It is a chronic autoimmune skin disease, in which the skin cells form a mass of scales. Usually, these patches of skin, which are dry, red and itchy, occur on the skin of the back, scalp, palms, knees, elbows and around the fingernails and toenails. But some people have the patches all over the body. The patches may also crack, flake and bleed. While there is no definite cure, the symptoms can be managed and treated.

Symptoms of Psoriasis

The symptoms of psoriasis may vary from patient to patient. However, if more than two of the following signs are seen, it is likely that psoriasis is the causative condition:

1. A sharp and localized pain in the joints accompanied by stiffness
2. Soreness in the throat
3. Tiny depressions in the nails or large brown patches under the nails
4. The diseased patches of skin can crack, peel and bleed
5. Swelling and tenderness of the limbs
6. Dental plaque
7. Muscle pain due to the swollen bands of connective tissue
8. A whitish and silvery mass of scales surrounded by red patches of stinging, itchy skin
9. The appearance of blisters or rashes on the dry scaly skin and also along the nails
10. Bumps on the folded skin like back of the knees, armpits etc.

Causes of Psoriasis

HIV
Human Immuno-deficiency Virus adversely affects the immune system and increases susceptibility of all kinds of infections and diseases. HIV-positive individuals have been found to have an increased risk of psoriasis than HIV-negative people.

Medication
Anti-malarial, anti-inflammatory and blood pressure medicines can cause psoriasis as a side effect. The disease is also an effect of withdrawal from topical steroid creams and other steroid-based medication.

Genetics
More than 32% of the cases of psoriasis have been linked to genes. In case of identical twins, if one twin has the disease,the other has a 70% chance of getting it too. There are several genes associated with the disease- most of these genes are related to the immune system. T cells (lymphocytes which affect cell specific immunity) can also cause psoriasis.

Other diseases
Diseases like strep throat, chronic infections, skin infections and stress may be responsible for the condition. Other factors like obesity, alcoholism, skin dryness and smoking can also lead to psoriasis.

Psoriasis: Symptoms and Causes

One of the effects of ageing is the double chin that is caused due to extra fluid or fat under the chin. It could also be due to increased weight, sagging skin, or merely genetic. Given that it produces an aged appearance, people with double chin are constantly trying to find ways to hide it. There are two main muscles in the neck area, and toning them helps to remove the double chin appearance. There are grooming tips like specific kinds of clothes, hairstyle, and makeup to conceal it. There are also some exercises which are believed to reduce the prominence of the double chin. However, these are temporary measures, and for a permanent solution, surgical correction is the only method of choice.

Some of the new methods to get rid of the double chin are listed below with some important additional details. Talk to your surgeon and understand what to expect before going ahead with the surgical correction.

Kybella: Approved by FDA, this is the new wonder drug to correct double chin. With no surgery involved, all it takes is about half an hour. The area is injected with a local anaesthetic and then Kybella. This contains deoxycholic acid, which is an enzyme that the body also produces naturally. This helps break down fat cells and so after a couple of weeks, the double chin gradually begins to literally melt away. Depending on the desired results, repeat injections might be required at monthly intervals. There could be mild swelling in the initial couple of days, which will subside shortly. The result would be a more defined chin line, producing a slimmer appearance.
CoolMini: This involves freezing the fat and massaging it to remove the double chin. This is a form of chin sculpting and is preferred in people with good skin tightness. Results will be evident in about 1 to 3 months.
Skin tightening using infrared light: A beam of infrared light is aimed at the double chin which causes tightening of the skin by stimulating the underlying collagen and elastin layers.
Chin liposuction: In people with excess fat deposition, chin liposuction where the excess fat is suctioned off is a good treatment option. This is a time-tested method and produces results more immediately than the above-mentioned procedures.
Subsequent to any of the above procedures, it is better to make some lifestyle changes so that the double chin does not return. Weight management and regular exercise can go a long way in preventing recurrence of the double chin. Speak to your doctor to draw up a weight management plan and an exercise regimen that can help in the same.

Double Chin - Ways You Can Get Rid Of It!

Foot problems can occur due to a number of causes that, in most cases, are easily diagnosed. An orthopedic is a specialized doctor whose advice you should seek if you have any kind of discomfort in one or both of your feet. Discomfort may include chronic or regular pain, difficulty in movement and/or disfigurement. These are generally a result of arthritis, physical injury or a genetic or hereditary condition. In some of the cases, the pain and discomfort can be treated without any surgery, by using medications. However, in extreme cases, where medication, physical therapy, and other such non-surgical methods fail to have any impact, surgery is the only way to go.

