Shortness of breath, medically known as dyspnea, is the sensation of tightening of chest accompanied by a feeling of suffocation. Most of us would have experienced this while doing intensive exercise, while in extreme temperature or high altitude to a certain extent. But when the breathlessness is severe, it is due to a lung or heart ailment. The lungs and the heart play the most important role in transporting oxygen to our tissues and removes carbon dioxide. And so, any kind of problem in either of the organs can affect our breathing.

Causes:
Numerous underlying conditions can lead to a shortness of breath. An insight into the most common causes are enumerated below.

Asthma: One of the common reason for shortness of breath is asthma. It is a serious condition in which the passage of air becomes narrow and swells up and produces extra mucus. This can result in shortness of breath, triggers wheezing, coughing and also makes breathing difficult. It cannot be cured but the symptoms can be controlled, and it is also necessary to consult with the doctor to track the symptoms and adjust the treatment.
Carbon monoxide poisoning: Another leading cause of shortness of breath is carbon monoxide poisoning. It is caused when carbon monoxide builds up in our blood stream. When there is excessive carbon monoxide in the surrounding air, our body replaces the oxygen in our red blood cells or RBCs with the carbon monoxide in the air. Appliances that are improperly ventilated and engines, especially in a sealed or tightly enclosed space might allow carbon monoxide to accumulate in our blood stream to a dangerous level.
A hiatal hernia: This is caused when part of our stomach pushes upward through your diaphragm. Our diaphragm usually has a small opening through which our esophagus or food pipe passes and connects the stomach. The stomach pushes up through this opening in case of a hiatal hernia and results in shortness of breath. In most of the cases it can be cured by medications, but in some situations, surgery is required.
Pulmonary embolism: It is a blockage in one of the pulmonary arteries in the lungs. In 95% of the cases of pulmonary embolism, it is caused due to blood clots that travel to the lungs from the legs or some other parts of the body. As the clot blocks the flow of blood to the lungs, it can also be life threatening besides causing a shortage of breath.
Apart from these conditions, others such as bronchitis, pneumonia, lung cancer, COPD, arrhythmia, hypertension, and many other lung and heart ailments can result in shortness of breath and can lead to dire consequences in certain cases. Thus, it becomes paramount to consult a pulmonologist when you frequently experience such breathing difficulty.

Shortness Of Breath - 4 Most Common Reasons Of It!

HIV is a systemic disease which affects all parts of the body. The oral cavity also has some tell-tale symptoms which indicate HIV / AIDS. A careful examination and detailed history of symptoms is essential. In some cases, the oral manifestations could be the area where HIV is suspected. This can help in reducing morbidity and improves prognosis. The oral lesions that occur in HIV patients can vary and differ significantly in children and adults. While there are a variety of oral lesions in HIV-infected individuals, listed below are some common infections seen in HIV patients. These are a combination of fungal, viral and bacterial infections.

Candidiasis: Candida is an opportunistic fungus that is normally present in the oral cavity and with reduced immunity of HIV, recurrent bouts of the infection begins to show up. It can be in the form of regular thrush which is whitish and cannot be scraped off (pseudomembranous candidiasis), hyperplastic candidiasis (white patches which can be scraped off) or erythematous (reddish patches). Candida can involve any part of the oral mucosa including the pharynx and the palate.
Herpes Simplex: This is the most common viral infection seen in patients with HIV/AIDS. There could be primary or secondary infection of herpes virus, especially inside the mouth and the vermillion border of the lips.
Herpes zoster: This virus, when already present in the body, can be reactivated with HIV/AIDS and with oral herpes. The distinction with herpes simplex is from their distribution. These are unilateral, along the distribution of the maxillary or mandibular nerve. The lesions appear both on the facial skin and the oral mucosa. While the facial ones break open and form crusts, the mucosal ones coalesce to form larger lesions.
Hairy Leukoplakia: This is present in about 20% of asymptomatic HIV patients. Onset of hairy leukoplakia is an indication of rapid progression of HIV with increased CD4 counts. The typical lesion is a non-movable, hairy lesion along the side of the tongue and can spread to the top and the undersurface of the tongue. There are large amounts of Epstein-Barr virus (EBV) identified from biopsies of hairy leukoplakia.
Cytomegalovirus: If the ulcers have a necrotic base with a halo surrounding it, it is CMV infection, usually seen on any oral mucosal surface.
Periodontal disease: This is one of the bacterial infections that manifests itself in HIV patients. It can take two forms such as Linear Gingival Erythema (LGE) which can subsequently lead to Necrotizing Ulcerative Periodontitis (NUP). The oral hygiene is generally good with minimal plaque and there is rapid bone loss and soft tissue reddening and swelling. The, mouth, therefore is certainly a window to one s health.
Diagnosing HIV with Western Blot Test-

It is a series of blood screenings are performed to test for HIV. The enzyme-linked immunosorbent assay (ELISA), also known as an enzyme immunoassay (EIA), is the first test that your healthcare provider will order to screen for HIV. ELISA, like the Western blot test, detects HIV antibodies in your blood. Antibodies are proteins your immune system produces in response to the presence of foreign substances, such as viruses. If you test positive for HIV on the ELISA test, your provider will order the Western blot test to confirm HIV infection. 

