The abdomen houses multiple organs and pain in the abdomen could indicate a problem with any of these organs. From a medical point of view, the abdomen and associated pain can be divided into nine areas or quadrants the right, middle and left sideways and the upper, middle, and lower quadrants from top to bottom. The doctor would usually ask the patient to point to the area of the problem for instance, right lower quadrant or upper left quadrant.

With a mental mapping of the organ in each of these quadrants, the diagnosis is arrived at, with confirmation by imaging if required. Some of the most common causes for lower abdominal pain are listed below, and the kidneys are important organs in this area.

Lower left abdominal pain is caused because of the problems in the large intestine, small intestine, spleen, left kidney, ureter, ovaries, fallopian tube, urinary bladder and their associated structures.
Some of the common issues in this area could be menstrual cramps, urinary tract infections (UTIs), left kidney stones, uterine disorders, intestinal obstruction, ectopic pregnancy, constipation, colon cancers, pelvic inflammatory disorder, Crohn s disease, inguinal hernia, and a ruptured spleen.
Lower right abdominal pain can be due to appendicitis, right inguinal hernia, UTI, right kidney stones, colon cancer, menstrual cramps, uterine disorders, intestinal obstruction, ectopic pregnancy, pelvic inflammatory disorders, diverticulitis, Crohn s disease, endometriosis, and lymph node inflammation.
As is evident from this list, many of these are related to the urinary tract and kidneys. Whether it is the kidneys per se, the urinary bladder, the ureters, or the associated nerves and blood vessels, UTIs are very common. And if one of these organs is affected, then the chance of the infection spreading to the surrounding organs is very high. There is a constant flow of urine through these structures, and so the infection can pass through easily.
A person who has had kidney problems would have very characteristic symptoms. The pain would be in the lower back, on either side of the spine, depending on which side is affected. While the pain experienced due to kidney stones is acute and can be stabbing in nature, the UTI would appear in bouts. The associated symptoms should always be kept in mind when identifying and treating kidney problems.
There could be nausea, diarrhoea, blood in the urine, fever, profuse sweating and severe fever, which could help in discovering the problem.
These should not be ignored and diagnosis should be confirmed with blood tests and imaging including X-rays and CT scans. The treatment would depend on the condition, and early identification of the problem leads to better prognosis and a simpler treatment.

Lower Abdomen Pain - Can It Be A Sign Of Kidney Problem?

HIV: QUICK FACTSIntroductionThe human immunodeficiency virus (HIV) is a subgroup of retrovirus (lentivirus) that causes HIV infection. After a period of time, this infection leads to what is called acquired immunodeficiency syndrome (AIDS).

Epidemiology

According to the Centers for Disease Control and Prevention (CDC), from 2010-2015, the estimated rate of HIV infection in all 50 US states decreased from 14.2 per 100,000 population in 2010 to 12.3 per 100,000 population in 2015. In 2015, 39,513 individuals were diagnosed with HIV infection. From 2010 to 2014, the annual number of new HIV infections decreased by 9%.

Virology HIV-1 and HIV-2 are retroviruses in the Retroviridae family, Lentivirus genus. They are enveloped, diploid, single-stranded RNA viruses with a DNA intermediate.Upon entry into the target cell, the viral RNA genome is converted into double-stranded DNA by an enzyme, reverse transcriptase that is transported along with the viral genome in the virus particle. The resulting viral DNA is then imported into the cell nucleus and integrated into the cellular DNA by a virally encoded enzyme, integrase. HIV contains three retroviral genes, namely gag, pol, and env.

Gag gene: Encodes group-specific antigen; the inner structural proteins
Pol gene: Encodes polymerase; it also contains integrase and protease
Env gene: Encodes the viral envelope, the outer structural proteins responsible for cell-type specificity. Glycoprotein 120, the viral envelope protein, binds to the host CD4+molecule
Pathophysiology

HIV infects vital cells in the human immune system, such as helper T cells (specifically CD4+ T cells), macrophages, and dendritic cells and leads to cellular immune deficiency. This results in the development of opportunistic infections and neoplastic processes.

Mode of Transmission
Sexual intercourse: Unprotected sexual intercourse; especially receptive anal intercourse and different sexual partnersContact with or transfer of blood, pre-ejaculate, semen, and vaginal fluids infected with the virus.Spread from an infected mother to her infant through breast milk. An HIV-positive mother can transmit HIV to her baby both during pregnancy and childbirth due to exposure to her blood or vaginal fluid.

Signs and Symptoms There are 3 categories of infection 

Category A: Asymptomatic HIV infection without a history of symptoms or AIDS-defining conditions
Category B: HIV infection with symptoms that are directly attributable to HIV infection
Category C: HIV infection with AIDS-defining opportunistic infections
Investigation

A high-sensitivity enzyme-linked immunosorbent assay (ELISA) should be used for screening.

Management

Start with antiretroviral therapy (ART) in all HIV-infected adults ready to start therapy. 
CD4 count is no longer a criterion for starting the therapy.
Use of nucleoside reverse transcriptase inhibitors and protease inhibitors.
For refractory cases, during the failing treatment regimen and before switching therapy, use rapid confirmation, perform resistance testing and reevaluate.

