Diseases Treatment

What is this Condition?

Diabetes mellitus is a chronic disease in which the body produces little or no insulin or resists the insulin that it does produce. Insulin transports glucose into the cells for use as energy and storage as glycogen. It also stimulates protein synthesis and free fatty acid storage in the fat deposits. When a person lacks sufficient insulin, body tissues have less access to essential nutrients for fuel and storage.

The incidence of diabetes mellitus is equal in men and women and rises with age. The disease increases the risk of heart attack, stroke, kidney failure, and peripheral blood vessel disease. What’s more, it’s a major cause of blindness in adults.

Classifying Diabetes

There are two main forms of diabetes mellitus: Type I or insulin-dependent, and the more prevalent Type II or non-insulin-dependent. Type I usually occurs before age 30, although it may strike at any age . The person with this type is usually thin and needs insulin injections and dietary modifications to control his or her blood sugar level. Type II usually occurs in obese adults over age 40. It’s most often treated with diet and exercise (possibly in combination with drugs that lower the blood sugar level), although treatment sometimes includes insulin therapy.

What Causes it?

The cause of diabetes mellitus remains unknown, but genetic factors may playa part in development of the disease. In Type I diabetes, cells in the pancreas that produce insulin are damaged, possibly because of an immune system problem. Consequently, these cells are able to produce very little or no insulin.

In Type II diabetes, the cells in the pancreas are still able to produce insulin, but not enough to meet the body’s needs. People with this type of diabetes are usually obese.

Other forms of diabetes, called secondary diabetes, may be caused by pregnancy, physical or emotional stress, or the use of certain medications.

What are its Symptoms?

All types of diabetes produce similar symptoms. The most common symptom is fatigue, caused by energy deficiency and abnormal processing of fats, carbohydrates, and proteins. Insulin deficiency causes high blood sugar. High blood sugar, in turn, causes increased and frequent urination, dehydration, excessive thirst, dry mucous membranes, and dry skin. Some people with diabetes may experience weight loss, as fat and muscles are burned up to provide energy and excessive amounts of glucose are excreted in the urine.

Symptoms of Type I diabetes may develop rapidly within weeks or months. Symptoms of Type II diabetes usually develop more gradually and may not appear until many years after the onset of the disease.

If not properly managed, diabetes may also lead to dangerous metabolic crises, such as ketoacidosis and hyperosmolar nonketotic syndrome. These crises result from excessive amounts of glucose in the blood and may lead to fluid loss and shock.

Long-term effects of diabetes may include retinal changes, kidney problems, atherosclerosis (plaque buildup in the arteries), and nervous system problems, such as pain or numbness in hands and feet or paralysis of the stomach resulting in nausea. Other nervous system effects include impotence, nighttime diarrhea, and dizziness when rising to an upright position (due to low blood pressure).

High levels of sugar in the blood encourage bacterial growth and reduce resistance to infection, possibly leading to skin and urinary tract infections and vaginal inflammation.

How is it Diagnosed?

When making a diagnosis of diabetes mellitus, the doctor observes the person for symptoms of uncontrolled diabetes. He or she will order blood tests to measure sugar levels. A blood sugar level equal to or above 200 milligrams per deciliter suggests diabetes mellitus. Another test for diabetes mellitus, called the fasting plasma glucose test, requires fasting for 12 or 14 hours before blood is drawn.

An eye examination may show retinal abnormalities. Other diagnostic and monitoring tests include urinalysis and additional blood tests.

How is it Treated?

The goal of treatment is to normalize the person’s blood sugar level. In Type I, this is achieved with insulin injections, diet, and exercise. The person may receive insulin in a single-dose, mixed-dose, split­mixed dose, or multiple-dose regimen. For a multiple-dose regimen, an insulin pump may be used. Insulin may be rapid-acting (regular), intermediate-acting (NPH), long-acting (ultralente), or a combination of rapid-acting and intermediate-acting (Mixtard); it may be standard or purified, and it may be derived from beef pork, or human sources. Today, purified human insulin is commonly used.

A person with either Type I or Type II diabetes must follow a strict diet to meet nutritional needs, control blood sugar levels, and reach and maintain appropriate weight. The person must follow the diet consistently and eat meals at regular times.

For an obese person with Type II diabetes, dietary measures aim to promote weight reduction. In many cases, diet alone may be sufficient to control Type II diabetes. Alternatively, a person with Type II diabetes may take oral antidiabetic drugs to stimulate the body’s insulin production, increase the cells’ sensitivity to insulin, and stop the formation of carbohydrates from noncarbohydrate sources in the liver.

