Appendicitis Meaning

Appendicitis is inflammation of the appendix , a finger like projection situated at joining of small intestine and large intestine. The appendix is located in the lower right portion of the abdomen.  It has no known function.  Removal of the appendix appears to cause no change in digestive function. If once the inflammation starts it is not corrected by medical treatment easily. As a medical emergency it should be managed carefully.
When treated promptly, most patients recover without difficulty. If treatment is delayed, the appendix can burst, causing infection and even death.  Appendicitis is the most common acute surgical emergency of the abdomen.  Anyone can get appendicitis, but it occurs most often between the ages of 10 and 30.

Appendicitis Causes

When the central part of the appendix, the lumen is obstructed it leads to inflammation. The pressure increases and the impaired blood flow, the inflammation, if not treated the rupture or the gangrene formation occurs.

The common causes for obstruction are:-

1. Fecal impaction
2. Bacterial infection
3. Viral infection
4. Traumatic injury to the abdomen.
5. Lymphatic spreading of inflammation.
6. Genetic factors.

Appendicitis Symptoms

Symptoms of appendicitis may include:

- Pain in the abdomen, first around the belly button, then moving to the lower right area
- Nausea
- Vomiting
- Loss of appetite
- Constipation or diarrhea
- Inability to pass gas
- Low fever that begins after other symptoms
- Abdominal distention.

People With Special Concerns

Patients with special conditions may not have the set of symptoms above and may simply experience a general feeling of being unwell. Patients with these conditions include:-

- People who use immunosuppressive therapy such as steroids
- People who have received a transplanted organ
- HIV virus infected people.
- People with diabetes mellitus.
- People who have cancer or undergone chemotherapy
- Obese people

The pregnant women, children, old age persons need special attention to rule out appendicitis. As the nausea and vomiting is usually seen in pregnant women which may sustain the signs in those ladies.  So the diagnosis should be done carefully.

Appendicitis Diagnosis

The diagnosis is made by complete physical examination, medical history, laboratory findings,x-ray etc.

Appendicitis Treatment

If the medical treatment is not effective, the surgical removal of appendix is the treatment of choice. The antibiotics are prescribed to controle post operative infection.

Obesity:-

Obesity is the medical term used to indicate the excess growth of body. in this condition the natural energy is reserved in the form of fat .obesity invites most of diseases, especially the cardiac diseases and diabetes, infertility etc.it has become the more cause for death(mortality).

obesity is both the individual and public health problem.the obese or excess body weight is very irritable to lead the normal life.the obese people are at risk for serious health problems.About 1.2 billion people in the world are overweight and at least 300 million of them are obese, even though obesity is one of the 10 most preventable health risks, according to the World Health Organization.

Obesity causes :-

Excess eating: over eating is main cause for obesity. the children and some adults cultivate an habit of eating. while eating often and often they use junk foods,curries, spices etc. the excess eating produces excess energy in the body.this energy is stored in the of fatty tissues and increases the girth of the body.high calorie consumption leads to energy imbalance and tends to fat formation. there are many causes for obesity some main cuases are:

1.genetic factors: the persons having genetic inheritance are prone to become obese.
2.endocrine disorders: hypothyroidism causes obesity.
3.eating disorders.
4.certain medications as anti psychotics.
5.sedentary life style.
6.excess fatty food, spicy, curries intake.
7.smoking cessation
8.sleep deprive
9.high glycemic diet.
10.stressful condition.

Some eating disorders are associated with obesity, especially binge eating disorder (BED). As the name indicates, patients with this disorder are prone to overeat, often in binges. A proposed mechanism is that the eating serves to reduce anxiety and some parallels with substance abuse can be drawn. An important additional factor is that BED patients often lack the ability to recognize hunger and satiety something that is normally learned in childhood.
some ethnic groups are prone to get excess body weight.

Obesity complications:-

*  Hypertension
*  Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
*  Type 2 diabetes
*  Coronary heart disease
*  Stroke
*  Gallbladder disease
*  Osteoarthritis
*  Sleep apnea and respiratory problems
*  Some cancers (endometrial, breast, and colon

Obesity controlling:-

*   important method of controlling obesity is to reduce he food intake. avoid excess energy intake.

*  avoid fatty food intake.

*  do regular exercises.

