Can Dipresson, Antidepressant Drug cause Anemia...?

*Restless leg syndrome (RLS* ☝ *Today about*☝ Definition Restless leg syndrome (RLS) or Willis-Ekbom disease(WED) is a common cause of painful legs. The leg pain of restless leg syndrome typically eases with motion of the legs and becomes more noticeable at rest. Restless leg syndrome also features worsening of symptoms and leg pain during the early evening or later at night. Restless leg syndrome Restless leg syndrome is often abbreviated RLS; it has also been termed shaking leg syndrome. Night time involuntary jerking of the legs during sleep is also known as periodic leg/limb movement disorder. History The first known medical description of RLS was by Sir Thomas Willis in 1672. Willis emphasized the sleep disruption and limb movements experienced by people with RLS. Initially published in Latin (De Anima Brutorum, 1672) but later translated to English (The London Practice of Physick, 1685), The term “fidgets in the legs” has also been used as early as the early nineteenth century. Subsequently, other descriptions of RLS were published, including those by Francois Boissier de Sauvages (1763), Magnus Huss (1849), Theodur Wittmaack (1861), George Miller Beard (1880), Georges Gilles de la Tourette (1898), Hermann Oppenheim (1923) and Frederick Gerard Allison (1943). However, it was not until almost three centuries after Willis, in 1945, that Karl-Axel Ekbom (1907–1977) provided a detailed and comprehensive report of this condition in his doctoral thesis, Restless legs: clinical study of hitherto overlooked disease. Ekbom coined the term “restless legs” and continued work on this disorder throughout his career. He described the essential diagnostic symptoms, differential diagnosis from other conditions, prevalence, relation to anemia, and common occurrence during pregnancy. Epidemiology Except perhaps in Asian populations, RLS is a common disorder, occurring in about 10% of the population. The age-adjusted prevalence of RLS determined by telephone interviews in a random population of 1803 adults in Kentucky was 10%. A Canadian survey of 2019 adults estimated the prevalence of RLS symptoms at 17% for women and 13% for men. A population-based survey in West Pomerania, Germany, of 4107 subjects found an overall 10.6% prevalence. Using standardized questions in face-to-face interviews, Rothdach et al. reported an overall prevalence of 9.8% in 369 participants ages 65-83 years in Augsburg, Germany. In a study from Japan, 4612 participants living in urban residential areas were assessed for a single symptom of RLS by a self-administered questionnaire of the following two items: (1) Have you ever been told you jerk your legs or kick sometimes and (2) have you ever experienced sleep disturbance due to a creeping sensation or hot feeling in your legs? The prevalence of RLS ranged from 3% in women ages 20-29 years to 7% in women ages 50-59 years and correlated with age. In contrast to the first three studies, RLS had a higher prevalence in men than women, with the difference reaching significance in those 40-49 years old; in men there was no positive correlation with age. Face-to-face interviews of 157 consecutive individuals ages 55 years and older participating in a health screening program and 1000 consecutive individuals ages 21 years and older from a primary health care center in Singapore yielded much lower prevalence data. Using IRLSSG criteria, the prevalence of RLS in this predominantly Asian population was 0.6% in the older (1 male) and 0.1% (1 female) in the younger cohorts. In the Kentucky and Singapore studies, there was no gender difference; however, in the two German studies, the prevalence was higher in women and in the Japanese study it was higher in men. The Canadian study reported a significantly higher occurrence of bedtime leg restlessness in women. Types Restless legs syndrome (RLS) can be either primary or secondary, and the causes vary. Primary RLS is a neurological disorder. Although the majority of people with RLS begin to experience symptoms in their middle years, some may have signs of the problem in childhood. Their symptoms may slowly progress for years before becoming a regular occurrence. Secondary RLS tends to be more severe than the primary type and stems from another underlying condition, including the following: Anemia or low blood-iron levels Folate deficiency Nerve damage due to diabetes or other conditions Kidney disease or dialysis Attention deficit disorder (ADD) Attention deficit/hyperactivity disorder (ADHD) Pregnancy Rheumatoid arthritis Parkinson’s disease Risk factors RLS/WED can develop at any age, even during childhood. The disorder is more common with increasing age and more common in women than in men. Restless legs syndrome usually isn’t related to a serious underlying medical problem. However, RLS/WED sometimes accompanies other conditions, such as: Peripheral neuropathy: This damage to the nerves in your hands and feet is sometimes due to chronic diseases such as diabetes