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Acne
Definition:
An inflammatory condition of the sebaceous glands characterized by comedones and pimples occurring most commonly on the face, back, and chest.
Who is at risk?
- Pubertal age: about 85% of young people ages 12 to 24 have acne
- Hormonal changes: acne is common in pregnancy, and can occur with the use of birth control pills
- People on certain medications (such as certain drugs to control epilepsy and medicine that contains hormones)
- Excessive use of cosmetics
- Family history of acne
Symptoms:
The patient may notice a few whiteheads and blackheads on the face, back, and chest. Whiteheads are caused by completely blocked pores that trap the sebum, dead cells, and bacteria, while blackheads occur in partially blocked pores when pigments in the skin are exposed to air. Severe acne may become red and painful, and develop into pustules or even abscesses which heal but with scarring.
Treatment:
Hygiene
Wash the face once or twice daily with mild soap or cleanser. Friction makes acne worse, so do not rub or scrub sensitive areas. Never pick or squeeze acne.
Local Non-prescription Treatment
Many preparations are available containing sulfur, resorcinol, salicylic acid, and benzoyl peroxide in different concentrations and combinations. These may work in some people with mild acne.
Other Topical Treatment
Stronger acne preparations are also available. Some may contain antibiotics and / or derivatives of Vitamin A called retinoids. These medications should only be used with care after consultation with a doctor.
Oral Medicine
Some patients may improve with oral antibiotics. Some oral medications work to regulate the hormones. Sometimes dermatologists may prescribe Vitamin A derivatives for patients with severe and disfiguring acne, but these drugs must be used with extreme caution.
Prevention:
Washing
Use warm water and a mild cleanser 1- 2 times per day to remove excessive oil and excessive dead skin cells, especially after exercise. Avoid using greasy and oily cosmetics. The choice can be very individual.
Avoid the Sun
Exposure to the sun tends to make acne worse.
Avoid Mechanical Factors
Acne tends to develop in sites affected by friction, so do not rub or scrub your face heavily. Never prick or probe acne. Pay attention to bra straps or collars if acne develops in those areas.
Food
Scientists are still debating if acne can be caused by the food we eat. If it¡¦s your experience that eating certain foods makes your acne worse, it is sensible to avoid them.
Alcoholism
Definition:
Alcoholism can be defined as a physical dependence on alcohol. Physical symptoms including nausea, sweating, shakiness, tremor, anxiety and hallucinations appear when drinking is suddenly stopped. A patient suffering from alcoholism has a strong craving to drink and is unable to stop once started. He needs to consume more and more alcohol to get "high".
People troubled with bouts of drinking but do not show physical dependence are said to be suffering from alcohol abuse. They do not have alcoholism in the strict sense, but still encounter recurrent problems socially with their drinking habits.
Alcoholism adversely affects intellectual function, physical skills, memory and judgment. Heavy alcohol intake can damage the liver, the brain, the nerves and the gut.
Who is at risk?
Alcohol problems are most common in young adults, and lowest amongst the elderly. More men than women are affected. Those who start drinking at an early age, say 14 or younger - are more prone to develop alcohol problems later. Statistically, heavy drinkers have 15 years shorter lifespan than non-drinkers.
Symptoms:
When you feel you should cut down on your drinking; if you feel bad about your drinking habit, or when you feel annoyed when people criticize the amount you are drinking; then you may be experiencing an alcohol problem. It's time to seek professional help.
Treatment:
For severe cases, treatment may need to be initiated in an institution, such as a hospital or a special centre, where the alcoholic is first "dried out" i.e. removed from a dinking environment. Psychiatrists, gastroenterologists or other specialists would help cope with withdrawal symptoms. After the stage of "detoxification", psychological counseling would consolidate abstinence with the support of family members. Patients with alcoholism must never touch alcohol again. Drugs that induce discomfort when a patient takes alcohol may be prescribed. Examples include disulfiram, naltrexone, and acamprosate.
Alopecia (Hair Loss) and Male-pattern Baldness
Definition:
Everyone has some hair loss every day. In fact, it is normal to lose up to 100 hairs a day. However, some people lose a lot of hair early in life because it runs in their family (inherited) or because of disease, medications, stress, injury or damage to the hair. This may result in a general thinning of hair or in a patchy loss of hair over the scalp and other hair bearing areas such as the beard or eyebrows. The most common type is pattern baldness (androgenetic alopecia). It accounts for about 95 percent of hair loss from the scalp. It is caused by a combination of 3 factors: Testoterone (the male hormone), age (after 20 years of age) and hereditary. It usually affects women later in life than men. It's typically permanent and can be attributed to heredity. In alopecia areata, on the contrary, the hair loss can be temporary. The hair loss is on the scalp or body. Its specific cause is unknown and thought to be immunogenic.
Who is at risk?
- People with inherited tendency. If one or both of your parents have hair loss, it is likely that you will also;
- Aged. Many people have some hair loss by the age of 50;
- Certain hair care and styling. Some methods of hair care or hairstyles can damage hair, causing hair loss;
- People with stress. Increased tendency of hair pulling;
- People with certain diseases or illnesses. The diseases may include ringworm of the scalp (tinea capitis), thyroid diseases such as hyperthyroidism and hypothyroidism, or lupus. The illness may include a severe infection or high fever;
- Medications and medical treatments. Certain medication or medical reatments can cause scalp problems and hair loss.
Symptoms:
Having androgenetic alopecia may mean you experience hair loss as early as your teen years.
- In men, hair loss typically begins at the temples and crown and proceeds in an M-shaped pattern. In the most advanced stage, only a rim of hair along the side and back of the scalp remains.
- In women, hair loss tends to be more widespread but better camouflaged. The top of the head down the middle is most commonly affected, often in a "Christmas tree" pattern. In contrast to men, the hairline along the forehead and temples usually remains normal in women. Complete loss of hair in any one place on the scalp is unusual and may suggest that a different process is at work, such as alopecia areata, a fungus infection or one of a number of skin conditions.