*  give up sedentary life style.

*  reduce non vegetarian food.

*  use staircase instead of lift.

*  control junk and curry foods.

*  use more vegetables in the diet.

*  lessen the consumption of milk products.

*  less calorie intake

*  engaging in some work to control eating habit.

If these goals are not achieved, pharmacotherapy can be offered. The patient needs to be informed about the possibility of side effects and the unavailability of long-term safety and efficacy data.

Drug therapy may consist of sibutramine,orlistat,phentermine etc. in sever cases of obesity, stronger drugs such as Amphetamine and Methamphetamine may be used on a selective basis. In patients with basal metabolic rate ( BMI) > 40 who fail to achieve their weight loss goals (with or without medication) and who develop obesity-related complications, referral for bariatric surgery may be indicated. The patient needs to be aware of the potential complications. the orlistat is the medication most commonly prescribed for diet/exercise-resistant obesity.

Epilepsy:-

Epilepsy is one of medical condition. it is one of the seizures disorder. it is common chronic neurological disorder. it is characterized by the recurrent unprovoked seizures. it effects nearly 50 million people throughout the world. it is not cured but can be controlled. it is usually treated with medical treatment. in some cases surgery is preferred, not all epilepsy syndromes are life long . in children it may disappear in later years.

Classification of Epilepsy:-

Epilepsy are classified as follows:

1. by the patients first cause, or etiology.
2. by observing the manifestations of seizures.
3. on the basis of where the seizures originates in the brain.
4. As a part of discrete, identifiable medical syndrome.
5. on the basis of event that triggers the seizures.

the international league against epilepsy proposed a classification scheme for individuals in 1981. Since 1997, the ILAE have been working on a new scheme that has five axes: ictal phenomenon, seizure type, syndrome, etiology and impairment.

Epilepsy diagnosis:-

The patient should be thoroughly evaluated to diagnose the disease in the proper manner. it is important to physician to collect careful history such as birth, childhood, family medical history, any neurological history, treatment regimen etc. history of nervous system, thorough history of drugs, alcohol intake, should be taken.
the detailed history about seizure is very important to distinguish the type of seizure. the significant events are as follows:

1. the events that occurs with seizures.

2. nature of the onset of the seizure

3. presence of triggers such as sleep deprivation etc.

4. at what time the seizure occurs in the day.

5. whether the seizure occurs during work or sleep.

6. whether the awareness recovers fast or it is prolonged.

The thorough physical examination and neurological assessment should be done. the blood test, urine test reveals any kidney diseases or liver disorders. augment adverse effects of anti epileptic drugs and rule out or identify certain underlying causes. These results also establish a baseline for monitoring kidney and liver function while the patient is on anti-epileptic medication. The kidney and liver metabolize most of these medications.

It is important to identify and treat any trauma or injury or any diseases that causes seizures.
1. head trauma
2. injury
3. drug intoxication

Conditions that produce symptoms similar to those that occur during seizures must be ruled out, such as the following:

1) Breath-holding spells: bluish tint to the skin, loss of consciousness, loss of muscle tone

2) Meniere’s disease: vertigo, visual phenomena, speech impairment, altered consciousness

3) Migraine: aura, loss of consciousness, nausea, photo-phobia , muscle weakness

4) Movement disorder: tics, chorea, tremor

5) Syncope: sudden loss of muscle tone and posture, loss of consciousness, vertigo, nausea, muscle spasm

Electroencephalogram:-

-it is the important test used to diagnose the seizure disorder. It identifies abnormal electrical activity in the brain, provides information about the type of seizure disorder locates the area in which area the seizures occurs.

-Some of the findings on EEG are specific to particular disorders and subtypes of epilepsy. Activity during a seizure can be identified by a pattern on the graph, called epileptiform, which indicates epilepsy. Correlating this type of data with clinical symptoms of seizures often helps make an accurate diagnosis. Additionally, the EEG recording between seizures is often abnormal in patients with epilepsy.

-the other tests conducted by the doctors are neurological exam that tests your reflexes, muscle tone, muscle strength, sensory function, gait, posture, coordination and balance. Your doctor may also ask questions to test your thinking, judgment and memory.

