MEDICAL BITS-10-DIGESTIVE SYSTEM

 RESEARCH BITS ON YOUR DIGESTIVE SYSTEM

1.GUT BACTERIA

The researches in The Babraham Institute in Cambridge, U.K., has revealed that it is possible to rejuvenate the older gut immune system at an older age.

Age can slowly destruct the gut's immune system by slowly changing the active gut microbiome and other flora from active to inactive state. Hence our digestive power is slowly declined when a person gets older.

The research shows that this can be prevented by transplanting feces from the younger ones to the older ones. The study is still on the table and performed in mice. But the result through light on the hope in future the fecal transplant can be successfully done from one to another to rejuvenate the older digestive system to be activated.

Mice are having the habit of nibbling each other's droppings. When an old and young mice are locked together in a cage they found that the older mouse gets more activated disregarding its age. This they found its nibbling of the younger one's droppings.

But this is not possible in human beings as a human has no habits nibbling droppings. Hence the scientists are trying to device a convenient method of fecal transplant.

2. COMMON ULCER Drugs -Linked to Heart Problems

Many drugs used to relieve acid reflexes, ulcers, and heartburn are found to have links with many fatal incidents including heart attacks.

Recent research conducted by Dr.Ziyad Ali et al from Washington University School Of Medicine, in St.Louis MO, and published in the journal BMJ has revealed that those who use Omeprazole, like PPI drugs and Ranitidine like H2 receptor blocker drugs are statistically 7% to 9% more likely to have heart diseases.

Most of the patients who use these drugs are advised to use these drugs unnecessarily for a long period.

PPIs and H-2 receptor inhibitors are available as on the counter (OTC) drugs in pharmacies. If necessary they can be used for a short period not over 10 days. For chronic use one should get proper doctor's advice.
The study continues to state that chronic use of PPIs and H-2 receptor antagonists leads to other fatal comorbidities including kidney and liver damages.

Examples:-

1.PPI drugs:-

a)Omeprazole,(Omez)
b)Pantoprazole,(Protonix)
c)Rabeprazole(Aciphex)
d)Esomeprazole (Nexium)

2.H-2 receptor Inhibitors:-

a)Cimetidine (Tagamet)
b)Ranitidine (Ranidine, Zantac,)
c)Famotidine (Pepcid)

3.HEARTBURN AND NAUSEA

There are many causatives for the above symptoms. Some of them are given below.

1.Acid Indigestion-Gastritis-In which there is inflammation at the inner linings of the stomach which causes gastric irritation and vomiting.

2.Esophageal Reflex 
3.Zollinger-Ellison's Disease-Stomach Cancer
4.Drugs of abuse such as alcohol, amphetamine, opium, cocaine, and marijuana.
5.Certain pain killers such as ibuprofen, diclofenac, naproxen phenoxybenzamine which causes ulcerations.

4.AUTISM AND GUT MICROBIOME:-

A recent study has revealed that a change gut bacterial flora can largely influence the autistic behavior of a child.

MEDICAL BITS-9-PSYCHOTHERAPY

KNOW YOUR BLUES-HOW TO GET OUT FROM THAT

1. METFORMIN-AN ANTIDIABETIC CAN HELP YOU TO GET RID OF ANXIETY AND DEPRESSION-RESEARCH:-

Diabetes Mellitus-2 a condition of metabolic defects in which insulin resistance plays an important role. Insulin resistance makes the body improperly handle or metabolize glucose and the result is high sugar level in the blood.

Usually insulin resistance occurs due to hormonal imbalances in the CNS. Stimulant hormones such as acetylcholine,nor-adrenaline, and dopamine overpowers the other hormones especially serotonin- the hormone of peace.

Because of this majority of the diabetics are more irritant, anxious, and depressed.

Research by French scientists published in The Journal of Neuroscience states that metformin a biguanide antidiabetic drug can dramatically help the person to fight the blues and get rid of them.