and alcoholism. Iron deficiency: Even without anemia, iron deficiency can cause or worsen RLS/WED. If you have a history of bleeding from your stomach or bowels, experience heavy menstrual periods or repeatedly donate blood, you may have iron deficiency. Kidney failure: If you have kidney failure, you may also have iron deficiency, often with anemia. When kidneys don’t function properly, iron stores in your blood can decrease. This, with other changes in body chemistry, may cause or worsen RLS/WED. Causes The cause of restless leg syndrome is unknown in most people. However, restless leg syndrome has been associated with Pregnancy, Obesity, Smoking, Iron deficiency and anemia, Nerve disease, Polyneuropathy (which can be associated with hypothyroidism, heavy metal toxicity, toxins, and many other conditions), Other hormone diseases such as diabetes, and Kidney failure (which can be associated with vitamin and mineral deficiency). Some drugs and medications have been associated with restless leg syndrome including: Caffeine, Alcohol, H2-histamine blockers (such as ranitidine [Zantac] and cimetidine [Tagamet]), and certain antidepressants (such as amitriptyline [Elavil, Endep]). Occasionally, restless leg syndrome run in families. Recent studies have shown that restless leg syndrome appears to become more common as a person ages. Also, poor venous circulation of the legs (such as with varicose veins) can cause restless leg syndrome. Symptoms The International Restless Legs Syndrome Study Group described the following symptoms of restless legs syndrome (RLS): Strange itching, tingling, or “crawling” sensations occurring deep within the legs; these sensations may also occur in the arms. A compelling urge to move the limbs to relieve these sensations Restlessness — floor pacing, tossing and turning in bed, rubbing the legs Symptoms may occur only with lying down or sitting. Sometimes, persistent symptoms worsen while lying down or sitting and improve with activity. In very severe cases, the symptoms may not improve with activity. Other symptoms of RLS include the following: Sleep disturbances and daytime sleepiness Involuntary, repetitive, periodic, jerking limb movements that occur either in sleep or while awake and at rest; these movements are called periodic leg movements of sleep or periodic limb movement disorder. Up to 90% of people with RLS also have this condition. In some people with RLS, the symptoms do not occur every night but come and go. These people may go weeks or months without symptoms (remission) before the symptoms return again. Complications Restless legs syndrome rarely results in any serious consequences. However, in some cases severe and persistent symptoms can cause considerable mental distress, chronic insomnia, and daytime sleepiness. In addition, since restless legs syndrome (RLS) is worse when resting, people with severe RLS may avoid daily activities that involve long periods of sitting, such as going to movies or traveling long distances. Diagnosis and test There’s no single test for diagnosing restless legs syndrome. A diagnosis will be based on your symptoms, your medical and family history, a physical examination, and your test results. Your GP should be able to diagnose restless legs syndrome, but they may refer you to a neurologist if there’s any uncertainty. There are four main criteria your GP or specialist will look for to confirm a diagnosis. These are: an overwhelming urge to move your legs, usually with an uncomfortable sensation such as itching or tingling your symptoms occur or get worse when you’re resting or inactive your symptoms are relieved by moving your legs or rubbing them your symptoms are worse during the evening or at night Blood tests Your GP may refer you for blood tests to confirm or rule out possible underlying causes of restless legs syndrome. For example, you may have blood tests to rule out conditions such as anaemia, diabetes and kidney function problems. It’s particularly important to find out the levels of iron in your blood because low iron levels can sometimes cause secondary restless legs syndrome. Low iron levels can be treated with iron tablets. Sleep tests If you have restless legs syndrome and your sleep is being severely disrupted, sleep tests such as a suggested immobilisation test may be recommended. The test involves lying on a bed for a set period of time without moving your legs while any involuntary leg movements are monitored. Occasionally, polysomnography may be recommended. This is a test that measures your breathing rate, brain waves and heartbeat throughout the course of a night. The results will confirm whether you have periodic limb movements in sleep (PLMS). Treatment and medications Treatment for RLS is targeted at easing symptoms. In people with mild to moderate restless legs syndrome, lifestyle changes, such as beginning a regular exercise program, establishing regular sleep patterns, and eliminating or decreasing the use of caffeine, alcohol, and tobacco, may be helpful. Treatment of