BUDD-CHIARI SYNDROME

                       
                                 BUDD-CHIARI SYNDROME 

             
      The Budd- Chiari syndrome is a heterogeneous group of disorders characterized by hepatic venous outflow obstruction at the hepatic venules, the large hepatic veins, the inferior vena cava, or the right atrium. Hepatic veno-occlusive disease refers to obstruction of hepatic venous outflow at the level of the central or sublobular hepatic veins or both. 

Etiology:

    Most patients with Budd-Chiari syndrome have an underlying one-third of patients, the condition is idiopathic. Causes of Budd-Chiari syndrome include the following: 
. Hematologic disorders
. Inherited thrombotic diathesis
. Pregnancy and postpartum
. Oral contraceptives
. Chronic infections. 
. Chronic inflammatory diseases 
. Tumors
. Congenital membranous obstruction
. Hepatic venous stenosis
. Hypoplasia of the suprahepatic obstruction
.  Postsurgical obstruction
. Posttraumatic obstruction 
. Total parenteral nutrition (TPN): Budd-Chiari syndrome has been reported as a complication of TPN via an IVC catheter in a neonate. 

Clinical manifestations: 

  The classic triad of abdominal pain, ascites, and hepatomegaly is observed in the vast majority of patients with Budd Chiari syndrome, but it is nonspecific. If the liver had developed collaterals and decompress, patients can be asymptomatic or present with few symptoms. As the syndrome progresses, however, it can lead to liver failure and portal hypertension with symptoms.  

The clinic variants of Budd-Chiari syndrome have been described as follows: 
. Acute and subacute forms: Characterized by the rapid development of abdominal pain, ascites, hepatomegaly, jaundice and renal failure. 
. Chronic form: Most common presentation; patients present with progressive ascites, jaundice is absent, approximately 50% of patients also have renal impairment. 
. Fulminant form: Uncommon presentation; fulminant or subfulminant hepatic failure is present, along with ascites, tender hepatomegaly, jaundice and renal failure. 

 Patients with acute onset of obstruction typically present with acute right upper quadrant pain. Abdominal distention can also be a significant symptom because of ascites. Jaundice is rarely observed. 

Evaluation: 

 Physical examination may reveal the following findings: 
. Jaundice
. Ascites
. Hepatomegaly
. Splenomegaly
. Ankle edema
. Stasis ulcerations
. Prominence of collateral veins
. Routine biochemical test results are usually nonspecific in BUDD-CHIARI SYNDROME, which aids in mitigating hepatic congestion and thereby, restoration of hepatic function and alleviation of portal hypertension. 

Imaging is essential for the early identification and evaluation of the disease extent in BUDD-CHIARI SYNDROME, which aids in mitigating hepatic congestion and thereby, restoration of hepatic function and alleviation of portal hypertension. 

Investigation: 

Liver function test:

 Liver function tests may show a mild elevation.

Prothrombin time:

This may be prolonged, which may be confusing if the condition is associated with a hypercoagulability state. 

Ascitic fluid:

This usually has high-protein content but the risks(eg, bacterial peritonitis) and benefits of paracentesis should be considered before this procedure is undertaken. 

Magnetic resonance imaging(MRI): 

MRI may show a prominent caudate lobe. It is more sensitive than CT scan. 

Doppler ultrasound: 

Doppler ultrasound may help to exclude hepatic venous or inferior vena caval thrombosis. Caval venography excludes caval webs and occluded hepatic veins. 

Liver biopsy: 

Liver biopsy often shows centrilobular congestion. 

Homeopathic Therapeutics: 

Aurum- Metallicum: 

Sclerosis of liver arterial system brain. Right hypochondrium hot and painful. Buring heat and cutting pain in right hypochondrium.

Calc-ars:

Hepatosplenomegaly in children. 

cholesterinum: 

Obstinate hepatic engorgement. Buring pain in the side; on walking holds his hand on the side, hurts him. Gallstone. 

Flouric-acid: 

Hob-nailed liver of alcoholics. Soreness over the liver. 

Iodium: 

Liver and spleen sore and enlarged. Jaundice, a region of liver sore to pressure, swelling and hypertrophy of liver.  

