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Anemia


 Definition

Anemia is the reduction in the number of red blood cells and the reduction of quantity of hemoglobin in the blood. In other cases anemia is said to be the decrease in ability of binding oxygen for haemoglobin molecule due to deformity or lack of development as in other types of haemoglobin deficiency. There are several kinds of Anemia. Anemia is classified in different ways. It is classified based on the morphology of red blood cells, the underlying etiologic mechanisms and the discernible clinical spectra. The three main categories of Anemia are excessive loss of blood which is an acute Anemia like hemorrhage. Another class is the excessive destruction of blood cell that is hemolysis. The last category is deficient in production of red blood cells. Anemia can be classified as either acute or chronic. Chronic Anemia occurs for a long period while the acute Anemia occurs quickly. The origin of Anemia can be classified as either nutritional or non nutritional. The Anemia that has nutritional origin is said to occur due to lack of some foods mainly iron. It can also result from lack of vitamins like C and enzymes. Non nutritional Anemia result due to lack of enough red blood cells or an increase in destruction of red blood cells (Goljan, 2004)


 Etymology

The word anemia was coined in 1800 to mean a want of blood. It originates from a Greek word anaimia (Goljan, 2004)


 Signs and symptoms

Anemia is not easily detected in most people. The signs and symptoms of Anemia vary from one person to another. The symptoms can be minor or major. The signs and symptoms of Anemia can be as a result of the Anemia or another cause. People suffering from Anemia show the following symptoms weakness, fatigue and uncomfortness. Others have poor concentration. Another symptom is shortness of breath this is as a result of increased cardiac output to compensate for lack of oxygen. Patients having heart diseases show symptoms like angina. Pain in the legs is also another symptom. There are other signs that are shown after a medical examination. This includes pale skin and mucosal lining. There other symptoms that occur as a result of cause of Anemia. In acute Anemia the signs include dynamic circulation. This is includes increased heart beat, flow murmurs and enlargement of the cardiac and heart failure. Less common symptoms include swelling of legs or arms, chronic heartburns. The patient can vomit; have increased sweating and blood in the stool (Goljan, 2004)


Biomedical treatment for anemia

The treatment for Anemia varies from one person to another depending on the type of Anemia and the category. If the Anemia is mild and it has no symptoms or the symptoms are minimal then the doctor should carry out investigations and treat the patient. If the Anemia is a result of sudden loss of blood due to an injury or bleeding as a result of stomach ulcers then transfusion of red blood cells is necessary to relieve the symptoms and to replace the lost blood. The treatment for Anemia can also be administered according to the type of Anemia. For example Anemia that is as result of deficiency in irony can be treated with iron supplements that are taken according to the doctor’s instruction. This treatment is carried out for a period. If iron deficiency is caused by loss of blood then the cause should be established and corrected either through surgery or any normal method. Other Anemia types are treated through use of intramuscular injections like Pernicious Anemia is treated using intramuscular injection of B-12 since this Anemia is caused by the deficiency of vitamin B-12.It is treated for several weeks after being diagnosed.


The treatment can also be carried out for a longer period like a year. Folic acid Anemia is treated by taking folic acid supplements daily and one in a day. Anemia that is occurs due to inheritance like hereditary hemolytic Anemia is treated by first eliminating infection the patient has and also by avoiding medications that strain the immunity system of the patient. This is because the medicine used attacks the red blood cells. The person can also be given blood transfusion regularly. Sick cell Anemia can be treated by giving the patient oxygen, fluids that are given orally or through injections and painkillers to reduce the pain and prevent complications. Blood transfusion can also be used for the patients having sickle cell Anemia if the Anemia becomes severe. The patients can also be given a bone marrow transplant. Other treatments are based on the cause of Anemia. For example if the bone marrow has stopped working because of leukemia then the doctors can use chemography to treat the patient. Surgical treatment can be used if the cause of the Anemia needs to be removed. For example if the cause of Anemia is colon cancer or uterine cancer then the doctors can use surgical treatment to remove the parts (Goljan, 2004)


