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Medical Articles
Shaken Baby Syndrome
Shaken baby syndrome (Shaken impact syndrome) is a serious form of abuse inflicted upon a child. It usually occurs when a parent or other caregiver has shaken a baby out of anger or frustration, often the baby will not cry.

Babies have very weak neck muscles that cannot fully support their proportionately large heads. Severe shaking causes the baby's head to move violently back and forth, resulting in serious and somethings fatal brain injury. These forces are exaggerated if the shaking is interrupted by the baby's head hitting a surface.

Is a serious brain injury caused by forcefully and violently shaking a baby? Other names for this condition include abusive head trauma, shaken impact syndrome, and whiplash shaken syndrome. it can result from as little as five seconds of shaking.

Babies have soft brains and weak neck muscles. They also have delicate blood vessels. Shaking a baby or young child can cause their brain to repeatedly hit the inside of the skull. this impact can trigger bruising in the brain, bleeding in the brain, and brain swelling. Other injuries may include broken bones as well as damage to the baby's eyes, spine, and neck.

The shaken baby syndrome is common in children under age 2, but it can affect children up to ae 5. Most cases of shaken baby syndrome occur among infants that are 6 to 8 weeks old, which is when babies tend to cry the most. Playful interaction with an infant, such as bouncing the baby on the lap or tossing the baby up in the air, won't cause the injuries associated with the shaken baby syndrome. Instead, these injuries often happen when someone shakes the baby out of frustration or anger.

Symptoms of Shaken baby syndrome:

Symptoms include:

. Difficulty staying awake

. Body tremors

. Trouble breathing

. Poor eating

. Vomiting

. Discolored skin

. Seizures

. Coma

. Paralysis

Deceleration of the head when it impacts a surface can cause the following:

Subdural hematoma, which is a collection of fo blood between the surface of the brain and the dura.

This occurs when the veins that bridge from the brain to the dura are stretched beyond their elasticity, causing tears and bleeding.

Subarachnoid hemorrhage, which is bleeding between the arachnoid and the brain.

Direct trauma to the substance itself, caused when the brain strikes the inner surface of the skull.

Shearing off or breakage of nerve cell branches in the cortex and deeper structures of the brain caused by violent motion to the brain.

Further irreversible damage to the brain substance from the lack of oxygen if the child stops breathing during shaking.

Further damage to the brain cells when nerve release chemicals that add to oxygen deprivation to the brain.

Retinal hemorrhages ranging from a few scattered hemorrhages to extensive hemorrhages involving multiple layers of the retina.

Skull fractures resulting from impact when the baby is thrown against a hard or soft surface.

Fractures to other bones, including the ribs, collarbone, and limbs, bruising to the face, head and entire body.


. Encephalopathy, brain swelling

. Subdural hemorrhage, or bleeding in the brain

. Retinal hemorrhage or bleeding in a part of the eye called the retina.

The doctor will order a variety of tests to check for signs of brain damage and to help confirm the diagnosis. These tests may include:

. MRI scan, which uses powerful magnets and radio waves to produce detailed images of the brain

. CT scan, which creates clear, cross-sectional images of the brain

. Skeletal X-ray, which reveals the spine, rib, and skull fractures

. Ophthalmic exam, which checks for eye injuries and bleeding in the eyes

Irreversible brain damage from shaken baby syndrome can occur in a matter of seconds. Many babies experience complications, including:

. Hearing loss

. Seizure disorders

. Development delays

. Intellectual disabilities

. Cerebral palsy, a disorder that affects muscle coordination and speech

Shaken Baby Syndrome is preventable. You can avoid harming your baby by not shaking them under any circumstances. It's easy to become frustrated when you can't get your baby to stop crying. However, crying is a normal behavior in infants, and shaking is never the right response.

It's important to find ways to relieve your stress when your child cries for extended periods. Calling a family member or a friend for support can help when you feel yourself losing control. Some hospital-based programs can teach you how to respond when infants cry and prevent the injuries associated with the shaken baby syndrome. Make sure your family members and caregivers are also aware of the dangers of shaken baby syndrome.

Shaken Baby Syndrome is completely preventable. Taking care of a baby can present challenges, especially for first- time parents. However, it is important to remember that it is never acceptable to shake, throw or hit a baby.

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Stretch marks
The medical for stretch marks is "Oestriae atrophic" which tabor's medical dictionary describes as fie pinkish- white or gry lines, usually 14cm in length, seen in part of the body where the skin has been stretched. Commonly seen on thighs, abdomen, and breasts of women who are or have been pregnant, in persons whose skin has been stretch by obesity, tumor, or dropsy, or in persons who have taken for a prolonged period.

