Symptoms of Back Problem- Back Pain

Various back Problem or back pain produce nearly similar types of symptoms. Pain in the lower part of the back or one of the leg is the main complaint. Variations in the onset of pain may occur. Sometimes , the pain mild and may even disappear quickly. but it soon appears either as persistent back pain or pain radiating to the leg. The type and severity of the back pain depends on the condition that is causing the back pain. Pain from injury to the muscles or ligaments of the back is usually confined to the back, and depending on the cause may or may not be aggrevated bybending the back. The variations that can coour in lower back pain can be:

• Pain radiates from the lower back down to the legs.
• Pain in the lower back occurs while bending or twisting.
• Severe lower back pain that causes discomfort in any position whether standing, sitting or lying down.

Other symptoms that may occur in back pain or back problem are muscle spasms and loss of control over bowel or bladder so that the patient is unable to hold the stool or urine.
In disc herniation or disc prolapse, when a person bends down to pick up an object he feels a sudden sharp pain in the back and gets stuck in bending position. He is unable to change his position or posture and has to be carried to the bed.

A doctor needs to be consulted if any of the following symptoms occur:

• Back pain significant and persist beyond a week.
• There is an associated,unexplained fever.
• There is redness or swelling on the back or spine.
• The pain travels down the legs below the knee (which suggests pressure on the nerves as they leave the spinal cord)
• The back pain is the result of a severe blow or fall.
• The back pain is caused by an injury received at work.
• There is weakness or numbness in one of the legs.
• Pain that continues to interrupt sleep for more than three nights.
• Bowel or bladder incontinence with lower back pain is serious- the doctor should b consulted immediately.
  

Cause of Back Pain

There are many cause of back pain. Anything that puts pressure on the back muscle or nerves can cause pain. Any illness or damage to the spine also can cause back pain. Back pain is often related to long-term problems of posture,lifting techniques and repetitive motions. These things would be the cause of back pain.In fact , about 85 per cent of back pains are caused by simple irritation of the back muscles. This irritation can be caused by irritation of the nerves controlling the muscles or fatigue or mechanical displacement or poor biochemical functioning of the back muscles and ligaments, resulting in chronic stress and strain. The discs are unaffected.

When posture is poor and the back is unsupported , weight load increases on the spine. If the person is overweight , excess weight in addition to poor posture increases the stress and strain on the spine makes the back more vulnerable to injury. It may cause of Back Pain.The spine can not maintain its natural curves when compensating for this type of posture. The result in increased stress on the supporting structures leading to chronic wear and tear of the muscles and ligaments. Another common cause of back pain is pot belly. A pot-bellied person has weak abdominal muscles. Weak abdominal muscles often mean weak back muscles, too.

Back Pain and Lower Back Pain

Spine is designed to carry the body’s weight and distribute the loads encountered during rest and activity. When a person is overweight his spine is forced to bear the burden. This may lead to structural compromise and damage the spine and surrounding to structural compromise and damage the spine and structures and contribute to the development of osteoporosis, Osteoarthritis(OA), Degenerative Disc Disease(DDD), Spinal Stenosis, and Spondylolisthesis.

Lower Back Pain:

Lower back pain is most vulnerable to the effects of obesity. Obesity coupled with lack of exercise leads to poor flexibility and weak muscles in the back, pelvis , and thighs. This can increase the curve of the lower back , causing the pelvis to tilt too far forward. Poor posture contributes to back pain. Obesity may aggravate an existing lower back problem and contributes to recurrence of the condition. Therefore , if you are overweight or obese , chances are you have, or will have , back pain.

Ayurveda- Ayurvedic View

Ayurveda has got something more than the above the general information about pulse. According to Ayurveda , every cell in our body sendn its own unique signal to the heart via different vital organs, and the blood stream. These Pranic currents of energy are then compressed into rhythmic pulsation, which can be decoded to reveal what is going on in going on in the liver or the kidneys, the left ventricle of the right fallopian tube. Ayurveda is really cheap and more powerful than other treatment. The first Ayurvda - Ayurvedic classic to describe pulse examination is Saarangadhara Samhita.

The term naadi literally means "a tube or channel through which something flows " Pulse examination is the examination of the arterail pulse ar certain points on the body. The early hours of the morning are the best time for pulse examination. It can be misleading or incorrect if done after the patient as taken food, exercise or bath, after taking intoxicants, having sex, sleep or when afficted with hunger, thirst,anger,grief or worry. When an Ayurveda - Ayurvedic phisician touches your wrist, he probes deep into your general state of health, ill health and even the bad prognosis. As the strings of a Veena bring out all the raagas , So does the naadi . Naadi Spandana is caused by heartbeats and the consequent movement of rasa (comparable plasma) and rakta(comparable to blood).

Ayurveda- Ayurvedic concept of health & Disease

Ayurveda is the science of life or longevity, which helps in the promotion of health , prevention of diseases and in achieving a long life. The basic philosophy of Ayurveda is based on the Panchamahabhoota (five elements) theory. This theory states that the universe as well as the human body is made up of five elements, namely air(vayu) , space(akash), Earth(prithvi), Fire(agni) and water(jal). According to Ayurveda these elements combine to form controlling forces or biological humours called Dosha. These dosha are , responsible for sustaining the living body is its normal state are of 3 types . Vaata, Pitta and kapha.

