The inflammation of the kidneys as an effect of Systemic Lupus Erythematosus (SLE) is known as Lupus Nephritis. Like lupus, this is an autoimmune disease. Inflammation of the kidneys hinders kidney functioning by not allowing the kidneys to regulate the optimum amount and types of fluids in the body and restricts the removal of waste through urine. It can also cause the protein to leak out of the kidneys. If not managed in time, this can eventually lead to kidney failure by scarring the kidney tissue. However, this is a rare occurrence. 

On an average, 6 out of 10 lupus patients suffer from lupus nephritis. In most cases, this disease develops within the first five years of lupus symptoms making their appearance. The symptoms of this disease are mild and can vary from person to person. Very often, the first signs of lupus nephritis become visible only in lab tests as the symptoms are similar to those exhibited by other kidney diseases. 

Some of the common symptoms of this condition are: 

Swelling of the feet, ankles and calves 
High blood pressure 
Weight gain 
Frothy, dark urine 
There are five stages types of this disease and hence, the first step to treating this disease is to identify its type. For this, your doctor will begin with a thorough physical examination and understand your medical history. He or she will also ask for a few tests including urine tests, blood tests, an ultrasound and a kidney biopsy to confirm the diagnosis. 

Lupus nephritis is usually treated with corticosteroids and immunosuppressive drugs. Medication may also be prescribed to lower blood pressure and prevent the clotting of blood. However, in some cases, this treatment may not be enough to stop the progression of the disease and some kidney function may be lost. If both kidneys fail, dialysis is the next medical step. This involves the use of a machine in place of the kidneys to filter and removes waste products from the body. This may be followed by the need for a kidney transplant. 

Since lupus patients are at a high risk of lupus nephritis, here are a few conscious lifestyle changes that can help prevent this condition:

Have a diet that is low in salt 
Avoid smoking and alcohol 
Exercise regularly 
Avoid non-steroid anti-inflammatory drugs("pain killers") and unproven alternative medications that can affect the kidneys.

What Is Lupus Nephritis?

Are you experiencing skin itchiness and development of dry, scaly rashes on your skin? This indicates you have eczema, which is a group of skin diseases occurring due to the inflammation and irritation of skin. Atopic dermatitis is the most common form of eczema. The disease can be controlled if proper treatment is undertaken.

Symptoms
Itchy skin is the most common symptom of eczema. In some cases, the itching starts before the development of the rash. The rash appears most commonly on the back of the knees, face, hands, wrists and feet. The affected areas become dry and thickened and in people with a fair complexion, the areas may turn reddish initially and then become brown.

Causes
The specific cause of eczema is yet to be determined. However, the condition is associated with an overactive response by the immune system to an external irritant. This response leads to eczema. The condition is more common in people who have a family history of allergies or asthma.

Treatment

As the condition turns the skin dry and itchy, certain creams and lotions are recommended to be used in order to keep the skin moist. You should apply these products when your skin is damp, ideally after taking a shower. This helps the skin in retaining moisture. You can use a cold compress to ease the itching.
Several creams such as hydrocortisone cream and ointments which contain corticosteroids are prescribed in order to reduce inflammation.
In case the affected area becomes infected, antibiotics should be taken to eliminate the infection-causing bacteria.
Antihistamines are used for reducing the severity of the itching. 
Prevention of Eczema Flare-ups

Moisturize your skin frequently
Avoid sudden changes in humidity or temperature
Abstain from overheating and sweating
Try to reduce stress
Avoid starchy material
Avoid soaps, detergents and solvents, which are harsh
Be aware of food items which trigger eczema flare-ups
It is recommended for you to consult a dermatologist if you experience any symptom of eczema. This will help you with a quick diagnosis so that you can start the treatment without further worsening of the symptoms.

Eczema - How You Can Prevent Its Flare-ups?

Corns are small circular patches of thick, hardened skin that generally develop on the toes or soles of feet. They may occur anywhere else on the body. They might be caused due to friction and pressure which may occur, if you wear poorly fitted shoes or as a symptom of some other conditions such as bunions (big toe bent towards other toes) or hammer toe (toe bent at the middle joint).

Corns, especially on feet will not get cured unless its root cause is treated. If left untreated, the skin becomes thicker and more painful. Cures for corns will depend on the cause or nature of the corn. Here are some effective ways to treat most types of corns.

1. Removal of hard skin: A dermatologist can help remove the thickened skin with a scalpel, which will relieve the pressure on the affected tissue.