These surgeries are less invasive and require a limited recovery time. They are also one of the most successful types of surgery. The surgical procedure is successful in dealing with the main complaints of a foot problem. It successfully treats a foot by,

Relieving pain: The pain in your feet interferes with your work, making it difficult to carry on with your daily life, affecting your personal and social relationships. Pain often indicates an underlying problem, and it is easier and effective to treat the problem with a surgery, as it relieves you from the chronic pain.
Restoring function: If your feet do not function properly, it will be impossible for you to move, as they are necessary for mobility. When a simple stride becomes a problem, your whole lifestyle is affected. Accepting defeat is not an option. A good orthopedic can help you to get back to your normal daily life by surgically treating your feet thus ensuring they function properly.
Improving appearances: Foot deformity, due to a number of reasons such as polio or bone spurs, can lead to a restricted lifestyle. Movement is hampered and so is freedom. Surgically it can be treated and the appearance of your feet can be improved.
Arthritis is also a cause of a number of foot problems. In more cases than not, surgery becomes a necessity to treat your foot. Here are some of the surgeries that cater to arthritis-related foot problems:

Repairing Fracture: If the fracture is beyond repair by non-surgical methods, surgery is the last refuge for an orthopedic surgeon. Surgery will include repositioning of the bone and the use of supports to keep them in position.
Arthroscopic debridement: This surgical procedure helps to remove inflamed tissues or spurs from the joint.
Arthrodesis: Also known as joint fusion, it involves the removal of the ends of the bones at the joint and replacing them with metal pins or screws.
Osteotomy: The surgical procedure involves realignment of a joint by cutting the bone.

Foot Problems - Can They Be Treated By Surgery?

Silk pillowcase slows down skin aging

Using silk pillowcase is known to slow down skin aging by giving you a wrinkle-free skin. This is due to many good qualities of silk fibers.

Silk is a natural fiber obtained from animals and contains amino acids which are compatible and friendly to the human skin. It also contains temperature regulators which adjust your skin to the changing temperatures. Hypoallergenic silk fibers resist many skin allergens like fungus, spores etc making it ideal for sensitive skin.

The tightly woven fiber which remains most in contact with your face retains moisture to your skin and keeps your skin well hydrated. Unlike dry and flaky skin, moistened skin cells are most likely to show fewer wrinkles and hence slow down skin aging process.

Did You Know a Silk Pillowcase Can Slow Down Your Skin's Aging?

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

In today s world, females have advance techniques available for shaping up their breasts. It is a part of their overall persona and beauty. Breast augmentation is one of the greatest plastic surgery operations that is done in hospitals across the globe. 

Gone are the days, when you would sit back at home and blame nature for your saggy breasts. You have the gift of plastic surgery at your rescue. Breast augmentation can enhance the beauty of your breast and uplift its features. In this process, the implant is put under the pectoral muscle so that you can still breastfeed your infant if needed.
The process is executed with the help of a small 4 cm incision. The recovery process takes a week s time. Breast augmentation can be carried out in a surgical centre or in any hospital s outpatient facility. It doesn t require a hospital stay in most cases. In some selected cases only, the procedure is done using local anaesthesia. In those cases, the patient stays awake. The breast region is made numb.

What to expect during the procedure?

The woman opting this must know what all are expected to happen during the procedure. The surgeon will insert the breast implant by making a single cut in one of the following three areas:

1. In the crease under breast 
2. Underarm (axillary)
3. Around the nipple (periareolar)

After the incision is done, the surgeon will try and separate the breast tissue from the patient s muscles and connective tissue. This will lead to the creation of a pocket either behind or in front of the pectoral muscle. After this, the surgeon will put the implant into the newly-created pocket. It will be centred behind the nipple. 

Saline implants are put in an empty form and then filled with sterile salt water. Silicone implants are, however, pre-filled with silicone gel. After the implant is over, the cut is stitched with sutures and the skin is bandaged with adhesive and tape.

What to expect after the procedure?
For a few weeks, the patient might experience Soreness and swelling. It is also possible to develop bruises. Your scars will fade away with time. It is quite possible that the scars will not vanish permanently ever in your lifetime. You must wear a compression or sports bra at the time of healing. You might be required to take painkillers, as advised by the surgeon.

Breast Augmentation - What to Expect from the Procedure?

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