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Nutrigenomics

                    Nutrigenomics
 Nutritional Genomics is a new scientific discipline that uses modern genomics technology to study the interrelationship between genes, nutrition, and health. it has long been apparent that some people respond differently from others to foods.We all know that the right foods can be therapeutic in nature, especially if they are consumed in accordance with your genetic profile. Nutritional Genomics allows us to understand how our genes affect our
behavior and response to the foods, beverages and the supplements we consume. it also affects how our foods have an impact on gene expression. 

The scientific study of the interaction of nutrition and genes, especially with regard to the prevention or treatment of disease.

Nutrigenomics is a branch of nutritional genomics and is the study of the effects of foods and food constituents on gene expression.This means that nutrigenomics is research focusing on identifying and understanding the molecular-level interaction between nutrients and other dietary bioactive with the genome.Nutrigenomics has also been described by the influence of genetic variation on nutrition, by correlating gene expression or SNPs with a nutrient's absorption, metabolism, elimination or biological effects. By doing so, nutrigenomics aims to develop rational means to optimise nutrition with respect to the subject's genotype.

   By determining the mechanism of the effects of nutrients or the effects of a nutritional regime, nutrigenomics tries to define the causality or relationship between these specific nutrients and specific nutrient regimes (diets) on human health. Nutrigenomics has been associated with the idea of personalized nutrition based on genotype. While there is hope that nutrigenomics will ultimately enable such personalized dietary advice, it is a science still in its infancy and its contribution to public health over the next decade is thought to be major. Whilst nutrigenomics is aimed at developing an understanding of how the whole body responds to a food via systems biology, research into the effect of a single gene/single food compound relationships is known as nutrigenetics. 

Definitions and terms: 

Genomics: The study of the genomes of organisms for determining the entire DNA sequence of organisms and fine-scale genetic mapping (Balammal, G., 2012) while the genome is the set of all genes, regulatory sequences, and other information contained within the noncoding regions of DNA of an organism (Frederick, P. Roth et al., 1998).

Nutritional genomics: The science of relationship between human genome, nutrition and health (Ordovas, J.M., 2004) or the genetic manipulation of plants to create vitamins and minerals that will improve human's diet and analysis of an organism's set of genes, so it is an area of science that looks at how environmental factors, such as diet, influence the genetic makeup (Ordovas, J.M., 2004).

Nutrigenetics: It is the interplay between nutrition and genetics of an individual, branch of science concerned with the effect of heredity on diet and nutrition (Simopoulos, A.P., 2010). The term Nutrigenetics refers to the research on the impact of changes in inherited traits of nuclear DNA, on the response to specific metabolic dysfunctions outcomes getting health chronic damages and disorders (Manzelli, Paolo, 2012, Simopoulos, A.P., 2010). According to WHO reports diet factors influence occurrence of more than two third of diseases and most of these factors belong to the categories of nutrigenetics. In other words, nutrigenetics concerns individual differences in the reaction to food based on the genetic factors and analyses direct influences of nutrients on gene expression (Svacina, S., 2007).

Proteomics: the study of structures and functions of protein and makes an analogy with genomics so, it is the study of the genes while proteome is the entire complement of proteins, including the modifications made to a particular set of proteins produced by an organism or system and the word proteome was coined by Marc Wilkins in 1994 by the blend of protein and genome (James, P., 1997, Marc, R. Wilkins et al., 1996).

Metabolomics: The systematic study of the unique chemical fingerprints that specific cellular processes leave behind with study of their small-molecule metabolite profiles and increasingly being used in a variety of health applications including pharmacology, preclinical drug trials, toxicology, transplant monitoring, newborn screening and clinical chemistry (Nanda T., 2011) while the metabolome is the collection of all metabolites in a biological cell, tissue, organ or organism, end products of cellular processes (Daviss, Bennett, 2005).

Gene expression: The process by which information from a gene is used in the synthesis of a functional gene product like proteins, but in non-protein coding genes such as ribosomal RNA (rRNA), transfer RNA (tRNA) or small nuclear RNA (snRNA) genes, the product is a functional RNA and this process is used by every living thing like eukaryotes, prokaryotes, and viruses, to generate the macromolecules for their body. This process occurs in two major stages, first is transcription in which the gene is copied to produce an RNA molecule with essentially the same sequence as the gene and second, is protein synthesis known as translation (Oliver Brandenberg et al., 2011, Twyman, Richard, 2003).