Some people with diabetes may be candidates for pancreas transplantation to help them produce insulin. But this procedure is experimental and requires long-term use of drugs that suppress the immune system.

Treating Complications

A diabetic with kidney failure may receive dialysis or a kidney transplant. A person with retinal abnormalities may undergo a procedure called photocoagulation, in which a laser or xenon arc light is used to cause condensation of protein material in the eye. Blood vessel disease may require vascular surgery.

What can a person with diabetes mellitus do?

• Be sure to comply with your prescribed treatment program.

• Make sure you understand - and follow - your doctor’s instructions on managing minor illnesses, such as a cold, flu, or upset stomach. (For instance, you may need to increase your insulin dosage.)

• For more information on this disease, contact the Juvenile Diabetes Foundation or the American Diabetes Association.

What is this Condition?

Tonsillitis is inflammation of the tonsils. It can be acute or chronic. The uncomplicated acute form usually lasts 4 to 6 days and commonly affects children between ages 5 and 10. The presence of proven chronic tonsillitis justifies surgical removal (tonsillectomy), the only effective treatment. Tonsils tend to grow during childhood and shrink after puberry.

What Causes it?

Tonsillitis usually is caused by infection with bacteria known as group A beta-hemolytic streptococci. It may result from other bacteria or viruses or from oral anaerobes.

What are its Symptoms?

Acute tonsillitis commonly begins with a mild to severe sore throat. A very young child, unable to complain about a sore throat, may stop eating. Tonsillitis may also produce difficulty swallowing, fever, swelling and tenderness of the lymph glands in the submandibular area, muscle and joint pain, chills, malaise, headache, and pain (frequently felt in the ears). Excess secretions may cause the child to complain of a constant urge to swallow; the back of the throat may feel constricted. Such discomfort usually subsides after 72 hours.

Chronic tonsillitis produces a recurrent sore throat and pus-filled drainage in the tonsillar crypts. Frequent attacks of acute tonsillitis may also occur. Complications include obstruction from swollen tonsils and an abscess around the tonsils.

How is it Diagnosed?

Diagnostic confirmation requires a thorough throat exam. The doctor notes generalized inflammation of the pharyngeal wall, swollen tonsils, and the presence of drainage with pus. The person may also have a swollen, inflamed uvula (the small, fleshy mass hanging down in the back of the mouth).

Lab tests are also important in making a diagnosis. Cultures may determine the infecting organism and indicate appropriate antibiotic therapy.

How is it Treated?

To treat acute tonsillitis, the doctor will prescribe rest, adequate fluid intake, aspirin or Tylenol and, if the person has a bacterial infection, antibiotics. If the organism causing tonsillitis is a group A beta­hemolytic streptococci, the doctor will usually prescribe penicillin, although another antibiotic may be substituted.

To prevent complications, antibiotic therapy should continue for 10 to 14 days. Chronic tonsillitis or the development of complications (obstructions from swollen tonsils or abscess around the tonsils) may require surgical removal of the tonsils. This operation should take place only after the person has been free of tonsillar or respiratory tract infections for 3 to 4 weeks.

Visual impairment can be very disturbing, but is also relatively easy to correct and treat. There are several ways of treating visual impairment. There are glasses, surgery with laser, and contact lenses , among other methods. The contact lens is an increasingly popular way of treating sight problems, and there are many reasons for this. Contact lenses are cheap, they are easy to handle and they have many fields of use. For example, lenses can be worn only during certain activities, for example when running or horseback riding, since they are so easy to put in and take out.

Today’s lenses can correct the vast majority of all sight problems, and they can be worn by almost everyone. Depending on your budget and if you are prepared to care for and clean your lenses on a regular basis, you can choose between certain types of lenses. Some lenses don’t require any maintenance, as you replace them every morning, while some lenses have to be put in saline solution every night. To buy contact lenses, simply type in “contact lenses” in the search field of any search engine, and make a quick contact lens price comparison ! You’re bound to find a lens you will like.

For most people, anxiety is a temporary reaction to stress. It becomes an illness only when it persists, and prevents you from leading a normal life. Some anxiety states are caused by severe stress, but in anxiety-prone people only slight stress, or none at all, may be involved. People who have “free-floating” anxiety live in a constant state of apparently causeless anxiety.