Can HIV Be Diagnosed Through Oral Manifestation?

Sweating is a normal function of the body, but some people sweat so much that their clothes are often drenched in sweat. Hyperhidrosis is a condition where the amount of sweat produced by the sweat glands cannot be regulated. It is characterized by excessive sweating commonly seen in the underarms, palms and soles. This disorder can affect a person at any age and if left untreated, can become a lifelong condition. Though this condition is not a serious threat to your health, it can be quite embarrassing and can hamper your lifestyle.

In many cases, there is no obvious trigger for Hyperhidrosis, and it is caused by the malfunctioning of the nervous system. This is known as primary Hyperhidrosis. Sweat is a function which helps the body cool itself. In cases of primary Hyperhidrosis, the brain sends a message to the sweat glands to produce sweat even though the body does not need to be cooled. A genetic mutation may also be the cause for some cases of Hyperhidrosis.

Hyperhidrosis with obvious trigger factors is known as secondary Hyperhidrosis. While primary Hyperhidrosis mostly affects the underarms, groin, palms and soles, secondary Hyperhidrosis can affect all parts of the body. Some of the common triggers for this condition are:

Pregnancy
Menopause
Anxiety
Low blood sugar
Hyperthyroidism
Medication side effects
Alcohol or drug withdrawal
Parkinson's disease
Hyperhidrosis can be challenging to diagnose and treat. Lifestyle changes are the easiest way to address this disorder. Some changes that can help you fight Hyperhidrosis are:

Avoid spicy food and alcohol
Replace deodorants with antiperspirants
Choose cotton fabrics over synthetic fabrics
Wear loose fitting clothes.
Try using armpit shields and wearing absorbent socks.
Anticholinergic or antimuscarinic medicines can also help treat Hyperhidrosis. This keeps the nervous system from activating the sweat glands. Dry mouth, blurred vision, constipation, abdominal cramps and difficulty in passing urine are some of the side effects associated with this medication. Iontophoresis is a more aggressive form of Hyperhidrosis treatment. This involves passing a weak electric current through a wet pad to the affected area to block the sweat glands. It is usually used to treat excessive sweating in the palms and soles. 

Botox injections can also help treat Hyperhidrosis by blocking the brain signals to the sweat glands. However this is not a permanent cure and may need to be repeated after a year or so. Endoscopic thoracic sympathectomy or a surgery to remove the sweat glands may also be recommended in extreme cases of Hyperhidrosis. This is usually seen as a permanent solution for excessive sweating, but are relatively new procedures and hence not very common.

Hyperhidrosis - Making Summer Miserable

What is Colitis?
Colitis is a chronic bowel disease that causes inflammation in the lining of your colon i.e. the large intestine.

Prevalence in India -
Once prevalent in Western countries, colitis is on the rise in India among other Asian countries. The causes for this rise are mainly the degrading environment and the consequent changes in your genes. Colitis brings many changes to your lifestyle. Therefore, it is important to arm yourself with all the information about the disease to better manage it and lead the life you want.

What are the causes?
The common causes of colitis are -

Infection due to virus, bacteria and parasites
Decreased blood supply
Allergic reactions
What are the signs and symptoms of Colitis?
The signs and symptoms of colitis include the following-

Extreme pain before, during or after diarrhoea in the lower abdomen
Aches in joints and muscles
Tender abdomen
Swelling of colon
Redness on the colon surface
Bleeding from stool
Diarrhoea or constipation
Loss of appetite
Weight loss
Fever, fatigue
Dehydration
Eye and skin inflammation
What can you do to prevent it?
In order to prevent the occurrence of colitis, you can adopt a few steps. Precautionary measures mostly include dietary changes. You should avoid intake of certain foods to eliminate the symptoms of the disease.

Avoid the consumption of dairy products
Avoid eating spicy foods
Avoid including vegetables like cabbage, dried beans, peas in your diet
Refrain from drinking alcohol, caffeine and carbonated drinks
Instead, include white bread, white rice, pureed vegetable soup, canned fruits, etc
Depending on the diagnosis and the treatment, people do get better. Many people can build successive careers after getting treatments. However, initially, the symptoms will cause a problem in your daily life. It is important to know how you can identify the early signs and what you can do to manage or prevent them.

Know More About Colitis!

Everyone can suffer from pain in the stomach, at one time or the other and we usually ignore it. But when the pain is sudden and severe abdominal pain then it is termed as acute pain and this should not be ignored.