Treatment:
- Minoxidil (Regain) and finasteride (Propecia) can promote new hair growth in addition to preventing hair loss.
- Injections of cortisone into the scalp can treat alopecia areata.
- Anthralin (Drithocreme) may stimulate new hair growth for cases of alopecia areata.
- Hair weave, wigs and toupees can be used. In addition, a variety of surgical techniques also can be used, including scalp reduction, hair flaps and hair transplants.
Prevention:
- Avoiding certain medications, reducing stress, getting adequate protein and iron in the diet may reduce or prevent hair loss.
- Avoid those over-the-counter scalp treatments, which can cause irritation and worsen hair loss.
- A variety of other creams, oils, lotions and herbal remedies for hair loss are regularly advertised. However, only minoxidil (Regain) and finasteride (Propecia) have been proven effective.
Alzheimer's Disease
Definition:
Alzheimer's disease is a progressive, irreversible disease characterized by degeneration of the brain cells. The patient suffers from severe loss of memory, impairment of thinking, with disturbances in behaviour and emotion. The condition is often relentlessly progressive, leaving the individual totally dysfunctional and dependent.
Who is at risk?
- Old age:
The disease tends to affect people over age 65, but can occur in people as young as 40. The risk increases with age. - Family history:
Patients with early-onset Alzheimer's disease often have a positive family history. Scientists have found that Alzheimer's disease is linked to genetic mutations in one of the chromosomes. - Other risk factors:
The disease is more common in females, since women live longer. There have been controversial studies which show that the risk is higher after major head trauma, and that it is more common in people with lower education level. Recent studies have also suggested that high blood pressure, high cholesterol and low vitamin folate intake may increase the risk of having Alzheimer's disease.
Symptoms:
- Loss of short-term memory
- Confusion
- Problems with attention
- Disorientation in space and time
- Personality changes
- Language difficulties
Treatment:
Although there's no cure for Alzheimer's disease yet, drugs and therapies may slow down its progress. Different medications can also improve symptoms in patients with problems such as sleeplessness, anxiety, wandering, agitation and depression.
Prevention:
The ageing should maintain mental fitness by continuous learning and having exercises. These can delay the onset of the disease. Recent studies suggested that a healthy lifestyle such as losing weight, regular exercise, and better control of blood pressure and cholesterol levels could also prevent Alzheimer's disease. However, no drugs and herbs can be recommended at present.
Amblyopia
Definition:
A newborn's eyes cannot see clearly. As the brain grows in early childhood, each eye must receive a sharp image, so that brain cells can establish a connection to the visual centers in the brain. Once passed the "critical period" (birth to 6 years of age), and there is no way to connect the eye with the brain's visual centers, the eye can be functionally useless. The impaired vision cannot be corrected with glasses, contact lenses or surgery, although the eye is normal in every aspect. The condition is called amblyopia. About three percent of children under the age of six have some form of amblyopia. The condition is commonly called lazy eye.
Who is at risk?
Children born with a squint (or crossed eyes) tend to suppress images from the deviating eye, and are at risk of amblyopia. Children with significantly different refractory errors in each of the eyes (for example, short sighted in one eye and long sighted in the other) are also at risk if proper glasses are not prescribed. In fact, anything that interferes with clear vision in either eye during the critical period can result in amblyopia.
Symptoms:
The patient may be found squinting and closing one eye to see. More often the condition does not cause any symptoms, and the problem is only detected when the eyes are checked.
Treatment:
The child must use the weaker eye most of the time, A patch is put over the stronger eye in order to achieve this. Sometimes, eye drops or special glasses are used for the same purpose. The treatment should be carefully supervised by professionals.
Prevention:
Children with correctable causes of impaired vision need to be treated without delay. Treatment of amblyopia is most effective if started early. If amblyopia is not corrected by 6 to 8 years old, the child would suffer from poor vision for life.
Anaemia
Definition:
Anaemia is a syndrome when you have an unusually low number of dysfunctional red blood cells. Because these red blood cells are the oxygen-carrying cells in the circulatory system, people with anaemia are not able to efficiently transfer oxygen from their lungs to the tissues in the rest of their bodies. As a result your body may become deprived of oxygen. Anaemia can be related to nutritional deficiency, acquired or hereditary anaemia and blood loss.
Who is at risk?
- Strict vegans, who may not get enough iron or Vitamin B-12 in their diet;
- People with poor diets: Consuming diets which are consistently low in iron and vitamins especially folate, increase risk of anaemia;
- People with family history of inherited anaemia. e.g. G-6PD deficiency;
- Women with menstruation. Greater risk of iron deficiency anaemia than men because of blood loss;
- Pregnant women. Greater risk of iron deficiency anaemia because their iron stores have to serve the increased blood volume of the mother as well as be a source of hemoglobin for the growing fetus;
- People with intestinal disorders. Surgical removal or diseases of the bowel that affects the absorption of nutrients in the small intestine such as Crohn's disease putting you at risk of anaemia;
- People with chronic conditions. Various cancer and chronic kidney problems can lead to a shortage of red blood cells while chronic blood loss from a stomach ulcer or cancer of bowel can deplete your body's store of iron, leading to iron deficiency anaemia;
- Alcoholic. Alcohol interferes with the absorption of folic acid;
- Others: People who have exposure to toxic chemicals or who are taking certain medications that affect red blood cell production can lead to anaemia.
Symptoms:
- Weakness, fatigue, and paleness (pallor) are the most common symptoms
- A fast heartbeat (severe anaemia)
- Shortness of breath (severe aneamia)
- Cognitive problems (Vitamin B-12 deficiency)
- Numbness or coldness in your extremities (pernicious anaemia)
- Pica, e.g. craving for clay or ice (iron deficiency anaemia)
Treatment:
Different forms of anaemia require different treatment.
