Schnitzler s syndrome is a very rare condition described by a reddish rash that looks like hives (urticaria) and lifted levels of a particular protein in the blood (monoclonal IgM gammopathy). Symptoms connected with the Schnitzler disorder may include increased levels of fever, joint inflammation, joint pain (arthralgia), bone agony, and different discoveries, for example, swollen lymph nodes (lymphadenopathy). It also causes weight reduction, discomfort, exhaustion, and broadened spleen and liver. This condition should be treated in terms of taking care of the symptoms so that they do not become debilitating.

Some of the other symptoms include the following:

Urticaria (hives) depicts red raised patches of the skin. These are once in a while irritated. They may last for about 12 hours to 3 days. This may become severely painful if not treated in time.
80% of such patients suffer from painful or swollen. A few patients experience bone pain as well.
High fever might be there accompanied by chills and night sweating. This can give rise to further uneasiness and is usually caused when the immune system is attacked by the ailment.
One of the main symptoms of the Schnitzler disorder is monoclonal gammopathy. This mostly means a raised level of immunoglobulin M (IgM)
Reasons behind it

The main cause behind the Schnitzler syndrome is unknown. Specialists believe that particular parts of the immune system may not work appropriately in the end because of the Schnitzler syndrome. Individuals with the Schnitzler disorder additionally have monoclonal IgM gammopathy, in which abnormal production of immunoglobins result in elevated levels of immunoglobulin M (IgM) in the body. Immunoglobulins are proteins delivered by the white blood cells. A few analysts believe that IgM antibodies accumulate in the skin (epidermis), setting off a reaction that causes the rash. At the time of diagnosis, IgM levels may just be somewhat raised and may stay stable for quite a long time.

Diagnosis

The diagnosis of the Schnitzler disorder is based upon an intensive clinical assessment, patient history, rejection of different other disorders and proof of fever, joint pain or aggravation, bone pain, discernible lymph nodes, amplification of the liver or spleen, lifted quantities of white platelets (leukocytosis), raised red platelet (erythrocyte) or anomalies, which can uncover expanded bone thickness (osteosclerosis).

Treatment: 
Anakinra is a successful treatment for Schnitzler syndrome. It is also very commonly used to treat rheumatoid joint inflammation. The following medicines and therapies have been proven to be successful for treating the Schnitzler disorder over a period of time. These are as follows:

Antihistamines
Nonsteroidal calming specialists
Systemic steroids (prednisone)
Hydroxychloroquine
Colchicine
Dapsone
Pamidronate
Thalidomide
Pefloxacin
Phototherapy
Immunosuppressive specialists (ciclosporin, methotrexate, cycloposphamide)
Biologic specialists (tocilizumab, rituximab)
The Schnitzler disorder is a long-term infection, so stopping a promising treatment can tend to cause a relapse and may cause the disease to reappear. Also, the medicines mentioned above should not be taken without consulting a doctor as they can have sever side effects, if not administered under the guidance of a physician.

Schnitzler Syndrome - Things You Must Know About It!

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

While most people recover from first and second degree burns without fatal consequences, third-degree burns pose a different story altogether.

Third-degree burns occur when the damage to the skin extends beyond the dermis, and perforates deep within the tissues. This sort of injury is the most serious one. For instance, injuries sustained from a fire breakout, acid attack, etc.

Symptoms include-

Charred/black skin
Numbness
The damage to the nerves caused by third-degree burns are so extensive, that the victim may feel very little or no pain.

Complications-
There are several complications associated with third-degree burn injuries, such as the following-

Infection
Sepsis
Scarring
Low volume of blood
Very low body temperature
Joint/bone problems
How Ayurveda heals third-degree burn injuries-
Burn injuries, especially of third-degree, leaves behind ugly, unpleasant scars. Moreover, such distressing marks can be traumatic for the victim as it may bring back horrific memories of the incident. Many times the person may feel hesitant to visit a doctor or go for a therapy. This is when Ayurveda comes to your aid.

Ayurveda uses therapeutic and natural remedies- essential oils, herbs and spices- to relieve pain, and helps you get rid of those burn scars. Some of the natural ingredients used in Ayurvedic treatment include-

Use of herbal oils Lavender and Calendula helps in quick relief from burn injuries.
An ointment prepared from red sandalwood, gairika, tugaksiri, and plaksa extracts can be applied on injuries caused due to third degree burn.
Applying cucumber juice or Jatyadi oil on the affected area with cotton balls offers relief from the pain.
Prepare a paste using mustard oil and henna leaves, and apply the same on burn injuries. This will provide instant relief from irritation.
Prepare an herbal pack using, turmeric, amla, etc. that are rich in anti-inflammatory, antibacterial properties. This can heal burn scars and ease pain.
Apart from these, Ayurveda also suggests following a bland (without spices), healthy diet so that the injury does not aggravate the injury further.

Third-Degree Burn Injuries - An Ayurvedic Approach!

Swollen breast tissues in men or boys caused by hormonal (testosterone and estrogen) imbalances is called gynecomastia. Both breasts or one breast, can be affected by gynecomastia. At any point in life, from birth to puberty, even in adulthood, you might develop gynecomastia. Most of the times, gynecomastia is caused by hormonal imbalances, but there might be some underlying causes as well.
Gynecomastia is normally not a serious condition, but it can be difficult to deal with the pain and embarrassment.
It can be cured with surgery or medication, if it doesn't go away on its own.