This is different from cellulite, which is a dimpling of the skin caused by a thin upper layer of the skin with large, irregular fat cells below. Stretch marks are, however, somewhat related to cellulite in that women are much more susceptible than men due to skin anatomy. Women have more subcutaneous fat, which has less of a cohesive cellular structure and also tend to have a thinner top layer of skin which makes the superficial skin more to damage of all kinds.

The top layer of skin and the underlying fatty layer are constructed mostly of fats. Besides eating good fats to preserve skin integrity, use plenty of Vitamin C. Vitamin C is the primary nutrient in connective tissue repair. Skin is the largest and thinnest connective tissue organ of the body and uses a high percentage of the available vitamin c for upkeep and repair. Vitamin C is very safe in doses high enough to cause loose stool, at the point you're wasting nutrients, so cut back to a dose that normalizes the stool. This is called taking vitamin C to bowel tolerance fats would be ideally from fresh-baked, broiled or steamed fish, or plant sources such as olive, flax, and safflower. Avoid margarine, fatty meats including lunch meats and canola oil. Avoid mass-produced baked goods, which tend to use poor quality fats.

The best approach to stretch marks is, of course, prevention. Keep in mind that skin quality is at least 50 percent genetics, and some women are more prone to stretch marks just because of hard-wired information inherited from parents and grandparents. If your family history points to a greater possibility for stretch marks, you should apply the prevention tactics described below as faithfully as possible.

As with all prevention approaches to optimal health, good food is critical. Minimize red meat and other saturated fats, avoid caffeine and excessive alcohol, get lots of greens and fresh fruits, plenty of pure water, and of course, regular moderate exercise. Balancing work with play is essential. Don't forget to sleep. America's most ignored vital nutrient. Please don't skimp on sleep. The best approach to stretch marks is, of course, prevention. Keep in mind that skin quality is at least 50 % genetics and some women are more prone to stretch marks just because of hard-wired information inherited from parent and grandparents. If your family history points to a greater possibility for stretch marks, you should apply the prevention tactics described below as faithfully as possible.

As with all prevention approaches to optimal health, good food is critical. Minimize red meat and other saturated fats, avoid caffeine and excessive alcohol, get lots of greens and fresh fruits, plenty of pure water, and of course, regular moderate exercise. Balancing work with play is essential. Don't forget sleep, America's most ignored vital nutrient. Don't skimp sleep.

Skin Brushing :

Daily brushing of the entire skin surface with a stiffy, dry, skin brush is a Scandinavian beauty secret. Skin brushing takes off the top layer of dead cells. First thing in the morning, firmly stroke the brush over the skin towards the heart. Start with the feet, moving up the legs, be extra firm around the thighs and buttocks. Gentler on the belly, move in a clockwise direction as you look down at your navel, this is the direction which waste travels out of your body in the colon. Use the long handle to get the whole back. Gently up under the breasts and down the neck and throat. Go up the arms starting from the hands. with time, the skin becomes healthier and much less susceptible to irreversible stretching.

Contrast Hydrotherapy:

The alternating application of hot and cold water to the skin is a fundamental health tool for naturopathic doctors and, hopefully, their patients. Hot water encourages blood flow to the skin, cold contracts the tiny vessels, pushing excess fluid or debris into the natural garbage collection system of the body, the lymphatic channels. The basic approach to contrast hydrotherapy is bathing in warm or hot water, then chasing with cold. Ideally, the temperature differential would be at least 60 degrees F. The treatment must end with cold water, and kames sure to get under the armpit and the groin area. Also, turn around to reach to kidneys which are protected by the lower ribs in back, to encourage waste elimination.

Not losing or gaining weight quickly:

This is usually the reason stretch marks occur. You can improve the elasticity of the skin with a good diet, vitamin C, vitamin E and the skincare measures described above, but preventing skin stretching is best. Pregnant women should be prepared to gain 25 to 40 pounds slowly and steadily and take a full 9 months to regain their pre-pregnancy weight. Crash diets are notoriously bad for the skin and they don't work for permanent weight loss either.

Vitamin E topically and by mouth:

Personally, attribute getting through pregnancy with not a single mark on the belly to high-quality Vitamin E. I slathered it on daily the third trimester, and sporadically before that, from neck to knees, ingested 400IUs of vitamin E daily throughout the pregnancy, always breaking open the gel cap with teeth and letting the oil start to absorb right in my mouth, tossing the empty gel cap. I learned this trick from a nutrition instructor if you can possibly chew your supplements like food, the thousand or nerve receptors in the mouth single the brain what's coming down the pike, and start to prepare the digestive tract with the proper enzymes for optimal digestion and absorption.

Fact on stretch marks:

- Stretch marks are long, narrow streaks or stripes that occur when the skin is stretched too quickly.

- Pregnancy, puberty, and rapid weight gain call all cause stretch marks.

- There is little medical evidence available confirming the effectiveness of current treatments for stretch marks.