 Nutraceutical treatment

There are two supplements used to treat iron. Lack of Vitamin B12 can lead to pernicious anemia. Vitamin B12 supplements are used to treat pernicious anemia. There are various food that contain vitamin B12.Patients with pernicious Anemia should be advised to eat meat ,eggs and dairy products as this food are rich in vitamin B12.Folic Acid is also another supplement that can be used to prevent Anemia. Folic acid is a form of vitamin that is found in foods and it useful in building and maintaining of new cells. Sources of folic acid include green vegetables and fruits. Vitamin C is also important as it helps the body in absorbing iron. Sources of vitamin C are fruits and vegetables. (Goljan, 2004)


IBS

Definition

Irritable bowel syndrome (IBS) is a bowel disorder that is shown by chronic abdominal pain, discomfort, excess gas and the changes in bowel habits. The symptoms above may be relieved by bowel movement. This disease is also predominated by Diarrhea and constipation. This two can alternate. IBS can occur after an infection or it can result from stress. IBS is classified as either diarrhea predominant (IBS-D), constipation predominant (IBS-C).It is also classified as IBS that has alternating stool pattern (IBS-A).In some patients IBS may be acute and it result from an infectious diseases that is involves fever, vomiting or diarrhea. The disease has no specific stages of development but the stages depend on the symptoms. In early stages the symptoms are not clearly evidenced but as the disease progresses the symptoms become common. The origin of IBS depends on many factors. It can originate from neurological dysfunction, stress and sensitivity to foods. The symptoms of IBS are related to sensitivity, intestinal motility and stress. Genetic factors also have an impact on the pain in IBS. Food substances can also lead to IBS symptoms like excess gas and poor digestion. These foods include wheat and Milk. This is because the patient’s body cannot tolerate the food substances. The inflammatory conditions in the intestines can also cause hypersensitivity. Psychological factors also play a great role in IBS. This is because of stressful conditions that result to IBS (Goljan, 2004)


 Etymology

IBS is a termed that is used today for a condition that was referring to as colitis, mucous colitis and functional bowel. (Goljan, 2004)


 Signs and Symptoms

The symptoms for IBS may vary from one person to another and they are similar to symptoms of most diseases. The main symptoms of IBS are abdominal pain or discomfort that is accompanied by regularly diarrhea and constipation and also changes in bowel movements. Other signs include urgency for bowel movement, incomplete evacuation. Bloating is also another sign of IBS. People suffering from IBS may have excess gas that causes discomfort (Goljan, 2004)


 A Rome ii diagnostic criterion is used to diagnose IBS. The doctor depends on various procedures and laboratory tests to diagnose IBS. It is used to diagnose the patient for IBS after carefully examining the patient’s medical records and physical abdominal examination. IBS can be diagnosed after at least 12 weeks after a patient has had abdominal discomfort or pain and the abdominal pain is associated with the following factors change in frequency of stool and change in form. The symptoms that can be used in diagnosis of IBS are abnormal stool frequency that exceds three bowel movement per day or less than three bowel movement per week. Another useful symptom is abnormal stool form and abnormal stool passage and excess gas. These symptoms are carefully assessed so as to diagnose IBS in patients (Goljan, 2004)


Biomedical treatment

Medication used in treatment of IBS includes stool softeners and laxatives that are used in treatment of constipation predominant IBS. The patients can also be given antidiarrheals to treat diarrhea predominant IBS if it has mild symptoms. Drugs that can heal serotonin in the intestine can also be used to reduce the symptoms. Serotonin arouses the gut motility and so they can be used in treatment of constipation predominate irritable bowel while antagonists can be used to treat diarrhea-predominant irritable bowel. Laxatives can be used to treat patients who do not respond to use of dietary fiber. Antispasmodics drugs are used to treat patients with cramps and diarrhea. Psychological therapies are used to help patients with IBS. This therapy includes cognitive behavioral therapy and hypnosis. Hypnosis is used to improve the mental health and cognitive behavioral therapy is used to provide strategies that help the patient in copying with stressing factors and also to restrain thoughts and behaviors which increase the symptoms of irritable bowel syndrome (Goljan, 2004)