-Blood tests may be needed to check for problems — such as infections, lead poisoning, anemia or diabetes — that could be causing or triggering your seizures.

before sending a person to the EEG the doctor should inform to avoid elaborate hair styling,greasy hair dressing or metallic hair dressing. avoid taking caffeine 6 hours before the procedure. the procedure is painless and it last for 30 minutes.

Computed Tomography:-

it is the procedure of computerized scanning . it is the special type of x-ray , which obtains the image of cross section of the brain in different angle. scan reveals the abnormality in the brain, such as cyst,tumor,strokes or strangled blood vessels.

Magnetic Resonance Imaging:-

It provides the detailed image of the brain using radio waves and strong magnetic field. it also reveals the abnormalities in the brain.

Signs and symptoms of Epilepsy:-

epilepsy is due to the abnormal activity of the brain. so the seizure can effect any process of our brain carries. the seizures can produce, short term mental confusion, uncontrollable jerking movements of the extremities, complete or partial loss of consciousness. seizure can begin in one part of the brain and it can spread to the other part. on the basis of abnormal activity of brain the seizures can be classified as partial or generalized.

Epilepsy without seizures; Is this possible?

-Epilepsy is a complex brain (mental) disorder. Although epilepsy is primarily characterized by seizures, the nature of the seizures can vary depending on the type of seizure and the individual person.

-In older adults, especially, seizures tend to be more subtle than in younger people and may appear as brief memory lapses or episodes of confusion. In some cases, seizures may cause little or no change in consciousness. Also, involuntary shaking is a less common feature of seizures in older adults. To someone nearby, a person having this type of seizure may simply appear to be staring into space and be unresponsive for a few seconds.

-Although it can occur at any age, the onset of epilepsy is quite common after age 65. So it is possible that your sister only recently developed epilepsy. The good news is that epilepsy can be treated. Appropriate treatment of epilepsy is important because recurrent seizures may put your sister and others at risk of physical harm — for example, if your sister has a seizure while driving and loses control of the car.

Complications of Epilepsy:-

The suspected complications are head injury, any accidents, falls, fractures,etc . the seizures person may fall to the water, touch fire etc. totally the seizures person is susceptible for all type of injuries.

Treatment of epilepsy:-

The anti epileptic drugs are effective treatment for the control of seizures in epileptic patient. some of the other drugs can reduce the intensity and duration of the seizures. the minimum dosage and duration has to be maintained. the minimum period of anti-epileptic drugs usage is two to three years.

prescribing the right medication and dosage can be complex. Your physician likely will first prescribe a single drug at a relatively low dosage, and may increase the dosage gradually until your seizures are well controlled. If the client have tried two or more single-drug regimens without success, the physician may recommend trying a combination of two drugs. the drugs to be taken regularly at correct time, and correct dosage.

All anti-seizure medications or anti epileptic drugs have some side effects. which may include mild fatigue, dizziness,general weakness and weight gain. In some cases more severe side effects include depression, skin rashes, loss of coordination, speech problems and extreme fatigue.

if medical treatment is not effective, surgery is indicated such as vagal nerve stimulation etc.

Self care for Epilepsy:-

The epileptic patient should follow certain measures to avoid complications, injuries,and to manage the seizures effectively. the client should have a small record with him as it contains the drugs using, referring doctor,address, vital statistics etc.the client should avoid alcohol and smoking, as they triggers the seizures.

As with number of chronic conditions, maintaining your overall health is an important step in controlling epilepsy. Sleep deprivation is a powerful trigger of seizures. Be sure to get adequate rest every night, and make a conscious effort to eat a balanced diet, exercise and manage stress effectively. meditation keeps the body and mind fresh and free.

Excessive alcohol consumption may worsen the condition. get advice by the doctor to avoid alcohol. ..

Depression:-

It is one of the psychiatric disorder. “is the state of mind characterized by reduced mental activity and dull physical performances”. is a state of intense sadness.which alters the social behavioral adjustment and altered daily living activities.One suffering from depression may feel tired, sad, irritable, lazy, unmotivated, and apathetic. it leads to constant negative thinking,or substance abuse.Extreme depression may end in attempting or committing suicide.

Causes of depression:-

1.genetic predisposing factors:the tendency to develop depression is inherited. it may run through the families, by means of biological or environmental factors. there is an evidence of this type.