- Nutritional or diet related anaemia: Making changes in your diet to incorporate these nutrients or by taking vitamin supplements such as iron and folic acid tablets, or Vitamin B-12 injections. When being treated for iron deficiency anaemia, it is important to get iron supplements made from gluconate because supplements made from ferrous sulfates can upset the stomach and cause digestive problems.
- Acquired or inherited anaemia: The only treatment is regular transfusion of red blood cells or hormone injections that speed up RBC production.
- Chronic blood loss e.g. cancer of bowel: Surgery may be the only solution.
Prevention:
- A healthy diet that includes foods rich in iron, folate and Vitamin B-12 may prevent anaemia associated with vitamin deficiencies. The sources of iron are beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables, dried fruit, nuts and seeds. Folate and folic acid can be found in citrus juices and fruits, dark green leafy vegetables, legumes and fortified breakfast cereals. Vitamin B-12 is found plentiful in meat and dairy products. Foods containing Vitamin C help increase iron absorption.
- Don't overcook food, as this may destroy some nutrients.
- Drink alcohol and caffeinated beverages such as soda and tea sparingly. They might interfere with the absorption of nutrients that is important for preventing anaemia.
- If you take aspirin or non-steroidal anti-inflammatory medication regularly, take them with food to minimize stomach irritation and lower the risk of gastrointestinal bleeding.
- Don't assume that if you're tired that you simply need to take iron supplements. Iron supplements are appropriate only when you need more iron than a balanced diet can provide. Overloading your body with iron can be dangerous.
Anal Fistula
Definition:
An anal fistula is an abnormal connection between the back passage and the opening to the outer skin surrounding the anus. On the surface of the skin around the anus, one or more of the fistula ends may be seen as holes, which tunnel down into the back passage. An anal fistula is usually the result of a previous abscess, which does not heal properly. It develops in about 50 percent of all abscess cases, and there is no real way to predict if this will occur. It is an acute fissure if present for less than 3 consecutive months, and after that it becomes a chronic fissure.
Who is at risk?
- Individual with Inflammatory bowel disease, such as Crohn's disease (Meaning: a chronic inflammatory disease, primarily involving the small and large intestine);
- Individual with Infection e.g. tuberculosis, diverticulitis (Meaning: inflammation of the diverticula (small outpouchings) along the wall of the colon, the large intestine);
- Individual with puncture wound in anal canal lining or injury from an enema tip;
- Individual suffered from cancer of the bowel;
- Individual who had injection treatment for internal hemorrhoids.
Symptoms:
- Constant or intermittent purulent discharge (meaning: pus)
- Firm and tender lump
- Pain during or after bowel movement
- Discoloration of skin surrounding fistula
- Other associated symptoms secondary to the associated diseases such as fever, abdominal pains, diarrhea, loss of appetite, weight loss, nausea and vomiting
Treatment:
- Very few anal fistulas heal spontaneously, so surgery is usually necessary.
- If an abscess is the cause of an anal fistula, surgery involves cutting the abscess and draining the pus under general anesthesia. After surgery for a low fistula, 80-90% of people will be cured.
- Antibiotics may be prescribed if an infection is present.
- Warm sitz baths (sitting in plain, warm water) after surgery to help relieve any discomfort.
- Regular diet, high in fiber.
- Stool softeners may be prescribed to prevent constipation.
- Resume work and normal activity as soon as possible.
- Dressing the wound is very important to ensure that healing progresses well and the fistula does not return.
- High fistula (above the anal sphincters) surgery will involve a temporary colostomy (Meaning: an alternative exit from the colon created to divert waste through a hole in the colon and through the wall of the abdomen) and has a lower success rate for cure, but permanent incontinence is unusual.
Prevention:
- Drink at least 2 litres of fluids daily.
- Exercise every day.
- Eat foods high in fiber, such as fruits, vegetables, legumes, and whole grains.
- Avoid straining during bowel movements.
Andropause
Definition:
Andropause is to men what menopause is to women - a syndrome associated with lack of or absence of testosterone. Male menopause involves the hormonal, physiological and chemical changes that occur in men generally between the ages of 40 and 55. It is a physical condition with psychological, interpersonal, social and spiritual dimensions. This decline in male hormone (testosterone) is gradual, spanning ten to fifteen years on average. If testosterone levels are normal, and a man is experiencing signs of Andropause, the hormonal culprit is usually estrogen, the female hormone. Both men and women must have a specific ratio of testosterone to estrogen. Young men may have a ratio of testosterone to estrogen of 50:1. The ratio drops to 20:1 or even as low as 8:1 with normal aging. When estrogen levels in a man increase, the effects of testosterone are negated.
Who is at risk?
- People with low level of testosterone: The elderly, patient with pituitary tumor;
- People with high estrogen level: Obese individual, alcoholics, individual with liver disease or zinc deficiency;
- People who had orchitis caused by mumps and glandular fever;
- People who had impaired descent of the testes.
Symptoms:
- A decline in physical energy
- Altered state of well-being
- Joint aches and stiffness of hands
- Hot flashes, sleep disturbances
- Difficulty in concentration
- Depression
- Forgetfulness
- Irritability and anger
- Reduced libido
- Premature aging
- Changes in hair growth and skin quality
- Obesity
- Erectile dysfunction
- Osteoporosis
Treatment:
- There is no doubt that the administration of testosterone to men with true testosterone deficiency states will improve their health and sense of well-being.
- Unfortunately, impotence, or the inability to sustain and erection, does not respond well to testosterone therapy except perhaps only in men with severe hormone deficiencies.
- Certain clinics offer the combined treatment of Viagra and Testosterone as the treatment for Andropause.
- However, the research on Hormone Replacement Therapy for men is relatively new. Therefore you should be cautious when embarking on such therapy.
- The condition of the heart, liver and prostate gland must be monitored and treatment should only be undertaken under supervision of a physician trained in this medical specialty.