 Nuctraceutical treatment

Patients having IBS can use several minerals to relieve the symptoms associated with IBS. Vitamin C is used to relieve the signs and symptoms of IBS as it acts as a natural laxative thus it is used to relieve constipation. The amount of vitamin C used should be regulated as excessive intake of vitamin C leads to diarrhea and it causes bloating due to excess acid in the body. Vitamin C acts as an antioxidant thus people with enough vitamin C in the body are les likely to suffer from IBS symptoms. Vitamin B12 can also be used to treat IBS. This is because the vitamin helps in correct functioning of cells in the body thus it can be useful in treating IBS since it helps in relieving pain that is found in the gastrointestinal tract. Vitamin A and B complex are also useful in treating IBS. This is because food rich in vitamin A like fruits and vegetables have beta-carotene that is useful in treatment of IBS. Foods rich in vitamin B complex contain folic acid which is useful in relieving the symptoms of IBS (Goljan, 2004)


Hypothyroidism

Definition

Hypothyroidism is a disease that occurs as a result of low production of thyroid hormone in the body. There are many diseases that can result in hypothyroidism as the disease can affect the thyroid gland directly or indirectly. Hypothyroidism is grouped according to the organ of origin. There are three types of hypothyroidism. Primary hypothyroidism that originates from the thyroid gland. The most common forms of primary hypothyroidism include hashimotos thyroiditis. Another type is secondary hypothyroidism that originates from the pituitary gland. This type of hypothyroidism occurs if the pituitary gland does not produce enough thyroxine and triiodothyronine. It is caused by damage of the pituitary gland as a result of growth of a tumor, radiation activities or surgical operation. The last type of hypothyroidism is tertiary hypothyroidism. This kind of hypothyroidism originates from the hypothalamus. It occurs when the hypothalamus fails to produce enough thyrotropin-releasing hormone. The thyrotropinn-releasung hormone prompts the pituitary gland to release thyroid stimulating hormone. The origin of hypothyroidism depends on the organ that is affected. It can originate from the thyroid, pituitary. The development stages for the disease depend on the symptoms. In early stages the symptoms are not clearly active but in later stages the symptoms are clearly evidenced thus requiring medical attention (Goljan, 2004)


 Etymology

The term hypothyroidism was coined between 1900 and 1905.The prefix hypo- means under and the word thyroid and the suffix –ism means a system of (Goljan, 2004)


 Signs and Symptoms

The symptoms of hypothyroidism can vary from one person to another. The symptoms can be classified as early symptoms, late symptoms and the symptoms that are not common. The early symptoms include patients feeling fatigued. The patients also have poor muscle tone and they are very sensitive to cold, they can also have depression and muscle cram and pains in the joints. Other symptoms include goiter. The patient can have thin and brittle nails and hair and osteoporosis. The patient can also have decreased sweating, and a dry skinny that is itchy and the patient can also gain weight and can also have low heart rate and constipation (Goljan, 2004)


 Hypothyroidism can be diagnosed by measuring the amount of thyroid stimulating hormone being produced by the pituitary gland. High levels of thyroid stimulating hormone indicate that the thyroid gland is not producing enough levels of thyroid hormone and small amounts triiodothyronine. Blood testing is also used to test secondary and tertiary hypothyroidism if the thyroid stimulating hormone is normal but the doctor suspects hypothyroidism in the patient (Goljan, 2004)


 Biomedical treatment

This disease can be treated using the levorotatory forms of thyroxin (L-T4) and triiodothyronine (L-T3).Synthetic and thyroid tablets that are derived from animals can be used to provide the patient with additional thyroid hormone. The thyroid hormone is taken daily and the doctors should monitor the blood level to ensure proper usage of the drug. The doctors can also use the thyroid replacement therapy. This therapy involves several different treatment stages. The first treatment is T4 Only. It involves use of levothyroxine alone as a supplement and in synthetic form. The next treatment involves a combination of T4 and T3.The doctor should give the patient a combination of L-T4 and L-T3. Another treatment is desiccated thyroid extract. It is an animal thyroid extract. It is a therapy that contains L-T4 and L-T3 (Goljan, 2004)