2. Products that treat corns: Some foot care products are specially designed to allow your skin heal and to redistribute the excess pressure that is causing the corn. These may be prescribed by your dermatologist for quick healing of your corns. Some of these products include:
a. Rehydration creams that soften thickened skin
b. Soft padding or foam insoles that can be inserted into shoes
c. Corn plasters that provide protection
d. Small foam wedges which can be placed between toes to cure soft corns
e. Special silicone wedges that change the position of your toes and help in redistribution of pressure.

3. Salicylic acid: Salicyclic acid, contained in several over-the-counter products is helpful in softening the first layer of dead skin, thereby facilitating its removal. Products containing salicylic acid should not be used if you suffer from conditions that cause circulation problems, such as diabetes, peripheral neuropathy or arterial disease. If you have cracked or broken skin in the area of the corn or sensitive skin, salicyclic acid is not suitable for you either.

You can prevent corns by practising proper foot care, as your feet carry the weight of the entire body and are very susceptible to problems. Using a pumice stone regularly to rub away hard, dead skin is a good way to prevent corns and bacteria. Wearing properly fitted shoes is a must to prevent corns. If you wear heels very often, they may put excessive pressure on your feet. If you suffer from diabetes or other diseases causing circulation problems, do consult a doctor as corns and infections in the feet can lead to more severe infections.

How to Treat Corns on the Skin

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

The process of breast augmentation, popularly known as breast enlargement or implants, effectively increases the size of the breasts through insertion of silicone gel implants or saline implants. It is known to be popular among women and is frequently done and shows quite satisfying results.

Why do women opt for breast augmentation?

Some women opt for implants to enhance their figure
Others opt for implants, when they experience some sort of sagging or alteration to their breast after a pregnancy or after losing some weight and even due to old age.
Some women also choose enhancement surgery, if they feel that one breast is smaller than the other.
What does a breast augmentation procedure involve?

Breast augmentation surgery is generally performed, while the patient is under the influence of general anaesthesia. In case of enhancement with the help of implants, an incision is made in the breast tissue and a pocket is created to place the implants. Once these implants are successfully placed the incision is closed and is allowed to heal.

What sort of implants is available?
There are basically 4 types of implants that are recommended on the basis of the body type:

Saline filled breast implants: These implants contain sterile water and are either pre-filled or filled during the surgery.
Silicone filled breast implants: These implants contain soft elastic gel and come prefilled. These types of implants also require an incision which is longer in size.
Cohesive gel silicone implants: Commonly known as 'form stable'implants, they contain cohesive gel that is more firm and thicker than normal silicone implants.
Autologous fat transfer: It consists of fat that has been removed through liposuction from a part of the body, like the abdomen or thighs. The fat is then refined and injected into the breasts. However, implants done through this method is not very common and is currently under research.
Breast implants are generally supposed to last for life, but on occasions they may need replacement. Thus regular check ups are essential, so as to monitor the condition of the implants.

All About Breast Augmentation

Can scratching your head lead to hair loss? (and how to banish that nagging itch without scratching)

Yes! scratching your head actually leads to hair loss so you should avoid doing it.

Scratching your head with your fingernails for as little as 90 minutes is enough to remove all your cuticular scale. A cuticular scale is a protective covering on every individual strand of hair. The loss of this covering leaves your hair shaft weak and damaged and hence leaves your hair susceptible to easy breakage and hair loss.

There are several ways you can deal with itchiness in your scalp that does not include scratching your head. These alternative ways will help ensure you don't suffer from any hair loss.

These include

1. Instead of scratching, pat or rub the sensitive area with the flat of your fingers.

2. Having a dry scalp can also increase itchiness. It would bee a good idea to use natural oil on your hair before you wash it if that's the reason behind your itch.

3. Sensitivity to a new product may be causing a sudden itchiness in your scalp. So, if you have switched to a new shampoo, mousse or anything else, do try abstaining from applying it for a few days to see if the itchiness subsides.

4. When your scalp feels itchy, try and distract yourself. The more you think about how itchy your scalp is, the more it will itch.

While scratching your hair does lead to hair loss, the good news is your hair will grow back because the damage is not permanent. However, it is not advisable to keep scratching your head because you'll just lose more hair.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: Should You Oil Hair When You Have Dandruff Problem?

Can scratching your head lead to hair loss? (And how to banish that nagging itch without scratching)

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