Symptoms and signs of gynecomastia include
a) Enlarged glands in the breast tissue
b) Tenderness in the breast

The causes that trigger gynecomastia include
1. Hormonal changes: Testosterone and estrogen control the sexual development in men and women respectively. Estrogen is not a hormone that only women produce; men produce it too. When the production of testosterone and estrogen are thrown out of balance, gynecomastia occurs.
2. Medication: Certain medications such as anabolic steroids, androgens, HIV/AIDS medicines, antibiotics and chemotherapy can cause gynecomastia.
3. Drugs and alcohol: Substances such as alcohol, marijuana, amphetamines, heroin and methadone cause gynecomastia.
4. Health condition: Certain factors, such as aging, hypogonadism (hormonal disorder), hyperthyroidism (overactive thyroid gland), tumors, kidney failure, cirrhosis, liver failure, malnutrition and starvation can lead to gynecomastia.
5. Herbal products: Essential oils derived from plants such as lavender or tea tree, used in lotions or shampoos, have weak estrogenic actives. They have been said to cause gynecomastia.

Gynecomastia can be cured either with medication or surgery. Surgical options for gynecomastia are, however, limited. The two surgical options for gynecomastia include:
a) Liposuction: Liposuction only removes the fat from the breast, not the breast gland tissue. It has fewer complications, there is limited or zero blood loss and there is less distortion of the nipple.
b) Mastectomy: Mastectomy removes the gland tissues in the breast. The surgery uses minimal incisions to remove the gland tissue. Also, it involves less time to recover.

Treating Gynecomastia With Surgery

Plastic surgery includes various procedures in order to repair body parts which are damaged and injured or for cosmetic reasons by transferring tissues. The most common procedures performed on patients are lipoplasty, breast augmentation, facelift, eyelid surgery and botox. There have been a lot of assumptions and myths around plastic surgery, but it is no different than any other medical procedures. Here are top plastic surgery myths that you need to be aware of.


	Women are the only customers: although women have been traditionally known to be the prime customers of plastic surgery, nowadays a lot of men are also opting for various procedures. Non penetrating mild procedures like botox, laser, and dermal fillers are highly popular among men. These are low cost and effective procedures that can make a mile of difference in your look.
	It's all about looking good: there are certainly many procedures focused on restructuring the body parts to enhance beauty but plastic surgery includes a lot of other procedures such as correcting sports injuries, burns, disfigurement due to an accident etc. Cosmetic surgeries are usually opted in those cases where normal exercises, diets and weight loss programs cannot alter the structure of a particular area.
	You will look young forever after opting for a plastic surgery: you can get procedures done to turn back time, but it is difficult to stay that way forever. Plastic surgery usually lasts for decades barring the non-invasive procedures such as botox and laser which are semi- permanent. A healthy lifestyle and occasional clinical touch ups can take away years from your look but it is humanly impossible to remain in the same way forever.
	Gives you smooth skin with no scars: there are procedures to reduce the appearance of scars but a surgery will sustain some kind of scar no matter how minuscule. Post surgery treatments are available to diminish scars but a slight remnant is to be endured.


If you are in need of plastic surgery it is advisable to gather necessary information before going through any procedure rather than believe assumptions.


Busting Plastic Surgery Myths

Psoriasis is a durable autoimmune disease defined by patches of irregular skin. These patches of skin are usually scaly, red and itchy. Its symptoms vary greatly in severity, the coverage might be small and focused or it could spread all over the body.

Types
There are mainly five types of psoriasis:
1. Plaque- also called psoriasis vulgaris, is the most common kind of psoriasis (90% of cases). It affects the skin behind the forearms, over the navel, shins and scalp, usually presenting itself in red patches with white- colored scales over it.
2. Guttate- has lesions that are drop-shaped.
3. Inverse- red patches show up in the folds of your skin.
4. Pustular- pus-filled blisters form. They are non-infectious.
5. Erythrodermic- the rash spreads wider. In some people, even fingernails and toenails get affected as pits may form on them or their colour may change.

Causes
Anything from emotional trauma and stress to streptococcal infection can cause psoriasis. Sometimes you might carry predisposition for psoriasis in your genes and stress may aggravate it. Environmental factors may also lead to psoriasis. And then again defects in the immune system may also be the underlying cause. Even after thirty years of research, the exact cause for psoriasis remains a mystery. There is no age limit to psoriasis. It can show up from anywhere between infancy to old age.

Symptoms
Common symptoms include
1. Pink or red scaly bumps that are smaller in size, but become plaques later, show up on the skin. Although these scales can show up anywhere, they are mostly common on sites where there is much friction, abrasion or scratching.
2. Small pinpoint depressions or pits might show up on toenails and fingernails. Distal onycholysis, which refers to large brown/yellow divisions on the nails, shows up as well.
3. Sore throat may follow if it is guttate psoriasis.

Treatment
Psoriasis is not curable. But its symptoms can be managed with steroid creams, ultraviolet creams, vitamin d3 creams and with medicines that act as immunosuppressants. Creams alone can help control symptoms in 75% of patients with psoriasis.

All About Psoriasis

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