Management of leavtor scapular region Pain
25/F has pain in levator scapular region on left side since 4months. She works in a food factory and has moderate to light tasks to be done for 8hours a day. Constant pain was 40% Onset- patient made theplas for 2 hours continuously after which she started getting constant pain for which she had pain killers for a week but to no relief. After a week, physiotherapy started Examination- Swelling seen on levator scapula region. Posture mildly protracted shoulders All shoulder n thoracic ranges were full. Cervical right wide flexion was minimally reduced with pain on left upper trapz region. Muscle strength- Levator scapula n upper trapz- tight Middle trapz lower trapz - weak All other girdle n shoulder muscles were weak as compared to her right side. Worked on those muscles and posture correction. Counselling for rests in between and reduced physical tasks. Intermittently physiotherapy was stopped by the patient and now her pain is reduced to 10% with heaviness in that region felt constantly. Her work profile has changed to computer work for 8 hours a day. Pain increases only when she does any physical work for more than 30mins. Pain subsides after she stops the work in another 30mins. Please advise further management of this patient and your views on it.
Investigation X Ray Cervical spine AP Lateral . CBC ESR Vitamin B 12 Vitamin D 3 Cervical traction & physiotherapy suggested Regular exercise Weight lifting should be stopped Neck collar use Rest for 21 days
Hi... Core muscle strength ? Cervical flexors are the first core muscles and in case that the individual has a tendency to use a forward head posture for tasks or the work table is not ergonomically designed, recurrent strain on the muscles is highly likely.. since it is not possible for person of such a young age to take rest or leave the job.. better to explain to the patient the importance of leading a healthy Lifestyle with strengthening exercises and also to make suitable changes to the workstation so that the joints can be well aligned during work...
Tell her to take break after 25 min (before fatigue) and do active movement of it in 5 min then restart work for another 25 min cont in this way...advice her neck pillow even or proper neck and back supporters available in market...if she will be able to do her work proper way then half of problem is solved and than you can continue strengthening of weak muscle and stretching of tight but she needs more focus ergonomically first and if swelling is also there icepack is must.
There is a weakness of that particular mucscle and repeatedly overuse are the main reason .ask patient to go with strength training of that particular muscle like it should be with gravity like supported and than against gravity and than with weight .but first make sure the tear should not be at grade lll .as grade lll muscle damage need different treatment than this.
Pl.get an MRI of the shoulder done to assess the extent of damage to the muscles and tendons and proceed accordingly.
Cases that would interest you
- Login to View the image
THYROID DISORDERS -EVERYTHING YOU SHOULD KNOW - by Dr Sunil kumar Dear friends and Curofians here's an brief information about thyroid disorders. Thyroid gland is a butterfly shaped gland in the front of the neck. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs. Thyroid disorders are conditions that affect the thyroid glands. It plays an important role in regulating numerous metabolic processes throughout the body. The Thyroid gland is located below the adam’s apple wrapped around the trachea. Thyroid disease is a common problem that can cause symptoms because of over- or under-function of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintain our body metabolism. The thyroid gland is located in the front of the neck below the Adam's apple. Thyroid disease can also sometimes lead to enlargement of the thyroid gland in the neck, which can cause symptoms that are directly related to the increase in the size of the organ (such as difficulty swallowing and discomfort in front of the neck). Thyroxine T4 is the primary hormone developed by the Thyroid gland. A small portion of the T4 released from the gland is converted to Triiodothyronine (T3) which is the most active hormone. Hyperthyroidism: Too much thyroid hormone results in a condition known as hyperthyroidism. Affects about 1 percent of women. It's less common in men. Grave’s disease is the most common cause of hyperthyroidism. Symptoms: RestlessnessNervousnessIrritabilityracing heartIncreased sweatingShakingRestlessnessTrouble sleepingThin skinBrittle hairNailsWeight lossMuscle weakness Causes: Toxic adenomas: Nodules develop in the thyroid glands and begin to secrete thyroid hormones upsetting the body's chemical balance.Subacute thyroiditis: Inflammation of the thyroid that causes the gland to leak excess hormones, resulting in temporary hyperthyroidism that lasts a few weeks but may persist for months.Pituitary gland: Malfunctions or cancerous growths in the thyroid gland. Although rare, hyperthyroidism can also develop from these causes. Treatments for hyperthyroidism: destroy the thyroid gland or block it from producing its hormones. Antithyroid drugs: such as methimazole (Tapazole) prevent the thyroid from producing its hormones.Radioactive iodine: a large dose of it damages the thyroid gland. A pill is given by mouth. As thyroid gland takes in iodine, it also pulls in the radioactive iodine, which damages the gland.Surgery: Surgery can be performed to remove your thyroid gland. Hypothyroidism: Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body’s development to slow down and reduces metabolism rates. Since the body needs some amount of thyroid for energy production and drop in hormone production leads to lower energy levels. Symptoms: FatigueDry skinIncreased sensitivity to coldMemory problemsConstipationDepressionWeight gainSlow heart rateComa What are the causes of Hypothyroidism? Hypothyroidism can be caused by a number of factors: Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body’s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto’s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.Iodine deficiency in diet: For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc. – for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery – this is called Postpartum thyroiditis.Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby’s heel. Who are at risk of developing Hypothyroidism? Women have a higher risk of suffering from hypothyroidism than men.Older people are at increased risk.People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison’s disease etc.People with psychiatric conditions such as bipolar disorderPeople with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism. How to diagnose hypothyroidism? Blood tests: TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.T4: A low level of thyroxine indicates hypothyroidism.T3: these levels are generally not needed to diagnose hypothyroidismAnti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.Ultrasound of the neck is done if the patient presents with a thyroid swelling. What is the treatment of hypothyroidism? Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30 – 45 minutes before breakfast. The treatment is continued for the rest of the patient’s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective. Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high. What are the side-effects of thyroxine medication? There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains. Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc. There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc. What are the complications of hypothyroidism? If untreated hypothyroidism can lead to: heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retentionobesityinfertilityjoint painsdepressionA pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma. If you wish to discuss about any specific problem, you can consult an Endocrinologist. Regards Dr Sunil kumar
Dr. Sunil Kumar14 Likes20 Answers - Login to View the image
*Hypothyroidism* *☝ all about☝* – also called underactive thyroid – is the most common thyroid disorder. It happens when your thyroid gland doesn’t produce enough thyroid hormone, which is essential because thyroid hormone helps regulate important body processes, such as your metabolism. But with low thyroid function, these body processes slow down. Pathophysiology The hormones produced by the thyroid gland are T3 and T4. These hormones have an action on almost all parts of the body. The secretion of these hormones is regulated by TSH or thyroid stimulating hormone that is secreted by the pituitary gland. The secretion of thyroid hormone occurs only from this particular gland. The presence of iodine and amino acid tyrosine are a must for the production of thyroid hormones. Hypothyroidism and low levels of the thyroid hormones can occur if there is a deficiency of iodine for thyroid or thyroid stimulating hormone (TSH). The hypothalamus of the brain secretes TRH thyroid releasing hormone which acts on the pituitary gland and initiates the release of TSH or thyroid stimulating hormone. TSH then acts directly on the thyroid gland to release thyroid hormones T3 and T4. The normal functioning of the thyroid (healthy thyroid) is regulated by negative feedback mechanism where the levels of thyroid hormones increase or decrease under the influence of TSH. Causes Hashimoto’s thyroiditis: This autoimmune disease is the most common cause of hypothyroidism. Medications: Certain medications, such as lithium, can cause hypothyroidism. Pregnancy: Hypothyroidism can develop during or after pregnancy. Treatment for hyperthyroidism: People who have hyperthyroidism (overactive thyroid) are treated with radioactive iodine therapy, which impairs thyroid function and can cause hypothyroidism. Thyroid surgery: If your thyroid gland is removed, you can’t make thyroid hormone, so you’ll need to take thyroid hormone replacement. Radiation therapy: Radiation used for the treatment of cancer in the head or neck, lymphoma, or leukemia, may slow or halt the production of thyroid hormone. This will almost always lead to hypothyroidism. Risk factors There are two main factors to consider – age and sex. The chances of being hypothyroid increase with age, and they are greater if an individual is a woman. You have a family history of thyroid disease or any autoimmune disease You have type 1 diabetes or rheumatoid arthritis, or other autoimmune disorders As mentioned in the causes section medications and thyroid surgery also a major risk factors Signs and Symptoms in adults Women who are over age 60, as well as men who are aging, should look out for these potential symptoms of hypothyroidism: Weight gain Fatigue Sensitivity to cold temperatures Depression Dry skin Thinning hair Heavy menstrual periods (in women) Trouble sleeping Difficulty concentrating Pain or swelling of the joints Constipation High cholesterol levels Muscle weakness Signs and symptoms in Children and teen Symptoms of hypothyroidism in children and teens are similar to symptoms in adults and can include: Poor growth or short stature Delayed puberty Slow reaction time Weight gain Coarse, dry hair or skin Muscle cramps Delayed mental development Increased menstrual flow for girls Signs and Symptoms in Infants Symptoms of hypothyroidism in infants may include: Jaundice (yellowing of the skin and whites of the eyes) Frequent choking Puffy face Constipation Complications Heart disease and stroke Hypothyroidism can lead to insulin resistance The myxedema coma Goiter Mental health issues Peripheral neuropathy Low levels of thyroid hormone can interfere with ovulation, which impairs fertility Birth defects Diagnosis and test Medical evaluation Your doctor will complete a thorough physical exam and medical history. They’ll check for physical signs of hypothyroidism, including: Dry skin Slowed reflexes Swelling A slower heart rate In addition, your doctor will ask you to report any symptoms you’ve been experiencing, such as fatigue, depression, constipation, or feeling constantly cold. Blood test There are several types of blood tests – the most definitive one is called the TSH test (thyroid-stimulating hormone). However, in some cases, physicians may refer to the free thyroxine or T4, free T4 index, or total T4 to aid in the diagnosis. TSH Test A thyroid-stimulating hormone or TSH is a blood test that measures the amount of T4 (thyroxine) that the thyroid is being signaled to make. If you have an abnormally high level of TSH, it could mean you have hypothyroidism. 