Health is Wealth

Pain

2007-10-06T00:09:00.000-07:00

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

2007-09-23T03:40:00.000-07:00

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

2007-09-21T09:58:00.000-07:00

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

2007-09-20T09:31:00.000-07:00

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

2007-09-20T09:05:00.000-07:00

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

2007-09-20T08:39:00.000-07:00

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

2007-09-20T08:15:00.000-07:00

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

Pimples

2007-09-03T11:10:00.000-07:00

Pimples are also called as acne. Acne is a common skin condition that occurs when oil and dead skin cells clog the skin's pores. These clogs cause lesions in the skin that are often red and swollen. When you have just a few red spots, known as pimples, you have a mild form of acne. Severe acne can mean hundreds of pimples that can cover the face, neck, chest, and back. While mild acne is merely annoying, severe acne can lead to emotional and physical scars. Acne most often affects teens; more than 85% develop at least a mild form of this condition.

CAUSES

Clogged pores cause acne to develop, most often during the teen years. During puberty, hormone levels rise and skin glands make more oil (sebum). The oil's job is to keep your skin moist. Acne starts when the oil mixes with dead skin cells. This mixture blocks skin pores and becomes infected with bacteria that seeps into nearby tissues. The result is swelling, redness, and pusacne.

There are many misconceptions and rumours about acne. Exactly why some people get acne and some do not is not fully known. Some of them might be due to hormonal activity such as menstrual cycles and puberty stress accumulation of dead skin cells, bacteria in the skin pores, skin irritation or scratching, use of anabolic steroids, exposure to high levels of chlorine compounds.

TREATMENT

Treatment for acne takes time. You may not see progress for up to 8 weeks. Sometimes acne will get worse before it gets better even with treatment. The good news is that treatments often work very well. Gentle cleansing with soap or nonprescription products, such as benzoyl peroxide lotions, often controls mild acne cases and prevents new outbreaks. If these treatments do not work, your doctor may prescribe creams or lotions. These treatments can contain antibiotics or other kinds of medication. Doctors may prescribe topical benzoyl peroxide lotions, which you apply to your skin for moderate to severe acne. Oral antibiotics are also used to treat acne. Sometimes you use the lotions along with antibiotics. This combination often works better than either medication alone. It also decreases your risk of developing antibiotic resistance.

If you have acne nodules solid, inflamed, painful lumps your doctor might first prescribe a topical retinoid, a cream or lotion that contains a form of vitamin A. Treatment can also include an antibiotic that you put on your skin and/or an antibiotic you take by mouth. If you have severe acne with deep nodules and cysts, your doctor may suggest an oral retinoid, such as isotretinoin (Accutane) if other treatments don't work. Though this medication works very well, doctors suggest it only as a last resort. Isotretinoin can cause some rare but serious side effects. Depression, high cholesterol levels, and birth defects are a few of the possible side effects. Just one dose of isotretinoin can cause severe birth defects if a woman is pregnant when she takes this medication.

Light wave therapy, which uses a high-intensity blue light, has U.S. Food and Drug Administration (FDA) approval for acne treatment. This therapy is rarely used, but in some cases may help with mild to moderate acne that hasn't improved with other treatments..

REMOVAL OF POST ACNE SCARS

Treatment can help acne scars look better and feel smoother. These treatments range from injecting collagen, to removing damaged layers of skin, to cutting out the scar and repairing the hole. The best treatment for you depends upon how severe the scarring is. You may have more than one treatment at the same time for best results.

A dermatological technique called microderm abration is most comonly used now a days. In this technique the superficial layers of skin are abraded which usually contain the sarred tissue.

- Dr. Moka Satyanarayana

Dandruff

2007-09-03T10:30:00.001-07:00

Dandruff is due to the excessive shedding of dead skin cells from the scalp. As it is normal for skin cells to die and flake off, a small amount of flaking is normal and in fact quite common. Some people, experience an unusually large amount of flaking, which can also be accompanied by redness and irritation. Most cases of dandruff can be easily treated with specialized shampoos

CAUSE:
The skin of scalp has cells arranged in layers, the outermost layer being the oldest. This layer continually replaces itself, cells are pushed outward where they eventually die and flake off. In most people, these flakes of skin are too small to be visible. However, certain conditions cause cell turnover to be unusually rapid. For people with dandruff, skin cells may mature and shed in 2 - 7 days, as opposed to around a month for people without dandruff. The result is that dead skin cells are shed in large, oily clumps, which appear as white or grayish patches on the scalp.

Dandruff is also said to occur due to excessive skin oil called sebum.

In some cases the cause also could be a fungus called "malassezia furfur" which is usually found even on the normal scalp.

PREVENTION:
1. Taking regular head bath
2. Applying oil especially in winters
3. Avoiding the sun and heat
4. Maintaining a good scalp hygeine

The most important of all is to use antidandruff shampoos like the ones mentioned below regularly.

