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Sunday 28 October 2018

Cerebrospinal Fluid (CSF) Leak & Homeopathy

  Cerebrospinal Fluid (CSF) Leak & Homeopathy 


CSF Rhinorrhea is a grave medical condition where fluid from brain ( called as CSF or Cerebrospinal Fluid in which the brain and spinal cord bath) get a vent or leakage due to bony defect at the base of the skull ( cribriform plate). Please note that CSF Rhinorrhea is just a symptom, not a disease itself.


INTRODUCTION:

What is a cerebrospinal fluid (CSF) leak?

Cerebrospinal fluid (CSF) is a watery fluid that circulates through the brain’s ventricles (cavities or hollow spaces) and around the surface of the brain and spinal cord. A CSF leak is a condition that occurs when the CSF leaks through a defect in the dura or the skull and out through the nose or ear.
A CSF leak results from a hole or tears in the dura, the outermost layer of the meninges. Causes of the hole or tear can include head injury and brain or sinus surgery. CSF leaks may also occur after lumbar puncture, also called a spinal tap or spinal anesthesia. Spontaneous CSF leaks can also occur for no known reason.


    Cerebrospinal fluid (CSF) bathes the brain and is contained within a lining around the brain called the dura. These intracranial structures (structures within the brain cavity) are also separated from the sinuses by bone. When there is a hole in the dura and bone, CSF can then leak into the sinuses and cause a CSF leak. This is noticed when there is clear drainage from the nose or into the back of the throat that may occur with straining or position changes and does not improve with medications aimed at other causes of an ‘a runny nose’. 

  If it drains out of the nose, it is usually from one side. If it drains into the throat, it has been described as salty tasting. The breaks in the bone and dura can occur from an accident involving the head, a complication from sinus or brain surgery, an expected consequence of removing a tumor within the sinuses, or from anything that can increase pressures on the CSF. The increased pressure on the CSF can ultimately erode the bone separating the brain and sinuses and break through the dura (the lining of the brain). High CSF pressures can occur spontaneously without any obvious cause. Your doctor may need to do additional studies to determine the most likely cause of your CSF leak.



INDICATIONS:

  Once it is confirmed that in fact, the clear drainage is CSF, determining the cause of the CSF leak will determine how it should be managed. A CSF leak as a result of trauma to the head usually is managed with placement of a lumbar drain and bed rest. A lumbar drain is a small tubing placed in the back that allows drainage of small amounts of CSF. This allows diversion of the brain fluid to minimize pressure through any injured areas so that they can heal. Over 90% of these leaks will heal with this management and do not require any surgical intervention.

   The other common causes of CSF leaks generally require surgical repair. For example, injury to the skull base with a CSF leak at the time of surgery often warrants an attempted repair at the time the leak is noted. 

   When a CSF leak develops from unexpected injury to the skull base at the time of surgery but its recognition or onset is delayed, a CT sinus is typically requested in order to identify the defect site (the site of the hole where the fluid can leak through). If the CT sinus suggests that in addition to a CSF leak there may be some brain tissue falling through the defect, then an MRI of the skull base may be indicated. On occasion, the defective skull base site may not obvious on imaging studies and the leak has to be identified in the operating room. A dye is added to the CSF via a lumbar drain (the tube in the back as described above) while the nasal cavity is examined carefully to identify the site of drainage. Once identified, then the leak can be repaired.

     Finally, a significant number of CSF leaks occur spontaneously without any preceding trauma or surgery. In those cases, it is thought that increased intracranial pressures may be eroding the skull base bone which ultimately results in a CSF leak. In those situations, once a CSF leak is confirmed with appropriate laboratory studies then CT and MRI of the sinuses and skull base can be used to identify the defect site(s). Again if the leak site cannot be found on imaging studies, dye placed into the spinal fluid, which mixes with the brain fluid, can be placed at the beginning of the repair surgery to identify the leak under direct visualization. 

PROCEDURE:

The defect site can be repaired either from the brain or the sinus side of the skull base. Repairing a CSF leak site from the brain side requires a cut through the skull, and slight pulling of the brain away from the skull base to identify and ultimately repair the defect. These procedures are typically performed by a neurosurgeon. The failure rates of repair from the brain side are quoted as high as 25%. 