Genotype: This is the genetic makeup of a cell, an organism, or an individual with reference to a specific character which is the internally coded, inheritable information, carried by all living organisms and this stored information is used as a blueprint or set of instructions for building and maintaining a living creature (Oliver Brandenberg et al., 2011).

Phenotype: The composite of an organism's observable characteristics or traits such as its morphology, development, biochemical or physiological properties, phenology, behavior, and products of behavior like physical parts, the sum of the atoms, molecules, macromolecules, cells, structures, metabolism, energy utilization, tissues, organs, reflexes and behaviors of a living organism (Oliver Brandenberg et al., 2011).

Polymorphism: Polymorphism in biology occurs when two or more clearly different phenotypes exist in the same population of a species, the occurrence of more than one form or morph. (Oliver Brandenberg et al., 2011).

Allele: An allele is one of two or more forms of a gene or a genetic locus used for an abbreviation of allelomorph and different alleles can result in different observable phenotypic traits, such as different pigmentation. (Oliver Brandenberg et al., 2011).

Epigenetic: A modification of gene expression that is independent of the DNA sequence of the gene (Egger, G., Liang G., et al., 2004). The current definition of epigenetics is the study of heritable changes in gene expression that occur independently of changes in the primary DNA sequence and these heritable changes are established during differentiation and are stably maintained through multiple cycles of cell division, enabling cells to have distinct identities while containing the same genetic information. This heritability of gene expression patterns is mediated by epigenetic modifications, which include methylation of cytosine bases in DNA, posttranslational modifications of histone proteins as well as the positioning of nucleosomes along the DNA (Sharma, Shikhar, 2010).

20.1.2 Nutrigenomics: Let food be thy medicine and medicine thy food (Hippocrates 400 B.C.)

Nutrigenomics is the study of how naturally occurring chemicals in foods alter molecular expression of genetic information in each individual. The term nutrigenomics refers the effect of diet on gene expression or to the impact of inherited on the response to a specific dietary pattern, functional food or supplement on a specific health outcome (Fenech, M., 2005) so called as the "next frontier in the post genomic era" (Castle, D. 2007). It can be described as the study of the relationship between genes, diet lifestyle and health that is nutrition regulate gene function like transcription, translation, and metabolism i.e. diet gene interaction (Ordovas, J.M., 2004).

   Nutrigenomics focuses on understanding that nutrition influences metabolism and maintenance of the internal equilibrium in the body and this regulation affects the diet related diseases (Ordovas J.M., 2004) and offers a powerful and exciting approach to unravel the effect of diet on health. In the past, the nutrition research concentrated on nutrient deficiency and impairment of health but nutrigenomics creates a junction between healthy diet and genomics and it will promote an increased understanding of how nutrition influences metabolic pathway and homeostasis control.

Bibliography: 

https://en.wikipedia.org/wiki/Nutrigenomics

Lifetime genetics program journel 

https://www.uniassignment.com/essay-samples/biology/the-benefits-of-nutrigenomics-biology-essay.php

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deadliest VIRUSES

These are the deadliest VIRUSES  the world has ever seen

MARBURG Virus: Marburg virus creates a hemorrhagic fever virus, which means it causes blood to escape from the circulatory system. The Soviet Union even had an offensive and defensive biological weapons program that included the Marburg virus. fatality rates range from 24% to 88% and it is transmitted and humans to humans

EBOLA VIRUS: Ebola virus disease is a hemorrhagic fever that is often fatal in humans. Its average fatality rate is 50% and can cause bleeding, usually from the eyes, and organ failure. it is transmitted to humans from wild animals, and from humans to humans.

HIV: Human immunodeficiency virus (HIV) cause acquired immunodeficiency syndrome(AIDS). AIDS is a progressive immune system failure which allows infections and cancers to thrive. Without treatment average survival time after being infected with HIV is 9 to 11 years.

Small pox: was an infections disease caused by 2 virus variants.it results in fever, rash, and oozing pustules that develop all over the skin. smallpox was responsible for 300. 500 million deaths in the 20th century but it was declared eradicated in 1980.

Dengue: the infection brought on by the dengue virus is the leading cause of death in the tropics and subtropics. it causes fever, headaches, and hemorrhaging. you contract dengue by getting bit by an infected mosquito. There are an estimated 100 million cases of dengue each year, with an estimated 25,000 of those resulting in death.