an RLS-associated condition also may provide relief of symptoms. Other non-drug RLS treatments may include: Leg massages Hot baths or heating pads or ice packs applied to the legs Good sleep habits A vibrating pad called Relaxis Medications may be helpful as RLS treatments, but the same drugs are not helpful for everyone. In fact, a drug that relieves symptoms in one person may worsen them in another. In other cases, a drug that works for a while may lose its effectiveness over time. Drugs used to treat RLS include: Dopaminergic drugs, which act on the neurotransmitter dopamine in the brain. Mirapex, Neupro, and Requip are FDA-approved for treatment of moderate to severe RLS. Others, such as levodopa, may also be prescribed. Benzodiazepines, a class of sedative medications, may be used to help with sleep, but they can cause daytime drowsiness. Narcotic pain relievers may be used for severe pain. Anticonvulsants, or antiseizure drugs, such as Tegretol, Lyrica, Neurontin, and Horizant. Although there is no cure for restless legs syndrome, current treatments can help control the condition, decrease symptoms, and improve sleep. Lifestyle and home remedies Making simple lifestyle changes can help alleviate symptoms of RLS/WED. Try baths and massages: Soaking in a warm bath and massaging your legs can relax your muscles. Apply warm or cool packs: Use of heat or cold, or alternating use of the two, may lessen your limb sensations. Try relaxation techniques: such as meditation or yoga. Stress can aggravate RLS/WED. Learn to relax, especially before bedtime. Establish good sleep hygiene: Fatigue tends to worsen symptoms of RLS/WED, so it’s important that you practice good sleep hygiene. Ideally, have a cool, quiet, comfortable sleeping environment; go to bed and rise at the same time daily; and get adequate sleep. Some people with RLS/WED find that going to bed later and rising later in the day helps in getting enough sleep. Exercise: Getting moderate, regular exercise may relieve symptoms of RLS/WED, but overdoing it or working out too late in the day may intensify symptoms. Avoid caffeine: Sometimes cutting back on caffeine may help restless legs. Try to avoid caffeine-containing products, including chocolate and caffeinated beverages, such as coffee, tea and soft drinks, for a few weeks to see if this helps.

Rheumatoid Arthritis it's an auto-immune disease that causes inflammation of the joints. This inflammation is chronic in nature and does not subside on its own. It causes destruction of the joint tissues Rheumatoid Arthritis or RA tends to occur more commonly after 40 years of age. This does not mean that it cannot occur in younger patients but it is more commonly seen in patients who are above 40. Similarly, more women are affected than men though the reason for the same is also not known. Symptoms of Rheumatoid Arthritis . CAUSES . Rheumatoid Arthritis is caused when the immune system of the body starts giving an abnormal response. The immunity of the body is meant to defend the body from external harmful agents. Such agentsmay be infectious like bacteria or virus or any microbe. In some cases, the immune system of the body starts attacking one’s own body instead of defending it. The immunity of the body attacks the joints and the synovial membranes lining the joints. Over a period of time, the cartilage of the joint is destroyed. Even the bone is damaged. The ligaments and tendons become weak and are unable to bear the weight of the body or undertake normal daily activities. Although the exact reason is still unknown, the following factors have been noted-Women are more prone to have Rheumatoid Arthritis. Family history of having RA increases your chances of having RA Smoking also increases your chances of having RA Obesity can be another factor when it comes to the chances of having Rheumatoid Arthritis . SOME OF FOLLOWING HOMOEOPATHIC REMEDIES WHICH HAS BEST RESULTS ARE. 1. Causticum- Causticum is one of the best Homeopathic remedies for Rheumatoid Arthritis where there are deformities in the joints. The patient tends to get weak over a period of time, with muscles losing their strength gradually but surely. The patient tends to be restless at night with the restlesness being centred more on the legs than any other part of the body. There may be contractions in the tendons causing severe pain and deformities. The pains are usually tearing and drawing in nature. In some cases, burning pains are also found. There is numbness and loss of sensation in the hands and other parts of the body. The muscles of the forearm and hands become weak and make it difficult to grip anything firmly. The ankles seem to be weak and cannot bear the weight of the body causingpain while walking. The gait may be unsteady and one even tends to fall while walking. The pains are better by warmth and more so from the warmth of bed. 2. Caulophyllum. another very good Homeopathic medicine for Rheumatoid Arthritis, is primarily a woman’s remedy, which means that the symptoms pointing to its