If you have an attack of anxiety, you will probably feel apprehensive and tense, and be unable to concentrate, to think clearly, or to sleep well. You may have frightening dreams and occasional symptoms of fear such as a pounding heart, sweating palms, trembling, or diarrhea. Some people in a state of anxiety find it hard to breathe, as if their lungs are under constant pressure. And they may become convinced that they have heart or stomach trouble when in fact they are physically healthy . A man may have trouble maintaining an erection or may have premature ejaculation . In so-called “anxiety attacks,” which can occur apparently without cause at any time, the physical symptoms of fear intensify alarmingly.

What are The Risks?

Anxiety is a very common form of psychological disorder. It is slightly more common in women than men, and adolescents and the elderly are especially susceptible. If severe anxiety is not treated, you may sink into psychotic depression.

What Should be Done?

If your anxiety is caused by a specific stress, try to remove it. For example, consider changing jobs if your current work makes you anxious. If there is no way to deal with the stress, or if severe anxiety persists, consult your physician, who will examine you to determine whether your symptoms may be due to a physical condition such as an over-active thyroid gland or a vascular disorder of the brain . If no physical cause for your symptoms is found, you may be referred to a specialist. The first time you have an anxiety attack, you may think you are having a heart attack. To be on the safe side, call your physician. If he or she is not available, call an ambulance to take you to a hospital.

What is The Treatment?

Self-help: Various methods of relaxation can lessen the severity of symptoms. Whenever you feel tense and troubled, try doing relaxation exercises or some physical activity such as swimming, jogging, or brisk walking.

Professional help: Your physician may suggest exercises to relax tense muscles. In addition, or alternatively, your doctor may prescribe an anti-anxiety drug or recommend psychotherapy. Severe cases may also require a period of hospitalization.

What are The Long-Term Prospects?

If your disorder is due to a stress that can be dealt with, you have a good chance of permanent cure. But if you are anxiety-prone or have free-floating anxiety, recurrent attacks are likely. You may be able to avoid them, or at least minimize symptoms, by continuing to do relaxation exercises even when you are not actively anxious. Ask your doctor if there is a drug that you can take as soon as you feel that an attack is beginning.

The bony orbit in which the eyeball lies is lined with soft tissue. In rare cases, bacteria enter the tissue, usually from infected sinuses in the nose , or from a boil near the eye, and cause an inflammation. This is called orbital cellulitis.The pressure of the swollen tissue pushes the eyeball forward, giving your eye a staring appearance . Other symptoms are severe pain and redness in the eye, swollen eyelids that you may not be able to close, and usually a fever.

In rare cases the eye exudes pus. The condition often resembles conjunctivitis. If there is pressure on the blood vessels that supply the eye, you may temporarily lose some vision. There is also a slight risk that the infection may spread to the brain and cause meningitis .

Treatment consists of high doses of antibiotics, given as tablets or by injection. If infected sinuses are the source of the problem, you may need an operation to have them drained to prevent cellulitis from recurring .

What is this Condition?

An anal fissure is a cut or crack in the lining of the anus that extends to the sphincter muscle. A fissure at the back of the anus, the most common injury, occurs equally in males and females. A fissure in the front of the anus, the rarer type, is 10 times more common in females. The chance for cure is very good, especially with surgery and good anal hygiene.

What Causes it?

A fissure at the back of the anus results from passage of large, hard stools that stretch the rectal lining beyond its limits. A fissure at the front usually results from strain on the perineum during childbirth and, rarely, from scar tissue that narrows the passage. Occasionally, the fissure is caused by inflammation, anal tuberculosis, or cancer.

What are its Symptoms?

An acute anal fissure starts with tearing, cutting, or burning pain during or immediately after a bowel movement. A few drops of blood may streak toilet paper or underclothes. Swelling at the lower end of the fissure, called a sentinel pile, can cause painful spasms. A fissure may heal spontaneously and completely, or it may partially heal and break open again. Repeated fissures leave scar tissue that hampers normal bowel movement.

How is it Diagnosed?

The doctor can use a scope to see the tear. Probing the area will cause pain and bleeding. The doctor may also pull back the skin to expose the swelling at the end of the fissure.

How is it Treated?

If the tear is superficial and no hemorrhoids have developed, the doctor may numb the area with a local anesthetic and stretch the sphincter muscle with his or her fingers. If the fissure has caused complications, it may require surgery to remove some tissue and loosen the muscle.

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Dyspareunia

What is this Condition?

Genital pain associated with intercourse may be mild, or it may be severe enough to affect enjoyment of intercourse. Painful intercourse is commonly associated with physical problems; less commonly, with psychological disorders. The prognosis is good if the underlying cause can be treated successfully.