 Nutraceutical treatment

Patients suffering from Hypothyroidisms should avoid goitrogens. These are foods that affect the thyroid gland in a negative way and prevent it from functioning. The foods are can be eaten if cooked buy they should be avoided if raw. They include cabbages, Soya beans etc. the patient should avoid alcohol as it acts as a depressant and reduces the amount of vitamin B in the body. The patient should eat food that is rich in iodine. Vitamin B complex is useful in treating hypothyroidisms as it help’s the thyroid to function well and this leads to control of hypothyroidisms in the body. The patient should also take food that is rich in vitamin B12 and vitamin C since they help in prevention of hypothyroidism in the body (Goljan, 2004)


Rheumatoid arthritis

Definition

 It is an immune disease that results to chronic inflammation of the joints. Rheumatoid arthritis can also cause inflammation of other tissues that are founds around the joint and other organs in the body. Autoimmune occurs when the tissues are attacked by other immune systems in the body. It is a chronic infection and patients can stay for long without showing signs of the disease. It can cause destruction to the joints and permanent disability of the legs or hands. The origin of Rheumatoid arthritis lies under several factors. The disease can originate from smoking and genetic inheritance. Smoking destroys cells that are responsible for providing immunity in the body and this leads to rheumatoid arthritis. The disease is also genetic as a person can get it from his or her parents. The disease has four development stages.


The first stage involves swelling of the synovial joint and the symptoms start being seen. In stage two the synovium tissue thickens as the cells in the inflamed joint start to separate and grow. The cartilage around the joint is destroyed and the joint is narrowed due to loss of cartilage. In stage three the inflamed joint releases enzymes that erode the cartilage around the joint exposing the bone for the enzyme to destroy. The joint loses its alignment and shape and movement becomes difficulty due to increase in pain. In stage four the deformities caused by the disease are evidenced and the disease is irreversible. The deformity causes loss in joint function and movement is impaired. Nodules are evidenced around the regions affected like the fingers (Goljan, 2004)


 Etymology

The name Rheumatoid arthritis is based on the term rheumatic fever. This is illness includes joint pain. It is derived from the Greek word rheumatos that means flowing. The suffix –oid that means resembling gives the translation as joint inflammation that resembles rheumatic fever. The disease was first recognized in 1880(Goljan, 2004)


 Signs and symptoms

The signs and symptoms of rheumatoid are not permanent and they can come and disappear depending on the inflammation of the tissue. The disease is said to be active when the tissues are inflamed and when the inflammation reduces the disease is said to be inactive. During the inactive time of the disease the symptoms are not evidenced and the patient feels well. The symptoms that are common when the disease is active include fatigue as the patient feels fatigued. The patient feels loss of energy and he may also lack appetite. The patient can have low grade fever and can have ache on muscle and joint and also stiffness. The stiffness of the muscles and the joints is common in the morning and the period of inactivity .Arthritis is common during flare. During this time the joints become red swollen and they are painful and tender. These symptoms are common at this time because the lining of the tissues of the joint are inflamed resulting to production of excess synovial fluid. The tissues around the joint also thicken during this time due to inflammation. (Goljan, 2004)


 Biomedical treatment

There is no known treatment for Rheumatic arthritis but the treatment available is aimed at reducing the inflammation of the joints and pain. It also aimed at improving the function of the joint. The treatment is also used to prevent destruction of the joints and cause of disability. Early treatment is important as it improves the outcome of the disease. Proper management if the disease can reduce the damage of the joints and disability since the joints is clearly monitored on X rays. Optimal treatment of rheumatoid arthritis involves a combination of several medications. It also involves rest and exercise that are aimed at strengthening of the joints. The patient should also be given enough care to protect the joints and the patient should be provided with enough education on how to take care of the diseases. The treatment for this disease is customized according to many factors.