use are found more commonly in women. It affects the small joints much more as compared to the larger joints of the limbs. Therefore, it is more useful for the Rheumatoid Arthritis of the fingers of the hand and toes of the foot. The pains are erratic or flying in nature ie they change their position every now and then, in a matter of minutes. The patient feels pain in the right hand for some time and afterwards the pain gets better on its own but the pain starts to affect the left hand;then the pain in the left hand stops and shifts to a foot. The pain is severe and drawing in nature. The wrist joints ache andthere is cutting pain on closing the hand. 3. Colchicum. Colchicum has been the mainstay of the treatment, when it comes to Homeopathic remedies for Rheumatoid Arthritis and rightly so. It is more suited to the chronic rheumatic states. It tends to affect all tissues like periosteum, synovial membranesand muscular tissues too. The parts tend to be inflamed as is evident from the redness,heat and swelling of the concerned parts. The pains are tearing in character and get worse in the evening and at night. The patient cannot afford to get the joints touched, so much is the sensitivity. There may be a feeling of pins and needles in the hands and fingers. The tips of the fingers may be numb. There is stiffness in the joints and feel warm or feverish. The patient feels a sense of tingling in the finger nails. The problems tend to get aggravated in the warm weather. 4. Ledum Pal. The defining characteristic of Ledum in thetreatment of Rheumatic Arthritis is that the rheumatism begins in the feet and later on spreads upwards to other joints of the body. The other important distinguishing characteristic of this remedy is that the patient feels cold and chilly but still cannot tolerate warmth of his bed. The small joints of the foot are more commonly affected with shooting pains. The ankle may be swollen and so may be the great toe. The pains are worse at night and better from cold or putting the feet in cold water. 5. Bryonia- another wonderful homeopathic remedy for rheumatoid arthritis, affects almost all joints and the serous membranes of the joints causing swelling and pain. The defining characteristic of this medicine happens to be the pains that it causes. The pains are stitching in nature and are aggravated by motin of any and every kind while the patient feels better when at rest.The joints are red and swollen with tearing and stitching pains. The patient feels worsein warmth and in warm weather and is better by lying on the painful side or by pressure and by cold. THANK YOU.

19 Known Side Effects of Going On the Pill The bad, the good, and the totally random. MORE FROM Health & Fitness HEALTH & FITNESS BIRTH CONTROL SIDE EFFECTS Acne. Spider veins. Ceaseless nausea. Mood swings. Anxiety. Depression. Read the #MyPillStory hashtag on Twitter and oral contraceptives may seem like the biggest disaster to hit women's health since the thalidomide crisis during your mom's early childhood. Adverse effects of the Pill are a legitimate concern for women on all iterations of estrogen and progesterone replacements. But the recent buzz on social media may distract from the Pill's many upsides. I rounded up the research and spoke with Sherry Ross, MD, ob-gyn, and women's health expert at Providence Saint John's Health Center in Santa Monica, California, to get the DL on what actually happens when you go on the Pill. Here are 19 known side effects of going on birth control pills — the bad, the good, and the bizarre. The Bad 1. Nausea. Though expected to last only up to three months , some women feel queasy when they start the Pill, Ross says. Taking your pill with a meal can help reduce how icky you feel during the time your body needs to adjust to new levels of estrogen and progesterone. 2. Breast tenderness. Alas, this downside of oral contraceptives can apparently last for up to 18 months on the Pill, according to a report by the American Family Physician . Sorry. 3. Bloating. Changes in the ups and downs of your body's sex hormones can lead to water retention and bloating. These effects may be particularly strong for women suffering from irritable bowel syndrome and other gastrointestinal tract disorders. That being said, many women feel better six months into a new pill regimen. GIPHY 4. Headaches. A 2005 study published in the American Journal of Obstetrics and Gynecology found that approximately 10 percent of women feel headachy within a month of starting the pill. Once the body acclimates to a new oral contraceptive, however, the study authors conclude most reports of headaches go away. 5. Increased appetite. Perhaps you recall from ever having PMS that hormones can make you super hungry. Same goes when you alter your estrogen and progesterone levels via birth control. But an increased appetite doesn't always lead to packing on pounds, Ross points out. In fact, she says, "there's still no definitive proof that birth control directly causes weight gain." GIPHY.COM 6. Yeast infections. Some women may need to invest in a few more Monostat packs after they go on the pill. Ross says this is likely due to changes in the use of tampons and new patterns of bleeding induced by the Pill. 7. Mood swings — and other emotional issues. This issue is complicated. While some women with a history of mood issues — depression, anxiety, even insomnia — tend to see an increase in their symptoms' severity once they go on some birth control pills, others report that going on the Pill improves their psychological turmoil. (More on this below.) 