Prevention:
According to Monash University Nursing and Health services, the following steps are recommended to alleviate symptoms of Andropause:
- Maintain a healthy diet, which includes a balanced amount of vegetables, fruits, meats, fish and diary products.
- Engage in regular exercise, including aerobic, muscular, and flexibility activities.
- Get regular health checkups. Regular health care visits and screenings can help prevent conditions such as heart problems, strokes and cancer of the testicles and prostate.
- Check hormone levels, as you get older. Particularly between the ages of 40 and 55 when a number of important hormone levels in a man's body begin to decline.
- Reduce stress and worry. Stress is a major source of trouble for men at midlife. Exercise and relaxation help reduce stress, as does talking to your partners, friends, and family about your problems.
- Get plenty of sleep.
Angina
Definition:
Angina means any kind of pain that is intense and suffocating. Often the word is understood to mean angina pectoris, which occurs when the heart muscles are not getting enough oxygen. The condition is usually caused by cholesterol, fibrous tissue and clots are being deposited in the coronary arteries, the blood vessels supplying blood to the heart.
Who is at risk?
- Old age
- Male
- High blood levels of cholesterol
- Smoking
- High blood pressure
- Diabetes
- Obesity
- Stress
- Family history of angina or related heart diseases
People can still suffer from angina despite the lack of any of the above risk factors. Menstruating women have a much lower risk. After menopause, the risk in women increases to approach that of men of similar age. Scientists are still researching on other possible causes for the disease.
Symptoms:
The pain appears in the chest, feeling like constricting or squeezing. It may also occur in the shoulders, arms, neck, jaw, or back, or in the stomach that feels like indigestion.
Not all chest pain or discomfort is angina, but all cases of chest pain should be checked by a doctor.The most typical feature of angina is that the pain occurs with exercise, and is relieved with rest after a few minutes, but this is not invariable.
Treatment:
Nitroglycerin tablets that dissolve under the tongue are effective and specific against angina. New forms of related medicine are applied in the form of patches on the skin or may be swallowed as slow release tablets. Other drugs aiming at slowing the heart rate, lowering the strain in the heart muscles, or relaxing the blood vessels by blocking the movement of calcium may also work.
When medicines fail, surgery may be needed to open up the narrowed arteries or bypass the blockage.
Patients may also need medication to lower their cholesterol and control the blood pressure. Drugs preventing the clumping of platelets and clotting of blood may help preventing heart attacks.
Prevention:
Many of the above risk factors are avoidable. Patients with angina need to change their habits to avoid bringing on an attack.
- Remain physically active as much as recommended by the doctor. Slow down or take rest breaks if necessary.
- Avoid large meals and foods that are rich and heavy.
- Eat healthy to control high blood pressure and obesity.
- Avoid stressful situations. Learn to calm down with relaxation techniques.
- Quit smoking.
- Check if you are diabetic or not, and if yes, keep your blood sugar levels under control.
Ankylosing Spondylitis
Definition:
Ankylosing Spondylitis is a chronic disease, which the joints between the vertebrae of the spine and the joints between the spine and pelvis become inflamed. The disease causes back pain and stiffness, and can lead to deformities of the spine. As the condition progresses, the spine becomes stiff and inflexible. The disease can also affect hip, the shoulder, as well as other limb joints. The rib cage may also be affected, resulting in restricted lung function.
Who is at risk?
Figures from the United States show that the disease affects about 130 per 100,000 of the population. It is more common in males around the age 16 to 40 years. People inherited with a particular white blood cell group (called HLA-B27) have a higher risk. It is also more common in people who have affected family members.
Symptoms:
Early signs and symptoms may include pain and stiffness in the lower back and hips. The upper spine, the neck, shoulders, knees and feet may be affected later. In advanced stages, the patient would have a stiff spine and stooped posture. The inflammation can affect the eyes.
Treatment:
- Medications
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that work like aspirin and can relieve pain, inflammation and stiffness.
- Disease-modifying antirheumatic drugs (DMARDs) are drugs that can modify the course of the disease.
- Corticosteroid, a hormone that can suppress inflammation, is very effective in suppressing inflammation. Side effects are often intolerable if high dosage is continued for more than a few weeks.
- A class of new drugs, called "tumor necrosis factor (TNF) blockers", can block off the effect of a protein that mediates inflammation.
- Physical therapy
Physical therapy can improve the joints' range of movement mobility and keep a patient's posture. Breathing exercises help maintain a patient's lung function. - Surgery
Surgery would not correct spinal deformities, but patients may benefit from surgical replacement of joints in the lower limbs if these are severely diseased.
Prevention:
It's not possible to prevent the disease, but early detection, diagnosis and treatment may prevent deformities and complications.
Anorexia Nervosa
Definition:
Anorexia Nervosa is an eating as well as mental disorder. It occurs when a person's obsession with dieting and exercise leads to excessive weight loss. People are generally considered anorexic when they refused to maintain their body weight at or above 85% of their ideal body weight. Body weight less than 85% of the ideal body weight is considered minimal. It usually begins in adolescence and is more prevalent in females. About 1% of all female adolescent girls develop anorexia. The disorder is more common in industrialized countries where thinness is a positive cultural trait. A person with a family member who has anorexia is more likely to develop anorexia. Studies have shown a range of mortality rates from 5 to 18 percent.
Who is at risk?
- Females, especially those in traditionally masculine cultures and certain subcultures where weight is uncommon, e.g. runners, dancers;
- Individuals with early physical development/puberty;
- Individuals who were overweight in childhood;
- Individuals who need other to assert their social status e.g. celebrity;
- Individuals who have difficulty asserting needs;
- Individuals with poor impulse control;
- Individuals with histories of substance or sexually abuse leading to psychological disorders;
- Individuals who engage in prolonged dieting;
- Individuals with high need for control;
- Individuals with obsessive need for perfection.