More recently, repair of these bony defect sites is commonly performed from the sinus/nose side. If the defect site is clear based on pre-operative images, then the surgeon will open up those sinuses and remove bone that may obstruct the view of the defect site. This surgery is performed through the nasal cavity under the direct visualization with a small scope called an endoscope. 
  Although generally, this surgery does not involve any incisions on the face, in rare situations where the defect is within the frontal sinuses above the eyes, a small incision may be necessary to allow repair of these sites that are difficult to reach with instruments and endoscope.

If the site is not clear based on pre-operative images or if the surgeon wants confirmation of the site of the CSF leak, intraoperative fluorescein (which has a fluorescent green-yellow color) can be added to the spinal fluid. Ultimately the dye will allow a way of visualizing leaking CSF while in the operating room. 

    Once the CSF leak site is identified, the mucosa (nasal and sinus lining) is then removed around the defect site to clearly see the bony defect. The specifics of the repair are often surgeon dependent and often influenced by the size and location of the defect. If the defect size is small, one layer placed over the defect on the sinus side may be sufficient. On the other hand, if the defect is large, then the surgeon may choose to tuck in a layer of support between the brain and the bony defect in addition to the layer on the sinus side. 

  Once the surgeon confirms that the layers used to repair the defect have stopped the CSF leak, then various sealants or packing may be placed next to the repair site to further support the repair.

A lumbar drain may or may not be kept in place after surgery to divert CSF away from the repair site to minimize pressure. Sometimes, bed rest is recommended for a day or a few days after the repair along with other medications to minimize pressure within the brain fluid. The success rate of endoscopic CSF leak repairs ranges above 90%.
  
RISKS:

   The risk of the surgery is basically similar to the risk of undergoing endoscopic sinus surgery. There is a less than 1% risk of unexpected damage to nearby critical structures including the brain and optic nerve (the nerve of vision). Another risk is that the leak can come back.

BENEFITS:


   The benefit of the surgery is to not only stop the CSF leak but also to remove the risk of an intracranial infection. The defect which allows CSF to drain into the sinuses can also allow bacteria (commonly found within the sinuses) to infect the brain and its surrounding tissue.
  
SUMMARY:

  CSF leaks can occur as a complication of sinus or skull base surgery or from an accident involving the head, or develop spontaneously if CSF pressure is too high. Once the clear drainage is confirmed to be CSF, the next step is to identify the leakage site. If surgical repair is necessary, a majority of these defects can be repaired endoscopically which requires no incisions on the face or head. The success of such repairs is over 90%.

Homeopathic Treatment for Rhinorrhea

What is the Cause for CSF Rhinorrhea?

     Trauma to the head is the most common reason for CSF rhinorrhea. CSF rhinorrhea is usually a sign of a basal skull fracture. In some cases, CSF rhinorrhea may be a symptom of pituitary adenoma. CSF rhinorrhea may also arise after surgical trauma during endoscopic sinus surgery or other neurosurgical procedures. Apart from the above reasons, CSF rhinorrhea may also occur due to increased intracranial pressure.

What are the Symptoms of CSF Rhinorrhea and the Investigations for its Diagnosis?

The primary symptom of CSF rhinorrhea is leakage of clear, watery discharge from the nose. The discharge of fluid is usually from one side of the nose. Bending the head forward makes the symptom worse. Draining of salty fluid from the nose into the throat is also a symptom in some individuals with CSF rhinorrhea. CSF rhinorrhea carries the risk of causing meningitis. The diagnostic test for CSF rhinorrhea includes Beta-2 transferrin test. Beta-2 transferrin is a protein exclusively present in CSF and thus helps in confirming CSF rhinorrhea. Other tests done in suspected cases of CSF rhinorrhea include CT scan of the head and CT cisternography.

Homeopathic Treatment for CSF Rhinorrhea


In homeopathy, a majorly indicated homeopathic medicine for rhinorrhea is Hedera Helix. Hedera Helix is derived from a species of common ivy from the plant family Araliaceae. The young shoots and flowering twigs of this plant are used to prepare Hedera Helix using the process of potentisation. Hedera Helix is a very effective homeopathic treatment for rhinorrhea.

Thursday 18 October 2018

Arthritis Do not Ignore

                                       Arthritis Do Not Ignore



    Arthritis is very common but is not well understood. Actually 

"arthritis" is not a single disease, it is an informal way of 

referring to joint disease. There are more than 100 different types of arthritis and related conditions. People of all age, sexes, and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older. 