8. Blood clots. Newer versions of birth control pills (like Yasmin ) appear to put some women at an elevated risk of blood clots compared to "first-generation" pills, whose progesterone has a different chemical makeup. So long as gynecologists and patients monitor side effects, this can be kept under control. But be sure to bring this up with your doctor, just to be safe. 9. Brown spots on your face. Oral contraceptives have been found to increase women's risk of a skin condition called melasma , which can make your face break out in some brown-colored splotches. Research shows, however, that this is more likely to occur in women who have a family history of the skin issue. Switching from the pill to an IUD may be able to resolve this, several case studies suggest. 10. Lower sex drive. Some women report decreases in their libido once they begin the Pill, Ross says. But she points out that much of this may be due to birth control's shorter-term side effects — think: bloating, breast pain. (Who wants to be sexual when everything hurts and you feel like there's a balloon in your belly?) GIPHY.COM That said, many women report that their sex drive picks back up again — or even gets stronger than pre-Pill levels — about nine months into their new hormone regimen. The Good 11. Reduced risk of certain cancers. A 2011 review of studies examining the link between birth control and cancer risk found that incidences of endometrial and ovarian cancers dropped by 30 to 50 percent among women without a history of HIV or HPV. 12. Fewer cramps. With a more regulated regimen of estrogen and progesterone entering your body, your periods get on a more predictable schedule. Often, once you get adjusted to the Pill, Ross says, "your periods may become lighter, which can mean less painful menstrual cramping." 13. Clearer skin. Because acne is largely influenced by high levels of male hormones, like androgen , balancing it out with female hormones (estrogen and progesterone) can help scale back the prevalence of pimples on your face. 14. Mood improvements. Yes, some women with a history of emotional issues have found the Pill worsens their symptoms. But others claim it's offered a boost to their psychological well-being. Evidence suggests the Pill can, for many women, decrease depression. GIPHY.COM 15. Stronger ligaments (maybe). Apparently birth control pills are linked with lower incidences of knee injuries. The researchers who found this correlation peg it to birth control's regulation of estrogen, which — if too high — may weaken young women's ligaments. 16. Fewer complications from anemia. Studies suggest a link between oral contraceptive use and fewer incidences of anemia. Likely, researchers believe, because the Pill can boost iron levels and the protein molecule hemoglobin in the bloodstream, both of which are lowered in cases of anemia. 17. Less pain during sex. In some cases , going on the Pill can increase a woman's vaginal lubrication and, as a result, make intercourse a heck of a lot less painful — especially if she experienced it as such prior to going on the Pill. 18. Greatly reduced chance of pregnancy. Remember that one? It's kind of why birth control was created. In case you needed a reminder. The Random 19. Changes in mate preference. Studies have also found a fascinating link between the use of oral contraceptives and women's preference for certain traits in their partners. Going on birth control can, according to some evidence , make women more inclined to choose nurturing men over sexually exciting ones, while going off birth control may influence how attractive we consider our significant others — and not for the better . All this goes to show that, like any medication, the Pill's got its own ups and downs. The trick, Ross says, is to find the right combination of hormones for you and allow about three months for your body to make that call.

A female 35 yrs old was admitted with complaints of pain Right Iliac Fossa since 7 days in some private nursing home was given treatment for the same but after treatment sge developed severe hemorrhagic lesions , bleeding from nose and mucosal surfaces and eruptions throughout the body....No documentation of the treatment she received could be retrieved....She developed Severe Pancytopenia....Discuss the cause and approach to this patient....

A badly infected and mutilated left lower limb of a 45 years old male. Planning to do hind quarter amputation. Can his limb be saved?