HIV - Quick Facts Need To Know!

Varicose veins is a medical condition where the veins become large and swollen and begin to appear so especially on the legs and feet though any vein can become varicose. This happens when the valves do not function properly and allow the blood to flow in the opposite direction or to pool. Due to this, the veins enlarge, and they begin to appear blue or dark purple on the skin. Legs and feet are the most commonly affected areas because standing or walking increases the pressure on the veins in the lower part of the body.

Symptoms of Varicose Veins
Apart from the twisted and bulging appearance like cords in blue and dark purple, varicose veins may include other painful symptoms as well such as-

Throbbing feeling and aching, heavy feeling in the legs.
Muscle cramping and swelling in the legs.
Severe pain after sitting or standing for a long period of time.
Bleeding varicose pains.
Treatment for Varicose Veins
In severe cases, varicose veins may rupture and form varicose ulcers on the skin. To avoid complications, it is best to get varicose veins treated before it worsens. Varicose veins can be treated in two ways- either by surgeries or by non-surgical methods, that is, by home remedies, medicines or non-invasive methods.

Surgical methods to treat Varicose Veins
Vein Stripping - Under general anesthesia, two cuts are made one below the groin and one behind the knee joint. The affected vein is then tied or clamped off at the top incision using a technique called vein ligation
Phlebotomy is another method where smaller incisions are made along the vein and using surgical instruments, the vein is pulled out.
Though treating varicose veins by surgeries is the most effective method, it involves several risks. Patients take a longer time to recover from surgeries than non-surgical methods. The sedation may cause complications. Chances of nerve injuries cannot be negated which may lead to fatal conditions such as deep vein thrombosis.

Non-surgical methods to treat Varicose Veins

Radiofrequency ablation is a method in which heat generated electromagnetic waves are used to close off the veins.
Endogenous laser ablation- in this case, lasers are used to close off veins.
Sclerotherapy is another method where a liquid or foam is injected into the affected vein to close it off.
Although big veins cannot be treated by these methods or additional treatments may be required, these methods are not only effective but also free from cuts and stitches or anesthesia. Performance of these treatments need not always take place in hospitals, special clinics can cure varicose veins using these methods. It is always advisable to consult doctors for treating varicose veins who can suggest the best treatment needed to cure varicose veins.


Surgical & Non-Surgical Treatment Options For Varicose Veins - Which Is Better?

Staying up late at night intentionally is not insomnia. If you find it difficult to fall asleep, or cannot sleep soundly for long, then it is indeed a case of insomnia. The inability to sleep can have terrible repercussions on your physical and psychological health.

A number of reasons could cause insomnia. Understanding the causes could help you identify your sleeplessness as insomnia and seek treatment right away.

What Health Issues cause Insomnia?

Here are some health problems of both the mind and body that can keep you awake  

  Stress Chronic stress and worry born out of our tense lives is a direct cause of insomnia. Long-term anxiety, panic disorders, as well as PTSD can induce sleeplessness.

  Irregular Sleep Patterns Your body would hate it if you deviate from the Circadian Rhythm   the body clock. It regulates the functions of your body, including your sleep patterns. But if you defy your body clock by sleeping at irregular hours   suppose you are staying up late to get some extra work done, or you may have opted for a night shift, or if you are experiencing a jet lag   then you will notice that when it is finally time for you to hit the bed, sleep will be elusive.

  Depression Depression is a horrific psychological disorder that makes a person lose interest in life itself. And one of the indicators of depression is loss of sleep. It is not just depression, but also other illnesses that cause psychological turbulence such as bipolar disorder and obsessive-compulsive disorders, triggering insomnia.

  Breathing Issues Sleep apnoea is a dangerous disorder that stops your breathing multiple times every night and will wake you up every time. Yet you will possibly not even remember waking up. However, this does disturb the quality of your sleep and affects your health adversely.

  Dementia Dementia is accompanied by a gradual loss of memory. But sometimes people who are suffering from dementia display anxiety, restlessness or even aggressive behaviour when it is time for them to go to bed. This is called the sundown syndrome and it might even keep them up all night.

  Pain Pain is one of the commonest reasons for losing sleep. Pain can originate due to any number of reasons   arthritis, a sprained joint, an injury, or if you are undergoing chemotherapy or radiotherapy, then it may keep you awake at night. This is actually a vicious circle because the inability to sleep will aggravate your pain. Talk to your doctor who will prescribe the appropriate pain medication.

  Parkinson s disease This disease is another reason behind insomnia. Parkinson s disease interferes with your nerve signals and this might cause disruption in your sleep.

  Menopause When a woman inches closer to her menopause, her body reduces the production of oestrogen and progesterone. This imbalance of hormones can trigger sleep loss.

How long can you go without sleeping?