0.4 mU/L to 4.0 mU/L is considered the reference range (there may be a slight variation depending on the laboratory), TSH >4.0/mU/L with a low T4 level indicates hypothyroidism. T4 (thyroxine) Test The thyroid gland produces T4 (thyroxine). The free T4 and the free T4 index are blood tests that, in combination with a TSH test, can let your physician know how your thyroid is functioning. Anti-thyroid Microsomal Antibodies Testing A third hypothyroid test is for anti-thyroid microsomal antibodies—anti-thyroid peroxidase (anti-TPO). These antibodies, which are produced by the immune system, may attack thyroid cells. If a blood test determines their presence, it shows that there has been thyroid damage which could potentially lead to hypothyroidism. Differentiation of Hypothyroidism Primary hypothyroidism Primary hypothyroidism is due to disease in the thyroid; thyroid-stimulating hormone (TSH) is increased. The most common cause is autoimmune. It usually results from Hashimoto thyroiditis and is often associated with a firm goiter or, later in the disease process, with a shrunken fibrotic thyroid with little or no function. The 2nd most common cause is post-therapeutic hypothyroidism, especially after radioactive iodine therapy or surgery for hyperthyroidism or goiter. Secondary hypothyroidism Secondary hypothyroidism occurs when the hypothalamus produces an insufficient thyrotropin-releasing hormone (TRH) or the pituitary produces insufficient TSH. Sometimes, deficient TSH secretion due to deficient TRH secretion is termed tertiary hypothyroidism. Subclinical hypothyroidism Subclinical hypothyroidism is elevated serum TSH in patients with absent or minimal symptoms of hypothyroidism and normal serum levels of free T4. Subclinical thyroid dysfunction is relatively common; it occurs in more than 15% of elderly women and 10% of elderly men, particularly in those with underlying Hashimoto thyroiditis. Treatment and medication Medications Hypothyroidism is a lifelong condition. For many people, medication reduces or alleviates symptoms. Hypothyroidism is best treated by using levothyroxine (Levothroid, Levoxyl). This synthetic version of the T4 hormone copies the action of the thyroid hormone your body would normally produce. The medication is designed to return adequate levels of thyroid hormone to your blood. Once hormone levels are restored, symptoms of the condition are likely to disappear or at least become much more manageable. Animal extracts that contain thyroid hormone are available. These extracts come from the thyroid glands of pigs. They contain both T4 and triiodothyronine (T3). If you take levothyroxine, you’re only receiving T4. But that’s all you need because your body is capable of producing T3 from the synthetic T4. These alternative animal extracts are often unreliable in dosing and haven’t been shown in studies to be better than levothyroxine. For these reasons, they aren’t routinely recommended. Thyroid Hormone Replacement Therapy The main goal is to compensate for the lack of hormone secreted by the thyroid gland. In most cases, an affected individual will take a daily dose of T4 (or T3 and T4) in a pill taken orally. But it’s important to understand that every patient’s therapy may be different. There is no cookie-cutter dosage or treatment plan when it comes to thyroid hormone replacement therapy. How the body absorbs the hormones, along with the number of hormones needed to help the body function properly is very varied. Prevention Taking iodine supplements can prevent hypothyroidism. Exercises and alternative therapies may prove more than effective in minimizing symptoms of thyroid imbalance than traditional treatments. Get a screening test every five years if you are 50 years old or older. Get regular screenings if you: Have Type 1 diabetes Have infertility (females) Take certain medications Natural remedies Do not use non-stick cookware Eliminate Soy: Soy restrains functions of the thyroid, imbalances hormones & it has been appeared to cause goiters Balance Estrogen Levels: Excessive consumption of estrogen slows down the thyroid organ. This implies disposing of anti-conception medication, expanding the fiber in the eating routine & keeping away from all non- organic meats. Adhere to an Alkaline Diet: This is greatly useful when curing any severe issue. Exercise: Find a physical movement activity that is fun & does it regularly. Iodine: The thyroid requires iodine to work appropriately & loads of individuals now experience the ill effects of iodine lacks. To test yourself, put some iodine on your stomach. In case it vanishes in 12 hours, at that point you are lacking iodine. Continue including iodine in increased amounts, until it doesn’t vanish in a 12-14 hours’ time. This works because of the way that the body trans-dermally absorbs iodine at the rate at which it is required. Avoid all types of fluoride Move for natural diet: To enable the body to recuperate itself, take away the loads on its immune system. This implies every single processed food, synthetic flavors, hues, additives, white sugar, white flour, table salt, hydrogenated oils, aluminum and etc. ought to be removed from the diet chart. Organic food is perfect. Chlorophyll: Including chlorophyll gives fundamental copper, oxygenates the body, adds healthy RBC’s, and in general helps with skin health. Chlorophyll is a safe strategy for the oral supplement of copper. Pears and Apples: Pears help most when combined with or mixed with apple juice. Try this pear juice formula, and drink it routinely. Zinc and Selenium: Studies demonstrate that serious zinc or selenium insufficiencies would cause diminished thyroid levels. Never take zinc first thing in the stomach. Brazil nuts are high in both zinc and selenium. Coconut Oil: Buy natural, fresh squeezed, coconut oil from a health store. Take around 1 teaspoon every day. You can likewise use it in cooking, yet be cautioned that it smokes at low cooking temperatures, so it should just be utilized for low-warm cooking. Coconut oil speeds up the digestion improve thyroid hormone generation and cut down candida yeast. Avoid Canola Oil: Canola oil meddles with the generation of thyroid hormones, among its numerous risks. Treat canola oil like the evil, genetically engineered hereditarily designed poison.