Symptoms:
- Excessive weight loss
- Obsession with food, calories, and fat content
- Dieting even when thin
- Intense fear of gaining weight, even when underweight
- Distorted self-image of being overweight despite evidence to the contrary
- Basing self-evaluation heavily on body weight or shape
- Delay in menarche (onset of periods) or loss of menstrual periods (secondary amenorrhea)
- Excessive exercising
- Feeling cold, especially hands and feet
- Hair loss and/or growth of fine hair on the body
- Fainting or severe lightheadedness
- Depression and/or anxiety
- Heart palpitations (Meaning: unpleasant sensations of irregular and/ or forceful beating of the heart)
Treatment:
The treatment goal is to get back to a healthy weight. A healthy weight is above 85% of the ideal weight. To achieve this, your intake of calories is gradually increased to between 1,500 and 3,500 per day. This can be accomplished through a number of interventions, including the following:
- Cognitive-Behavioural Therapy (CBT): Help to develop a healthier and more realistic self-image and find new ways to think about the body and the diet.
- Interpersonal Therapy: Help to understand and cope with concerns about relationships.
- Family Therapy: Many patients cannot recover unless their families recognize their roles in the problem and make changes. All families need to understand the disorder and provide support.
- Antidepressants: Selective serotonin reuptake inhibitors (Meaning: prescribed drugs for treating depression, changes in the serotonin levels in the brain can alter the mood) e.g. Sertraline (Meaning: an antidepressant which exhibits selectivity for the blockage of serotonin reuptake) or fluoxetine (Meaning: the first highly specific serotonin uptake inhibitor used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants) are used in combination with psychotherapy (Meaning: the treatment of a behaviour disorder, mental illness, or any other condition by psychological means). When used alone, antidepressant therapy is not an effective treatment for anorexia.
- Medications and supplements may include: Vitamins and minerals to maintain adequate nutrition and hormone replacement to prevent bone loss.
- Hospitalization: May be necessary if weight drops below 25-30 % of ideal body weight or there are signs of severe physical and psychological deterioration. A multidisciplinary team approach with consistent support and counseling is essential for long-term recovery from all severe eating disorders. Depending on the severity and type of disorder, team members may include physicians specializing in the relevant medical complications; psychotherapists/ cognitive-behavioural- therapists, dietitians and nurses.
Prevention:
- There are no guidelines for preventing anorexia nervosa.
- Early detection and treatment has been more successful than prevention.
Anxiety
Definition:
Anxiety is a normal reaction to stress. Everybody knows what it's like to feel anxious - the butterflies in your stomach before a first date, the tension you feel when your boss is angry, or the way your heart pounds when you are in danger. Anxiety rouses you to action. It gears you up to face a threatening situation. It makes you study harder for that exam. In general, it helps one cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder and it can keep you from coping and can disrupt your daily life. There are several types of anxiety disorders: Generalized anxiety disorder (GAD), Obsessive-Compulsive Disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD) and social phobia.
Who is at risk?
A person's genetics, biochemistry, environment, history, and psychological profile all seem to contribute to the development of anxiety disorders. Most people with these disorders seem to have a biological vulnerability to stress, making them more susceptible to environmental stimuli than the rest of the population.
- People with abnormalities in the brain: Abnormalities in the amygdale area and in the neurotransmitters gamma-aminobutyric acid (GABA) and serotonin may have a particular role in susceptibility to anxiety disorders;
- Women: With the exception of Obsessive-Compulsive Disorder (OCD) and possibly social anxiety, women have twice the risk for most anxiety disorders as men;
- Family history: Up to 50% of people with panic disorder and 40% of Generalized anxiety (GAD) patients have close relatives with the disorder;
- Migrants: Increased risk of both depression and anxiety, probably resulting from feelings of alienation.
Symptoms:
- Generalized anxiety disorder: Their worries are accompanied by physical symptoms, especially fatigue, headaches, muscle aches, trembling, twitching, irritability, sweating, and hot flashes.
- Obsessive-Compulsive Disorder (OCD): Recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive "rituals" such as repetitive hand washings, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away.
- Panic disorder: During a panic attack, the heart will pound and one would feel weak, faint, or dizzy. The hands may tingle or feel numb, and feel flushed and sweaty. There might be chest pain with a fear of impending death.
- PTSD: Persistent frightening thoughts and memories of ordeal (flashbacks) and feel emotionally numb. There might be sleep problems, feeling detached or easily startled.
- Social phobia: Persistent and intense fear of being watched and judged by others. Also feel embarrassed or humiliated by one's own performance. (e.g. giving a speech). Accompanied physical symptoms include blushing, profuse sweating, trembling, nausea, and difficulty talking.
Treatment:
Treatment for anxiety disorders typically includes a combination of medication and psychotherapy.
- Medication: The medications prescribed to treat these disorders are not cures and are only meant to relieve the symptoms. Each medication comes with its own set of side effects.
- Psychotherapy: Cognitive Behavioural Therapy teaches the patient to react differently to situations that trigger attacks and focuses on helping him change his thinking patterns. The therapy would focus on changing specific actions and use such techniques as diaphragmatic breathing (to combat hyperventilation which is common when panicking). During exposure therapy the patient is gradually exposed to what frightens him and helps him cope with his/her fears. Group therapy and self-help groups can also be helpful.
Prevention:
There is no way to prevent generalized anxiety disorder. However, cutting down on caffeine, alcohol or other triggering substances might avoid the aggravation of the symptoms.
Arteriovenous Malformation
Definition:
Arteriovenous malformation (AVM) is a congenital defect in which arteries and veins are abnormally tangled up in a mass. Since the normal structure of the vessels are lacking, they are extremely fragile and easy to bleed.
AVM can occur in different parts of the body, but those located in the brain, brainstem and spinal cord are most important, where bleeding can compress onto cells of the nervous system with serious consequences.
Who is at risk?
- Family history of AVM increases the risk slightly
- People born with a large vascular birth mark on one side of the face may have AVM in the same side of the brain
Symptoms:
- Seizures
- Headaches
- Local neurological symptoms, such as muscle weakness or paralysis, loss of coordination, dizziness, visual disturbances or abnormal sensations depending on the part of the brain affected.