There is no data on how long a human can function without sleep. The longest someone stayed awake is 11 days. Usually, the body cannot last that long without some sound shut-eye. Your brain flushes out the waste matter its cells produce during sleep. That is why even 24 hours without sleep can make your brain sluggish and disoriented. If you stay awake for more than 48 hours at a stretch, your cognitive abilities will start failing you. Sleep is instrumental to a healthy mind and body. If you are experiencing insomnia, talk to a doctor immediately or look up some remedies.

Health Problems That Keep You Awake!

Our kidneys act as filters which constantly flushes out toxins and excess minerals with water in form of urine. Urine contains lots of minerals which may precipitate and form stones. Urine has lots of pro-precipitating agents and anti-precipitating agents. When their balance disturbs due to some disease, stones start forming. These stones may often lead to abdominal pain which is referred to as renal colic. 

What exactly is renal colic? 

Renal or ureteric colic is the term used for typical pain in one side of abdomen in flank region starting from back and radiating forward towards lower abdomen up to scrotum. This is usually associated with nausea, vomiting and urinary discomfort. There may be blood in urine. 

How kidney stones are related to renal colic? 

Kidney stones usually form inside kidney and lies there without causing any pain. But whenever they are dislodged and stuck at mouth of kidney (pelvis) or anywhere in ureter, they block the passage of urine of that kidney. This causes swelling in kidney termed as hydronephrosis. This swelling in kidney causes renal / ureteric colic. This colic is protective phenomenon and tries to push out the stones. Small stones do come out in urine by this natural process. This spontaneous expulsion of small stones is common and many local practitioners used to get credit of it feigning benefit of their medicine. However large stones need some form of intervention to come out. Otherwise, they do harm to kidneys in long term. 

Symptoms of kidney stones along with renal /ureteric colic - 

Most stones which are lying in calyces of kidney are asymptomatic 
Nausea & vomiting 
Frequent urinary tract infections 
Fever with chills 
Foul smelling urine 
Hesitency, frequency and burning in urination 
Blood in urine (urine with a reddish, pink or brownish hue) 
Passage of small stones in urine 
Treatment of renal colic 

Treatment of ureteric/renal stones involves control of symptoms and stone removal. 

Expectant Treatment or Medical Expulsion Therapy: Small stones of less than 4 mm size usually pass on its own and some medicines like alpha-blockers and steroid hasten up their expulsion. Medium size stone (4-6 mm), sometimes passes with aid of these medications. But stones larger than 6 mm usually require intervention. 
Lithotripsy: This method involves breaking of stones by shock waves into small dusty particles which pass through urine on its own. This is usually suitable for stones upto 1.5 cm and lying in kidneys. This is non-operative treatment which can be done on OPD or Daycare basis. 
Ureteroscopy (URS): This method involves entry of very thin semirigid scope through urethra into ureter. Stone is broken by LASER and removed. This involves single day admission and spinal anaesthesia. 
RIRS- Retrograde Intra Renal Surgery: In this method very thin flexible scope in maneuvered through urethra into the upper ureter and pelvi-calyceal system of kidney. Stones in kidney or upper ureter are broken by LASER and removed. This is also done under anaesthesia and requires a day admission. 
Mini- PCNL: This method is suitable for large renal stones. In this technique, a small hole is made into the kidney through back and tiny scope is entered into the kidney. Stones are broken by LASER and removed. This is done under anaesthesia and require two to three days admission.

Renal Colic - Ways it Can Be Treated?

Nail fungus is a fungal infection that develops under the tip of the toenail or the fingernail. It has a whitish or yellowish appearance and as the condition progresses, it causes the affected area of the nail to thicken, discolor and crumble at the edges. Usually this condition does not require any treatment, but if it turns severe, then you may require treatment to limit it from spreading.

The symptoms of this disorder are:
1. The affected nail thickens
2. There can be distortion in the shape of the nail
3. The nail can become crumbly and ragged
4. Discolored nails that lose its natural shine
5. Accumulation of debris on the nail
The infected nail may also be separated from the nail bed, causing pain and a foul odor.

Causes
The condition is usually caused by the dermatophyte fungus. In some cases, molds and yeasts can also cause fungal infections. Fungi are microscopic organisms that have certain characteristics such as:
1. They can cause complications if your nails are often exposed to moist and warm conditions
2. They usually thrive in moist and warm conditions such as showers and swimming pools

3. These fungi get into the skin through small cuts on your skin

The fungus usually affects toenails because, when you wear shoes, a warm and moist environment is created which is the perfect breeding spot for the fungus. The factors that can increase your chances of getting affected by this fungal infection are

1. Heavy perspiration
2. Athlete s foot (a condition which is characterized by rashes between the toenails)
3. Older people are affected more as blood circulation is reduced
4. Wearing socks for extended periods of time creates warm and a humid condition for the fungi to grow
5. Certain medical conditions such as diabetes

Treatments
There are certain medications that are used to treat fungal infections:

Oral anti fungal drugs: These medications help in getting rid of fungal infections.
Nail creams: There are certain anti fungal nail creams available that you can apply on your nails to get rid of this condition.

Nail Fungus - Understanding the Causes and Symptoms

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