 Common arthritis joint symptoms include swelling, pain, stiffness and decreased the range of motion. Symptoms may come and go. they can be mild, moderate or severe. They may stay about the same of years but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. some types of arthritis also affect the heart, eyes, lungs, kidneys, and skin as well as the joints. 

There are different types of arthritis:

 Degenerative Arthritis:

  Osteoarthritis is the most common type of arthritis. When the cartilage, the slick, cushioning surface on the ends of bones- wears away, bone rubs against bone, causing pain, swelling and stiffness. Over time joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age, and previous injury, when the joint symptoms of osteoarthritis are mild or moderate, they can be managed by: 

- Balancing activity with rest
- Using hot and cold therapies
- Regular physical activity
- Maintaining a healthy weight
- Strengthening the muscles around the joined for added support
- Using assistive devices
- Avoiding excessive repetitive movements

  If joint symptoms are severe, causing limited mobility and affecting the quality of life some of the above management strategies may be helpful. Osteoarthritis can be prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements. 

Inflammatory Arthritis:

 A healthy immune system is protective. It generates internal inflammation to get rid of the infection and prevent disease. But the immune system can go awry mistakenly attacking the joints with uncontrolled inflammation, potentially causing. Joint erosion and may damage internal organs, eyes and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental risk factor that can trigger rheumatoid arthritis in people with certain genes. With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment are critical. 

Infectious Arthritis:

 A bacterium, virus or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and Shigella (food poisoning or contamination), chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C (a blood- to- blood infection, often through shared needles or transfusions). 

Metabolic Arthritis: 

 Uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can't get rid of the uric acid quickly enough. In some people the uric builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joints pain, ar a gout attack. Gout can come and go in episodes or, if uric acid levels aren't reduced, it can become chronic, causing ongoing pain and disability. 

Diagnosing Arthritis:

 Arthritis diagnosis often begins with a primary care physician who performs a physical exam and may do a blood test and imaging scans to help determine the type of arthritis. An arthritis specialist, or rheumatologist, should be involved in the diagnosis is uncertain or if arthritis may be inflammatory. Rheumatologist typically manages ongoing treatment for inflammatory arthritis, gout, and other complicated cases. 

Can be done about Arthritis:

  There are many things that can be done to preserve joint function, mobility % quality of life. Learning about the disease and treatment option, making time for physical activity and maintaining a healthy weight is essential. Arthritis is a commonly misunderstood disease. The Arthritis Foundation is the only nonprofit organization dedicated to serving all people with arthritis. 

Arthritis & Homeopathy:

 Homeopathy is a standout amongst the most prevalent all-encompassing system of medicine. The determination of remedy is based upon the theory of individualization and symptoms comparability by utilizing a comprehensive approach. To the extent therapeutic medicine is concerned, a few very much demonstrated medicines are accessible for homeopathic treatment of arthritis that can be chosen on the premise of the cause, sensation, location, modalities, and augmentation of the protests. For Individualized remedy determination and treatment, the patient ought to counsel a qualified homeopathic doctor. 

Homeopathy treats Joint Inflammation

 Homeopathic method of treatment is extremely powerful in treating Rheumatoid arthritis. Homeopathic medicines treat rheumatoid arthritis by directing the overactive immune system. They decrease joint inflammation and symptoms including swelling, pain, and stiffness of joints. Homeopathy offers an extensive variety of medicines for Rheumatoid arthritis. However, there is no one cure for ill connected with this condition. The most fitting homeopathic medicine for Rheumatoid arthritis is chosen in light of an inside and out analysis of individual symptoms. Exceedingly successful homeopathic medicines for Rheumatoid arthritis are Actaea spicata, Rhus-tox, Causticum, Bryonia, Kalmia, Calophyllum, Ledum pal, Guaiacum, Benzoic acid, Calcarea carb. 

 The knee is known as the largest and one of the most complex joints in the human body, and also one of the most vulnerable, as it supports the weight of the entire body. The knee joint is made up of several elements including the kneecap, meniscus, connective tissue, tendons, ligaments, cartilage, and muscles. Damage to any part of the knee can cause chronic pain. so how can you protect your knee from damage and injury?

Dealing with Load:
  
  Weight is a big one. Carrying around extra pounds and kilograms can be detrimental for your knees in the long run. Your knee is not equipped to handle the excessive weight. It already supports three to five times your weight when you get up and walk around or indulge in some mild jogging. One must be careful of those extra pounds to take the load off the knee and keep it from falling prey to damage.