Often the following can be expected with acute pain:

Acute abdomen pain is usually synonymous with rapid onset of the symptoms which might indicate life threatening intra-abdominal pathology.
Pain is just a feature and not necessary that it is present at all times. An acute abdomen which is pain free usually occurs in children and women who are in their third trimester of pregnancy.
The differential diagnosis is difficult and wide especially in primary care. This is because the different organs within their peritoneal cavity might have different areas of referred pains.
Abdominal pain usually happens to be in the top three symptoms when patients present their state in the emergency and accident departments. But only few of these have acute abdominal pain.
Management of the abdominal pain should be the primary focus and an assessment should be done to reach the differential diagnosis so that care can be given accordingly.
The clinical evaluation regarding abdomen pain can change quickly. Any diagnosis which had been made can change and both doctor and patient should not be hesitant and seek other treatment.
Conditions which might cause acute abdomen pain are:

Meckel's diverticulitis or Acute appendicitis
Acute cholecystitis
Ectopic pregnancy
Acute pancreatitis.
Peptic ulcer disease
Diverticulitis.
Intestinal obstruction, including paralytic ileus (adynamic obstruction)
Pelvic inflammatory disease.
Gastrointestinal (GI) haemorrhage
Gastroenteritis.
Acute intestinal ischaemia/infarction or vasculitis.
Acute urinary retention
Renal colic or renal tract pain
Testicular torsion
Abdominal aortic aneurysm
Non surgical diseases like pericarditis, sickle cell crisis, acute intermittent porphyria, HIV-associated lymphadenopathy, bowel disease, typhoid, opiate withdrawal, enteritis, pneumonia, myocardial infarction and hepatitis.
Rare causes might include thromboemboli, phytobezoar, and phytobezoar
Diagnosis of abdominal pains:

Patients can be ordered to get their blood tests done. Also if need be then imaging can also be referred to them.
Following tests can be done to rule out the condition causing the abdominal pain:
Blood Tests: these include FBC, LFTs, glucose, amylase, clotting, calcium and arterial blood gas for pancreatitis
Crossmatch or group and save
Pregnancy test in women of childbearing age
Blood cultures
Peritoneal lavage in case of an abdominal trauma
Urine analysis
X ray of the abdomen, ultrasound, CT scan
ECG and cardiac enzymes
Laparoscopy should be a routine procedure

Don't Ignore the Acute Abdominal Pain

Peyronie's disease is a problem predominantly found in 3-9% of adult men, especially after 40 years of age. In the disease, a scar tissue is formed in the outer layer of the penis called tunica albuginea. Scar tissue is a just plaque inside the penis.

Peyronie's disease causes the penis to bend sideways or upwards and can make sex become difficult due to deformity and erection may be a painful process. It is usually associated with erectile dysfunctions, severe anxiety and reduced testosterone levels. It is worth noting that there are treatments for peyronie's disease, however, the pain often goes away on its own, generally, in 6-18 months of onset, but the deformity stays.

Here is everything you need to know about this disease:

Causes
It is not known exactly what causes peyronie's disease, however, there are some factors, which make it more likely than others. Here are those factors:

1. Trauma: this is the most common factor which causes peyronie's disease. It is believed that when someone suffers from tiny bleeding of the penis, which is very common in patients of diabetes, the plaque starts to build up. The injury or trauma, which causes the bleeding may go unnoticed as well.
2. Genes: genes are also a possible cause of peyronie's disease.

Symptoms
The symptoms of peyronie's disease vary, such as:
1. Pain on erection: there is usually pain in erection during the initial phase.
2. Bent penis: when the penis becomes hard before sex, it may bend downwards or sideways by more than 15 degree, so the vaginal entry becomes impossible or is painful for the partner.
3. Scars: tissue may form on other parts of the body, as well including the hand and feet. In fact, it has been said that men who have scarring in the hand, which affect the fingers are more likely to contract the disease as well.
One may see extensive scarring in hands in a disease called dupuytren's contracture. 

Treatment
1. Wait &amp; watch: it is worth noting the acute phase with pain is treated by wait and watch, controlling contributory factors like diabetes, low testosterone and psychogenic factors. Antioxidants are useful. Large number of cases are relieved of the pain in 1 to 1.5 years.
2. Intralesional injection: if the bend is significant enough to interfere in sexual functioning, it can be treated by injecting medicines in the plaque. The medicine, xiaflex is currently not available in india and other medicines given are not very effective.
3. Surgery: this is a last option when peyronie's disease has not gone on it's own and medicines are not helping either. The two most common procedures performed are removing the plaque and putting a tissue graft in its place and also removing the tissue opposite the plaque to counter the bending effect. The results are fairly good.

Going for a penile implant is the last option, which is a permanent solution and is commonly done in india. And, the success rate for penile implant is also very high.

Peyronie's Disease: About Bent Penis

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