These Controlling forcrs or the doshas act on the tissues of the body known as the Datus and help in the various physiological functions. Now a days Ayurveda has its own status. The waste products formed as a result of varios bodily functons are Malas, which are end products of body.

Sexually Transmitted Diseases- STDs

Sexually transmitted diseases (STDs) are among the most common infectious diseases in the United States today. More than 20 different STDs have been identified, and 13 million men and women are infected each year in the United States. Depending on the disease, the infection can be spread through any type of sexual activity involving the sex organs or the mouth; the infection can also be spread through contact with blood during sexual activity.Depending on the disease, STDs can be spread with any type of sexual activity. STDs are most often caused by viruses and bacteria.Common STDs have a variety of symptoms (if symptoms develop at all) and many different complications, including death.

• Most common of all STDs caused by bacteria
  
  
• No symptoms in 80% of women and 50% of men
  
  
• Discharge from the vagina or the penis, burning or pain during urination
  
  
• Transmitted through vaginal, oral, or anal sexual contact
  
  
• Ectopic pregnancy and infertility for women most serious complications
  
  
• Treatable with antibiotics
  

• Genital herpes: One type of herpes typically causes cold sores in the mouth, and another type causes genital sores; however, each type can cause either type of infection.
  
  

  • Recurring outbreaks of blisterlike sores on the genitals

  • Can be transmitted from a mother to her baby during birth

  • Reduction in frequency and severity of blister outbreaks with treatment but not complete elimination of infection.
  
  
• Hepatitis (A, B, C, D)
  
  
  • Hepatitis B most often associated with sexual contact
    
    
  • Yellowish skin and eyes, fever, achy, tired, might feel like the flu
    
    
  • Severe complications, including cirrhosis and liver cancer
    
    
  • No cure available, remission possible with some aggressive medications
    
    
  • Immunizations available to prevent hepatitis A and B

• Gonorrhea
  
  
  • Discharge from the vagina or the penis
    
    
  • Painful urination
    
    
  • Ectopic pregnancy and infertility for women most serious complications
    
    
  • Treatable with antibiotics

• Syphilis
  
  
  • Mild symptoms, often goes undetected initially
    
    
  • Starts with painless genital ulcer that goes away on its own
    
    
  • Rash, fever, headache, achy joints
    
    
  • Treatable with antibiotics
    
    
  • More serious complications associated with later stages of disease if undetected and untreated

• Chancroid
  
  
  • Not common in the United States
    
    
  • Causes painful ulcers on the genitals
    
    
  • Can be confused with syphilis or herpes
    
    
  • Treatable with antibiotics

• HIV/AIDS
  
  
  • Spread primarily by sexual contact and from sharing IV needles
    
    
  • Can be transmitted at the time a person becomes infected with other STDs
    
    
  • Fatigue, night sweats, chills or fever lasting several weeks, headaches, cough
    
    
  • No current cure and generally fatal, with death usually occurring after 2-3 years; medication available to slow disease progression

• Genital warts
  
  
  • Caused by a virus related to skin warts
    
    
  • Small, painless bumps in the genital or anal areas (sometimes in clusters that look like cauliflower)
    
    
  • Various treatments available (for example, freezing or painting the warts with medication)

• Pubic lice
  
  
  • Very tiny insects living in pubic hair
    
    
  • Can be picked up from clothing or bedding
    
    
  • First notice itching in the pubic area
    
    
  • Treatable with creams, anti-lice agents, and combing

• Scabies
  
  
  • Skin infection caused by a tiny mite
    
    
  • Highly contagious
    
    
  • Spread primarily by sexual contact or from contact with skin, infested sheets, towels, or furniture
    
    
  • Treatment with creams

Parkinson's disease Treatment and Medicines

Parkinson's disease is a chronic disorder that requires broad-based management including patient and family education, support group services, general wellness maintenance, exercise, and nutrition. At present, there is no cure for PD, but medications or surgery can provide relief from the symptoms.

Levodopa

Stalevo for treatment of Parkinson's disease

The most widely used form of treatment is L-dopa in various forms. L-dopa is transformed into dopamine in the dopaminergic neurons by L-aromatic amino acid decarboxylase (often known by its former name dopa-decarboxylase). However, only 1-5% of L-DOPA enters the dopaminergic neurons. The remaining L-DOPA is often metabolised to dopamine elsewhere, causing a wide variety of side effects. Due to feedback inhibition, L-dopa results in a reduction in the endogenous formation of L-dopa, and so eventually becomes counterproductive.

Carbidopa and benserazide are dopa decarboxylase inhibitors. They help to prevent the metabolism of L-dopa before it reaches the dopaminergic neurons and are generally given as combination preparations of carbidopa/levodopa (co-careldopa) (e.g. Sinemet, Parcopa) and benserazide/levodopa (co-beneldopa) (e.g. Madopar). There are also controlled release versions of Sinemet and Madopar that spread out the effect of the L-dopa. Duodopa is a combination of levodopa and carbidopa, dispersed as a viscous gel. Using a patient-operated portable pump, the drug is continuously delivered via a tube directly into the upper small intestine, where it is rapidly absorbed.

Tolcapone inhibits the COMT enzyme, thereby prolonging the effects of L-dopa, and so has been used to complement L-dopa. However, due to its possible side effects such as liver failure, it's limited in its availability.