Dr. Shailendra Kawtikwar10 Likes10 Answers - Login to View the image
Friends today I am discussing about a very serious problem known as Low sperm count. Low sperm count means that the fluid (semen) you ejaculate during an orgasm contains fewer sperm than normal. A low sperm count is also called oligospermia (ol-ih-go-SPUR-me-uh). A complete absence of sperm is called azoospermia. Your sperm count is considered lower than normal if you have fewer than 15 million sperm per milliliter of semen. Having a low sperm count decreases the odds that one of your sperm will fertilize your partner's egg, resulting in pregnancy. Nonetheless, many men who have a low sperm count are still able to father a child. Symptoms The main sign of low sperm count is the inability to conceive a child. There might be no other obvious signs or symptoms. In some men, an underlying problem such as an inherited chromosomal abnormality, a hormonal imbalance, dilated testicular veins or a condition that blocks the passage of sperm may cause signs and symptoms. Low sperm count symptoms might include: Problems with sexual function — for example, low sex drive or difficulty maintaining an erection (erectile dysfunction) Pain, swelling or a lump in the testicle area Decreased facial or body hair or other signs of a chromosome or hormone abnormality When to see a doctor See a doctor if you have been unable to conceive a child after a year of regular, unprotected intercourse or sooner if you have any of the following: Erection or ejaculation problems, low sex drive, or other problems with sexual function Pain, discomfort, a lump or swelling in the testicle area A history of testicle, prostate or sexual problems A groin, testicle, penis or scrotum surgery Request an Appointment at Mayo Clinic Causes The production of sperm is a complex process and requires normal functioning of the testicles (testes) as well as the hypothalamus and pituitary glands — organs in your brain that produce hormones that trigger sperm production. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated out of the penis. Problems with any of these systems can affect sperm production. Also, there can be problems of abnormal sperm shape (morphology), movement (motility) or function. However, often the cause of low sperm count isn't identified. Medical causes Low sperm count can be caused by a number of health issues and medical treatments. Some of these include: Varicocele. A varicocele (VAR-ih-koe-seel) is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it might be related to abnormal testicular temperature regulation. Varicoceles result in reduced quality of the sperm. Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved. Ejaculation problems. Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out of the tip of the penis. Various health conditions can cause retrograde ejaculation or lack of ejaculation, including diabetes, spinal injuries, and surgery of the bladder, prostate or urethra. Certain medications also might result in ejaculatory problems, such as blood pressure medications known as alpha blockers. Some ejaculatory problems can be reversed, while others are permanent. In most cases of permanent ejaculation problems, sperm can still be retrieved directly from the testicles. Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to destroy them. Tumors. Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. Surgery, radiation or chemotherapy to treat tumors also can affect male fertility. Undescended testicles. During fetal development one or both testicles sometimes fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men with this condition. Hormone imbalances. The hypothalamus, pituitary and testicles produce hormones that are necessary to create sperm. Alterations in these hormones, as well as from other systems such as the thyroid and adrenal gland, may impair sperm production. Defects of tubules that transport sperm. Many different tubes carry sperm. They can be blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma or abnormal development, such as with cystic fibrosis or similar inherited conditions. Blockage can occur at any level, including within the testicle, in the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts or in the urethra. Chromosome defects. Inherited disorders such as Klinefelter's syndrome — in which a male is born with two X chromosomes and one Y chromosome instead of one X and one Y — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis, Kallmann's syndrome and Kartagener's syndrome. Celiac disease. A digestive disorder caused by sensitivity to gluten, celiac disease can cause male infertility. Fertility may improve after adopting a gluten-free diet. Certain medications. Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal and antibiotic medications, some ulcer medications, and other medications can impair sperm production and decrease male fertility. Prior surgeries. Certain surgeries might prevent you from having sperm in your ejaculate, including vasectomy, inguinal hernia repairs, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others. In most cases, surgery can be performed to either reverse these blockages or to retrieve sperm directly from the epididymis and testicles. Environmental causes Sperm production or function can be affected by overexposure to certain environmental elements, including: Industrial chemicals. Extended exposure to benzenes, toluene, xylene, herbicides, pesticides, organic solvents, painting materials and lead might contribute to low sperm counts. Heavy metal exposure. Exposure to lead or other heavy metals also can cause infertility. Radiation or X-rays. Exposure to radiation can reduce sperm production. It can take several years for sperm production to return to normal. With high doses of radiation, sperm production can be permanently reduced. Overheating the testicles. Elevated temperatures impair sperm production and function.Although studies are limited and are inconclusive, frequent use of saunas or hot tubs might temporarily impair sperm count. Sitting for long periods, wearing tight clothing or working on a laptop computer for long stretches of time also might increase the temperature in your scrotum and slightly reduce sperm production. Health, lifestyle and other causes Other causes of low sperm count include: Drug use. Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. Use of cocaine or marijuana might reduce the number and quality of your sperm as well. Alcohol use. Drinking alcohol can lower testosterone levels and cause decreased sperm production. Occupation. Certain occupations might be linked with a risk of infertility, including welding or those associated with prolonged sitting, such as truck driving. However, the data to support these associations is inconsistent. Tobacco smoking. Men who smoke might have a lower sperm count than do those who don't smoke. Emotional stress. Severe or prolonged emotional stress, including stress about fertility, might interfere with hormones needed to produce sperm. Depression. Being depressed may negatively affect sperm concentration. Weight. Obesity can impair fertility in several ways, including directly impacting sperm and by causing hormone changes that reduce male fertility. Sperm testing issues. Lower than normal sperm counts can result from testing a sperm sample that was taken too soon after your last ejaculation; was taken too soon after an illness or stressful event; or didn't contain all of the semen you ejaculated because some was spilled during collection. For this reason, results are generally based on several samples taken over a period of time. Risk factors A number of risk factors are linked to low sperm count and other problems that can cause low sperm count. They include: Smoking tobacco Drinking alcohol Using certain illicit drugs Being overweight Being severely depressed or stressed Having certain past or present infections Being exposed to toxins Overheating the testicles Having experienced trauma to the testicles Being born with a fertility disorder or having a blood relative, such as your brother or father, with a fertility disorder Having certain medical conditions, including tumors and chronic illnesses Undergoing cancer treatments, such as radiation Taking certain medications Having a prior vasectomy or major abdominal or pelvic surgery Having a history of undescended testicles Complications Infertility caused by low sperm count can be stressful for both you and your partner. Complications can include: Surgery or other treatments for an underlying cause of low sperm count Expensive and involved assisted reproductive techniques, such as in vitro fertilization (IVF) Stress related to the inability to have a child Prevention To protect your fertility, avoid known factors that can affect sperm count and quality. For example: Don't smoke. Limit or abstain from alcohol. Steer clear of illicit drugs. Talk to your doctor about medications that can affect sperm count. Maintain a healthy weight. Avoid heat. Manage stress. Avoid exposure to pesticides, heavy metals and other toxins. Homeopathic solutions for low sperm count can be altered to address the particular triggers or physiological components at play in every individual case. Some of the most effective solutions for homeopathy are as follows: Homeopathic medications for low sperm count with orchitis (aggravation of the testicles): The best homeopathic medications for low sperm count with inflamed testicles are conium, staphysagria and rhododendron. Conium is chosen when there is swelling and enlargement of the testicles. A razor sharp pain is felt in the testicles. The testicles are additionally indurated and solidified. Homeopathic solutions for low sperm count caused by hydrocele: Aurum met, Rhododendron and Iodum are brilliant homeopathic prescriptions for low sperm count caused by hydrocele. Apart from hydrocele, high sex drive and night time problems are additionally present. Homeopathic prescriptions for low sperm count with reduced sexual power (erectile dysfunction): Homeopathic prescriptions like agnus castus, caladium and selenium offer the best treatment for low sperm count that come with reduced sexual power in guys. Agnus castus is an unmistakable solution for low sperm count with diminished sexual drive. In such a situation, there is weakness and fatigue to accomplish erections and the privates are casual, wilted, chilly and limp. Homeopathic treatment for low sperm count with varicocele: Other homeopathic prescriptions for low sperm count accompanied with varicocele are arnica, aurum met, hamamelis and acid phos. All these are normal solutions for enhancing the sperm number when varicocele is the cause. Homeopathic meds for low sperm count with a medical history of semen loss: Homeopathic medicines like elenium, acid phos and staphysagria are used for oligospermia with a background marked by over the top seminal misfortune. They are considered where a man is has automatic seminal discharges during rest, urination and stools. The greatest advantage of homeopathic drugs for low sperm count is that they are common solutions that help in enhancing the sperm count as well as the sperm quality. These homeopathic solutions for low sperm count do not cause any harmful symptoms. They treat the condition in the most secure and most effective way. Homeopathic prescriptions work by treating the basic cause behind oligospermia. However, it is important that you consult a Homeopathic before taking any of these medicines, as the potency and frequency of medicine is prescribed by the doctor only based on each and every individual's condition.