Active ingredient ************Example of product
Zinc pyrithione *************** Head & Shoulders, Clinic All Clear, Pantene Pro V
Ketoconazole*****************Nizoral
Selenium sulphide**************Selsun, Vichy Dercos Anti-Dandruff shampoo
Tea tree oil ******************Himalaya Anti-dandruff shampoo
Tar************************Neutrogena T/Gel
Piroctone olamine**************Octopirox

Out of the above shampoos having ketoconazole and selenium sulphide are considered the best.

- Dr. Moka Satyanarayana

Loss of Hair

2007-08-30T11:45:00.000-07:00

Almost everyone on the earth has this problem. It is actually a natural process and a loss of 15-25 strands of hair per day is normal. It occurs while taking head bath, wiping hair, combing, rubbing against a pillow or even heavy breeze. One should not be worried about this. Hair loss is considered significant only when there is a loss of 100 strands of hair per day occuring continuously over a period of time. The process of loosing hair is inevitable, occurs due to hormones and indirectly controlled genetically.

The process of loosing hair can be slowed by application of minoxidil(a drug used in hypertension, but when used topically on scalp it stops hairfall by increasing blood supply around the hair follicles/roots). But once you stop applying minodoxil the hair loss will return as usual.Other causes of hair loss are iron deficiency, malnutrition, hormonal disorders like hypothyroidism, hypopitutarism, dandruff. Dandruff can be controlled by using ketoconazole shampoo(one commerical version is Nizral shampoo)

Hair loss also occurs due to intake of certain drugs like drugs used in cancer, asprin, few antibiotics and other drugs. Counselling and reassurance is a major part in treatment of hair loss.

- Dr. Moka Satyanarayana

Doctor's limits

2007-08-26T09:58:00.001-07:00

We often think that doctors have much power to heal, but consider the following. Hair transplantation is done with artificial or dead hair and cannot be done to re-grow the hair. A single hair is a dead tissue which is supported by the growth at the nerve ending on the top of the head skin. During hair transplantation doctors push the dead hair into the nerve ending and lock it and the hair remains the same and doesn’t grow. They cannot make a single tiny nerve ending rework properly. Whatever the doctors do they only can replace a part or extend life for a few days or months but they cannot recreate the original thing, only God can do it.

Weight loss walk

2007-08-24T12:09:00.000-07:00

I have read somewhere and quite like the following point to reduce weight. Weight should be reduced gradually and through an exercise which could only be regular in life to avoid the risk of gaining weight again. The regular exercise can be a walk which is an amble (easy pace) because the easy pace walk burns more fat. The more effort you put in doing an exercise the faster you decrease your glucose levels and burn very less fat. So an easy pace walk every now and then burns more fat permanently than heavy irregular exercises which burn readily available glucose and energy in the body and make you eat more.

Maybe i like the above point because i am lazy and a bit overweight:)

Acidity

2007-08-22T12:07:00.000-07:00

It is a condition in which a person encounters burning sensation usually accompanied with pain in the upper abdomen. In some severe cases it is usually misunderstood with myocardial infarction..ie, heart attack.

Reasons for the pain: It is due to irritation of nerve endings in the stomach. It occurs when there is damage to the first protective layer of stomach by increased acid secretion occuring due to various reasons. When this first layer called gastric mucosa is damaged the nerve endings in stomach get exposed to acid causing pain.

Causes:
1. Irregular food consumption
2. Greater intake of spicy food
3. Psychological due to mental tension
4. OvereatingSedentary life style
5. Habits like smoking and
6. Consuming alcohol.

Prevention: simple but difficult to implement.
1. Taking regular food at regular intervals with regular quantities.
2. Walk around for 5-10 mins after taking food, instead of just sitting or lying down.
3. As far as possible avoid smoking and alcohol.

Treatment: Depends on the severity.It is started with antacids, then H1 blockers like ranitidine and Finally to proton pump inhibitors like omeprasole.In cases with severe pain a syrup having antacid with a local anaesthetic is given.

Hyper acidity for a long period leads to formation of gastric ulcers.

Health blog

2007-08-22T11:35:00.000-07:00

Why did i start this blog. I am generally interested about knowing how our body works and had met a good friend "Dr. Moka Satyanarayana" of mine who has just completed his MBBS in Bangalore. I used to stay in a room besides his when he was pursuing his MBBS course and we used to have long discussions on health, diseases, medicines etc. With our discussions going on i have realised that doctors are agents who can only extend our life span by a few years by making some sacrifices. This came as a shock to me since i have really believed that they are much more capable than that.

For example, to a person who has lost both the kidneys, a retransplant would extend his life by two years and that too with a long prescription of drugs to make his body adjust to the newly transplanted kidney, and even after all this the kidney becomes useless after two years and another retransplant should be done to extend his life by another two years. And eventually the person dies of excessive use of drugs. What an irony.

And there are a lot of misconceptions about the doctors and their treatments among the people(includes myself) which prompted me to start this blog to learn and may be provide information which can be useful to few people.