These factors include the activity of the disease, the type of joints that are affected by the disease. The treatment is also customized according to age, general health of the patient and the occupation. For the treatment to be successful there should be enough cooperation between the doctor, the patient and his family. Two categories are used to treat rheumatoid arthritis. This category includes fast acting drugs and slow acting drugs. The fast acting drugs are referred as first line drugs while the slow acting rugs are referred as second line drugs or disease modifying ant rheumatic drugs. The first line drugs are used to reduce pain and inflammation of the tissues.This drugs includes aspirin and cortisone. The slow acting drugs are used to promote disease remission and to prevent progressive joint destruction. These drugs are not anti-inflammatory agents. Example of second line drug is methotrexate.The destruction caused by rheumatoid arthritis varies from one patient to another.  the disease is less destructive and the disease has quieted after years of activity. The disease can be managed with rest and also with pain and anti inflammatory medicine. The destruction of joints by  the disease and the disability caused by the disease can be reduced if the is treated early using second line drugs like methotrexate.The second line drugs can be used in combination. If the deformity caused on the joint is severe then a surgical operation can be carried out to relieve the infection. First line drugs like aspirin, naprosyn are examples of no steroidal anti inflammatory drugs (NSAIDs).


NSAIDs are used to reduce inflammation of the tissues, pain and swelling. NSAIDs are not cortisone. High doses of aspirin than the doses used to treat headache can be used as an anti inflammatory medication for rheumatoid. Aspirin has been used to treat joint problems. The NSAID function like aspirin and the response varies from one patient to another. Thus the doctor should try several NSAID drugs so as to identify the most effective drug for the patient with fewer side effects. The side effects caused by aspirin and NSAIDs are stomach upset, abdominal pain and ulcers. The drugs can also cause gastrointestinal bleeding. In order to reduce the gastrointestinal effects the patient should take the drugs with food. The patient can also be given other medications to protect the stomach from ulcers like antacids. The patient can be given corticosteroid medication. This medication is given orally or injected directly into the tissues and joints. They are more effective in reducing inflammation and restoring joint mobility and function than NSAIDs.


The corticosteroids are useful when the disease activity is severe and when the disease is not responding to NSAIDs. This medication should be given in small doses as the medication has side effects when given in high doses and when used for a long period. The side effects include weight gain and thinning of the bones and destruction of joints like hip joints. They can also subject the patient to other infections. To reduce the side effects the use of corticosteroid medication can be reduced gradually but not instant discontinuation as this can cause more side effects. The second line drugs can be used to stop damage to the cartilage, bones and the tissues surrounding the joins. For ideal management of the disease modifying antirheumatic drugs are used. They are available in different forms. These drugs promote remission thus controlling damaging of the joint and deformity. A combination of second line drugs can be used as therapy (Goljan, 2004)


 Nutraceutical treatment

Vitamin B6 is useful in treatment of rheumatoid arthritis. They help the nerves to function well and they also help the body to metabolize fats and proteins. It helps in formation of several neurotransmitters and it is important in development of the brain and its function. It also helps in formation of hormones. The proper functioning of the body important as it helps the body in maintaining good health. It also helps in production of red blood cells and immune system cells. The immune cells are important in preventing rheumatoid arthritis since it is an immune disease. Foods rich in magnesium are useful in treating the disease (Goljan, 2004)


 Sciatica

Definition

 It is a set of symptoms that are caused by general compression or irritation of one of the five nerve roots that give rise to the scatiatic nerve. It can also be the irritation of the sciatic nerve itself. It also includes pain that is felt on the lower back and various parts of the legs and the foot. The pain may be severe and the irritation varies from one person to another. The disease includes numbness and weakness of the muscles, pins. Movement of the leg and its control becomes difficulty. The stages of the sciatica disease depend on the degree of the pain. In early stages the pain may be minimal but in later stages the pain becomes severe causing the patient to undergo surgery. The sciatica pain originates from the compression of the sciatic nerves (Goljan, 2004)


Signs and symptoms.