The research conducted in mice which are fed with high fatty diet to simulate insulin resistance in them. High fat produces branched amino acids in the blood which block the entry of the amino acid tryptophan to enter into the brain.

Tryptophan is an essential amino acid necessary for the brain to prepare serotonin (5-hydroxytryptophan) -the hormone of peace and happiness.

The researchers have found out that metformin the anti-diabetic drug prevent the formations of branched-chain amino acids and thereby make more tryptophan to cross the blood-brain barrier. Thus it helps the brain to prepare enough serotonin the hormone of peace in diabetic patients.

2.ELECTROCONVULSIVE THERAPY FOR SUICIDAL THOUGHTS:-

A research by Dr.Youssef et al a psychiatrist from the Medical College of Georgia at the Augusta University specializing in Electrical Convulsive Therapy have found out the ECT with low amplitude can relive and drive out suicidal ideas without affecting cognition and memory.

3. LEARNED HELPLESSNESS-SYMPTOMS AND TREATMENTS:-

Psychotic disorders are many which lead to many mental diseases such as schizophrenia, anxiety, Obsessive and Compulsive Disorders (OCD), and Post Traumatic Stress Disorder (PTSD)

Learned Helplessness is a pro depressive stage if it persists chronically in a person may lead to serious mental disorders such as OCD.

If a person is continuously exposed to painful events he becomes adaptive to the situation by losing his confidence. He will allow all stress full events to happen with a sense of no outlets are available to solve the problems. He will sadly allow all the abusive events without any motivation to solve the problems even though there are solutions.

< His mind is full of negative thoughts and becomes depressive. This is known as Learned Helplessness L.H.)

If a child is continuously abused within his family and by the society he may develop adulthood L.H.

later.

Symptoms include,

1.low self-esteem,

2.Low expectations for the goal

3.Slow motivation.Always dull.

4. Not look for help even though help is available

5. Ascribing loss of success to inability and luck.

Therapies include,

1. Try to get help, support, and encouragement from friends and beloved ones.

2. Believe that you are not alone

3.Meditations

4. Devote and submit yourself to the belief of God.

5.Learn ways to keep you busy and encouragements

6. Avoid negative feelings.

7. Avoid stressful situations by engaging in reading writing and other hobbies.

8. Have a good night's sleep.

HIGH SODIUM-HYPERNATREMIA-II-CONTINUED

HYPERNATREMIA-DRUG ABUSES AND OTHER CAUSES

Hypernatremia occurs due to the improper use of certain drugs such as osmotic diuretics.

Osmotic diuretics are drugs producing diuresis to excrete more urea nitrogen and glucose and competitively inhibit the excretion of sodium and water. They increase the blood and extracellular water and sodium level and thereby produce hypernatremia.
Other medications such as anabolic steroids(Durabolin), ACTH (Adreno Cortico Tropic Hormone) and female sex hormones also produce hypernatremia 

The best examples for osmotic diuretics are mannitol and isosorbide.
The concept of osmotic diuretics is to produce high osmotic pressure between blood capillaries and kidney tubules and thereby suck more solvent towards the tubules for excretion. But in this case urea, glucose and blood urea nitrogen are the solutes that suck the water towards the tubules and thereby raise the mineral content of the blood including sodium.
Glucocorticoids on the contrary inhibit the excretion of the solvent along with sodium by the kidneys and thereby raise the blood volume and sodium.

Those who have diabetes mellitus, kidney failure with high blood urea nitrogen(BUN) should avoid the use of mannitol and isosorbide in their B.P.drugs profile.