2.neurological:Many modern antidepressant drugs change levels of
certain neurotransmitters such as serotonin which leads to neurogenesis and causes depression

3.medical conditions:Certain illnesses, including cardiovascular diseases, hypothyroidism,hepatitis, some organic disorders which degenerates the brain function such as
Parkinson disease, Multiple sclerosis etc.

4.dietary causes : certain diets such as intensively formed farmed foods and processed food which contain reduced amount of omega -3 fatty acids. it is believed that it causes depression.

5.alcohol:Alcohol can have a negative effect on mood, and misuse of alcohol leads to depression.

6.drugs :drugs such as tranquilizers, benzodiazepines and sleeping drugs may increase the duration and severity.

7.poor sleep : the poor sleep quality tends to depression. if an individual won’t attain the 4th stage of sleep which has the restoring capacity will go for depression.

8.:Seasonal affective disorder: (SAD) is a type of depressive disorder that occurs in the winter when daylight hours are short. It is believed that the body’s production of melatonin, which is secreted during the dark plays a major part in the onset of SAD.

9.postpartum depression: it occurs in the mother after giving birth to the child. due to the physical pain, stress,it typically sets within three months

social and psychological causes:-

1.low self esteem: the person who have low self esteem self defeating thinking are related with depression.

2.Early experiences: such as death of parents, lovely ones, rejection by someone,neglected by care givers, any chronic illness, sexual abuse, premature ejaculation, traumatic events may trigger depression.

3.life experiences: like job loss, prolonged poverty,financial difficulties, long term unemployment,inability to have proper sex, rape, breakage of committed relationships, divorce etc can end with depression.

Treatment:-

Treatment of depression varies broadly among individuals and the levels, types, and methods of intervention around the globe varies dramatically. Various types and combinations of treatments are used. the two primary modes of treatment are
medications and psychotherapy.in some cases electroconvulsive therapy is used.some clients may not response to the treatment need the combined therapy of both medicine and psychotherapy. the careful assessment, counseling, increase of drug dosage is needed.

Medications:-

many medications are there to relieve the symptom of depression.typical first-line therapy for depression is selective serotonin re uptake inhibitor. like citalopram, fluoxetine,sertraline etc
for the attentive care to prevent suicide, the psychiatric hospitalization is necessary.

Counseling:-
the proper counseling is necessary to treat the depression in a effective manner. the counselling should be get by the counselor or with the psychiatrist.

Stress definition:-

The word stress has a meaning in oxford dictionary as” a state of involving demand on physical or mental energy” the stress condition disturbs the mental and physical health of an individual.
In medical parlance ’stress’ is defined as a perturbation of the body’s homeostasis. every functional individual will have a stress at any movement.even though the stress is commonly seen it is harmful to the health. the modern competitive world has made us to surrender for stress.it is the condition which tends the mind to the state conflict when the work load is high.
the mind tries to cope with the problems when the work load becomes high, it leads to stress.
due to diversification of human activities we get so many causes of stress.stress for the period of short term is not harmful but the severe stress leads to number of disorders.
person’s physiological response to an internal or external stimulus

the stress can be defined as ” person’s physiological response to an internal or external stimulus”

CAUSES:-

we will get stress as when we try to reach goal or target in a limited period. the students who imposed by the parents to get good marks will try to work hard,they will skip sleep they have to do a continuous hard work,they have to study different subjects, this work load leads to stress. the employees who have to reach target in the company, the lady who have to do different works such as caring for the baby, serving husband, job. the businessman who has got a loss in the business,  man who has taken the loan and not able to repay it, loss of lovely persons or lovely things , such circumstances lead to the stress. the demand for relationships,
chronic diseases are also the cause for stress.
the stress effects all the age group,children, teenagers, adults, old age,even the fetus also.

Nothing gives one person so much advantage over another as to remain always cool and unruffled under all circumstances.”—Thomas Jefferson

In a challenging situation the brain prepares the body for defensive action, and stimulates the gland to release stress hormones such as cortisone,and adrenaline.this hormones rises the blood pressure and prepares the body to respond to the situation. the stress hormones in the blood get used up, entailing reduced stress effects and symptoms of anxiety.
when we fail to cope with the stress situation the hormones are not released and the physical changes such as uncontrolled muscle movements, sweating, anxiety,dizziness etc.

the stress can cause disorders such as headache,irritable bowel syndrome, back pain ,insomnia,gastric acidity,fatigue,etc. the major disorders like diabetes  ,hypertension,cardiac disorders are also caused by stress.