Symptoms appear in only about 12 percent of patients. For those who experience no symptoms, the condition may be picked up incidentally by radiological examinations.
Bleeding from AVM can occur in patients of all ages. It may present as a stroke and can lead to permanent disability or result in sudden death. Unfortunately some cases of AVM are only diagnosed after a complication has occurred.
Treatment:
Definitive treatment options of AVM include:
Surgical removal
Neurosurgeons may remove the AVM after tying up all the blood vessels feeding into it. However, the proximity to vital centers of the brain may preclude this option.
Radiosurgery
A high dose of radiation can be delivered to the AVM by different equipments such as the proton beam, linear accelerator (Cyberknife), or gamma knife. After radiation treatment, the AVM would slowly clot off.
Embolization
From an artery in the groin, a catheter is inserted and manipulated to the feeding arteries. Glue-like substances are injected to block the blood supply to the AVM.
Prevention:
Being a congenital condition of unknown cause, there is no way to prevent AVM.
Arthritis
Definition:
The word "arthritis" literally means inflammation of the joints. Any joint in the body can be affected.
Arthritis can be caused by many different diseases. The most common causes include:
- Osteoarthritis
- Gout
- Rheumatoid arthritis
Who is at risk?
- The elderly
- Women
- Overweight people
- Family history of arthritis
- People who are born with bony deformities or had suffered from injuries to their joints
- People who repetitively and excessively use their joints as a result of their occupations
Symptoms:
- Swelling in one or more joints
- Stiffness around the joints that lasts for at least 1 hour in the early morning
- Constant or recurring pain or tenderness in a joint
- Difficulty using or moving a joint normally
- Warmth and redness in a joint
Treatment:
- It is important to keep in mind that there are many forms of arthritis. Some may require special treatments.
- Joint pain can also be the early symptom of an underlying serious disease. Talk to your doctor if you suspect that you may have arthritis.
- Oral drugs or sometimes injections are very useful in the acute stage. Physiotherapy may also help.
- You should rest and relax acutely painful joints.
- After the acute stage, regular exercises can help to keep mobility and a proper diet to control weight should be started.
- Physiotherapists and occupational therapists can give valuable advices to patients who have to live with their arthritis.
- Assist devices, such as splints or braces may help. Surgery may be needed for some patients.
Prevention:
- Protect your joints from injuries or overuse.
- Maintain an appropriate body weight to minimize the risk of developing osteoarthritis. Research has found that even a modest loss of 11 pounds of weight can decrease the occurrence of osteoarthritis in the knees.
- Some of the causes of arthritis, such as gout and rheumatoid arthritis, can be prevented from progressing if being diagnosed and treated at early stage.
Anxiety
Definition:
Anxiety is a normal reaction to stress. Everybody knows what it's like to feel anxious - the butterflies in your stomach before a first date, the tension you feel when your boss is angry, or the way your heart pounds when you are in danger. Anxiety rouses you to action. It gears you up to face a threatening situation. It makes you study harder for that exam. In general, it helps one cope. But when anxiety becomes an excessive, irrational dread of everyday situations, it has become a disabling disorder and it can keep you from coping and can disrupt your daily life. There are several types of anxiety disorders: Generalized anxiety disorder (GAD), Obsessive-Compulsive Disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD) and social phobia.
Who is at risk?
A person's genetics, biochemistry, environment, history, and psychological profile all seem to contribute to the development of anxiety disorders. Most people with these disorders seem to have a biological vulnerability to stress, making them more susceptible to environmental stimuli than the rest of the population.
- People with abnormalities in the brain: Abnormalities in the amygdale area and in the neurotransmitters gamma-aminobutyric acid (GABA) and serotonin may have a particular role in susceptibility to anxiety disorders;
- Women: With the exception of Obsessive-Compulsive Disorder (OCD) and possibly social anxiety, women have twice the risk for most anxiety disorders as men;
- Family history: Up to 50% of people with panic disorder and 40% of Generalized anxiety (GAD) patients have close relatives with the disorder;
- Migrants: Increased risk of both depression and anxiety, probably resulting from feelings of alienation.
Symptoms:
- Generalized anxiety disorder: Their worries are accompanied by physical symptoms, especially fatigue, headaches, muscle aches, trembling, twitching, irritability, sweating, and hot flashes.
- Obsessive-Compulsive Disorder (OCD): Recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive "rituals" such as repetitive hand washings, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away.
- Panic disorder: During a panic attack, the heart will pound and one would feel weak, faint, or dizzy. The hands may tingle or feel numb, and feel flushed and sweaty. There might be chest pain with a fear of impending death.
- PTSD: Persistent frightening thoughts and memories of ordeal (flashbacks) and feel emotionally numb. There might be sleep problems, feeling detached or easily startled.
- Social phobia: Persistent and intense fear of being watched and judged by others. Also feel embarrassed or humiliated by one's own performance. (e.g. giving a speech). Accompanied physical symptoms include blushing, profuse sweating, trembling, nausea, and difficulty talking.
Treatment:
Treatment for anxiety disorders typically includes a combination of medication and psychotherapy.
- Medication: The medications prescribed to treat these disorders are not cures and are only meant to relieve the symptoms. Each medication comes with its own set of side effects.
- Psychotherapy: Cognitive Behavioural Therapy teaches the patient to react differently to situations that trigger attacks and focuses on helping him change his thinking patterns. The therapy would focus on changing specific actions and use such techniques as diaphragmatic breathing (to combat hyperventilation which is common when panicking). During exposure therapy the patient is gradually exposed to what frightens him and helps him cope with his/her fears. Group therapy and self-help groups can also be helpful.
Prevention:
There is no way to prevent generalized anxiety disorder. However, cutting down on caffeine, alcohol or other triggering substances might avoid the aggravation of the symptoms.