- Stretch marks often fade over time without treatment and do not pose any serious long- term health risks.

What are stretch marks??

Stretch marks are scars or disfiguring lesions. They are also called striae, striae distensae, striae atrophicans, and striae gravidarum.

The most common areas affected include:

- Abdomen

- Breasts

- Hips

- Flank

- Buttocks

- Thighs

Stretch marks are not physically dangerous but can cause problems with self-image and anxiety, for some people, stretch marks are a significant cosmetic concern that can affect day-to-day living.

Signs and symptoms:

Before stretch marks begin to emerge, the skin can appear thin and pink, it may also feel irritated or itchy.

The marks initially develop as wrinkly, raised streaks that can be red, purple, pink, reddish-brown or dark brown, depending on skin color. The streaks eventually fade and flatten and tend to change to a silvery color over time.

Causes and risk factors:

Extreme skin growth or shrinkage can cause stretch marks, common causes of skin stretching include:

- Pregnancy: Between 50 and 90 % of women who are pregnant experience stretch marks during or after birth.

- Puberty: Rapid growth is typical in young people going through puberty. This can lead to stretch marks.

- Rapid weight gain: Putting on a lot of weight in a short of time can cause stretch marks.

- Medical conditions: Certain conditions can cause stretch marks, such as Marfan the skin tissue, and Cushing's syndrome can lead the body to produce too much of a hormone that leads to rapid weight gain and skin fragility.

- Corticosteroid use: Prolonged use of corticosteroid creams and lotions can decrease levels of collagen in the skin. Collagen strengthens and supports the skin, and a reduced amount can increase the risk of stretch marks.

The skin consists of three key layers. Stretch marks form in the dermis, or middle layer, when the connective tissue is stretched beyond the limits of its elasticity. This is normally due to rapid expansion or contraction of the skin.

As the body grows, the connecting fibers in the dermis slowly stretch to accommodate alow growth. However, rapid growth leads to sudden stretching. This causes the dermis to tear, allowing deeper layers of skin to show through.

This can form stretch marks and contributes to the way they look.

Stretch marks eventually fade to a silvery, white, or glossy appearance, due to the pale fat beneath the skin becoming visible instead of the usual blood vessels.

They are more likely to develop and become more severe where there are high levels of circulating cortisone, or when cortisone is applied to the skin. Cortisol, the stress hormone produced by the adrenal glands, is converted into cortisone. This weakness elastic fibers in the skin.

Risk factors:

A number of risk factors have been associated with the development of stretch marks, but the evidence varies. More research is needed to confirm the causes of stretch marks.

The risk factors for developing stretch marks could be linked to:

- Family history

- Chronic diseases

- Body mass index (BMI) before pregnant

- Birthweight of the child in women who are pregnant

These finding can be explained by the greater degrees of skin stretching in obese women with larger babies and by age-related changes in skin collagen and connective tissue that affect the likelihood of tearing.


Stretch marks are easily diagnosis based on a skin examination and a review of a person's medical history.

The doctor will usually ask questions based on signs and symptoms, as well as any medications currently being used or existing medical conditions.

Stretch marks are not harmful and do not cause medical problems. In rare cases, they may indicate an underlying medical issue that requires treatment or monitoring.


Stretch marks cannot always be prevented. However, the following steps may help to reduce the risk:

- Maintain a healthy weight

- Avoid yo-yo dieting

- Eat a balanced diet rich in vitamin and minerals. Consuming a suitable amount of vitamin A and C can help support the skin, as well as the minerals zinc and silicon.

- Aim for slow and gradual weight gain during pregnancy.

- Drink six to eight glasses of water every day.

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Vitiligo is a disease that causes the loss of skin in blotches. The extent and rate of color loss from vitiligo are unpredictable. It can affect the skin on any part of your body. It may also affect the hair and the inside of the mouth.

Vitiligo is a skin disorder in which the cells that make melanin pigments are destroyed. The destruction results in the appearance of white patches o the skin. Vitiligo can occur at any age, but usually before the age of 20 in about 50 % of patients.

Normally, the color of hair and skin is determined by melanin. Vitiligo occurs when the cells that produce melanin die or stop functioning. Vitiligo affects people of all skin types, but it may be more noticeable in people with darker skin. The condition is not life-threatening or contagious. It can be stressful or make you feel bad about yourself.

There are five main types of vitiligo, which are based upon the location of the white patches and the pattern of involvement, focal, generalized, acrofacial, segmental and universal.

Focal vitiligo: minimal involvement with only one or a very few white patches scattered on the skin.

Generalized Vitiligo: The most common type with symmetrical patches on any location on the skin including the trunk and or extremities.

Acrofacial Vitiligo: White patches limited to the fingers and around the mouth and eyes.

Segmental Vitiligo: White patches on one side of the body and in a linear or line like distribution.