A similar drug, entacapone, has similar efficacy and has not been shown to cause significant alterations of liver function. A recent follow-up study by Cilia and colleagueslooked at the clinical effects of long-term administration of entacapone, on motor performance and pharmacological compensation, in advanced PD patients with motor fluctuations: 47 patients with advanced PD and motor fluctuations were followed for six years from the first prescription of entacapone and showed a stabilization of motor conditions, reflecting entacapone can maintain adequate inhibition of COMT over time.

Dopamine agonists

The dopamine-agonists bromocriptine, pergolide, pramipexole, ropinirole , cabergoline, apomorphine, and lisuride, are moderately effective. These have their own side effects including those listed above in addition to somnolence, hallucinations and /or insomnia. Several forms of dopamine agonism have been linked with a markedly increased risk of problem gambling. Dopamine agonists initially act by stimulating some of the dopamine receptors. However, they cause the dopamine receptors to become progressively less sensitive, thereby eventually increasing the symptoms.

Dopamine agonists can be useful for patients experiencing on-off fluctuations and dyskinesias as a result of high doses of L-dopa. Apomorphine can be administered via subcutaneous injection using a small pump which is carried by the patient. A low dose is automatically administered throughout the day, reducing the fluctuations of motor symptoms by providing a steady dose of dopaminergic stimulation. After an initial "apomorphine challenge" in hospital to test its effectiveness and brief patient and caregiver, the primary caregiver (often a spouse or partner) takes over maintenance of the pump. The injection site must be changed daily and rotated around the body to avoid the formation of nodules. Apomorphine is also available in a more acute dose as an autoinjector pen for emergency doses such as after a fall or first thing in the morning.

MAO-B inhibitors

Selegiline and rasagiline reduce the symptoms by inhibiting monoamine oxidase-B (MAO-B), which inhibits the breakdown of dopamine secreted by the dopaminergic neurons. Metabolites of selegiline include L-amphetamine and L-methamphetamine (not to be confused with the more notorious and potent dextrorotary isomers). This might result in side effects such as insomnia. Use of L-dopa in conjunction with selegiline has increased mortality rates that have not been effectively explained. Another side effect of the combination can be stomatitis. One report raised concern about increased mortality when MAO-B inhibitors were combined with L-dopa; however subsequent studies have not confirmed this finding. Unlike other non selective monoamine oxidase inhibitors, tyramine-containing foods do not cause a hypertensive crisis.

Speech therapies

The most widely practiced treatment for the speech disorders associated with Parkinson's disease is Lee Silverman Voice Treatment (LSVT). LSVT focuses on increasing vocal loudness.

A study found that an electronic device providing frequency-shifted auditory feedback (FAF) improved the clarity of Parkinson's patients' speech.

Physical exercise

Regular physical exercise and/or therapy, including in forms such as yoga, tai chi, and dance can be beneficial to the patient for maintaining and improving mobility, flexibility, balance and a range of motion. Physicians and physical therapists often recommend basic exercises, such as bringing the toes up with every step, carrying a bag with weight to decrease the bend having on one side, and practicing chewing hard and move the food around the mouth.

Surgery and deep brain stimulation

Illustration showing an electrode placed deep seated in the brain

Treating Parkinson's disease with surgery was once a common practice, but after the discovery of levodopa, surgery was restricted to only a few cases. Studies in the past few decades have led to great improvements in surgical techniques, and surgery is again being used in people with advanced PD for whom drug therapy is no longer sufficient.

Deep brain stimulation is presently the most used surgical means of treatment, but other surgical therapies that have shown promise include surgical lesion of the subthalamic nucleus and of the internal segment of the globus pallidus, a procedure known as pallidotomy.

Methods undergoing evaluation

Gene therapy

Currently under investigation is gene therapy. This involves using a harmless virus to shuttle a gene into a part of the brain called the subthalamic nucleus (STN). The gene used leads to the production of an enzyme called glutamic acid decarboxylase (GAD), which catalyses the production of a neurotransmitter called GABA. GABA acts as a direct inhibitor on the overactive cells in the STN.

GDNF infusion involves the infusion of GDNF (glial-derived neurotrophic factor) into the basal ganglia using surgically implanted catheters. Via a series of biochemical reactions, GDNF stimulates the formation of L-dopa. GDNF therapy is still in development.

Implantation of stem cells genetically engineered to produce dopamine or stem cells that transform into dopamine-producing cells has already started being used. These could not constitute cures because they do not address the considerable loss of activity of the dopaminergic neurons. Initial results have been unsatifactory, with patients still retaining their drugs and symptoms.

Neuroprotective treatments

Neuroprotective treatments are at the forefront of PD research, but are still under clinical scrutiny. These agents could protect neurons from cell death induced by disease presence resulting in a slower pregression of disease. Agents currently under investigation as neuroprotective agents include apoptotic drugs (CEP 1347 and CTCT346), lazaroids, bioenergetics, antiglutamatergic agents and dopamine receptors. Clinically evaluated neuroprotective agents are the monoamine oxidase inhibitors selegiline and rasagiline, dopamine agonists, and the complex I mitochondrial fortifier coenzyme Q10.

Neural transplantation

The first prospective randomised double-blind sham-placebo controlled trial of dopamine-producing cell transplants failed to show an improvement in quality of life although some significant clinical improvements were seen in patients below the age of 60. A significant problem was the excess release of dopamine by the transplanted tissue, leading to dystonias. Research in African green monkeys suggests that the use of stem cells might in future provide a similar benefit without inducing dystonias.