Mannitol is usually recommended by the eye specialist to reduce intraocular pressure(IOP) in the treatment of glaucoma. Similarly both mannitol and isosorbide are drugs of choice to reduce intracranial pressure for B.P. patients. Before starting with this drug you must submit your full medical history including diabetes and kidney problems.
Other medications such as sodium chloride (table salt), and sodium bicarbonate (Baking salt) also can raise your blood and extracellular sodium level if used in high quantity.
Chronic use of corticosteroids such as aldosterone(Aldomet) can raise blood sodium levels by increasing potassium loss with the exchange of sodium by the distal tubule of the kidneys.
Glucocorticoids such as hydrocortisone and cortisol also produce hypernatremia by suppressing the secretion of ADH by the brain.
Male and female sex hormones can also produce hypernatremia

Foods with high sodium contents:-

Foods such as salty foods and beverages such as Soup, and vegetable juice
Instant puddings,
Shrimps
Cottage cheese
Salads
Pizzas.
These foods should be avoided if you are positively diagnosed with hypernatremia.

Symptoms:-

1. The main symptoms are lethargy and confusion verily in the case of Diabetes Insipidus.

2. Craving for salt is one of the symptoms that you have high sodium in your body.

3.Extreme thirsty which indicates you have high osmotic pressure between your lower intracellular fluid volume and higher extracellular fluid volume.

4.Frequent Urinations

5.Swellings

6.Episodes of Headaches

7. Hesitate to take food in spite of hungry.

Diagnosis:-

Blood and urine tests.

Treatments:-

For acute cases slow intravenous drip of 5% glucose.

For chronic cases intravenous drip of half-normal saline (0.045%)

HIGH SODIUM-HYPERNATREMIA-I

HIGH-LEVEL SODIUM-D

THE SODIUM ION

If a patient's sodium level in the blood goes above 145 mmol/Liter (normal range is 130 to 145 mmol/Liter) then the patient is said to be suffering from high blood sodium level or Hypernatremia.

Etiology:-

There are many causes of the increased sodium level in the body.

But very importantly improper uses of some drugs such as diuretics which may drain out extra water from the body by leaving sodium in.

Insufficient water or fluid consumption during severe thirsty leading to hypovolemia in the serum as well as in the extracellular fluid which results in the elevation of sodium level in the body.

Hormonal defects such as insufficient secretion of an antidiuretic hormone known as vasopressin from the posterior pituitary which is known as Diabetes Insipidus.

 In diabetes-insipidus (DI) kidney fails to excrete sodium and drain out only empty water in urine.

Anti Diuretic Hormone (ADH) or Vasopressin is a hormone produced by the hypothalamus in the brain and stored in and released from the posterior part of the pituitary gland.
During the time of hot sun and dehydration the secretion of ADH is raised which sends signals to the kidney to reabsorb more water.
But during winter season ADH secretion is diminished and the kidney will drain out more water as urine.
There are many causes for the occurrence of Diabetes Insipidus (DI).

Central DI occurs when there is insufficient secretion of ADH from the pituitary. This is due to any one of the following reasons.
1.A head injury that causes damage to either the hypothalamus or pituitary gland or both.
2.Due to genetic defects.
3.Head tumors
4.Head surgery

Nephrogenic DI is another kind and more dangerous which occurs when the kidney does not respond to ADH in spite of the hormone's proper availability.
Nephrogenic DI can occur due to chronic kidney failure.

Dipsogenic DI is not due to pituitary or hypothalamus damage and dissimilar to nephrogenic DI and it is due to the kidney's inability to respond to ADH without any damage. In nephrogenic DI there are other causes to damage the kidney such as hypertension, hypotension, hyperglycemia, kidney stones, and certain drugs.
But in dipsogenic DI the main reasons for the kidney's inability to respond to ADH without any damage is due to chronic heavy fluid intake which suppresses the secretion of ADH. Hence frequent intake of alcoholic drinks, cool drinks, or even water unnecessarily should be avoided.

Gestagenic DI occurs during pregnancy. But it is temporary and will go after the completion of the pregnancy. But it may relapse during the next pregnancy. It is very mild and not dangerous. The reason is a placental secretion which elevates blood calcium level and thereby suppresses ADH secretion.

Symptoms:

All types of DI have the following common symptoms.

1.High, frequent, colorless watery urine output -Polyurea which may exceed 2.5 to 3 liters /day

2.Excessive Thirsty-Polydipsia

3.Dry mouth.