Universal Vitiligo: Widespread patches involving the entire body.

The cause of vitiligo is not well understood. It is believed to be an autoimmune, disorder which means that certain blood cells in your body, lymphocytes, turn against and attack the melanocytes. Another theory is that vitiligo is caused by an interaction between the body nerve cells and melanocytes.

Vitiligo may be associated with other immune disorders. They include Addison disease, alopecia areata, diabetes mellitus, thyroid disease, melanoma, chronic mucocutaneous candidiasis, pernicious anemia, and uveitis.

Skin is made up of many layers, the skin is the largest organ of the body. It protects, maintains the temperature balance, releases out the toxins out of the body in the form of sweat and maintains the equilibrium. It reflects the internal and general health of the person. Unhealthy, dry, discolored and pigmented skin depicts indication for certain medical diseases.

Skin cell contains melanin, a dark pigments that give the color to the skin and protects it from the strong rays of the sun that are particularly harmful. If the melanin is destroyed at a certain part of the body or not produced then the skin looses, its color and turns leave white spots known as Leukoderma or Phulveri in laymen's language. Leukoderma means Leuco- white and derma, the skin is also known as vitiligo in medical terminology. It is also true that all white spots are not of leukoderma.

Children born with congenital absence of melanin have complete white skin of the whole body called Albinism that is a congenital and incurable condition.


The main sign of vitiligo is patchy loss of skin color. Usually, the discoloration first shows on sun-exposed areas, such as the hands, feet, arms, face, and lips.

Vitiligo signs include:

. Patchy loss of skin color

. Premature whitening or graying of the hair on your scalp, eyelashes, eyebrows or beard.

. Loss of color in the tissues that line the inside of your mouth and nose

. Loss of or change in color of the inner layer of the eyeball

Vitiligo can start at any age, but often appears before age 20

Depending on the type of vitiligo you have, the discolored patches may cover;

Many parts of your body. with the most common type, called generalized vitiligo, the discolored patches often progress similarly on corresponding body parts

Only one side or part of your body. This type, called segmental vitiligo, tends to occur at a younger age, progress for a year or two, then stop.

One of only a few areas of your body. This type is called localized vitiligo.

It's difficult to predict how your disease will progress. Sometimes the patches stop forming without treatment. In most cases, pigment loss spreads and eventually involves most of your skin. Rarely, the skin gets its color back.


Vitiligo is obscure, the various hypothesis is suggestive of its genesis. Among these the important ones are

. Immune Hypothesis:

Melanocyte destruction and dysfunction or both may result in Hypopigmentation of vitiligo.

. Neural Hypothesis:

Neurochemical inhibitors are released at nerve endings that destroy the melanocytes or inhibit their functioning.

. Melanocyte self- Destruction Hypothesis:

Proposes that an intermediate in melanin synthesis causes melanocyte destruction.

.Dietary deficiency of proteins and cupro minerals is a major factor for causing vitiligo. Serum skin and cerebrospinal fluid copper levels are low in these cases.

. A gastrointestinal disorder like chronic amoebiasis, chronic dyspepsia, and intestinal worms may be additional factors.

. Use of broad-spectrum antibiotics, especially chloramphenicol and streptomycin leads to the appearance of vitiligo.

. Trauma or local irritation caused by wearing the sari or trousers too tightly do produce vitiligo in individuals predisposed to it.

. Acute stress may be followed by a fast-spreading type of vitiligo proving the theory of Troponeurosis. The emotional crisis may be an additional factor.

. An Endocrinal disorder may be operative, Diabetes, Pernicious anemia, Thyrotoxicosis, Myxoedema, and Addison's disease may be associated with vitiligo.

. Composite Hypothesis- None of the theories alone is entirely satisfactory. The actual mechanism of inhibition or destruction of melanocytes is much more complex than any of these mechanisms suggested.

Precipitating Factors:

. Emotional crisis- Death in the family, loss of a job, sudden shock

. Gastrointestinal tract disorders like worms, Jaundice, amoebiasis.

. Prolonged use of drugs, antibiotics, oral ovulating agents

. Local causes like trauma burns exposure to chemicals etc.

. pathologically: A defect in enzyme Tyrosinase is held responsible for vitiligo. According to some dermatologists, it is a Trophoneurosis and melatonin, a substance secreted at nerve endings inhibits Tyrosinase, thus interfering in pigment formation.

Clinical Presentation of Vitiligo:

Localized type:

Focal- one or more macules in two single areas but not segmented.

Segmental- One or more macules in a dematomal pattern.

Mucosal- Involvement of mucous membranes alone.

Generalized Type:

Acrofacial- Involvement of face and distal extremities

Vulgaris- Scattered macules in symmetrical or asymmetrical distribution.

Universalis- Total or nearly whole body involvement


There are certain precautions, which can delay or stop the onset of the disease.