Nutrients

Nutrients have been used in clinical studies and are widely used by people with Parkinson's disease in order to partially treat PD or slow down its deterioration. The L-dopa precursor L-tyrosine was shown to relieve an average of 70% of symptoms. Ferrous iron, the essential cofactor for L-dopa biosynthesis was shown to relieve between 10% and 60% of symptoms in 110 out of 110 patients.

More limited efficacy has been obtained with the use of THFA, NADH, and pyridoxine—coenzymes and coenzyme precursors involved in dopamine biosynthesis. Vitamin C and vitamin E in large doses are commonly used by patients in order to theoretically lessen the cell damage that occurs in Parkinson's disease. This is because the enzymes superoxide dismutase and catalase require these vitamins in order to nullify the superoxide anion, a toxin commonly produced in damaged cells. However, in the randomized controlled trial, DATATOP of patients with early PD, no beneficial effect for vitamin E compared to placebo was seen.

Qigong

There have been two studies looking at qigong in Parkinson's disease. In a trial in Bonn, an open-label randomised pilot study in 56 patients found an improvement in motor and non-motor symptoms amongst patients who had undergone one hour of structured Qigong exercise per week in two 8-week blocks. The authors speculate that visualizing the flow of "energy" might act as an internal cue and so help improve movement.

The second study, however, found Qigong to be ineffective in treating Parkinson's disease. In that study, researchers used a randomized cross-over trial to compare aerobic training with Qigong in advanced Parkinson's disease. Two groups of PD patients were assessed, had 20 sessions of either aerobic exercise or qigong, were assessed again, then after a 2 month gap were switched over for another 20 sessions, and finally assessed again. The authors found an improvement in motor ability and cardiorespiratory function following aerobic exercise, but found no benefit following Qigong. The authors also point out that aerobic exercise had no benefit for patients' quality of life.

Botox

Recently, Botox injections are being investigated as a non-FDA approved possible experimental treatment.^{[citation needed]}

Causes of Parkinson's disease

Most people with Parkinson's disease are described as having idiopathic Parkinson's disease (having no specific cause). There are far less common causes of Parkinson's disease including genetic, toxins, head trauma, and drug-induced Parkinson's disease.

Genetic

In recent years, a number of specific genetic mutations causing Parkinson's disease have been discovered, including in certain populations (Contursi, Italy). These account for a small minority of cases of Parkinson's disease. Somebody who has Parkinson's disease is more likely to have relatives that also have Parkinson's disease. However, this does not mean that the disorder has been passed on genetically.

Toxins

One theory holds that the disease may result in many or even most cases from the combination of a genetically determined vulnerability to environmental toxins along with exposure to those toxins. This hypothesis is consistent with the fact that Parkinson's disease is not distributed homogeneously throughout the population: rather, its incidence varies geographically. It would appear that incidence varies by time as well, for although the later stages of untreated PD are distinct and readily recognizable, the disease was not remarked upon until the beginnings of the Industrial Revolution, and not long thereafter become a common observation in clinical practice. The toxins most strongly suspected at present are certain pesticides and transition-series metals such as manganese or iron, especially those that generate reactive oxygen species, and or bind to neuromelanin, as originally suggested by G.C. Cotzias. In the Cancer Prevention Study II Nutrition Cohort, a longitudinal investigation, individuals who were exposed to pesticides had a 70% higher incidence of PD than individuals who were not exposed.

MPTP is used as a model for Parkinson's as it can rapidly induce parkinsonian symptoms in human beings and other animals, of any age. MPTP was notorious for a string of Parkinson's disease cases in California in 1982 when it contaminated the illicit production of the synthetic opiate MPPP. Its toxicity likely comes from generation of reactive oxygen species through tyrosine hydroxylation.

Other toxin-based models employ PCBs, paraquat (a herbicide) in combination with maneb (a fungicide) rotenone (an insecticide), and specific organochlorine pesticides including dieldrin and lindane.Numerous studies have found an increase in PD in persons who consume rural well water; researchers theorize that water consumption is a proxy measure of pesticide exposure. In agreement with this hypothesis are studies which have found a dose-dependent an increase in PD in persons exposed to agricultural chemicals.

Head trauma

Past episodes of head trauma are reported more frequently by sufferers than by others in the population. A methodologically strong recent study found that those who have experienced a head injury are four times more likely to develop Parkinson’s disease than those who have never suffered a head injury. The risk of developing Parkinson’s increases eightfold for patients who have had head trauma requiring hospitalization, and it increases 11-fold for patients who have experienced severe head injury. The authors comment that since head trauma is a rare event, the contribution to PD incidence is slight. They express further concern that their results may be biased by recall, i.e., the PD patients because they reflect upon the causes of their illness, may remember head trauma better than the non-ill control subjects. These limitations were overcome recently by Tanner and colleagues, who found a similar risk of 3.8, with increasing risk associated with more severe injury and hospitalization.

Parkinson's Diagnosis

There are currently no blood or laboratory tests that have been proven to help in diagnosing PD. Therefore the diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. The Unified Parkinson's Disease Rating Scale is the primary clinical tool used to assist in diagnosis and determine severity of PD. Indeed, only 75% of clinical diagnoses of PD are confirmed at autopsy.^[13] Early signs and symptoms of PD may sometimes be dismissed as the effects of normal aging. The physician may need to observe the person for some time until it is apparent that the symptoms are consistently present. Usually doctors look for shuffling of feet and lack of swing in the arms. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases. However, CT and MRI brain scans of people with PD usually appear normal.