What Causes it?

Painful intercourse may result from either physical or psychological causes.

What are its Symptoms?

Painful intercourse produces discomfort, ranging from mild aches to severe pain before, during, or after intercourse. It also may be associated with vaginal itching or burning.

How is it Diagnosed?

A physical exam and lab tests help determine the underlying cause. Diagnosis also depends on a detailed sexual history to elicit physical and temporal factors contributing to the pain.

How is it Treated?

Treatment of physical causes may include creams and water-soluble gels for inadequate lubrication, appropriate medications for infections, excision of scars on the hymen, and gentle stretching of painful vaginal scars. The woman may be advised to change her position during intercourse to reduce pain on deep penetration.

Treatment of psychologically based painful intercourse varies with the particular person. Sensate focus exercises deemphasize intercourse itself and teach appropriate foreplay techniques. Teaching contraception methods can reduce the fear of pregnancy; teaching about sexual activity during pregnancy can relieve fear of harming the fetus.

What is this Condition?

Pseudomembranous enterocolitis is an acute inflammation that damages the tissue of the small and large intestines. It usually affects the mucus coating but may extend into submucosa and, rarely, other layers of the intestine. Marked by severe diarrhea, this rare condition is generally fatal in 1 to 7 days from severe dehydration and from toxicity, peritonitis, or perforation.

What Causes it?

The exact cause of pseudomembranous enterocolitis is unknown, but Clostridium difficile may produce a toxin that may playa role in its development. It typically strikes people weakened by abdominal surgery or those receiving broad-spectrum antibiotics. The infection begins suddenly with lots of watery or bloody diarrhea, abdominal pain, and fever. Serious complications may follow this disorder, including severe dehydration, electrolyte imbalance, hypotension, shock, and perforated colon.

How is it Diagnosed?

The doctor may have difficulty making a diagnosis because onset of enterocolitis is sudden and creates an emergency situation. The doctor needs to know the patient’s history, but uses a rectal biopsy to confirm pseudomembranous enterocolitis. Stool cultures can identify C. difficile.

How is it Treated?

A person who is receiving broad-spectrum antibiotic therapy must immediately stop. The doctor usually prescribes orally administered Flagyl. Oral Vancocin is typically given for severe or resistant cases. A person with mild pseudomembranous enterocolitis may take anion exchange resins, such as Questran, to bind the toxin produced by C. difficile. The person must be protected from dehydration, hypotension, and shock.

Vaginismus

What is this Condition?

Vaginal spasms are involuntary spastic constrictions of the lower vaginal muscles, usually caused by fear of vaginal penetration. It may coexist with painful intercourse and, if severe, may prevent successful intercourse. The condition affects women of all ages and back­grounds. The prognosis is excellent for a motivated woman who doesn’t have untreatable physical abnormalities.

What Causes it?

Vaginal spasms may be physical or psychological in origin. They may occur spontaneously as a protective reflex to pain, or they may result from organic causes, such as hymen abnormalities, genital herpes, obstetric injury, and atrophic vaginitis.

Psychological causes may include:

• childhood and adolescent exposure to rigid, punitive, and guilt­ridden attitudes toward sex

• fears resulting from painful or traumatic sexual experiences, such as incest or rape

• early traumatic experience with pelvic exams

• fear of pregnancy, venereal disease, or cancer.

What are its Symptoms?

The woman with this disorder typically experiences muscle spasms with pain when any object-such as a tampon, diaphragm, or speculum-is inserted into her vagina. She may express a lack of interest in sex or have a normal level of sexual desire.

How is it Diagnosed?

Diagnosis requires a sexual history and pelvic exam to rule out physical disorders. The sexual history includes early childhood experiences and family attitudes toward sex, previous and current sexual responses, contraceptive practices and reproductive goals, the woman’s feelings about her sexual partner, and specific details about the pain she feels on insertion of any object into the vagina.

A carefully performed pelvic exam confirms the diagnosis by showing involuntary constriction of the muscles surrounding the outer portion of the vagina.

How is it Treated?

Treatment is designed to eliminate abnormal muscle constriction and underlying psychological problems. In Masters and Johnson therapy, the woman inserts a graduated series of dilators into her vagina while tensing and relaxing her pelvic muscles. She controls the time the dilator is left in place and dilator movement. Together with her sexual partner, she begins sensate focus and counseling therapy to increase sexual responsiveness, improve communication skills, and resolve any underlying conflicts.