STRESS – POSITIVE:-

according to the psychologists, the moderate stress is healthy one .
-the stress full practice in athletes leads to the victory.
-the stressful scientist will invent the new phenomenon
-the stressful student will get good marks in the examinations.
-the stressful work in the factory gives the good production .
-stress situations boosts our inner potential.
-stress helps in the maximum utilization of mental power.
-stress keeps the person punctual.

STRESS MANAGEMENT: -

-meditation :is the natural method of overcoming stress, it helps to the relaxation of mind . it enhances a spirit and provides calmness. as it stabilises the mind one can cope with stress.

laughing: is one of the effective measure to cope with stress.
-it reduces the blood pressure

-reduces anxiety,

-keeps the heart healthy

-enhances the freshness in the mind.

- Reduces stress hormones

-laughing cleans the lungs.

-it increases the muscle reflection and relaxation Produces a general sense of well-being
-laughter helps in the release of endorphin a natural pain killer in the body.
-Produces a general sense of well-being

Acquired Immune Deficiency Syndrome. as an evil it has threatened the whole world. it has effected the millions of peoples through out the world. as it not a curable disease, the prevention is better and awareness is needed to entire world.

important facts about AIDS:-

One new HIV infection occurs every 6 seconds of every minute o Young people (under 25 years old) account for half of all new HIV infections worldwide f every day.
UNAIDS, AIDS Epidemic Update (extrapolated from), December 2005, UNAIDS

In 2005, there were 4.9 million people newly infected with HIV; of these new infections, 700,000 occurred in children under the age of fifteen.

In 2005, 5 million new HIV infections occurred worldwide; approximately 14,000 every day.
UNAIDS, AIDS Epidemic Update, December 2005, UNAIDS

globally half of people living with Aids is represented by women.

Scientists are developing and testing topical microbicides that women could apply before intercourse to protect themselves against HIV and other sexually transmitted organisms.
Global Campaign for Microbicides, About Microbicides, March 2006, GCFM

The risk of HIV transmission from mother to newborn is less than 2% if women receive a combination of antiretroviral therapies during pregnancy.
National Institutes for Allergy and Infectious Diseases, HIV Infection in Women, May 2004, NIAID

The latest statistics on the world epidemic of AIDS & HIV were published by UNAIDS/WHO in November 2006, and refer to the end of 2006. the estimated cases are as follows..

People living with HIV/AIDS in 2006 – 39.5 million

Adults living with HIV/AIDS in 2006 – 72.2 million.

Women living with HIV/AIDS in 2006 -17.7million

Children living with HIV/AIDS in 2006 -2.2million

People newly infected with HIV in 2006 -4.3million

Adults newly infected with HIV in 2006 -3.8 million

Children newly infected with HIV in 2006 -0.53 million

AIDS deaths in 2006 -2.9million

Adult AIDS deaths in 2006-2.6million

Child AIDS deaths in 2006-0.38 million

since 1981 , more than 25 million people have been died of Aids.

12million orphans are there in Australia.

Young people (under 25 years old) account for half of all new HIV infections worldwide .

AIDS was first identified in the USA in 1981. The epidemic has now spread to every part of the USA and to all sectors of society.

more than one million people are living with Aids in USA and half million have died after developing Aids.

Aids is a syndrome and HIV is the virus which causes Aids. aids is an incurable disease. millions of people already surrendered for death due to Aids and more millions are getting affected with it. the HIV after entering to the body it multiplies in the host and destroys the immune system , especially the T-lymphocytes, which provides cellular immunity to the body. when the body immune system is destroyed the body is susceptible to infections. the other infective organisms enter the body and leads top different diseases.

the people can become infected when they come to contact with infected objects,sexual intercourse with them , blood contact etc.
the person who is diagnosed as HIV infected is said to be HIV-positive.

when HIV becomes AIDS:-

without drug treatment HIV progress to Aids averagely within 10 years. the who takes a well balanced diet and maintains hygiene can live healthy for some years. while the malnourished can get more infections and may die.

window period: the time between initial infection and the development of detectable antibodies against the infection is known as window period.