Parkinson's Symptoms

Parkinson disease affects movement (motor symptoms). Typical other symptoms include disorders of mood, behavior, thinking, and sensation (non-motor symptoms). Individual patients' symptoms may be quite dissimilar and progression of the disease is also distinctly individual.

Motor symptoms

The cardinal symptoms are:

• tremor: normally 4-7 Hz tremor, maximal when the limb is at rest, and decreased with voluntary movement. It is typically unilateral at onset. This is the most apparent and well-known symptom, though an estimated 30% of patients have little perceptible tremor; these are classified as akinetic-rigid.
• rigidity: stiffness; increased muscle tone. In combination with a resting tremor, this produces a ratchety, "cogwheel" rigidity when the limb is passively moved.
• bradykinesia/akinesia: respectively, slowness or absence of movement. Rapid, repetitive movements produce a dysrhythmic and decremental loss of amplitude. Also "dysdiadokinesia", which is the loss of ability to perform rapid alternating movements
• postural instability: failure of postural reflexes, which leads to impaired balance and falls.

Other motor symptoms include:

• Gait and posture disturbances:
  • Shuffling: gait is characterized by short steps, with feet barely leaving the ground, producing an audible shuffling noise. Small obstacles tend to trip the patient
  • Decreased arm swing: a form of bradykinesia
  • Turning "en bloc": rather than the usual twisting of the neck and trunk and pivoting on the toes, PD patients keep their neck and trunk rigid, requiring multiple small steps to accomplish a turn.
  • Stooped, forward-flexed posture. In severe forms, the head and upper shoulders may be bent at a right angle relative to the trunk (camptocormia) ^[5].
  • Festination: a combination of stooped posture, imbalance, and short steps. It leads to a gait that gets progressively faster and faster, often ending in a fall.
  • Gait freezing: "freezing" is another word for akinesia, the inability to move. Gait freezing is characterized by inability to move the feet, especially in tight, cluttered spaces or when initiating gait.
  • Dystonia (in about 20% of cases): abnormal, sustained, painful twisting muscle contractions, usually affecting the foot and ankle, characterized by toe flexion and foot inversion, interfering with gait. However, dystonia can be quite generalized, involving a majority of skeletal muscles; such episodes are acutely painful and completely disabling.
• Speech and swallowing disturbances
  • Hypophonia: soft speech. Speech quality tends to be soft, hoarse, and monotonous. Some people with Parkinson's disease claim that their tongue is "heavy" or have cluttered speech.^[6].
  • Festinating speech: excessively rapid, soft, poorly-intelligible speech.
  • Drooling: most likely caused by a weak, infrequent swallow and stooped posture.
  • Non-motor causes of speech/language disturbance in both expressive and receptive language: these include decreased verbal fluency and cognitive disturbance especially related to comprehension of emotional content of speech and of facial expression^[7]
  • Dysphagia: impaired ability to swallow. Can lead to aspiration, pneumonia.
• Other motor symptoms:
  • fatigue (up to 50% of cases);
  • masked faces (a mask-like face also known as hypomimia), with infrequent blinking;^[8]
  • difficulty rolling in bed or rising from a seated position;
  • micrographia (small, cramped handwriting);
  • impaired fine motor dexterity and motor coordination;
  • impaired gross motor coordination;
  • Poverty of movement: overall loss of accessory movements, such as decreased arm swing when walking, as well as spontaneous movement.

Non-motor symptoms

Mood disturbances

• Estimated prevalence rates of depression vary widely according to the population sampled and methodology used. Reviews of depression estimate its occurrence in anywhere from 20-80% of cases.^[9] Estimates from community samples tend to find lower rates than from specialist centres. Most studies use self-report questionnaires such as the Beck Depression Inventory, which may overinflate scores due to physical symptoms. Studies using diagnostic interviews by trained psychiatrists also report lower rates of depression.

• More generally, there is an increased risk for any individual with depression to go on to develop Parkinson's disease at a later date.^[10]

• 70% of individuals with Parkinson's disease diagnosed with pre-existing depression go on to develop anxiety. 90% of Parkinson's disease patients with pre-existing anxiety subsequently develop depression; apathy or abulia.

Cognitive disturbances

• slowed reaction time; both voluntary and involuntary motor responses are significantly slowed.
• executive dysfunction, characterized by difficulties in: differential allocation of attention, impulse control, set shifting, prioritizing, evaluating the salience of ambient data, interpreting social cues, and subjective time awareness. This complex is present to some degree in most Parkinson's patients; it may progress to:
• dementia: a later development in approximately 20-40% of all patients, typically starting with slowing of thought and progressing to difficulties with abstract thought, memory, and behavioral regulation. Hallucinations, delusions and paranoia may develop.
• short term memory loss; procedural memory is more impaired than declarative memory. Prompting elicits improved recall.
• medication effects: some of the above cognitive disturbances are improved by dopaminergic medications, while others are actually worsened.^[11]

Sleep disturbances

• Excessive daytime somnolence
• Initial, intermediate, and terminal insomnia
• Disturbances in REM sleep: disturbingly vivid dreams, and REM Sleep Disorder, characterized by acting out of dream content - can occur years prior to diagnosis