Hantavirus can develop into hantavirus pulmonary syndrome, which has a 36 % fatality rate. it is airborne and humans can contract it by breathing air infected with hantaviruses that are shed in rodent urine and feces.

Rabies: Rabies is almost always fatal following the onset of clinical symptoms. it can cause delirium and violent behavior. and as rabies spreads to the central nervous system, the brain and spinal cord fatality inflame. dogs are the number one carriers of rabies. Luckily rabies is vaccine-preventable and immediate treatment can keep the virus from developing.

Influenza: No disease has claimed more worldwide pandemics than influenza. the outbreak of the Spanish flu in 1918 caused 50 million deaths in 2 years. and the swine flu in 2009 saw 89 million infections. vaccines exist but the influenza virus is constantly mutating and creating new strains. better stock up on hand sanitizer.

Stress and Health

                                      Stress and Health 

  Stress is a response to pressure or threat. Under stress, we may feel tense, nervous, or on edge. The stress response is physical, too. Stress triggers a surge of a hormone called adrenaline that temporarily affects the nervous system. 

In medical terms, stress is described as" a physical or psychological stimulus that can produce mental tension or physiological, reaction that may lead to illness". When you are under stress, your adrenal gland releases corticosteroids, which are converted to converted to cortisol in the bloodstream. Cortisol has an immune suppressive effect in your body.

  Stress is born with modern society. Better still it is a real disease whose causes lie in the frenetic rhythm of metropolitan life. On the contrary, the past generation was not under the stress pressure. Hence not always the progress creates advantages. 

  The reason of stress in modern world are different, principally due to the increase of daily activity, The race to money, dissatisfaction, urban traffic, overcrowding, together also influence psychologically men determining a state of stress, Consequently, everyone who lives actively their time is stressed; the children who apparently seems to have not problems, actually assimilate it through their parents. As their parents, children are too busy, not only with school commitments but sport and play activity too. 

 On the contrary, past generation did not have such daily activity. Work hours were greater as distractions were fewer. They spent their time with family. The cities were not overcrowded, no traffic, no pollution, but surely the service were not as today. The man lived in a different way, almost contenting himself of what he had. As result the stress was less, probably one-time life was different and better than nowadays. 

 In conclusion with the passing of time, the things seem to be changed in positive but evidently is not right. In the past there was less stress than today, it is strange but the increase of the activity has raised the stress. 

The Effects of stress on your body: 

   Stress in any change in the environment that requires your body to react and adjust in response. The body reacts to these changes with physical, mental, and emotional responses. 

 Stress is a normal part of life. Many events that happen to you and around you and many things that you do yourself put stress on your body. You can experience good or bad forms of stress from your environment, your body and your thoughts. 

How Does Stress Affects Health???

  The human body is designed to experience stress and react to it. Stress can be positive(eustress) such as a getting a job promotion or being given greater responsibilities keeping us alert and ready to avoid danger. Stress becomes negative(distress) when a person faces continuous challenges without relief or relaxation between challenges. As a result, the person becomes overworked and stress-related tension builds. 

 Distress can lead to physical symptoms including headaches, upset stomach, elevated blood pressure, chest pain, and problems sleeping. Research suggests that stress also can bring on or worsen certain symptoms or diseases. 

    Stress also becomes harmful when people use alcohol, tobacco, or drugs to try to relieve their stress. Unfortunately, instead of relieving the stress and returning the body to a relaxed state, these substances tend to keep the body in a stressed state and cause more problems. Consider the following: 

 Forty-three percent of all adults suffer adverse health effects from stress. 

 Seventy-five percent to 90% of all doctor's office visits are for stress-related ailments and complaints.

  Stress can play a part in problems such as headaches, high blood pressure, heart problems, diabetes, skin condition, asthma, arthritis, depression, and anxiety. 

  The occupational safety and health administration declared stress a hazard of the workplace. Stress costs American industry more than $300 billion annually. 

 The lifetime prevalence of an emotional disorder is more than 50% often due to chronic, untreated stress reaction. 

The Effects of Stress on Your Body: 

  

  You're sitting in traffic, late for an important meeting, watching the minutes tick away. Your hypothalamus, a tiny control tower in your brain, decides to send out the order: Send in the stress hormones! These stress hormones are the same ones that trigger your body's "fight or flight" response. Your heart races, your breath quickens, and your muscles ready for action. This response was designed to protect your body in an emergency by preparing you to react quickly. But when the stress response keeps firing, day after day, it could put your health at serious risk. 