4.Tiredness and Weakness due to heavy loss of fluids

5.Heart failure due to low B.P.

6.Dry skin

7.Constipation.

8.Urinary incontinence -Bedwetting.

Diagnosis:-

Diagnosis involves mainly a urine test. The doctor will see the color and odor of it. Also a blood test is required for the amount of sodium and other minerals.

ADH tests also should be performed in the blood.

Treatments:-

Diabetes Insipidus is not curable but can be controlled.

The following medicines are recommended:-

1.Desmopressin-A synthetic vasopressin

 2.Vasopressin

Both are available as nasal sprays.

Other etiologies of Hypernatremia will be discussed later in the following next post.

                                       -Will be continued

MEDICAL BITS-8-ORTHOPEDICS

MUST TO KNOW BITS (ORTHOPEDICS)

1.BACK PAIN

Lower back pains may be sudden or gradual for some people when they do their daily routine works such as lifting heavy weights improperly, anaerobic exercises, or due to some underlying causes.

Cauda Equina Syndrome is a rare condition that develops when something damages or compresses a bundle of nerves known as Cauda Equina at the lower part of the spinal cord. This condition may occur due to herniated disc, spinal stenosis, infections tumors, or injuries that damage the spine.

The symptoms include numbness in legs, difficulty walking, severe back pain, bowel and bladder malfunctions, etc.

Cauda Equina is a medical emergency and surgery is the only option as treatment.

2. Collagen is a protein that maintains skin elasticity. Also it helps to provide structural support in connective tissues, muscles, and skin.

It plays an important role in healthy bone and joints.

2.HEALTHY SKIN

During aging the functions of collagen are affected and retarded and hence the skin wrinkles and other posture disabilities develop and appear gradually.

Collagen supplements are available in the market and can be used according to doctor's advice without any harm.

3.POSTURE AND FITNESS

Posture is very important and bad posture can damage your health as follows.

Bad postures can cause back pain, breathing trouble, headaches, urinary troubles, constipation, and heartburn.

Some exercises can help to keep good posture such as bridge, plank, and chest expanding.

There are medical devices such as chair are available.

4.SPRAINS

A sprained ankle can be experienced by pain and swellings.

Sprains are due to the ligaments that connect the ankle gets damaged, stretched, or torn. Sprains differ from the strain that sprain affects ligaments, where strains injure muscle or tendons.

Hence an ankle sprain can cause deep severe pain so that it is very difficult to move the ankle and sometimes a sprained ankle may feel like a broken bone.

CALCIUM IRREGULARITIES DUE TO DISEASEs-3

pharmalatest2-21

HYPERCALCEMIA-ADDISON'S DISEASE

Prelude:-

Addison's Disease is a rare pathological condition that affects 1 in 100000 persons in the world. This disease affects almost all systems of the body's physiology, including minerals homeostasis.

Hypercalcemia is commonly associated with this disease due to adrenal cortex insufficiency and overactivity of the parathyroid hormone.

The etiology is unknown but it is believed that there is some abnormal elevation of the body's own defense mechanism which destroys the body's vital organs such as the adrenal cortex.

Because of the insufficient adrenal corticosteroids circulating in the blood there is an overstimulation of the anterior hypophysis to secret more and more Adreno Cortico Tropic Hormone (ACTH) to further complications.

Addison's disease is a fatal condition in which the body experiences insufficient adrenal activities. This is defined in short as an adrenal failure.