Sensation disturbances

• impaired visual contrast sensitivity, spatial reasoning, colour discrimination, convergence insufficiency (characterized by double vision) and oculomotor control
• dizziness and fainting; usually attributable orthostatic hypotension, a failure of the autonomous nervous system to adjust blood pressure in response to changes in body position
• impaired proprioception (the awareness of bodily position in three-dimensional space)
• reduction or loss of sense of smell (microsmia or anosmia) - can occur years prior to diagnosis,
• pain: neuropathic, muscle, joints, and tendons, attributable to tension, dystonia, rigidity, joint stiffness, and injuries associated with attempts at accommodation

Autonomic disturbances

• oily skin and seborrheic dermatitis^[12]
• urinary incontinence, typically in later disease progression
• nocturia (getting up in the night to pass urine) - up to 60% of cases
• constipation and gastric dysmotility that is severe enough to endanger comfort and even health
• altered sexual function: characterized by profound impairment of sexual arousal, behavior, orgasm, and drive is found in mid and late Parkinson disease. Current data addresses male sexual function almost exclusively
• weight loss, which is significant over a period of ten years - 8% of body weight lost compared with 1% in a control group.

Parkinson's disease

Parkinson's disease (also known as Parkinson disease or PD) is a degenerative disorder of the central nervous system that often impairs the sufferer's motor skills and speech.

Parkinson's disease belongs to a group of conditions called movement disorders. It is characterized by muscle rigidity, tremor, a slowing of physical movement (bradykinesia) and, in extreme cases, a loss of physical movement (akinesia). The primary symptoms are the results of decreased stimulation of the motor cortex by the basal ganglia, normally caused by the insufficient formation and action of dopamine, which is produced in the dopaminergic neurons of the brain. Secondary symptoms may include high level cognitive dysfunction and subtle language problems. PD is both chronic and progressive.

PD is the most common cause of parkinsonism, a group of similar symptoms. PD is also called "primary parkinsonism" or "idiopathic PD" (having no known cause). While most forms of parkinsonism are idiopathic, there are some cases where the symptoms may result from toxicity, drugs, genetic mutation, head trauma, or other medical disorders.

Bone diseases- Bone disease treatment-Bone cancer images

Bone diseases are now a days not only a serious matter but also a serious matter. There are many kind of bone diseases are there. Many of bone diseases are not chronic. But some of them are very chronic. some bone diseases are life threatening. But most diseases are curable. Now a days people think that many dieases are not curable. Effective treatment are there near by you. Many bone disease are curable in days. People dont know the importants of many treatments. Bone disease can be affect any parts of body. Even it in ribs, wrist or knee nothing to worry. Even bone cancer also can be treated. There are many reasons for a bone disease.

1. Osteoporosis makes bone weak and easy to break

2. Osteogenesis inperfecta makes your bone brittle

3. Bone also causes cancer

Cancer that begins is the bone is called primary bone cancer. It is found most often in the arms and legs, but it can occur in any bone in the body. Children and young people are more likely than adults to have bone cancer.

Rare diseases and Medicines

A rare disease is usualy can be seen in very rare in population.Rare diseases are usually chronic and life-threatening. This is so because, given its rarity, less severe illness are just not identified as such. Eurordis estimates that at least 80% of them have identified genetic origins. Other rare diseases are the result of infections and allergies or due to degenerative and proliferative causes. Symptoms of some rare diseases may appear at birth or in childhood, whereas others only appear once adulthood is reached.

Aids Virus

Human immunodeficiency virus (HIV) is a retrovirus that can lead to acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). Previous names for the virus include human

Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unprotected sexual intercourse, contaminated needles, and transmission from an infected mother to her baby at birth, or through breast milk. Screening of blood products for HIV in the developed world has largely eliminated transmission through blood transfusions or infected blood products in these countries.

HIV infection in humans is now pandemic. As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics in recorded history. In 2005 alone, AIDS claimed an estimated 2.4–3.3 million lives, of which more than 570,000 were children. It is estimated that about 0.6% of the world's living population is infected with HIV. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty. According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries.

HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells), macrophages and dendritic cells. HIV infection leads to low levels of CD4+ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4+ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections. If untreated, eventually most HIV-infected individuals develop AIDS (Acquired Immunodeficiency Syndrome) and die; however about one in ten remains healthy for many years, with no noticeable symptoms.Treatment with anti-retrovirals, where available, increases the life expectancy of people infected with HIV.

Aids-Mother-to-child transmission

HIV can be transmitted from a mother to her baby during pregnancy, labour and delivery, and later through breastfeeding. The first step towards reducing the number of babies infected in this way is to prevent HIV infection in women, and to prevent unwanted pregnancies.

There are a number of things that can be done to help a pregnant woman with HIV to avoid passing her infection to her child. A course of antiretroviral drugs given to her during pregnancy and labour as well as to her newborn baby can greatly reduce the chances of the child becoming infected. Although the most effective treatment involves a combination of drugs taken over a long period, even a single dose of treatment can cut the transmission rate by half.

A caesarean section is an operation to deliver a baby through its mother’s abdominal wall, which reduces the baby’s exposure to its mother’s body fluids. This procedure lowers the risk of HIV transmission, but is likely to be recommended only if the mother has a high level of HIV in her blood, and if the benefit to her baby outweighs the risk of the intervention.

