Neurocysticercosis

Nuerocysticercosis is infection of the central nervous system with the larval forms called cysticerci of Taenia solium. It manifests in different forms depending on the location and number of cysts, and include seizures, hydrocephalus, and a variety of other neurologic dysfunctions; often accompanied by distinctive lesions visible by computed tomography or magnetic resonance imaging. It is a form of cysticercosis which is a disease caused by encystment of larvae of tapeworms in subcutaneous, muscle, or central nervous system. When cysticercosis affects the central nervous system, it is called neurocysticercosis. In human beings, it results from the hatching of eggs of Taenia solium in the intestines. Neurocysticercosis may cause serious nervous system damage. It is a primay cause for epilepsy. The eggs of Taenia solium which are accidentally ingested travels from the stomach to the brain via the vascular system.

Neurocysticercosis is treated mainly by antiparastic drugs like Albendazole and phenytoin. The treatment duration includes administration of drugs up to 3 years regularly. Another important thing is to avoid eating improperly cooked meat.

Taku-Tsubo Syndrome

Tako-Tsubo syndrome or stress cardiomyopathy is a rare dreadful illness that appears under circumstances of exceptional and extreme stress, some times associated with anger. In the human body, stress cardiomyopathy (or broken heart syndrome) is a condition in which heart muscles are temporarily weakened. Stress cardiomyopathy could easily be confused with a heart attack, but stress cardiomyopathy is much less serious. Emotional stress may trigger stress cardiomyopathy. Tako-tsubo means octopus trap in the Japanese language. It does not affect the apex of the heart always and is related to a midventricular wall motion abnormality. It is also called transient left ventricular apical ballooning. The function of the distal and apical segments of the LV are depressed, and there is compensatory hyperkinesis of the basal walls, producing ballooning of the apex with systole. Stress-induced cardiomyopathy is more common in women than in men.

Radiation: Medical Application and Side Effects

Radiation is widely applied today in medical field. Radiology Department of a hospital uses radiation for both diagnostic purposes and for treatment of a disease condition. A patient is subjected to powerful radiations in the form of x-rays, CT scan, etc. for diagnostic purposes. Gamma rays, which are high-energy x-rays, are also used in radiation. The electromagnetic radiation from these sources passes through the body tissues resulting in the structural change of tissues or even cell death. Long-term exposure to radiation can lead to many complications and exposure to radiation in high-doses can even be fatal.

In medical parlance, there are two types of radiations used. First one relates to the use of x-ray and CT scan for diagnostic purposes and the second one involves the use of electromagnetic radiation or high-energy x-rays called Gamma rays. Gamma rays are used widely in radiation oncology or the use of radiation in the treatment of neoplasms that might be benign (benign tumor) or malignant (cancer). Gamma rays are used to destroy the affected cells resulting in death of the tumor cells and surrounding tissues.

The side effects of radiation exposure can be limited to that particular person who is subjected to it or can even lead to genetic malignancy which may affect the next generations also. The effects of radiation can be immediate like vision changes due to damage to the cornea and infertility. The long-term effects include cancer of the skin etc.

The extent of side-effects of radiation is also determined by many factors like age, organs subjected to exposure, and dosage. Children and the elderly are the worst affected with radiation as the immune system are either in the developing stage or in the declining stage whereas adults are less affected due to their strong immune system. Ovary, kidneys, reproductive system, eyes, bone marrow etc. are easily affected by the rays.

Sievert (Sv) is the SI unit of ionizing radiation effective dose, equal to the absorbed dose in gray, weighted for both the quality of radiation in question and the tissue response to that radiation. The unit is the joule per kiligram and 1 Sv=100 rem.

Colonoscopy: Definition, Indications, and Procedure.

Colonoscopy is the visual examination of the inner surface of the colon (large intestine) with a colonoscope.
It is done for the indication of colon cancer screening, rectal bleeding, constipation, angiodysplasias, peptic ulcer disease, erosive gastritis, colitis etc. The bowel will be emptied with laxatives and the patient will be kept NPO prior to the procedure.
Medical instruments used for colonoscopy: Olympus PCF-160 colonoscope.
Below given are some case studies which will help in portraying a larger picture of colonoscopy and its indications, procedure, medications used etc.

CASE STUDY #1:
PREOPERATIVE DIAGNOSES: A 60-year-old male who needs colon cancer screening. Chronic mild bright red rectal bleeding with episodes of constipation.
MEDICATIONS USED: Fentanyl 100 mcg IV and Versed 4 mg IV.
DESCRIPTION OF PROCEDURE: The patient was placed in the left lateral position and a rectal examination done which was normal. After receiving above intravenous conscious sedation, an Olympus PCF160 pediatric colonoscope was introduced into the rectum under direct visualization. The scope was advanced through the entire colon,into the cecum which was identified by the ileocecal valve,appendiceal orifice, and triradiate fold. Throughout the colon,the bowel prep was satisfactory and adequate visualization of thecolon mucosa was obtained. The entire colon exam and colon mucosawas normal. There was no evidence of colitis, colon polyps, or mass lesions. Retroflexion exam in the rectum revealed moderate-sized internal hemorrhoids. The entire colonoscopy was normal. The procedure was completed without any complications.
RECOMMENDATIONS: Anusol HC cream 2.5% to the rectal area once a day for two weeks. Followup colonoscopy in ten years.

