symptoms in their early teens, with improvement occurring in the late teens and continuing into adulthood.

   Tics are classified as either simple or complex. Simple motor tics are sudden, brief, repetitive movements that involve a limited number of muscle groups. Some of the more common simple tics include eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking.  Simple vocalizations might include repetitive throat-clearing, sniffing, or grunting sounds. Complex tics are distinct, coordinated patterns of movements involving several muscle groups. Complex motor tics might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may actually appear purposeful, including sniffing or touching objects, hopping, jumping, bending, or twisting. Simple vocal tics may include throat-clearing, sniffing/snorting, grunting, or barking. More complex vocal tics include words or phrases.  Perhaps the most dramatic and disabling tics include motor movements that result in self-harm such as punching oneself in the face or vocal tics including coprolalia (uttering socially inappropriate  words such as swearing) or echolalia (repeating the words or phrases of others).   However, coprolalia is only present in a small number (10 to 15 percent) of individuals with TS. Some tics are preceded by an urge or sensation in the affected muscle group, commonly called a premonitory urge. Some with TS will describe a need to complete a tic in a certain way or a certain number of times in order to relieve the urge or decrease the sensation.

   Tics are often worse with excitement or anxiety and better during calm, focused activities. Certain physical experiences can trigger or worsen tics, for example tight collars may trigger neck tics, or hearing another person sniff or throat-clear may trigger similar sounds. Tics do not go away during sleep but are often significantly diminished. 

   The symptoms of TS are involuntary, some people can sometimes suppress, camouflage, or otherwise manage their tics in an effort to minimize their impact on functioning. However, people with TS often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed (against their will). Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.

   The cause of TS is unknown, current research points to abnormalities in certain brain regions (including the basal ganglia, frontal lobes, and cortex), the circuits that interconnect these regions, and the neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication among nerve cells. Given the often complex presentation of TS, the cause of the disorder is likely to be equally complex.

Many individuals with TS experience additional neurobehavioral problems that often cause more impairment than the tics themselves.  These include inattention, hyperactivity and impulsivity (attention deficit hyperactivity disorder—ADHD);   problems with reading, writing, and arithmetic; and obsessive-compulsive symptoms such as intrusive thoughts/worries and repetitive behaviors. For example, worries about dirt and germs may be associated with repetitive hand-washing, and concerns about bad things happening may be associated with ritualistic behaviors such as counting, repeating, or ordering and arranging.  People with TS have also reported problems with depression or anxiety disorders, as well as other difficulties with living, that may or may not be directly related to TS.  In addition, although most individuals with TS experience a significant decline in motor and vocal tics in late adolescence and early adulthood, the associated neurobehavioral conditions may persist.  Given the range of potential complications, people with TS are best served by receiving medical care that provides a comprehensive treatment plan.

Hepatitis

 Hepatitis is an inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world but other infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases can also cause hepatitis. So there is either infectious hepatitis or non infectious hepatitis,

There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of greatest concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.

Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids. Common modes of transmission for these viruses include receipt of contaminated blood or blood products, invasive medical procedures using contaminated equipment and for hepatitis B transmission from mother to baby at birth, from family member to child, and also by sexual contact.

Acute infection may occur with limited or no symptoms, or may include symptoms such as jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.

Scientists have identified 5 unique hepatitis viruses, identified by the letters A, B, C, D, and E. While all cause liver disease, they vary in important ways.

Hepatitis A virus (HAV) is present in the faeces of infected persons and is most often transmitted through consumption of contaminated water or food. Certain sex practices can also spread HAV. Infections are in many cases mild, with most people making a full recovery and remaining immune from further HAV infections. However, HAV infections can also be severe and life threatening. Most people in areas of the world with poor sanitation have been infected with this virus. Safe and effective vaccines are available to prevent HAV.

Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen, and other body fluids. HBV can be transmitted from infected mothers to infants at the time of birth or from family member to infant in early childhood. Transmission may also occur through transfusions of HBV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. HBV also poses a risk to healthcare workers who sustain accidental needle stick injuries while caring for infected-HBV patients. Safe and effective vaccines are available to prevent HBV.

Hepatitis C virus (HCV) is mostly transmitted through exposure to infective blood. This may happen through transfusions of HCV-contaminated blood and blood products, contaminated injections during medical procedures, and through injection drug use. Sexual transmission is also possible, but is much less common. There is no vaccine for HCV.

Hepatitis D virus (HDV) infections occur only in those who are infected with HBV. The dual infection of HDV and HBV can result in a more serious disease and worse outcome. Hepatitis B vaccines provide protection from HDV infection.


Hepatitis E virus (HEV) is mostly transmitted through consumption of contaminated water or food. HEV is a common cause of hepatitis outbreaks in developing parts of the world and is increasingly recognized as an important cause of disease in developed countries. Safe and effective vaccines to prevent HEV infection have been developed but are not widely available.

 Symptoms of hepatitis can be summed up as