Weighing risks against benefits is also critical when selecting the best feeding option. The World Health Organisation advises mothers with HIV not to breastfeed whenever the use of replacements is acceptable, feasible, affordable, sustainable and safe. However, if safe water is not available then the risk of life-threatening conditions from replacement feeding may be greater than the risk from breastfeeding. An HIV positive mother should be counselled on the risks and benefits of different infant feeding options and should be helped to select the most suitable option for her situation.

What are the obstacles?
In much of the world a lack of drugs and medical facilities limits what can be done to prevent mother-to-child transmission of HIV. Antiretroviral drugs are not widely available in many resource-poor countries, caesarean section is often impractical, and many women lack the resources needed to avoid breastfeeding their babies.

HIV-related stigma is another obstacle to preventing mother-to-child transmission. Some women are afraid to attend clinics that distribute antiretroviral drugs, or to feed their babies on formula, in case by doing so they reveal their HIV status.

Aids-Transmission through blood

People who share equipment to inject recreational drugs risk becoming infected with HIV from other drug users. Methadone maintenance and other drug treatment programmes are effective ways to help people eliminate this risk by giving up injected drugs altogether. However, there will always be some injecting drug users who are unwilling or unable to end their habit, and these people should be encouraged to minimise the risk of infection by not sharing equipment.

Needle exchange programmes have been shown to reduce the number of new HIV infections without encouraging drug use. These programmes distribute clean needles and safely dispose of used ones, and also offer related services such as referrals to drug treatment centres and HIV counselling and testing. Needle exchanges are a necessary part of HIV prevention in any community that contains injecting drug users.

Also important for injecting drug users are community outreach, small group counselling and other activities that encourage safer behaviour and access to available prevention options.

Transfusion of infected blood or blood products is the most efficient of all ways to transmit HIV. However, the chances of this happening can be greatly reduced by screening all blood supplies for the virus, and by heat-treating blood products where possible. In addition, because screening is not quite 100% accurate, it is sensible to place some restrictions on who is eligible to donate, provided that these are justified by epidemiological evidence, and don’t unnecessarily limit supply or fuel prejudice. Reducing the number of unnecessary transfusions also helps to minimise risk.

The safety of medical procedures and other activities that involve contact with blood, such as tattooing and circumcision, can be improved by routinely sterilising equipment. An even better option is to dispose of equipment after each use, and this is highly recommended if at all possible.

Health care workers themselves run a risk of HIV infection through contact with infected blood. The most effective way for staff to limit this risk is to practise universal precautions, which means acting as though every patient is potentially infected. Universal precautions include washing hands and using protective barriers for direct contact with blood and other body fluids.

What are the obstacles?
Despite the evidence that they do not encourage drug use, some authorities still refuse to support needle exchanges and other programmes to help injecting drug users. Restrictions on pharmacies selling syringes without prescriptions, and on possession of drug paraphernalia, can also hamper HIV prevention programmes by making it harder for drug users to avoid sharing equipment.

Many resource-poor countries lack facilities for rigorously screening blood supplies. In addition a lot of countries have difficulty recruiting enough donors, and so have to resort to importing blood or paying their citizens to donate, which is not the best way to ensure safety.

In much of the world the safety of medical procedures in general is compromised by lack of resources, and this may put both patients and staff at greater risk of HIV infection.

Aids-Sexual transmission

Someone can eliminate or reduce their risk of becoming infected with HIV during sex by choosing to:

Abstain from sex or delay first sex
Be faithful to one partner or have fewer partners
Condomise, which means using male or female condoms consistently and correctly
There are a number of effective ways to encourage people to adopt safer sexual behaviour, including media campaigns, social marketing, peer education and small group counselling. These activities should be carefully tailored to the needs and circumstances of the people they intend to help. Specific programmes should target key groups such as young people, women, men who have sex with men, injecting drug users and sex workers.4 56

Comprehensive sex education for young people is an essential part of HIV prevention. This should include training in life skills such as negotiating healthy sexual relationships, as well as accurate and explicit information about how to practise safer sex. Studies have shown that this kind of comprehensive sex education is more effective at preventing sexually transmitted infections than education that focuses solely on teaching abstinence until marriage.

Numerous studies have shown that condoms, if used consistently and correctly, are highly effective at preventing HIV infection. Also there is no evidence that promoting condoms leads to increased sexual activity among young people. Therefore condoms should be made readily and consistently available to all those who need them.

There is now very strong evidence that male circumcision reduces the risk of HIV transmission from woman to man by around 50%, which is enough to justify its promotion as an HIV prevention measure in some high-prevalence areas. It is not known whether circumcision also affects the likelihood of male-to-female or male-to-male sexual transmission; further research on this issue is ongoing.11

Another significant intervention is providing treatment for sexually transmitted infections, such as chlamydia and gonorrhoea. This is because such infections, if left untreated, have been found to facilitate HIV transmission during sex.

One group that shouldn’t be overlooked by HIV prevention programmes is those who are already living with the virus. Regular counselling can help HIV positive people to sustain safer sexual behaviour, and so avoid onward transmission.

What are the obstacles?
It is usually not easy for people to sustain changes in sexual behaviour. In particular, young people often have difficulty remaining abstinent, and women in male-dominated societies are frequently unable to negotiate condom use, let alone abstinence. Many couples are compelled to have unprotected sex in order to have children.

Some societies find it difficult to discuss sex openly, and some authorities restrict what subjects can be discussed in the classroom, or in public information campaigns, for moral or religious reasons. Particularly contentious issues include premarital sex, condom use and homosexuality, the last of which is illegal or taboo in much of the world. Marginalisation of groups at high risk, such as sex workers and men who have sex with men, can be another hindrance to HIV prevention efforts.