HIV test:

the individuals blood is tested for HIV enzyme immuneoassay.
detect for HIV antibodies in the sera or plasma, oral fluids or urine.
western blot assay.

in case of positive reaction HIV antibodies are seen in body fluids.

Symptoms of the disease:-

1. unusual weight loos
2. anorexia (not able to take food)
3. fatigue.
4. fever
5. nausea
6. headache
7. respiratory tract,urinary tract or any infections.
8. diarrhea
9. tuberculosis
10. general weakness

stages of AIDS:-

# stage 1: HIV infection is asymptomatic and not recognized as Aids.
#  stage 2: includes minor mucocutaneous manifestations and recurrent upper respiratory tract infections
# stage 3: includes unexplained chronic diarrhea for longer than a month, severe bacterial infections and pulmonary tuberculosis
# stage 4: includes taxoplasmosis of brain, candidiasis of the esophagus, trachea, bronchi or lungs.

AIDS transmission:-

- an unprotected sexual intercourse with an infected person. Sexual intercourse without a condom is very risky, as the virus can enter the body through the semen or sexual fluids.

- Contact with an infected person’s blood If sufficient blood from an infected person enters someone’s body then it can pass on the virus. you may come contact with blood while getting blood transfusion, using a same razor for shave, direct contact with infected material, especially by the health professionals without barrier.

- From mother to child HIV can be transmitted from an infected woman to her baby during pregnancy, delivery and breastfeeding. There are special drugs have been introduced which can prevent this if used in right time.

- while injecting a drug using the same needle, especially the drug abuses are vulnerable to HIV infection.

AIDS won’t spread through:-

- insect / animal bites
- touching, hugging or shaking hands
- eating food prepared by someone with HIV
- toilet seats
- sharing cracker and cutlery

AIDS prevention:-

- have only one sexual partner.
- if necessary to have a sex except partner use condoms.
- don’t use the razors of others.
- don’t get injected by the used needle.
- confirm the blood is tested before transmission.
- abstinence.

Hypertension / high blood pressure:-

Hypertension is nothing but high blood pressure. in us adults one among three have high blood pressure. it is one of the silent killer. those who attain an age of 30 should undergo for medical check up to find it. if it early find out, it can be well controlled. an undiagnosed high blood pressure prolongs for long time may cause damage to our heart, kidneys and brain.

What is  blood pressure?

it is the pressure exerted by the blood against the blood vessels as it is pumped by the heart. when the pressure exerted by the blood increased, is known as high blood pressure or hypertension. this high blood pressure develops without showing any signs and symptoms.so early check up is better to find it and we can prevent complications. the blood pressure is checked by a device known as sphygmomanometer, with the help of stethoscope.

the normal blood pressure of an healthy individual is 120/80 mm of Hg.

the pressure exerted by the blood when the heart contracts is known as systolic blood pressure and the pressure exerted when the heart dilates is known as diastolic blood pressure.

Definition of Hypertension:-

” hypertension is the persistent high blood pressure, in which the systolic is more then 140mm of Hg, and diastolic is more then 90mm of Hg which are measured in two or more consecutive days in a week”.

In patients with diabetes or kidney disease studies have shown that blood pressure over 130/80 mm Hg should be considered high and warrants further treatment.

Type of hypertension:-

There are the two major type of hypertension,

1. essential hypertension ( primary ) : accounts for 95% of hypertension. The cause of essential hypertension is multi factorial, that is, there are several factors whose combined effects causes this. Essential hypertension affects approximately 75 million Americans, yet its basic causes or underlying defects are not always known. Approximately 30 % of cases of essential hypertension are attributable to genetic factors. they have an increased resistance (stiffness or lack of elasticity) in the tiny arteries that are most distant from heart.

2. non essential or secondary hypertension : which accounts for 5% of hypertension, the high blood pressure is secondary to (caused by) a specific abnormality in one of the organs or systems of the body.

Other types of hypertension :-

1) accelerated hypertension :it is the progressive hypertension with the funduscopic vascular changes.

2) adrenal hypertension : that associated with an adrenal tumor which secretes mineralocorticoids.