Appendicitis
Definition:
Appendicitis means inflammation of the appendix, which is a small pouch about the size of the small finger projecting from the colon. The condition can be started off if the appendix is blocked by fecal particles, or when the wall of the appendix is invaded by bacteria. If not treated promptly, the appendix may rupture with fatal consequence.
Who is at risk?
The incidence of appendicitis is highest between the ages of 10 and 30. The risk of appendicitis may increase in the following occasions:
- In pregnant women, who may experience pain in atypical locations that makes diagnosis difficult
- In young children and elderly, who may have difficulty in conveying their symptoms
Symptoms:
The abdominal pain typically starts around the belly button. It is often vague to start with, but becomes increasingly sharp and severe within 12 hours. The pain would be worsened by pressing on the right lower part of the abdomen, coughing, walking or sudden movements.
Other associated symptoms may include:
- Nausea and vomiting
- Fever, chills
- Loss of appetite
- Diarrhea or constipation
Treatment:
The standard treatment for appendicitis is surgical removal of the appendix. If diagnosed early, laparoscopic surgery may be possible and only requires a few small abdominal incisions. This would allow the patient to recover faster and heal with less scarring. The surgeon may perform traditional open surgery, using a single abdominal incision if the appendix has ruptured and infection has spread beyond the appendix or if an abscess is present, because the surgeon needs to clean the abdominal cavity. The patient will need intravenous antibiotics and have to stay in the hospital longer during recovery.
Prevention:
There is no proven way to prevent appendicitis. Studies have shown that the incidence of appendicitis is much lower in countries where a high-fibre diet is common.
Arthritis
Definition:
The word "arthritis" literally means inflammation of the joints. Any joint in the body can be affected.
Arthritis can be caused by many different diseases. The most common causes include:
- Osteoarthritis
- Gout
- Rheumatoid arthritis
Who is at risk?
- The elderly
- Women
- Overweight people
- Family history of arthritis
- People who are born with bony deformities or had suffered from injuries to their joints
- People who repetitively and excessively use their joints as a result of their occupations
Symptoms:
- Swelling in one or more joints
- Stiffness around the joints that lasts for at least 1 hour in the early morning
- Constant or recurring pain or tenderness in a joint
- Difficulty using or moving a joint normally
- Warmth and redness in a joint
Treatment:
- It is important to keep in mind that there are many forms of arthritis. Some may require special treatments.
- Joint pain can also be the early symptom of an underlying serious disease. Talk to your doctor if you suspect that you may have arthritis.
- Oral drugs or sometimes injections are very useful in the acute stage. Physiotherapy may also help.
- You should rest and relax acutely painful joints.
- After the acute stage, regular exercises can help to keep mobility and a proper diet to control weight should be started.
- Physiotherapists and occupational therapists can give valuable advices to patients who have to live with their arthritis.
- Assist devices, such as splints or braces may help. Surgery may be needed for some patients.
Prevention:
- Protect your joints from injuries or overuse.
- Maintain an appropriate body weight to minimize the risk of developing osteoarthritis. Research has found that even a modest loss of 11 pounds of weight can decrease the occurrence of osteoarthritis in the knees.
- Some of the causes of arthritis, such as gout and rheumatoid arthritis, can be prevented from progressing if being diagnosed and treated at early stage.
Arteriovenous Malformation
Definition:
Arteriovenous malformation (AVM) is a congenital defect in which arteries and veins are abnormally tangled up in a mass. Since the normal structure of the vessels are lacking, they are extremely fragile and easy to bleed.
AVM can occur in different parts of the body, but those located in the brain, brainstem and spinal cord are most important, where bleeding can compress onto cells of the nervous system with serious consequences.
Who is at risk?
- Family history of AVM increases the risk slightly
- People born with a large vascular birth mark on one side of the face may have AVM in the same side of the brain
Symptoms:
- Seizures
- Headaches
- Local neurological symptoms, such as muscle weakness or paralysis, loss of coordination, dizziness, visual disturbances or abnormal sensations depending on the part of the brain affected.
Symptoms appear in only about 12 percent of patients. For those who experience no symptoms, the condition may be picked up incidentally by radiological examinations.
Bleeding from AVM can occur in patients of all ages. It may present as a stroke and can lead to permanent disability or result in sudden death. Unfortunately some cases of AVM are only diagnosed after a complication has occurred.
Treatment:
Definitive treatment options of AVM include:
Surgical removal
Neurosurgeons may remove the AVM after tying up all the blood vessels feeding into it. However, the proximity to vital centers of the brain may preclude this option.
Radiosurgery
A high dose of radiation can be delivered to the AVM by different equipments such as the proton beam, linear accelerator (Cyberknife), or gamma knife. After radiation treatment, the AVM would slowly clot off.
Embolization
From an artery in the groin, a catheter is inserted and manipulated to the feeding arteries. Glue-like substances are injected to block the blood supply to the AVM.
Prevention:
Being a congenital condition of unknown cause, there is no way to prevent AVM.
Arthritis
Definition:
The word "arthritis" literally means inflammation of the joints. Any joint in the body can be affected.
Arthritis can be caused by many different diseases. The most common causes include:
- Osteoarthritis
- Gout
- Rheumatoid arthritis
Who is at risk?
- The elderly
- Women
- Overweight people
- Family history of arthritis
- People who are born with bony deformities or had suffered from injuries to their joints
- People who repetitively and excessively use their joints as a result of their occupations
Symptoms:
- Swelling in one or more joints
- Stiffness around the joints that lasts for at least 1 hour in the early morning
- Constant or recurring pain or tenderness in a joint
- Difficulty using or moving a joint normally
- Warmth and redness in a joint
Treatment:
- It is important to keep in mind that there are many forms of arthritis. Some may require special treatments.
- Joint pain can also be the early symptom of an underlying serious disease. Talk to your doctor if you suspect that you may have arthritis.
- Oral drugs or sometimes injections are very useful in the acute stage. Physiotherapy may also help.