 Stress is a natural physical and mental reaction to life experiences. Everyone expresses stress from time to time. Anything from everyday responsibilities like work and family to serious life events such as a new diagnosis, war or death of a loved one can trigger stress. For immediate, short-term situations, stress can be beneficial to your health. It can help you cope with potentially serious situations. Your body responds to stress by releasing hormones that increase your heart and breathing rates and ready your muscles to respond. Yet if your stress response doesn't stop firing, and these stress levels stay elevated far longer than is necessary for survival, it can take a toll on your health. Chronic stress can cause a variety of symptoms and affect your overall well-being. Symptoms of chronic stress include: 

Irritability, Anxiety, Depression, Headaches, Insomnia. 

Central Nervous and Endocrine Systems: 

 Your central nervous system(CNS) is in charge of your"fight or flight" response. In your brain, the hypothalamus gets the ball rolling, telling your adrenal glands to release the stress hormones adrenaline and cortisol. These hormones rev up your heartbeat and send blood rushing to the areas that need it most in an emergency, such as your muscles, heart, and other important organs. When the perceived fear is gone, the hypothalamus should tell all systems to go back to normal.If the CNS fails to return to normal, or of the stressor doesn't go away, the response will continue. Chronic stress is also a factor in behaviors such as overeating or not eating enough, alcohol or drug abuse, and social withdrawal.  

Respiratory and Cardiovascular Systems:  

  Stress hormones affect your respiratory and cardiovascular systems. During the stress response, you breath faster in an effort to quickly distribute oxygen-rich blood to your body. If you already have a breathing problem like asthma or emphysema, stress can make it even harder to breathe problem like asthma or emphysema, stress can make it even harder to breathe. Under stress, your heart also pumps faster. Stress hormones cause your blood vessels to constrict and divert more oxygen to your muscles so you'll have more strength to take action. But this also raises your blood pressure. As a result, frequent or chronic stress will make your heart work too hard for too long. When your blood pressure rises, so do your risks for having a stroke or heart attack.  

Digestive System:

  Under stress, your liver produces extra blood sugar (glucose) to give you a boost of energy. If you're under chronic stress, your body may not be able to keep up with this extra glucose surge. Chronic stress may increase your risk of developing type 2 diabetes. This rush of hormones, rapid breathing, and increased heart rate can also upset your digestive system. You're more likely to have heartburn or acid reflux thanks to an increase in stomach acid. Stress doesn't cause ulcers (a bacterium called H.pylori often does) but it can increase your risk for them and cause existing ulcers to act up. Stress can also affect the way food moves through your body, leading to diarrhea or constipation. You might also experience nausea, vomiting, or a stomachache. 

Muscular System: 

  Your muscles tense up to protect themselves from injury when you are stressed. They tend to release again once you relax, But if you are constantly under stress, your muscles may not get the chance to relax. Tight muscles cause headaches, back and shoulder pain, and body aches. Over time, this can set off an unhealthy cycle as you stop exercising and turn to pain medication for relief. 

Sexuality and Reproductive System: 

 Stress is exhausting for both the body and mind. It' not unusual to lose your desire when you are under constant stress. While short-terms stress may cause men to produce more of the male hormone testosterone levels can begin to drop. This can interfere with sperm production and cause erectile dysfunction or impotence. Chronic stress may also increase the risk of infection for male reproductive organs like the prostate and testes. For women, stress can affect the menstrual cycle. It can lead to irregular, heavier, or more painful periods. Chronic stress can also magnify the physical symptoms of menopause. 

Immune System: 

   Stress stimulates the immune system, which can be plus for immediate situations. This stimulation can help you avoid infection and heal wounds. But over time. stress hormones will weaken your immune system and reduce your body's response to foreign invaders. People under chronic stress are more susceptible to viral illness like the flu and common cold, as well as other infection. Stress can also increase the time it takes you to recover from an illness or injury. 

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Dr. Farooq Khan's Elite Clinic

Shop No. 6, Darul falah colony,

near Darul Falah masjid,

Kausa-mumbra. Thane 400612

Phone no: 022-25350699