Pain

It is a strongly unpleasant feeling caused by illness, injury or mental suffering. It is the most annoying thing a person can feel. Pain is sensation transmitted from sensory nerves through the spinal cord and to the sensory area of the cerebrum where the sensations are perceived. It is defined by the International Association for the Study of Pain (IASP) as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage”. As a part of the body's defense system, pain triggers mental and physical behavior that seeks to end the painful experience. It is also a feedback system that promotes learning, making repetition of the painful situation less likely. The nociceptive(pain-detecting neurons) system may transmit signals that trigger the sensation of pain, it is a critical component of the body's ability to react to damaging stimuli and it is part of a rapid-warning relay instructing diverse organs and principally the central nervous system to initiate reactions for minimizing injury. The experience of physiological pain can be grouped according to the source and related nociceptors (pain-detecting neurons). Cutaneous pain is caused by injury to the skin or superficial tissues. Cutaneous nociceptors terminate just below the skin, and due to the high concentration of nerve endings, produce a well-defined, localized pain of short duration. Examples of injuries that produce cutaneous pain include paper cuts, minor cuts, minor (first degree) burns and lacerations. Somatic pain originates from ligaments, tendons, bones, blood vessels, and even nerves themselves. It is detected with somatic nociceptors. The scarcity of pain receptors in these areas produces a dull, poorly-localized pain of longer duration than cutaneous pain; examples include sprains and broken bones. Myofascial pain usually is caused by trigger points in muscles, tendons and fascia, and may be local or referred. Visceral pain originates from body's viscera, or organs. Visceral nociceptors are located within body organs and internal cavities. The even greater scarcity of nociceptors in these areas produces pain that is usually more aching and of a longer duration than somatic pain. Visceral pain is extremely difficult to localize, and several injuries to visceral tissue exhibit "referred" pain, where the sensation is localized to an area completely unrelated to the site of injury. Myocardial ischaemia (the loss of blood flow to a part of the heart muscle tissue) is possibly the best known example of referred pain; the sensation can occur in the upper chest as a restricted feeling, or as an ache in the left shoulder, arm or even hand. The popularized term "brain freeze" is another example of referred pain, in which the vagus nerve is cooled by cold inside the throat. Referred pain can be explained by the findings that pain receptors in the viscera also excite spinal cord neurons that are excited by cutaneous tissue. Since the brain normally associates firing of these spinal cord neurons with stimulation of somatic tissues in skin or muscle, pain signals arising from the viscera are interpreted by the brain as originating from the skin. The theory that visceral and somatic pain receptors converge and form synapses on the same spinal cord pain-transmitting neurons is called "Ruch's Hypothesis". Phantom limb pain, a type of referred pain, is the sensation of pain from a limb that has been lost or from which a person no longer receives physical signals. It is an experience almost universally reported by amputees and quadriplegics. Neuropathic pain can occur as a result of injury or disease to the nerve tissue itself. This can disrupt the ability of the sensory nerves to transmit correct information to the thalamus, and hence the brain interprets painful stimuli even though there is no obvious or known physiologic cause for the pain. Neuropathic pain is, as stated above, the disease of pain. It is not the sole definition for chronic pain, but does meet its criteria. In some cases, treating the underlying disorder eliminates or minimizes the pain. For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain. However, even if the underlying disorder can be treated, pain relievers (analgesics) may still be needed to quickly manage the pain. Doctors choose an analgesic based on the type and duration of pain and on the likely benefits and risks. Most analgesics are effective for nociceptive pain (due to ordinary injury of tissues) but are less effective for neuropathic pain (due to damage or dysfunction of the nerves, spinal cord, or brain), which often requires different drugs. For some types of pain, especially chronic pain, non drug treatments are also important.

Headache

It is a condition where there will be pain in the head which can be due to various reasons and of different types. Causes 1. Sinusitis, refractory errors in vision, migraine, brain tumors, anxiety 2. Stress, fatigue, decreased blood supply to the brain, decreased glucose to the brain 3. Associated with fever, associated with cold, depression, motion sickness. 4. Prolonged exposure in a dark room, exposure to the noise and reading in a moving vehicle, 5. Pollution, ear problems, infections in the scalp Symptoms It is a feeling of discomfort preventing a person from doing his routine work, causing frustration and compelling to take rest. It can occur with different levels of severity, mild ones are tolerable, moderate ones are bearable, severe ones are torturous. It may be present only in one part of the head or may be present all over the head. Treatment 1. Just rest is sufficient for mild type of headache 2. Analgesics like paracetamol, anacin, nice or even a hot cup of coffee is sufficient for moderate type 3. For severe type of headache a thorough evaluation is required. Drugs like aspirin, ergotamines are used and evaluation starts from heamoglobin estimation to ct scan. “Headache is a headache for the patients to bear and for the physicians to treat” - Dr. Moka Satyanarayana