- Maintain good general disease

- It is a non- communicable disease

- Any patch should be thoroughly examined first

- Application of any unconfirmed tropical medication on the skin should be avoided

- Use of synthetic clothes should be restricted

- Avoid excess intake of sour things

- Avoid steroids

- It is a myth that leukoderma occurs by drinking milk over the fish. Thre is no relevance in avoiding anything to eat or drink which is white in color as assumed by some people similarly in cases of jaundice for yellow-colored things.


Offers a comprehensive treatment as it goes to the root of the problem by helping build up immunity and eventually restores the pigmented patches back to the normal skin color. I have observed in the clinic that there is some definite connection in the patents who are being treated for Hypothyroidism then getting Hypertjyroidism show patches of leukoderma as drugs induced leukoderma.


- Syphilitic- Destruction of melanocytes- the predominance

- Psoric - Though in Aphorism 195, Dr. Hahnemann states that in chronic local maladies that are not obviously venereal, the internal antipsoric treatment alone requisite suggests that it is Psoric in nature.

- Sycotic- As sycosis is the miasm which disturbs the pigment metabolism and produces hyperpigmentation and depigmentation in patches or diffuses in different parts.

How effective is Homeopathy?

Homeopathy is able to give wonderful and miraculous cures in many of vitiligo. This is due to the fact that homeopathy treatment enhances the natural production of pigments. According to Homeopathic philosophy vitiligo not a disease in itself but an expression of an inner disturbed state of the body. Thus, the cure should occur at a level where things have gone wrong. In order to archive this, the patient is analyzed on various aspects of mental and physical and familial attributes and also a complete study is done on the psychological environment that the patent has gone through in his life.

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Dementia comes from a Latin word "Demens" which means "Absence of mind" chronic impairment of thinking that affects a persons ability to function in a social or occupational setting. The impairment is severe enough to interfere with the patient's ability to perform routine activities.

According to WHO:

Dementia is a syndrome, usually of a chronic or progressive nature, in which there is deterioration in cognitive function beyond what might be expected from normal aging. It affects memory, thinking, orientation, comprehension, calculating, learning capacity, language, and judgment. Consciousness is not affected. The impairment in cognitive function is commonly accompanied and occasionally preceded, by deterioration in emotional control, social behavior, or motivation.

Dementia is not a specific disease. It's an overall term that describes a group of symptoms associated with a decline in memory or other thinking skills severe to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80% of cases. Vascular dementia, which occurs after a stroke, is the second most common dementia type. But there are many other conditions that can cause symptoms of dementia, including some that are reversible, such as thyroid problems and vitamin deficiencies. Dementia is often incorrectly referred to as senility or senile dementia which reflects the formerly widespread but incorrect belief that serious mental decline is a normal part of aging.

Dementia is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. A progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging. Areas particularly affected include memory, attention, judgment, language, and problem solving, madness or insanity. Alzheimer's disease international estimates that are currently 30 million people with dementia in the world with 4.6 million new cases annually. The number of people affected will over 100 million by 2050.

The age group most commonly affected by this illness is 60 and over still, there is some risk group that is not age-dependent, such as people that suffer from high blood pressure, smokers high cholesterol patients and so on. Dementia is a brain disorder, beings after the age of 60 that seriously affects a person's ability to carry out daily activities. It begins slowly, involving the parts o the brain that control thought, memory & language. People with AD may have trouble remembering recent events, name of people.

Over times symptoms get worse and the patient might have trouble in speaking, reading & writing. They may forget how to brush their teeth or comb their hair, become anxious or aggressive, and wander away from home.


Dementia is caused by damage to brain cells, this dan-mages interferes with the ability of brain cells to communicate with each other. When brain cells can not communicate normally, thinking, behavior and feeling can be affected. The brain has many distinct regions, each of which is responsible for different function (for example, memory, judgment, and movement). When cells in a particular region are damaged, that region cannot out its functions normally.

Causes divided into primary and secondary causes.

Primary Causes:

- Alzheimer's disease:

Is the most common form of dementia, and the disease most people associate with memory loss. Usually diagnosed after age 80 and is uncommon in people under the age of 65.

-Vascular dementia:

Occurs when small strokes or brain lesions impair blood flow to the brain. It is the cause of 20% of dementia cases, making it the second most common cause after Alzheimer's disease.

- Pick's Disease:

Symptoms are often hard to distinguish from Alzheimer's disease. Pick's disease damages nerve cells in the brains frontal and temporal lobes. Nerve cells affected by Pick's disease weaken and eventually die.

-Huntington's disease:

Is a genetically inherited neurological disease that can dementia. Huntington disease causes behavioral changes and chorea. The usual age of Huntington's disease onset is between forty and sixty years old.