- You should rest and relax acutely painful joints.
- After the acute stage, regular exercises can help to keep mobility and a proper diet to control weight should be started.
- Physiotherapists and occupational therapists can give valuable advices to patients who have to live with their arthritis.
- Assist devices, such as splints or braces may help. Surgery may be needed for some patients.
Prevention:
- Protect your joints from injuries or overuse.
- Maintain an appropriate body weight to minimize the risk of developing osteoarthritis. Research has found that even a modest loss of 11 pounds of weight can decrease the occurrence of osteoarthritis in the knees.
- Some of the causes of arthritis, such as gout and rheumatoid arthritis, can be prevented from progressing if being diagnosed and treated at early stage.
Asthma
Definition:
Asthma is a chronic condition that occurs when the main air passages of the lungs, the bronchial tubes, become inflamed. The muscles of the bronchial walls tighten and extra mucus is produced causing the airways to narrow. Asthma is thought to have two primary stages: hyper-reactivity and the inflammatory response. About 1 in 5 child might suffer from asthma in childhood and up to 1/3 of childhood asthma would have persistent or recurrent symptoms by the age of 26.
Who is at risk?
- People with family history of asthma or allergies;
- Young children who were not breastfed are more likely to develop asthma;
- People with occupational exposure to plastic resin, wood dust, and metals;
- People with allergic conditions such as eczema, hay fever or exposure to workplace allergens such as animal products and biological enzymes;
- People who have exposure to air pollutants;
- Smokers;
- People taking drugs such as aspirin;
- People with stresses such as viral infection, exercise, emotional upset, noxious odours, and tobacco smoke.
Symptoms:
The common symptoms of asthma are the same and common symptoms of other conditions such as heart disease or emphysema. It is important to check with your doctor if you are having any of these problems:
- Chest tightness and shortness of breath with exercise
- Wheezing upon breathing out
- Rapid, shallow breathing that becomes easier by sitting up
- Breathing difficulty
- Coughing, especially at night, with little sputum
- Waking up at night feeling breathless or wheezy
- Severe symptoms of acute attack: Bluish skin, exhaustion with grunting respiration, inability to speak and mental changes or confusion
Treatment:
- Identify triggers and remove them.
- Tailoring the treatment to the symptom severity.
- The best way to think about asthmatic drugs is in terms of controllers and relievers. The controller is the drug that treats the problem that's at the root of your asthma, whereas the reliever is a temporary quick fix.
- Controllers: Corticosteroids tablets & puffers, Cromolyn sodium and nedocromil puffers, Long-acting beta-2 agonists (e.g. Seretide puffer), Methylxanthines (oral theophylline), Leukotriene modifiers (e.g. Singulair), Immunotherapy (e.g. Omalizumab).
- Relievers: Short-acting beta-2 agonists (Ventolin) & Anticholinergics (e.g. Ipratropium bromine/Atrovent). Ventolin is the therapy of choice to relieve acute asthma symptoms and prevent exercise-induced symptoms whereas Atrovent may provide some added benefit to inhaled beta-2 agonists for severe asthma attacks or as an alternative to those who are allergic to Ventolin.
- Prepare a personal action plan for severe asthma. e.g. > 6 puffs of Ventolin per day is an indication of attending emergency department.
- Importance of exercise. Asthma shouldn't keep you from daily activities or exercise. In fact, activity helps your lungs in the long run. You can learn ways to exercise by changing your environment or taking drugs.
Prevention:
- Know what triggers your asthma.
- Breast-feeding: Reduce future risk of asthma in child.
- Avoid cigarette smoke.
- Avoid exposure to dust mites.
- Encase your bed mattress and pillows in special allergen-impermeable dust-proof covers.
- Protect yourself from animal dander and other irritants.
- Avoid exposure to pollen and outdoor mold.
- Reduce moisture to help eliminate indoor mold.
- Get a yearly flu shot to protect yourself against influenza.
Atrial Fibrillation
Definition:
Normally the beatings of the upper and lower chambers of the heart are synchronized. In atrial fibrillation, the upper chambers of the heart (the atria) are beating so fast (up to 350 to 600 times per minute) that they cannot pump blood effectively. The beating of the lower chambers becomes independent of that of the upper chambers. The result is an irregular and rapid heart rate.
Who is at risk?
Atrial fibrillation is a common problem in the elderly. It affects nearly 10 percent for those older than 80. The following may be affected at a younger age:
- Those suffering from coronary artery disease;
- Thyroid problems;
- People with congenital heart diseases or those who had heart surgery;
- Diabetes;
- Hypertension.
Symptoms:
- Palpitations, with rapid thumping or a pounding sensation in the chest
- Irregular heart beat
- Chest discomfort
- Shortness of breath
- Fatigue
- Dizziness, light-headedness or fainting
Treatment:
Doctors would investigate vigorously to see if there is a treatable underlying cause. When the underlying condition is satisfactorily controlled, the heart beat may return to normal. This is often the case when atrial fibrillation is caused by an overactive thyroid gland.
When there is no treatable underlying condition, the doctor may try to correct the beating rhythm of the upper chambers by drugs, electrical shock, or surgery carried out through a catheter.
In many patients, it is not possible to bring back a normal rhythm to the upper chambers. Doctors may aim at controlling symptoms and preventing complications by regulating the rate and rhythm of the lower chambers.
Turbulent blood flow in a heart beating with an irregular rhythm can develop clots. Patients may also need to be on drugs to prevent clots from forming.
Prevention:
Patients with atrial fibrillation may not experience subjective symptoms. The condition should be screened for by periodic checkups, which may include an ECG in order to diagnose the condition early and prevent any complications.
Smoking is an important risk factor for coronary heart disease, which in turn is a common cause for atrial fibrillation. Caffeine, certain drugs, acute alcoholic intoxication or alcohol withdrawal may precipitate atrial fibrillation in susceptible individuals.