Exercise:

 Moderate to intense exercise is prescribed for one and all. This, of course, depends on one's overall health and age. If you are already suffering from joint pain, then you may want to go easy on the exercise with a focus on building muscle strength and foundation. If you are healthy, then some amount of daily exercise as a routine will keep those knees in prime working condition and well lubricated as well. Inactivity and a sedentary lifestyle can affect the knee very badly. 

 Do not Ignore:

  Warning signals such as chronic or acute knee pain should not be ignored, Rember to see a doctor or specialist to find out if you have contracted an infection or if you may have suffered a fracture due to an injury. Also, it is important to take a bone density test regularly, especially after the age of 40 or for women going through menopause, as this will point to any deficiencies and even warn you in case there is any trace of osteoporosis. Rest, exercise and food should be kept in fine balance for a healthy body. These are a few measures that one can take to keep pain at bay. Yet, it is also advisable to speak with a doctor at length regarding measures to protect your knees. 


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Wednesday 10 October 2018

World Obesity Day 11 October 2018

      World Obesity Day 11 October 2018

    The social stigma of obesity or anti-fat bias has created negative psychosocial impact and has broadly defined as bias (prejudicial and negative attitudes, beliefs, and/or stereotypes) or discriminatory behaviors targeted at the individual, because of their weight. Such social stigmas can span one's entire life, as long as the excess weight is present, starting from a young age and lasting into adulthood. Several studies from across the world incident overweight and obese individuals experience higher levels of stigma relative to their thinner counterparts. 


   For #WorldObesityDay 2018 we are raising awareness about the prevalence, severity, and diversity of weight stigma. Stigma occurs in a wide variety of settings and the media has been identified as one of the main perpetrators. Current media portrayals of obesity reinforce inaccurate and negative stereotypes about weight which can lead to weight stigma. 



  We are calling on all media outlets to end their use of stigmatizing language and imagery and instead portray obesity in a fair, accurate and informative manner.

Also, there are many of my blogs  about Obesity: 


History of obesity and their prevention


https://drfarooqeliteclinic.blogspot.com/2017/10/history-of-obesity-and-their-prevention.html


https://drfarooqeliteclinic.blogspot.com/2018/02/lifestyle-diseases.html


https://drfarooqeliteclinic.blogspot.com/2018/04/how-to-reduce-weight.html


https://drfarooqeliteclinic.blogspot.com/2017/07/fast-food-and-health-junk-foods-dark.html


https://drfarooqeliteclinic.blogspot.com/2018/02/dr-hahnemann-as-father-of-modern.html


Tuesday 9 October 2018

Mental Health & Homeopathy

                   Mental Health & Homeopathy 





Mental health refers to our cognitive, behavioral, and emotional wellbeing, it is all about how we think, feel and behave. The term "Mental health" is sometimes used to mean an absence of a mental disorder. 

Mental health can affect daily life, relationship, and even physical health. Mental health also includes a person's ability to enjoy life- to attain a balance between life activities and efforts to achieve psychological resilience. 

"Mental health" & "Mental illness" what is meant by terms?

Definition

 Emotional, behavioral and social maturity or normality, the absence of a mental or behavioral disorder, a state of psychological well- being in which one has achieved a satisfactory integration of one's instinctual drives acceptable to both oneself and one's social an appropriate balance of love, work, and leisure pursuits. 

According to WHO:

  A state of well being in which the individual realizes his or her own abilities can cope with the normal stresses of life can work productively and fruitfully and is able to make a contribution to his or her community. 
The WHO stresses that mental health" is not just the absence of mental disorder."

Risk Factors

    Expert says we all have the potential to develop mental health problems, no matter how old we are whether we are male or female, rich or poor, or which ethnic group we belong to. Almost 1 in 5 Americans experiences mental health problems each year. In the united states estimated 9.8 million adults over 18 had a serious mental health. the equates to 4.8 percent of all American adults. 
   
   In India, 4.5% suffers from depression at this moment, another 38 million Indians suffer from anxiety disorders. Thus, according to the latest world health organization report on depression released. Almost 7.5% of Indians suffer from major or minor mental disorders the require export intervention. 

Common Disorders: 

 The most common types of mental illness are anxiety disorders, mood disorders, and schizophrenia disorders, below we explain each in turn:

 Anxiety Disorders:

 Anxiety disorders are the most common types of mental illness. The individual has a severe fear or anxiety, which is linked to certain objects or situations. Most people with an anxiety disorder will try to avoid exposure to whatever triggers their anxiety. 