- Parkinson's disease:

Is a progressive neurological disease that affects movement and muscle control. Symptoms of Parkinson's disease include tremors, balance problems, difficulty walking, and a rigid posture.

-Lewy- body dementia:

Related to Alzheimer's disease. The cause is the presence of abnormal substances called Lewy-body in parts of the brain such as cortex and brain stem. Lewy body dementia causes classical dementia symptoms, including memory loss. The disease can also cause hallucinations, depression, and paranoia.

Secondary causes:

Dementia like symptoms can develop as a result of an underlying condition can be treated, the symptoms will generally improve. The following are some of the common secondary causes that can lead to dementia.

-Alcohol Dementia and substance abuse:

Alcohol abuse can lead to symptoms of dementia. The long term toxic effects of alcohol on the brain are enough to cause it. Symptoms can often be improved by abstaining from alcohol.

-Infections diseases:

A number of infections that affect the central nervous system have been known to cause dementia symptoms, including HIV, meningitis, and encephalitis.


As people age, they tend to require more medication for their health. Many of the medications include dementia symptoms as aside effect. The list of medications is incredibly long and includes such common medication as anti-diarrhea medication, anti-epileptic medications, antihistamines, cold and flu medication, sleeping pills, tricyclic antidepressants.

Pseudo Dementia:

Depression can result in dementia symptoms, including memory loss and a lack of motivation. Elderly people dealing with health problems, the loss of spouse, or loneliness are particularly susceptible to depression. Treating depression often result in the reversal of dementia symptoms.

Metabolic disorders:

Metabolic disorders can also symptoms of dementia. These disorders include cortisol hormone imbalances, diabetes, electrolyte levels, kidney failure, liver diseases, and thyroid disorders.

Wernicke- Korsakoff syndrome:

It results from a deficiency in thiamine (Vitamin B1) and is often due to chronic, severe alcoholism. It can also result from general malnutrition, eating disorders, or the effects of chemotherapy. Dementia due to Wernicke- Korsakoff syndrome involves confusion, apathy, hallucination, communication problems, and severe memory impairment.

Brain Tumors:

Brain tumors put pressure on and damage the surrounding brain tissue. A brain tumor can cause a number of symptoms, including dementia. The tumor may originate in the brain or may have spread to the brain from other organs.

Signs and symptoms:

Dementia affects each person in a different way, depending upon the impact of the disease and the person before becoming ill. The signs and symptoms linked to dementia can be understood in three stages.


The early stage of dementia is often overlooked because the onset is gradual. Common symptoms include:

- Forgetfulness

- Losing track of the time

- Becoming lost in familiar places.

Middle stage:

As dementia progresses to the middle stage, the signs and symptoms become and more restricting. These include:

- Becoming forgetful of recent events and people's names

- Becoming lost at home

- Having increasing difficulty with communication

- Needing help with personal care

- Experiencing behavior changes, including wandering and repeated questioning.


The late stage of dementia is one of near-total dependence and inactivity. Memory disturbances are serious and the physical signs and symptoms become more obvious. Symptoms include:

- Becoming unaware of the time and place

- Having difficulty recognizing relatives and friends

- Having an increasing need for assisted self-care

- Having difficulty walking

- Experiencing behavior changes that may escalate and including aggression.

Handling Money:

Trouble remembering simple words, often dementia sufferers will substitute inappropriate words without realizing.

Common forms of dementia:

There are many different forms of dementia. Alzheimer disease is the most common form and may contribute to 60-70% of cases. Other major forms include vascular dementia, dementia with Lewy bodies, and a group of diseases that contribute to frontotemporal dementia. The boundaries between different forms of dementia are indistinct and mixed forms often co-exist.

Rates of dementia:

Worldwide, around 50 million people have dementia, with nearly 60% living in low and middle-income countries. Every year, there are nearly 10 million new cases. The estimated proportion of the general population aged 60 and over with dementia at a given time is between 5-8%. The total number of people with dementia is projected to reach 82 million in 2030 and 152 in 2050. Much of this increase is attributable to the rising numbers of people with dementia living in low and middle-income countries.


There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer's and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. Doctors can determine that a person has dementia with a level of certainty. But it's harder to determine the exact type of dementia because of the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnosis dementia and not specify a type. If this occurs it may be necessary to see a specialist such as a neurologist or a psychologist.

Diagnosis requires a medical history, physical examination, including neurological examination and appropriate laboratory tests.

Taking a thorough medical history involves gathering information about the onset duration, and progression of symptoms, any possible risk factors for dementia, such as a family history of the disorder or other neurological diseases, history of stroke, and alcohol or other drug use.

The various laboratory investigations include:

- Thyroid hormone tests to check for an underactive thyroid.

- Vitamin B12 blood test to look for a vitamin deficiency.

- Complete blood count, or CBC, to look for infection.