Dr. Rajesh Gupta4 Likes9 Answers - Login to View the image
Friends today I am discussing about a problem known as Scleroderma. Scleroderma refers to a range of disorders in which the skin and connective tissues tighten and harden. It is a long-term, progressive disease. This means it gradually gets worse. It is considered a rheumatic disease and a connective tissue disorder. It is also thought to be an autoimmune condition, in which the body's own immune system attacks the body's tissues. This results in an overproduction of collagen, the protein that forms the basis of connective tissue. The result is a thickening, or fibrosis, and scarring of tissue. Scleroderma is not contagious. It may run in families, but it often occurs in patients without any family history of the disease. It ranges from very mild to potentially fatal. Up to 1 in 3 people with the condition develop severe symptoms. It is thought to affect between 75,000 and 100,000 people in the United States, mostly women aged from 30 to 50 years. Symptoms Swelling in the hands and feet can be a symptom of scleroderma. swollen hand Scleroderma means "hard skin." Early symptoms of scleroderma include changes in the fingers and hands, for example, stiffness, tightness, and puffiness because of sensitivity to cold or emotional stress. There may be swelling in the hands and feet, especially in the morning. Overall symptoms of scleroderma include: calcium deposits in connective tissues a narrowing of the blood vessels to the hands and feet, known as Raynaud's disease problems of the esophagus, which links the throat and stomach tight, thickened skin on the fingers red spots on the face and hands However, symptoms will vary according to the type and how it affects the person, and whether it affects one part of the body or a whole body system. Types The two main types of scleroderma are localized and systemic. Localized scleroderma mainly affects the skin, but it may have an impact on the muscles and bones. Systemic scleroderma affects the whole body, including the blood and internal organs, and especially the kidneys, esophagus, heart, and lungs. Localized scleroderma Localized scleroderma is the mildest form of scleroderma. It does not affect the internal organs. There are two main types: morphea and linear scleroderma. Morphea: Symptoms include oval-shaped patches of lighter or darker skin, which may be itchy, hairless, and shiny. The shapes have a purple border, and they are white in the middle. Linear scleroderma: There may be bands or streaks of hardened skin on the limbs, and rarely the head and face. It can affect bones and muscles. Systemic scleroderma Systemic scleroderma affects the circulation of the blood and the internal organs. There are two main types: limited cutaneous systemic sclerosis syndrome, or CREST diffuse systemic sclerosis Limited cutaneous systemic sclerosis Limited cutaneous systemic sclerosis is the least severe type of systemic scleroderma. It affects the skin on the hands, feet, face, and lower arms and legs. There may be problems with the blood vessels, lungs, and the digestive system. It is sometimes known as CREST syndrome, because the symptoms form the acronym, CREST: C: Calcinosis, or calcium deposits in tissues and under the skin R: Raynaud's disease E: Esophageal problems, including GERD S: Sclerodactyly, or thick skin on the fingers T: Telangiectasias, or enlarged blood vessels, manifesting as red spots The first sign is often Raynaud's disease, in which blood vessels narrow in the hands and feet, leading to circulatory problems in the extremities. Patients may experience numbness, pain, and color changes in response to stress or cold. The skin on the hands, feet, and face may start to thicken. The impact on the digestive system can lead to difficulty swallowing and gastroesophageal reflux disease (GERD), or acid reflux. The intestinal muscles may be unable to move food through the intestines properly, and the body may not absorb nutrients. Some of these symptoms can have other underlying causes. Not everyone who has Raynaud's disease or GERD will have scleroderma. Most do not. Sclerodactyly: What it is, causes, and treatment Sclerodactyly: What it is, causes, and treatment Find out more about sclerodactyly, which affects the fingers READ NOW Diffuse systemic sclerosis In diffuse systemic sclerosis, the skin thickening usually affects the area from the hands to above the wrists. It also affects the internal organs. People with systemic types of scleroderma may experience weakness, fatigue, difficulty breathing and swallowing, and weight loss. Causes It is not known what causes scleroderma, but it is thought to be an autoimmune condition that causes the body to produce too much connective tissue. This leads to a thickening, or fibrosis, and scarring of tissue. Connective tissue forms the fibers that make up the framework that supports the body. They are found under the skin and around the internal organs and blood vessels, and they help support muscles and bones. Genetic factors are thought to play a role, and possibly environmental factors, but this has not