CASE STUDY #2:
PREOPERATIVE DIAGNOSES: A 66-year-old patient who needs colon cancer screening. Past history of mild left lower quadrant abdominal pain. Past history of chronic mild bright red rectal bleeding attributed to hemorrhoids. Family history of colon cancer.
MEDICATIONS USED: Fentanyl 100 mcg IV and Versed 4 mg IV.
DESCRIPTION OF PROCEDURE: The patient was placed in the left lateral position and a rectal examination done which was normal. An Olympus PCF-160 pediatric colonoscope was introduced into the rectum under direct visualization. The scope was advanced through the entire colon into the cecum which was identified by the ileocecal valve,appendiceal orifice, and triradiate fold. Throughout the colon, the bowel prep was satisfactory and adequate visualization of thecolon mucosa was obtained. Few small scattered diverticula werenoted in the sigmoid colon. The rest of the colon exam wascompletely normal. Retroflexion exam in the rectum revealed moderate size internal hemorrhoids. There was no active bleedingseen. The procedure was completed without any complications. The rest of the colonoscopy was normal.
RECOMMENDATIONS: High fiber diet and dietary precautions for diverticulosis. Anusol HC cream 2.5% to the rectal area once a day for two weeks. Follow up colonoscopy in five years.

CASE STUDY #3
PREOPERATIVE DIAGNOSES: A 41-year-old patient with melena, anemia of blood loss, rule out ulcerative colitis, Crohn's colitis, colon polyps, and colon cancer.
MEDICATIONS USED: Fentanyl 150 mcg IV and Versed 6 mg IV.
DESCRIPTION OF PROCEDURE: The patient was placed in the left lateral position and a rectal examination done which was normal. After receiving above intravenous conscious sedation, an Olympus PCF-160 pediatric colonoscope was introduced into the rectum under direct visualization. The scope was advanced through the entire colon into the cecum, which was identified by the ileocecal valve, appendiceal orifice, and triradiate fold. Throughout the colon, the bowel prep was satisfactory and adequate visualization of thecolon mucosa was obtained. There was slight amount of solid stool mixed with liquid stools in the cecum, however this area was thoroughly irrigated with water and adequate visualization was obtained. The entire colon exam and colon mucosa was normal. There was no evidence of colitis, colon polyps, or mass lesions. Retroflexion exam in the rectum revealed small internal hemorrhoids. There was no active bleeding seen.
RECOMMENDATIONS: Follow up on hemoglobin and hematocrit. Protonix. Follow up on gastric biopsy results.

Kidney Disease, It is Fatal: Symptoms, Diagnosis, Treatment options, and Care

Kidneys are one the most vital organs under the genitourinary system in our body located in the posterior part of the abdomen. These are bean-shaped organs one on either side which is approximately the size of a closed fist. The functions of kidney include hormone secretion, maintaining blood pressure, and excretion of wastes from body.

One of the major causes of kidney disease is longstanding diabetes mellitus which manifests into diabetic nephropathy. According to internationaly surveys, in more than 65% people, diabetes is the key cause for kidney disease. High cholesterol and high blood pressure are also other notable causes of kidney disease. Direct kidney infection is the other cause for kidney disease. After the diagnosis of diabetes, it takes approximately 8-9 years before it manifests into kidney disease.

Though kidney transplant is an option for those suffering from end-stage kidney disease, it is not without its peritnent risks. The patient has to take many medications in order to avoid rejection of the transplanted kidney which in turn alters the blood sugar level, and the patient has to take additional medications again to control his diabetes. Dialysis is another treatment option in a large number of cases though that option is also not without its pertinent drawbacks in terms of treatment duration, costs, etc; the patient has to undergo dialysis at least 3 times a week. Two types of dialysis are hemodialysis and peritoneal dialysis.

Early diagnosis:
The initial symptoms of kidney failure may include abdominal pain, vision changes etc, hypertension etc. Diagnosis of kidney disease in its early stages is of immense value in treating the disease. Basic tests to measure the level of serum creatinine and urea can detect kidney disease. Microalbuminuria is also an early indication for renal disease. These tests can be done on an annual basis to detect and treat renal disease early and effectively. Diabetic patients should also be careful of vision changes because vision changes can be an indication for renal disease in diabetics.

Initial symptoms to take care of:

• Nocturia: Urination at night caused by increased nocturnal urine secretion.
• Hematuria: Blood in the urine.
• Dysuria: Difficulty or pain in urination.
• Edema due to failure of the kidney to produce and excrete waste resulting in volume overload.
• Lethargy and fatigue: This is caused due to failure of kidney to produce erythropoetin and red blood cells.
• Abdominal pain, groin pain, leg pain, nausea, vomiting, shortness of breath, and chills are also symptoms related to renal disease.

Patients, remember please:

• Proper diet and exercise.
• Increase calcium and phosphorous intake.
• Monitor cholesterol levels.
• Hepatitis B immunization.
• Maintanence of blood pressure.
• Control of blood sugar.
• Avoid nephrotoxic drugs.
• Control of fluid and salt intake.
• Prevent anemia.