Adrenals are small in size and look like two small mushroom caps fitted above the heads of the two kidneys.
In this article we are not going to study adrenal glands but to have a prompt study about mineral metabolism including the calcium irregularities due to adrenal failure during Addison's disease.
Why only calcium?
because its irregular metabolism is more serious than other minerals metabolism even it may bring death within a year if it left unnoticed and untreated.
A lake of ADH (anti-Diuretic Hormone)secretion from the pituitary gland may raise sodium level by draining out empty water content in the urine.
In Addison's disease lake of aldosterone a mineralocorticoid may lead to severe potassium loss by distal tubule of the kidneys.
In Addison's disease the impaired adrenal glands do not sufficiently secrete glucocorticoids such as cortisol and hydrocortisone.
Glucocorticoids are responsible for the correction of serum calcium levels by eliminating extra calcium in the urine.
This is performed by increasing the glomerular filtration of calcium and reducing its reabsorption by the kidneys.
In Addison's disease this process is impaired due to insufficient glucocorticoids and the result is hypercalcemia.
In Addison's disease there is a high calcium input into the extracellular fluids leads to many complications such as vascular and nephron calcification and cardiac problems.
Further high bone resorption pours more calcium into the blood and makes the condition from worse to worst.
The serum dihydroxy vitamin D3 content becomes low.
Parathyroid activity is impaired.
Even though calcium irregularities associated with Addison's disease is rare but if hyperparathyroidism or treated hypoparathyroidism is followed by Addison's disease then here is 99% possibility to get hypercalcemia

Symptoms of Addison's Disease:

Although Addison's disease is uncommon and rare the medical condition is fatal. If you experience the following symptoms see a doctor.

1.More skin darkening areas like pigments

2.Deep tiredness, fatigue, and weakness.

3.Weight loss

4.G.I distress, nausea and vomiting, stomach pain.

5.Headache

6.Craving for salt.

7.Joint pain.

Addison's disease can be treated by administration fludrocortisone an analog of aldosterone to correct sodium and potassium level.
Glucocorticoid can be given to correct calcium metabolism 
Alternatively bisphosphonates, plicamycin, calcitonin (a parafollicular hormone of the thyroid gland), and loop diuretics along with rigorous rehydration can also be engaged by your according to the situations.
The administration of ACTH is a diagnostic test to find out the presence of Addison's disease.

KNOW YOUR CALCIUM IRREGULARITIES-DUE TO DISEASES-2

HYPERCALCEMIA-ZOLLINGER-ELLISON'S SYNDROME(ZES)

This condition usually affects the stomach, duodenum, jejunum, and pancreas, but some times it spreads its wings to (metastasize) outside the digestive system such as to the heart lungs and parathyroid.

The feature of this disease is formations of extra tumors to produce more secretions of the concerned organ of the body.

If it is stomach and duodenum the formed tumors over stimulates gastrin secretions which in turn causes more acid secretions into the stomach which causes ulcerations.

Similarly if it affects the parathyroid gland then there are higher secretions of Para-Thyroid Hormone (PTH) which in turn causes elevations of calcium ion in the blood.

PTH stimulates osteoclastic cells (bone cells) which causes erosion and resorption of calcium in the form of hydroxyapatite crystals to result in hypercalcemia associated with Zollinger- Ellison's Disease.

Elevations of calcium ion in the serum cause many complications such as calcium deposits in the blood vessels (vascular calcifications), kidney stones, and nephro-calcifications. 

Experiments have been demonstrated as patients having extra stomach tumors and have parathyroid hyperplasia (Zollinger-Ellison's Syndrome of both the organs) have got higher secretions of gastrin and gastric acid because of the elevated calcium ion in the blood due to parathyroid hyperplasia.

Hence experimentally it was shown that a parathyroidectomy (removal of the extra tumors of the hyperplastic parathyroid) causes a reduction in the serum calcium level and thereby controls the gastric acid secretions.

Hypercalcemia due to any etiology can cause

1.Kidney stones

2.High Blood Pressure due to vascular calcification

3.Cardiac Arrhythmias

4. High blood calcium may increase insulin resistance and decrease insulin receptor activities. Hypercalcemia also decrease insulin's action on fat cells due to a reduced number of glucose transporters (GLUT4)
High blood calcium due to hyperactivity of PTH can cause high blood glucose due to raised tissue insulin resistance.
5. Pancreatic hyperplasia may also be due to Zollinger-Ellison's tumors developed in the pancreas results in elevated pancreatic secretions.