- ALT or AST, blood tests that check liver function.

- Syphilis test to look for this disease.

- Chemistry screen to check the level of electrolytes in the blood and to check kidney function.

- Glucose test to check the level of sugar in the blood.

- MRI or CT to look for tumors.

Other lab tests that may be done include:

- HIV testing to look aids

- Erythrocyte sedimentation rate, a blood test that looks for signs of inflammation in the body.

- Toxicology screen, which examines blood, urine, or hair to look for drugs that could be causing problems.

- Antinuclear antibodies, a blood test used to diagnose autoimmune diseases

- Testing for heavy metals in the blood, such as a lead test.

Risk factors and prevention:

Although age is the strongest known risk factor for dementia, it is not an inevitable consequence of aging. Further, dementia does not exclusively affect older people- young-onset dementia accounts for up to 9% of cases. Studies show that people can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling and blood sugar levels, Additional risk factors include depression, low educational attainment, social isolation, and cognitive inactivity.

Social and economic impact:

Dementia has significant social and economic implications in terms of direct medical and social care costs, and the costs of informal care. In 2015, the total global societal cost of dementia was estimated to be 818 billion, equivalent to 1.1% of global gross domestic product. The total cost as a proportion of GDP varied from 0.2% in low and middle-income countries to 1.4% in high-income countries.

Impact on families and carers:

Dementia can be overwhelming for the families of affected people and for their carers. Physical, emotional and financial pressure can cause great stress to families and carers, and support is required from the health, social and legal systems.

WHO response:

WHO recognizes dementia as a public health priority. On May 2017, the World Health Assembly endorsed the Global action plan on the public health response to dementia 2017- 2025. The plan provides a comprehensive blueprint for action, for policy-makers, international, regional and national partners, and WHO as in the following areas, addressing dementia as a public health priority, increasing awareness of dementia and establishing dementia-friendly initiatives, reducing the risk dementia, diagnosis, treatment and care, information systems for dementia, support for dementia carers, and research and innovation. An international surveillance platform, the global Dementia Observatory, has been established for policymakers and researchers to facilitate monitoring and sharing of information on dementia policies, service delivery, epidemiology, and research.

WHO has developed Towards a dementia plan, a WHO guide, which provides guidance to the Member States in creating and operationalizing a dementia plan. The guide is closely linked to WHO's GDO and includes associated tools such as a checklist to guide the preparation, development, and implementation of a dementia plan. It can be used for stakeholder mapping and priority setting.

WHO Guidelines on risk reduction of cognitive decline and dementia provide evidence-based recommendations on interventions for reducing modifiable risk factors for dementia, such as physical inactivity and unhealthy diets, as well as controlling medical conditions linked to dementia, including hypertension and diabetes. Dementia is also one of the priority conditions in the WHO mental health gap action program, which is a resource for generalists, particularly in low- and middle-income countries, to help them provide first-line care for mental, neurological and substance use disorders.

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Anorexia Nervosa
An eating disorder causing people to obsess about weight and what they eat.

Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.

The condition commonly involves emotional challenges, an unrealistic body image, and an exaggerated fear of becoming overweight or obese. If often begins during the teenage years or early adulthood, but it can begin in the preteen years. It is the third most common chronic illness among teens.

Eating disorders affect some 30 million men and women in the United States. Both men and women can develop anorexia, but it is 10 times more common in females. Nearly 1 in every 100 American women will experience anorexia some time. Anorexia nervosa is different from anorexia, which means a loss of appetite or inability to eat.

Fast facts on Anorexia Nervosa:

Here are some key points about anorexia nervosa

. Anorexia nervosa is a psychological condition that involves an eating disorder.

. Symptoms include a very low body mass index, a refusal to eat, and attempts to lose weight, even when body mass index is very low.

. It is thought to be triggered by a combination of biological, environmental, and genetic factors.

. Treatment can take some time, but with a combination of counseling and other types of therapy, recovery is possible.

Anorexia nervosa is a psychological condition and an eating disorder in which the individual loses more weight than is healthy for their height and age. The individual will maintain a body weight of 85% or less of their expected weight.

. A person with anorexia will internationally restrict their food intake, generally due to a fear of being or becoming fat, even when their body mass index is already low. They may also practice excessive, use laxatives, and vomit to reduce weight, but to a lesser extent then those diagnosed with bulimia.

.Complication can be severe. An eating disorder is reported t have the highest mortality rate of any mental illness. Treatment includes hospitalization and counseling.


Anorexia nervosa is a complex condition, but the main sign is usually severe weight loss. The person may also talk about being overweight, although objective measures, such as BMI, show that this is not true.

Behavioral changes may include a refusal to eat, exercising excessively, and use of laxatives or vomiting after consuming food.