The symptoms in sciatica include the irritation of the sciatica nerve. The patient can also have a general compression or irritation of one of the five nerve root that give rise to sciatic nerve. Another symptom is pain that is felt in the lower back and can be felt on various parts of the leg and foot. The pain may be severe. Numbeness and weaknesses of the muscles are other symptoms. The patient can have difficulty in moving the leg or in controling the leg. The symptoms are felt on one side of the body. The symptoms vary from one patient to another.Sciatica is a common form of low back pain and leg pain. The treatment for this disease is different and depends on the cause of the symptoms since sciatica is asset of symptoms (Goljan, 2004)


 A diagnostic test for this disease comes in a series of exams that are carried out by the doctor. The patient should adapt to numerous positions and actions as instructed by the doctor so as to diagnose the disease. The patient can walk on toes, squat and bend either forward or backward. The doctor can also ask the patient to rotate his spine, lye on the back and raising one leg at a time. This is to establish the signs and symptoms that are associated with sciatica. The patient can experience increase in pain during this activities. If the patient does not show symptoms in six weeks then the doctor can carry out imaging to diagnose the disease. This includes CT or MRI. Imaging methods like MR Neurography can be used to diagnose the disease and to treat it. MR Neurography is a form of MRI technique that uses MRI software to provide better picture of the spinal nerve and it also shows the effect of compression on the spinal nerve. This technique is useful in diagnoses of the disease since it can be used to diagnose piriformis syndrome which a cause of sciatica (Goljan, 2004)


 Etymology

The word sciatica was first used in 1451(Goljan, 2004)


 Biomedical Treatment

The treatment of sciatica varies from one patient to another. This is because the treatment of sciatica depends on the cause of the disease. The patient can be given anti inflammatory medication like NSAIDs or oral steroids to treat the disease. The patient can be treated using narcotics that are used to reduce severe pain. Psychical therapy can also be used to relieve the disease like stretching exercises. The doctors can use epidural steroid injection on the patient. Non surgical spinal decompression can be used to reduce pain that is caused by the compression of the nerves. Massage therapy play an important role in reducing the pain. Weight loss measures can also be used to reduce pressure on the roots of the spinal nerve. Surgical operations can be used if necessary to relieve the symptoms of sciatica. The surgical operation is used if the sciatica is pain is severe and it has not relieved within six weeks to twelve weeks. Then the patient can consider having a spine surgery.


Two surgical procedures are used depending on the cause of the sciatica and the duration. These procedures include the microdecompresion and an open decompression. The microdecompresion surgical procedure is used if the sciatica pain is due to a disc herniation. This procedure is used after four to six weeks and the pain has not been relieved by non surgical treatment. It can also be considered early if the pain is very severe and the disability is also severe. Urgent surgery is needed if the patient the muscles become weak and the patient looses control of bowel movement. Open decompression is done through a stenosis surgery. This surgery is used if the patient is not able to tolerate the pain. The surgical operations depend on the patient’s decision. (Goljan, 2004)


 Nutraceutical treatment

The patient can use weight loss measures to reduce the weight so as to reduce the pressure on the spinal nerves. This will help the patient in relieving symptoms of sciatica like pain in the back that can be caused by pressure on the roots of spinal nerves. This is important as relieves the symptoms of sciatica helping the patient from further treatment like surgery. Vitamins and mineral are important in treating sciatica. This is because the minerals and vitamins make the bones and spine strong and health. Minerals like calcium, magnesium and vitamin D are useful in treating sciatica symptoms. This minerals and vitamins build the bones and prevent osteoporosis. Other vitamins also ensure proper functioning of nerves and the general spinal health. These vitamins include vitamin B12, vitamin K, vitamin A, and vitamin C .Dietary supplements like glucosamine and chrondroitin are used to maintain a healthy spine. They also prevent osteoporosis. The vitamins, mineral and dietary supplements above are useful in relieving the symptoms associated with sciatica thus helping the patient in saving costs for more treatment like surgery. (Goljan, 2004)


 Reference

Goljan,E. (2004).Pathology. Elsevier Health Sciences


 

 
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