Examples of anxiety disorders include

Panic disorder

 The person experiences sudden paralyzing terror or a sense of imminent disaster. 

Phobias:

 These may include simple phobias (a disproportionate fear of objects), social phobias ( fear of being subject to the judgment of others), and agoraphobia (dread of situations where getting away or breaking free may be difficult). We really do not know many phobias there are- there could be thousands of types. 

Obsessive Compulsive disorder (OCD)
  
 The person has obsessions and compulsions. In other words, constant stressful thoughts (obsessions), and a powerful urge to perform repetitive acts, such as hand washing (compulsion). 

Post Traumatic stress disorder (PTSD)

 This can occur after somebody has been through a traumatic event, something horrible or frightening that they experienced or witnessed. During this type of event, the person thinks that their life or other people's lives are in danger. They may feel afraid or feel that they have no control over what is happening. 

Mood disorders:

 These are also known as affective disorders or depressive disorders. Patients with this condition have significant changes in mood, generally involving either mania or depression. 

More mood disorders include:

Major Depression:

  The individual is no longer interested in and does not enjoy activities and events that they previously liked. There are extreme or prolonged periods of sadness. 

Bipolar disorder:

 Previously known as manic-depressive illness or manic depression. The individual switches from episodes of euphoria (mania) to depression. 

Persistent depression disorder:

 Previously known as dysthymia, this is mild chronic depression. The patient similar symptoms to major depression but to a lesser extent. 

SAD(Seasonal affective disorder):

 A type of major depression that is triggered by a lack of daylight. It is most common in countries far from the equator during late autumn, winter, and early spring. 

Young people and mental health in a changing world:

  Adolescence and the early years of adulthood are a time of life when many changes occur, for example changing schools, leaving home, and starting university or a new job. For many, these are exciting times. They can also be times of stress and apprehension, however. I some cases if not recognized and managed, these feeling can lead to mental illness. 

Prevention begins with a better understanding

 Much can be done to help build mental resilience from an early age to help prevent mental distress and illness among adolescents and young adults, and to manage and recovery from mental illness. Prevention beings with being aware of and understanding the early warning signs and symptoms of mental illness. 
 Parents and teacher can help build life skills of children and adolescents to help them cope with everyday challenges at home and at school. Psychosocial support can be provided in school and other community setting and of course training for health workers to enable them to detect and manage mental health disorders can be put in place, improved or expanded. 

 Investment by the government and the involvement of the social, health and education sectors in comprehensive, integrated, evidence-based programmes for the mental health of young people is essential. This investment should be linked to programmes to raise awareness among adolescents and young adults of ways to look after their mental health and to help peers, parents, and teachers know to support their friends, children, and students. 

Mental health & Homeopathy

 Homeopathy gives great importance to mental health both in the treatment of physical and mental illness. The homeopathy understanding of health is intimately connected to its understanding of the mind in general. They generally assume that body and mind are dynamically interconnectedness of body and mind is not simply a vague, impractical concept. Homeopaths base virtually every homeopathic prescription on the physical and psychological symptoms of the sick person. Psychological symptoms often play a primary role in the selection of the correct medicine. 

  Homeopathy is based on the philosophy of treating the whole person based on mind, body, and life force relationship. In this concept, health is considered a perfect state of harmony of functions in the mind, and body life force and illness is often the result of disharmony. The disharmony can come from a dysfunction in anyone. Holistic healthcare believes that a dysfunction in one affects the whole person and not just that one part of the body. Holism promotes that human beings must be treated together to achieve healing rather than simply treating a person for a specific illness. Holistic health looks into the need of the sick and provides customized care. 



  



Tuesday 2 October 2018

How to control your anxiety???

          What to do to control your Anxiety:

- Notice how it is affecting you and pay attention to how you would rather be feeling. 
- Remember to breathe.
- Focus on something interesting and engaging, a hobby, a project, a conversation with a friend. 
- Play with a pet or children, Play a sport.
- Stay active in your life. Continue going to work and/or school. 
- Take care of the children.
- Keep your house clean. 
- Take care of your personal hygiene.
- Surround yourself with people who care about you.
- Engage in conversation that is interesting and meaningful.
- At other times, engage in trivial talk.
- Try to limit discussion about the anxiety to less than 5% of your conversation. 
- Pay attention to whether what you are doing or thinking is what you want to be doing or thinking.