- Severe loss of muscle mass

- Hypotension, or blood pressure
- Listlessness, fatigue, exhaustion

- Lightheadedness or dizziness

- Hypothermia, or low body temperature, and cold hands and feet

- Bloated or upset stomach and constipation

- Dry skin

- Alopecia, or hair loss

- Swollen hands and feet

- Infertility

- Insomnia

- Loss of menstruation or less frequent periods

- Brittle nails

- Osteoporosis, or loss of bone density

- Irregular or abnormal heart rhythms

- Lanugo, fine downy hair growing all over the body, and increased facial hair signs of vomiting include bad breath and tooth decay, due to the acid in the vomit.

Psychological signs and symptoms include:

- Obsession with food, for examples, reading cookery books

- Excessive concern about being fat or overweight

- Frequently measuring and weighing themselves and inspecting their bodies in the mirror

- Lying about food intake

- Not eating or refusing to eat

- Reduce sex drive

- Self- denial

- Lack of emotion or a depressed mood

- Over-exercising

- Irritability

- Memory loss

- Obsessive-compulsive behavior

Food and eating become associated with guilt. It may be difficult to talk to the person about a possible problem, as they will likely refuse to acknowledge that anything is wrong.


No single cause has been identified for anorexia nervosa. It probably happens as a result of biological, environmental, and psychological factors.

- Being susceptible to depression and anxiety

- Having difficulty handling stress.

- Being excessively worried, afraid, or doubtful about the future

- Being perfectionist and overly concerned about rules.

- Having a negative self-image

- Having eating problems during early childhood or infancy

- Having had an anxiety disorder during childhood.

- Holding specific regarding beauty and health, which may be influenced by culture or society

- Having a high level of emotional restraint or control over their own behavior and expression, the person may be overly worried about their weight and shape, but this is not necessarily the key factor.

33 and 50 % of people with anorexia also have a mood disorder, such as depression, and around half have an anxiety disorder, such as Obsessive-compulsive disorder and social phobia. This suggests that negative emotions and a low self-image may contribute, in some cases. A person may develop anorexia Nervosa as a way of gaining control of some of their life. As they exert control of their food intake, this feels like success, and so the behavior continues.

Environmental factors:

Environmental factors may include the hormonal changes that occur during puberty, plus feelings of anxiety, stress, and low self-esteem. The fashion industry and media messages suggesting that being thin is beautiful may have an impact.

- Physical, sexual, emotional or other types of abuse

- Family or other relationship problems

- Being bullied

- Fear and pressure to succeed

- A stressful life event, such as bereavement or becoming unemployed.

Genetic Factors:

Studies have found that some people with eating disorders may have an imbalance in certain brain chemicals that control digestion, appetite, and hunger. Further research is needed to confirm this. Genetic factors may affect a person's susceptibility to eating disorders, as they can run in families. between 50 to 80% of the risk for anorexia is thought to be genetic.

Vicious cycle:

Once a person starts losing weight, low weight and lack of nutrients may contribute to brain changes in a way that reinforces the behaviors and obsessive thoughts related to anorexia nervosa. The changes could involve the part of the brain that controls appetite,

Once a person starts losing weight, low weight and lack of nutrients may contribute to brain changes in a way that reinforces the behaviors and obsessive thoughts related to anorexia nervosa.

The changes could involve the part of the brain that controls appetite or they could increase the feelings of anxiety and guilt that become associated with eating.

Anorexia nervosa may have different gut microbial communities than those without the condition. The authors suggested that this could contribute to anxiety, depression, and further weight loss. People with anorexia nervosa are less able to differentiate between different types of positive emotion. This can lead to further weight-loss behavior, as self- deprivation becomes associated with a sense of pride.


Diagnosis and prompt treatment increase the chance of a good outcome.

The physician will ask the patient about weight loss, how they feel about their weight, and, for females, about menstruation. It can be hard fo the patient to open up and speak frankly about themselves. It can take years to confirm a diagnosis, especially if the person was previously obese. If the physician detects signs of anorexia nervosa, they may order tests to rule out other underlying medical conditions with similar signs and symptoms.

- Diabetes, Addison's disease

- Chronic infections, Malabsorption

- Immunodeficiency, Cancer

- Inflammatory bowel disease, Hyperthyroidism


Complications can affect every body system, and they can be severe.

Physical complications include:

- Cardiovascular problems: These include low heart rate, low blood pressure, and damage to the heart muscle.

- Blood problems: There is a higher risk of developing leukopenia, or low white blood cell count. and anemia, a low red blood cell count.

Gastrointestinal problems: Movement in the intestines slow significantly when a person is severely underweight and eating too little, but this resolves when the diet improves.

Kidney problems: Dehydration can lead to highly concentrated urine and more urine production. The kidneys usually recover as weight levels improve.

Hormonal problems: Lower levels of growth hormones may lead to delayed growth during adolescence.

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