3) borderline hypertension : in which the arterial blood pressure is sometimes within the normal range and sometimes within the hypertensive range.

4) gestational hypertension : it develops in the pregnant mothers.

5) malignant hypertension : a severe hypertensive state with papilledema of the ocular fundus and vascular hemorrhagic lesions, thickening of the small arteries and arterioles, left ventricular hypertrophy, and poor prognosis.

6) ocular hypertension : it develops in the intraocular region, without signs of glaucoma.

7) portal hypertension : abnormally increased pressure in the portal veins which brings blood to the liver.

renal hypertension : that associated with or due to renal disease with a factor of parenchymatous ischemia.

9) pulmonary hypertension : it is the pressure exerted in the pulmonary arteries.

10) systemic venous hypertension : elevation of systemic venous pressure, usually detected by inspection of the jugular veins.

Causes of hypertension:-

1. obesity.

2. excess salt intake.

3. sedentary life style

4. vascular diseases

5. renal diseases

6. adrenal gland tumor

7. genetic factor

8. Coarctation of the aorta

9. The metabolic syndrome

10. unknown cause.

Symptoms of hypertension:-

- dizziness

- headache

- night sweating

- hearing own heart sound.

- measurement of bp above 140/90mm of Hg

Complications:-

While elevated blood pressure alone is not an illness, it often requires treatment due to its short- and long-term effects on many organs. The risk is increased for:

1. HYPERTENSIVE CARDIOMYOPATHY.(heart failure)

2. RENAL DAMAGE.

3. CEREBRO VASCULAR ACCIDENT (STROKE)

4. RETINAL DAMAGE. (retinopathy)

5. MYOCARDIAL INFRACTION.(heart attack)

investigations done in newly diagnosed hypertension.

Common blood tests are:-

- creatinine :to identify any underlying kidney diseases or to check any damage to kidney due to hypertension.

- electrolytes (sodium and potassium)

- cholesterol

- electrocardiogram (ECG)
Treatment of hypertension:-

LIFE STYLE MODIFICATION :  don’t become slave to the snacks and spices. because these leads to increased cholesterol level in the body. the regular exercises are very helpful to control hypertension. the doctor usually recommend to reduce your weight or to reduce obesity. how to reduce weight? we should reduce the fat intake in the food. use more vegetables foods. avoid food stuffs such as chicken, mutton,egg, cheese,  etc. the recommendation is to give up SMOKING and Alcohol .smoking leads to changes in the blood vessels and alcohol damages the organs. instead of using lifts use stair cases. avoid sedentary life styles. cultivate an habit of walking every day morning or evening. do an half an hour exercises at least 3 days a week if you are busy. otherwise do the regular exercises it keeps you healthy and freshness as it enhances the easy blood flow in the body.

reduce the amount of SALT in the diet.the regular intake of calcium has an effect in reducing hypertension.use the fruits and vegetable rich diet, low fat or reduced fat,low sodium diet. This diet is known as the DASH diet(Dietary Approaches to Stop Hypertension), and is based on National Institutes of Health sponsored research. the fruits, vegetables, and nuts have the added benefit of increasing dietary Potassium, which offsets the effect of sodium and acts on the kidney to decrease blood pressure.

the stress situation should be avoided, such as avoiding high sound levels or high illuminations helps in reducing blood pressure. to avoid stress condition the Meditation is preferred.

Avoid heavy workload and be tension free.

Medications:-

there are number of drugs to treat hypertension called antihypertensive drugs. which lowers the blood pressure. Evidence suggests that reduction of the blood pressure by 5-6 mm Hg can decrease the risk of stroke by 40%, of coronary heart disease by 15-20%, and reduces the likelihood of dementia, heart failure, and mortality from vascular disease.

Commonly used drugs are:-

1. ace inhibitors : such as captopril, enalapril etc
2. angiotensin receptor antagonist : such as irbesartan ,
3. alpha blockers : Eg. prazosin
4. beta blocker ; such as metoprolol, atenolol, labetalol.
5. calcium channel blocker such as amlodipine verapamil etc.
6. diuretics: hydrochlorothiazide.
7. direct renin inhibitor: tekturna.

this type of many medications should be used initially for hypertension. then the combination of drugs is given.