Cataract

When transparency of the lens present on the centre of the eye ball is lost gradually due to various reasons it leads to the formation of cataract. It is usually seen in elderly people aged above 55 years. The reason is that the lens become opaque and hence hinders the formation of images resulting in blurred vision or even sometimes complete irreversible blindness. It is the most common cause of blindness in the world. Causes 1. Loss of elasticity of the lens during old age or higher water content which increases the 2. refractive density of the lens. 3. Metabolic causes such as diabetes 4. Heavy metal toxicity (copper, mercury, iron) 5. Blunt trauma to the eye and lens. 6. Post inflammatory or infectious causes. 7. Congenital or hereditary causes. Symptoms 1. Blurred vision for both near and far objects. 2. Colored halos around bright light. 3. Vision that could not be corrected with spectacles. 4. The center of eye which should normally be transparent is lost in cataract. Treatment The only treatment is surgery. If treatment is not taken it may lead to complications which increase the pressure in the eye causing red eye and sudden loss of vision. After the surgery antibiotic eye drops are prescribed for three months and after one week of the surgery, power of the eye is checked and glasses are prescribed. "Cataract surgery brings sudden light after darkness in life" -Dr Moka Satyanarayana

Depression

It is a disorder of the mind and is a thought. As the word rightly appears, it is a feeling of feeling low. The thought process of the mind is inhibited and makes self esteem low. Brain is clouded with negative thought’s which lowers the energy levels. Causes Depression is caused by multiple factors, it may be as complicated as the brain itself, and may lead to the death of the person, or it can be as simple that it may last for a few hours. Pathologically it may be due to the decrease of seretonin which is a chemical required to keep the brain alert and active. It can be due to emotional stress, academic failure, accidents, incidents, socioeconomic status, societal status, work, handicaps, diseases, old age, family affairs. Depression occurs for different reasons for different people. Symptoms The person feels dull, looks expression less, weeps for small reasons, likes to be lonely, does not feel comfortable in crowd, cannot concentrate, bad memory, sleeplessness or over sleeps, eats too much or too little, tiredness, and can indulge in smoking or alcohol to relieve the symptoms and may get addicted to drugs. The person may have suicidal tendencies, try to commit or in severe cases may end up in a suicide. Treatment 1. Mainly counseling by a psychiatrist and dear ones 2. Anti-depressives 3. For severe cases electro convulsive therapy is given, i.e. shock treatment. Ultimately "The more you think about your depression the more depressed you become” - Dr. Moka Satyanarayana

Common cold

It is a very common condition seen in all the age groups. It is present as a running nose, pain in the throat, difficulty in swallowing, dry cough or with sputum and almost always associated with headache. Causes It’s most commonly caused by virus, sometimes it can be super-infected by bacteria and it can also be allergic Treatment 1. Household remedies such as drinking hot milk with pepper and a pinch of turmeric 2. Salt water gargling 3. Antihistaminics like citrezine, cpm tablets 4. Mucolytics for cough 5. Mild analgesic for headache like paracetamol or combiflam With the above remedies common cold can vanish in 2 days if not takes a week! The treatment is to produce relief and not to treat the disease as such. - Dr. Moka Satyanarayana

Fever

An increase in the body temperature above the range of normal limits is known as fever. It can be sensed by just feeling the temperature over the forehead or the neck. Normally the body temperature ranges from about 35-37.5 degree celsius, and any increase above this is known as fever Fever is just a symptom and not the disease itself, hence a number of diseases occur with fever as one of the symptom. Basically fever is caused due to the liberation of pyrogens which increase the body temperature. This is indirectly stimulated by the white blood cells which are numerous in infections. Fever is of different types, it may be continuous or intermittent. Fever can also vary in severity; it may be mild, moderate or severe in condition. Fever actually protects the body by lessening damage caused by infectious agents. In-fact fever also occurs in case of a disease such as syphilis to kill bacteria which are temperature sensitive. Treatment for fever is by antipyretics 1. Paracetamol tablets, syrup, injectables etc. 2. Sometimes tepit sponging is required to decrease the temperature. - Dr. Moka Satyanarayana

Heart attack

It is a very common condition in the growing sedentary lifestyle of developing and developed nations. People think that heart attack is just chest pain but it is just the tip of iceberg of this condition. Cause It occurs due to decreased nutrition to the heart which is the mechanical pump to the whole body, causing release of substances which cause pain. The nutrition deficiency is due to the occlusion of a blood vessels supplying blood to the heart. The causes for the occlusion are many to mention, few being increased cholesterol levels to the most least understood genetic patterns. Symptoms It occurs as discomfort in the chest, pain over the chest which may be typically over the center of the chest, stabbing in nature, severe, with duration of about few seconds to few minutes. It sometimes radiates from the chest to the left shoulder up to the hand. It can be associated with difficulty in breathing, sweating and increased heart beat with feeling of ones own heart beat. Sometimes it might be so symptomless that it can occur as a slight headache and the person might never guess it could be a "HEART ATTACK" Sometimes it could b so severe that the person could die on the spot. People often get confused about acidity with heart attack. Treatment 1. Sublingual nitrates 2. Aspirin 3. Clopidogril 4. If hypertention or diabetes is present control of the condition is essential 5. In severe cases streptokinase in injectable form is given Prevention 1. Keeping the body fit with regular exercises and an active lifestyle with avoidance of smoking and alcohol. 2. Low fat diet 3. Regular screening for cholesterol 4. Low salt diet with daily intake of less than 5gms 5. Avoid anxiety 6. Care of diabetis and hypertention. - Dr. Moka Satyanarayana