been confirmed. People with scleroderma often come from families in which another autoimmune disease exists. It is not contagious. Diagnosis Scleroderma may be hard to diagnose because it develops gradually and appears in different forms, and because some of the symptoms, such as GERD, can occur in people without scleroderma. The physician will carry out a physical examination and some tests. The patient may be referred to a rheumatologist, a specialist in joint and connective tissue diseases. The following tests may be necessary: looking at the skin under a microscope to check for changes in the tiny blood vessels, or capillaries, around the finger nails skin biopsy blood tests to assess the levels of certain antibodies The doctor will look for signs of skin thickening, GERD, shortness of breath, joint pain, and calcium deposits. They may also check for lung, heart, or gastrointestinal complications. Treatment There is currently no cure for scleroderma, and no medication can stop the overproduction of collagen. However, organ system complications can be treated to minimize damage and maintain functionality. Localized scleroderma may resolve on its own. Some medications may help control the symptoms and help prevent complications. The aim will be to relieve the symptoms, to prevent the condition from worsening, or at least slow it down, to detect and treat complications as soon as possible, and to minimize disabilities. Treatment depends on how the disease affects the individual. Blood pressure medication may help dilate the blood vessels. This can reduce problems with the organs, such as the lungs and kidneys, and they can help to treat Raynaud's disease. Immunosuppressants may calm, or suppress, the immune system. Physical therapy may help manage pain, improve mobility, and improve strength. Aids, such as splints, may help with daily tasks. Ultraviolet light therapy and laser surgery may help improve the condition and the appearance of the skin. Scientists are continuing to look for a treatment for scleroderma and are optimistic that a solution will be found. Complications The complications of scleroderma range in severity from mild to life-threatening. There is also an increased risk of cancer. Movement may become restricted as the skin tightens and swelling occurs in the hands and fingers, and around the face and mouth. Joint and muscle movement may also become harder. Raynaud's disease can permanently damage the fingertips and toes, resulting in pits or ulcers in the flesh, and possibly gangrene, if severe. Amputation may be necessary. Lung complications can cause breathing problems. High blood pressure in the artery that carries blood from the heart to the lungs, called pulmonary hypertension, can cause permanent lung damage. There may be failure of the right ventricle of the heart. A lung transplant may be needed. Kidney damage can cause hypertension, or high blood pressure, and excess protein in the urine. Kidney failure is possible. Symptoms include headache, vision problems, seizures, breathlessness, swelling of the legs and feet, and reduced urine production. Heart arrhythmias, or abnormal heartbeats and congestive heart failure may result from scarring of heart tissue. The patient may develop an inflammation or the lining around the heart, known as pericarditis. This causes chest pain and fluid build-up around the heart. Dental problems can arise. If a tightening of facial skin makes the mouth smaller, even daily dental care can become more difficult. Dry mouth is common, increasing the risk of tooth decay. Acid reflux may destroy tooth enamel. Changes in gum tissue may cause teeth to become loose and fall out. Sexual function is affected, and male erectile dysfunction is common. A woman's vaginal opening may be constricted, and there may be decreased sexual lubrication. The thyroid gland can become underactive. This is known as hypothyroidism, and it causes hormonal changes that slow down the metabolism. Intestines may become underactive, resulting in bloating, constipation, and other problems. The esophagus may have problems moving solids and liquids into the stomach. Most fatalities due to scleroderma are associated with lung, heart, and kidney problems. Management Living with scleroderma can be challenging, depending on the type and the extent of the impact. There is no treatment at this time. However, there are strategies to reduce some of the impact: eating smaller meals to reduce the impact of GERD keeping skin well moisturized and taking care to avoid finger injuries wrapping up warm to minimize circulatory problems doing appropriate exercise to ease stiffness Number of tips avoiding tobacco, alcohol, caffeine, and recreational drugs getting enough sleep minimizing and stress and managing anxiety, for example, through yoga and meditation avoiding processed foods, sugar, and soda Patients with scleroderma are also advised not to take echinacea, as it boosts the immune system. This can be harmful for people with an auto-immune disease. Homoeopathic treatment Silica, Arnica, Ruta, Rustic and other on the basis of totality of symptoms.