Safe male circumcision demands considerable medical resources; some cultures are strongly opposed to the procedure.

Aids Prevention- First requirements

There are three key things that can be done to help prevent all forms of HIV transmission. First among these is promoting widespread awareness of HIV and how it can be spread. Media campaigns and education in schools are among the best ways to do this.

Another essential part of a prevention programme is HIV counselling and testing. People living with HIV are less likely to transmit the virus to others if they know they are infected and if they have received counselling about safer behaviour. In particular, a pregnant woman who has HIV will not be able to benefit from interventions to protect her child unless her infection is diagnosed. Those who discover they are uninfected can also benefit, by receiving counselling about how to remain that way.1 2

The third key factor is providing antiretroviral treatment. This treatment enables people living with HIV to enjoy longer, healthier lives, and as such it acts as an incentive for people to volunteer for HIV testing. It also brings people into contact with health care workers who can deliver prevention messages and interventions. However, it is important that people understand the limitations of the treatment, and that reduced fear of HIV doesn’t lead to more risky behaviour

Aids Prevention

HIV can be transmitted in three main ways:

Sexual transmission
Transmission through blood
Mother-to-child transmission

Wherever there is HIV, all three routes of transmission will take place. However the number of infections resulting from each route will vary greatly between countries and population groups.

For each route of transmission there are things that an individual can do to reduce or eliminate risk. There are also interventions that have been proven to work at the community, local and national level.

To be successful, an HIV prevention programme must make use of all approaches known to be effective, rather than just implementing one or a few select actions in isolation.

Although most of this page looks separately at each transmission route, it should be remembered that many people don’t fit into only one “risk category”. For example, injecting drug users need access to condoms and safer sex counselling as well as help to reduce the risk of transmission through blood.

HIV aids Info

AIDS is the most severe acceleration of infection with HIV. HIV is a retrovirus that primarily infects vital organs of the human immune system such as CD4+ T cells (a subset of T cells), macrophages and dendritic cells. It directly and indirectly destroys CD4+ T cells. CD4+ T cells are required for the proper functioning of the immune system. When HIV kills CD4+ T cells so that there are fewer than 200 CD4+ T cells per microliter (µL) of blood, cellular immunity is lost, leading to the condition known as AIDS. Acute HIV infection progresses over time to clinical latent HIV infection and then to early symptomatic HIV infection and later to AIDS, which is identified on the basis of the amount of CD4+ T cells in the blood and the presence of certain infections.

Liver disease

The various functions of the liver are carried out by the liver cells or hepatocytes.

The liver produces and excretes bile (a greenish liquid) required for emulsifying fats. Some of the bile drains directly into the duodenum, and some is stored in the gallbladder.
The liver performs several roles in carbohydrate metabolism:
Gluconeogenesis (the synthesis of glucose from certain amino acids, lactate or glycerol)
Glycogenolysis (the breakdown of glycogen into glucose) (muscle tissues can also do this)
Glycogenesis (the formation of glycogen from glucose)
The breakdown of insulin and other hormones
The liver is responsible for the mainstay of protein metabolism.
The liver also performs several roles in lipid metabolism:
Cholesterol synthesis
The production of triglycerides (fats).
The liver produces coagulation factors I (fibrinogen), II (prothrombin), V, VII, IX, X and XI, as well as protein C, protein S and antithrombin.
The liver breaks down hemoglobin, creating metabolites that are added to bile as pigment (bilirubin and biliverdin).
The liver breaks down toxic substances and most medicinal products in a process called drug metabolism. This sometimes results in toxication, when the metabolite is more toxic than its precursor.
The liver converts ammonia to urea.
The liver stores a multitude of substances, including glucose in the form of glycogen, vitamin B12, iron, and copper.
In the first trimester fetus, the liver is the main site of red blood cell production. By the 32nd week of gestation, the bone marrow has almost completely taken over that task.
The liver is responsible for immunological effects- the reticuloendothelial system of the liver contains many immunologically active cells, acting as a 'sieve' for antigens carried to it via the portal system.
Currently, there is no artificial organ or device capable of emulating all the functions of the liver. Some functions can be emulated by liver dialysis, an experimental treatment for liver failure.

Liver

The liver is an organ present in vertebrates and some other animals. It plays a major role in metabolism and has a number of functions in the body, including glycogen storage, plasma protein synthesis, and detoxification. This organ also is the largest gland in the human body. It lies below the diaphragm in the thoracic region of the abdomen. It produces bile, an alkaline compound which aids in digestion, via the emulsification of lipids. It also performs and regulates a wide variety of high-volume biochemical reactions requiring specialized tissues.

Hemorrhoid

Hemorrhoids (AmE), haemorrhoids (BrE), emerods, or piles) are varicosities or swelling and inflammation of veins in the rectum and anus.

Disease

A disease is an abnormal condition of an organism that impairs bodily functions. In human beings, "disease" is often used more broadly to refer to any condition that causes discomfort, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person. In this broader sense, it sometimes includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, and atypical variations of structure and function, while in other contexts and for other purposes these may be considered distinguishable categories. This article primarily describes human diseases, one of man's greatest enemies.
While many diseases are biological processes with observable alterations of organ function or structure, others primarily involve alterations of behavior.