гастрит: —

стомах е член на орган в коремната област. стомах магазини и digests храната, получени чрез хранопровода. стомах има различни видове клетки, което помага при храносмилането. солна киселина е основна сок отделяна от специализирани клетки. възпаление на стомаха е известен като гастрит. възпалението се причинява поради белите кръвни клетки, натрупани в стомашната киселина увреденото място на стомаха.

причините за гастрит: –

Helicobacter pylori: е бактерии в стомашната лигавица и да не засегнат и стомашната лигавица. когато стомашна слой е разрушен от излишък на стомаха стомашната секреция, Helicobacter pylori инфектира дълбоките слоеве на стомашната лигавица и води до гастрит.

НСПВС продължителната употреба: не стероиден анти възпалителни лекарства, използвани за вероятният болка, особено при артрит. когато се използват за дълъг период от време тези НСПВС и аспирин използва prostaglandins, който покрива стомашната лигавица, унищожаването на предпазни слой на стомашната лигавица предизвиква гастрит.

авто-имунни нарушения и злокачествена анемия също предизвиква гастрит.

алкохол: продължителната консумация на алкохол, предизвиква гастрит, тъй като химикали в алкохолът разрушава стомашната лигавица от секретиращ излишък на солна киселина. случайни алкохол не предизвиква гастрит, хроничен, но консумацията на алкохол води до гастрит.

гастрит също се развива след голяма операция, изгаряния, продължителната употреба лекарства, наранявания на стомаха, тежък стрес и др.

конкретни случаи на гастрит: —

* Свръх консумация на кофеин,
* Пушенето на цигари,
* Гъбична инфекция на стомашната лигавица,
* Паразитни инфекции,
* Стомашна алергени
* Туберкулоза,
* Радиация лечение на рак,
* Ендоскопия и други процедури,
* Калиеви добавки,
* Желязо таблетки,
* Хронично повръщане др

симптоми на гастрит: —

* Абдоминален дискомфорт,
* Стомашен кръвоизлив,
* Над стомашна киселина,
* Загуба на апетит,
* Гадене,
* Повръщане,
* Парене в стомаха,
* Температура др.

диагностициране на гастрит: —

бариевият хранене и gastroscopy са чести диагностични тестове, за да се диагностицира гастрит.

Събирането на пациента историята като приемате някакви лекарства, консумация на алкохол, тютюнопушене, всички кабинети, стресова ситуация, други хронични заболявания помага при диагностициране гастрит. Тя включва:

* Биопсия,
* Табуретка антиген тест,
* Специфичен антитяло тест в кръвта и т.н.

лечение на гастрит: —

отстраняване на причината или лечение на причинен фактор за гастрит е лечението опция. за лечение на инфекция, антимикробиални се използва и за лечение на инфекция с Helicobacter pylori, тройна терапия се използва. тройна терапия е комбинация от две антибиотици и Proton помпа инхибитор. лечение включва:

* Избягване на алкохол,
* Напускане навика на тютюнопушенето,
* Избягване на свръх кофеин,
* Облекчаване стрес др

tinnitus eller ringing i øret: —

oppfatning av ringetoner lyd i det menneskelige øret, i fravær av eksterne tilsvarende lyd kalles som ringer i øret.

ringer i øret kan oppstå i ett øre eller begge ørene. Ringetype lyden vil bli følt i forskjellige måte i ulike individ. Ringetype lyd kan bli følt som whistling, tikkende, brusande, summende, klikke etc..

ringing av øret er ikke en sykdom, men er et symptom på underliggende årsaken.

nesten 35 millioner amerikanere lider av problemet med ringer i øret, eller noen lyder i øret.

tinnitus kan følt at noen del av øret, dvs. ytre øre, middels øre eller indre øret. noen tinnitus er normalt og hørt når alle ytre lyder er
opphørt.

årsakene til ringing i øret: —

* Ringing i øret er normalt, og når voks hindre det ytre øre,

* Øret infeksjoner,

* Væsken i midten øre,

* Sykdom av middels øret bein kan forårsake tinnitus eller ringing lyd.

* Etter eksponering for høyt støynivå, noen lyder høres i øret.

* Medisiner som aspirin kan forårsake tinnitus.

* Skade eller misdannelse av øret trommelen kan forårsake ringer i øret.