Dr. Rajesh Gupta3 Likes8 Answers - Login to View the image
Friends today I am discussing about a severe problem of females with heavy bleeding known as Menorrhagia. Menorrhagia is the medical term for menstrual periods with abnormally heavy or prolonged bleeding. Although heavy menstrual bleeding is a common concern, most women don't experience blood loss severe enough to be defined as menorrhagia. With menorrhagia, you can't maintain your usual activities when you have your period because you have so much blood loss and cramping. If you dread your period because you have such heavy menstrual bleeding, talk with your doctor. There are many effective treatments for menorrhagia. Symptoms Signs and symptoms of menorrhagia may include: Soaking through one or more sanitary pads or tampons every hour for several consecutive hours Needing to use double sanitary protection to control your menstrual flow Needing to wake up to change sanitary protection during the night Bleeding for longer than a week Passing blood clots larger than a quarter Restricting daily activities due to heavy menstrual flow Symptoms of anemia, such as tiredness, fatigue or shortness of breath When to see a doctor Seek medical help before your next scheduled exam if you experience: Vaginal bleeding so heavy it soaks at least one pad or tampon an hour for more than two hours Bleeding between periods or irregular vaginal bleeding Any vaginal bleeding after menopause Causes Fibroid locations Fibroid locations Uterine polyps Uterine polyps Normal uterus vs. uterus with adenomyosis Adenomyosis In some cases, the cause of heavy menstrual bleeding is unknown, but a number of conditions may cause menorrhagia. Common causes include: Hormone imbalance. In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormone imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding. A number of conditions can cause hormone imbalances, including polycystic ovary syndrome (PCOS), obesity, insulin resistance and thyroid problems. Dysfunction of the ovaries. If your ovaries don't release an egg (ovulate) during a menstrual cycle (anovulation), your body doesn't produce the hormone progesterone, as it would during a normal menstrual cycle. This leads to hormone imbalance and may result in menorrhagia. Uterine fibroids. These noncancerous (benign) tumors of the uterus appear during your childbearing years. Uterine fibroids may cause heavier than normal or prolonged menstrual bleeding. Polyps. Small, benign growths on the lining of the uterus (uterine polyps) may cause heavy or prolonged menstrual bleeding. Adenomyosis. This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and painful periods. Intrauterine device (IUD). Menorrhagia is a well-known side effect of using a nonhormonal intrauterine device for birth control. Your doctor will help you plan for alternative management options. Pregnancy complications. A single, heavy, late period may be due to a miscarriage. Another cause of heavy bleeding during pregnancy includes an unusual location of the placenta, such as a low-lying placenta or placenta previa. Cancer. Uterine cancer and cervical cancer can cause excessive menstrual bleeding, especially if you are postmenopausal or have had an abnormal Pap test in the past. Inherited bleeding disorders. Some bleeding disorders — such as von Willebrand's disease, a condition in which an important blood-clotting factor is deficient or impaired — can cause abnormal menstrual bleeding. Medications. Certain medications, including anti-inflammatory medications, hormonal medications such as estrogen and progestins, and anticoagulants such as warfarin (Coumadin, Jantoven) or enoxaparin (Lovenox), can contribute to heavy or prolonged menstrual bleeding. Other medical conditions. A number of other medical conditions, including liver or kidney disease, may be associated with menorrhagia. Risk factors Risk factors vary with age and whether you have other medical conditions that may explain your menorrhagia. In a normal cycle, the release of an egg from the ovaries stimulates the body's production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding. Menorrhagia in adolescent girls is typically due to anovulation. Adolescent girls are especially prone to anovulatory cycles in the first year after their first menstrual period (menarche). Menorrhagia in older reproductive-age women is typically due to uterine pathology, including fibroids, polyps and adenomyosis. However, other problems, such as uterine cancer, bleeding disorders, medication side effects and liver or kidney disease must be ruled out. Complications Excessive or prolonged menstrual bleeding can lead to other medical conditions, including: Anemia. Menorrhagia can cause blood loss anemia by reducing the number of circulating red blood cells. The number of circulating red blood cells is measured by hemoglobin, a protein that enables red blood cells to carry oxygen to tissues. Iron deficiency anemia occurs as your body attempts to make up for the lost red blood cells by using your iron stores to make more hemoglobin, which can then carry oxygen on red blood cells. Menorrhagia may decrease iron levels enough to increase the risk of iron deficiency anemia. Signs and symptoms include pale skin, weakness and fatigue. Although diet plays a role in iron deficiency anemia, the problem is complicated by heavy menstrual periods. Severe pain. Along with heavy menstrual bleeding, you might have painful menstrual cramps (dysmenorrhea). Sometimes the cramps associated with menorrhagia are severe enough to require medical evaluation. Homoeopathic medicines for menorrhagia Belladonna: It is one of the haemorrhagic cures. The flow is mostly dark red and hot and once in a while it comes as decayed blood. The related side effect is pain in the back. It is a decent solution for the initial phases of swelling. The blood is constantly overflowing. Crocus sativus: This cure is generally used by a large number of homeopathic doctors. It is one of the most effective cures in stopping excessive bleeding during the periods. The bleeding is extremely thick at times. The blood flow consists of threads or strings and is usually very dark. Erigeron: During the menstrual cycle, since the bleeding is dark and profuse, an important side effect, which is very common, is burning urine and irritation in the rectum. This is one of the symptoms that is particularly cured by this medicine. Ferrum met: Ferrum met is one of the cures that prevents haemorrhaging. Women who are having long and heavy periods that tend to come early are better off with this cure. The people who are weak and pale are the appropriate individuals for this cure. Cyclamen: It generally plays a very important part in female reproductive organs and helps in curing numerous infections that happen in the female reproductive system. During periods, the women have extreme pain that feels like they are in labour and the blood flow is thickened. After periods, they have swelling and tenderness in their breasts and sometimes also experience a milky secretion as well. Crotalus horridus: Delayed periods and the blood is usually a diluted, thin and light liquid. This kind of blood flow can also cause infections. This homeopathic medicine tends to treat the same and maintain a normal flow and colour of the blood.
Dr. Rajesh Gupta4 Likes6 Answers
5 Likes