It is a slowly and gradually progressing disease in which healthy liver tissue is replaced with scar tissue, hence preventing the liver from proper functioning. The developed scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver. Cirrhosis is a complication of liver disease which involves loss of liver cells and irreversible scarring of the liver. In other words, Cirrhosis is a condition in which the liver does not function properly due to long-term damage. Typically, the disease comes over months or years.

Although there are many other causes for cirrhosis, the commonest is excessive use of alcohol, viral hepatitis B and C infections and non-alcoholic fatty liver disease. Thus the scarring is most often caused by long-term exposure to toxins such as alcohol or viral infections.

According to the National Institutes of Health, it is the 12th leading cause of death. Men are more prone to develop cirrhosis than women. Globally approximately 57% of cirrhosis is attributable to either hepatitis B (30%) or hepatitis C (27%).Alcohol consumption accounting for about 20% of cirrhosis.

Persons most commonly affected: Adults of both sexes.

Unani approach to Cirrhosis of Liver (Talayyuf-e- Kabid)-

In Unani literature Cirrhosis of the liver is known as  Talayyuf-e- kabid ,  Sighr-al- kabid  or  Jigarki laghari . It is of two types.

1. AcuteType of Cirrhosis of Liver (Talayyuf-e- Kabid Hadd)-

It is rare but very dangerous. It is also called Yarqaan-e- khabees or Huzaal-e- asfar. Mainly occurs due to inflammation in hepatic cells, in which hepatic cells squeeze in few days resulting in improper functioning of liver. It is a disease in which cells throughout the liver are destroyed. Although they are replaced by areas containing normal new cells but also by much scar tissue, which alters the structure of the liver.

Causes and risk factors: Excessive use of alcohol/ chronic alcoholism, poor nutrition, highly toxic condition of the body system, viral infections caused by chronic viral hepatitis (types A, B and C), metabolic diseases such as alpha-1-antitrypsin deficiency, galactosemia and glycogen storage disorders,inherited diseases such as Wilson's disease and hemochromatosis, biliary cirrhosis, toxic hepatitis due to severe reactions to prescription drugs or prolonged exposure to environmental toxins and repeated bouts of heart failure with liver congestion etc.

Signs and Symptoms: The main signs and symptoms of this type are jaundice, pain at the site of liver, vomiting, headache, dizziness, increased body temperature, increased pulse rate, brownish coloured and dry tongue, increased thirst, initially whitish coloured diarrhoea, later on, colour becomes blackish due to contamination of blood, urine passes in less quantity and reddish in colour due to contamination of yellow bile in it,  haemorrhage from nose, stomach, intestine and uterus even abortion in women are seen. The size of the liver feels small on palpation.

2. Chronic type of Cirrhosis of Liver (Talayyuf-e- KabidMuzmin)

This type of the disease occurs due to the improper blood supply to the hepatic cells resulting in the size of liver very small in appearance but liver cells stay normal.

Causes and risk factors: The main causes of this type are the application of permanent pressure at the site of the liver such as ascites, alcohol abuse, hepatitis C virus infection, cardiomegaly, poor nutrition, highly toxic condition of the body system, peritoneal inflammation, improper diet in old age and starvation etc. Other causes which develop this disease are, obstruction of the external bile duct by stone, scar, inborn defect or tumour, use of certain medications, syphilis and passive liver congestion. Obesity has recently been recognized as a risk factor in non-alcoholic hepatitis and cirrhosis.

Signs and Symptoms: It is a slowly progressing disease. In early-stage symptoms, of indigestion like flatulence, constipation and diarrhoea may be present. General weakness, the feeling of being unwell, loss of appetite, loss of weight, and a loss of interest in sex may also be there. There may be a dull abdominal ache, nausea and vomiting. Eventually, the patient dies due to anaemia or ascites. The feeling of dullness is the peculiar sign of the disease. Other symptoms and signs include low-grade fever, bad breath, jaundiced skin and bloated and swollen abdomen.

Complications and Risks associated with Cirrhosis of Liver (Talayyuf-e-Kabid)-

Ascites (retention of fluid in the abdominal cavity) is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infection and a poor long-term outcome. Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from oesophageal varices. Cirrhosis is generally irreversible, and treatment usually focuses on preventing progression and complications. In advanced stages of cirrhosis, the only option is a liver transplant.

Preventive measures for cirrhotic patients (Talayyuf-e- Kabid ke Mareezon ke liye Ehtiyaati Tadaabir):

Cirrhotic patients must completely avoid alcohol. Alcohol accelerates liver failure and hastens death in cirrhotic patients.
Avoid liver toxins. Acetaminophen (Tylenol), should be avoided because they can be toxic in cirrhotic patients.
Juice therapy helps the liver to detoxify toxins from the body. Cirrhotic patients should mix one part of pure juice with one part of water before drinking.
Cirrhotic patients are strongly advised to eat smaller meals. To avoid overworking the liver, five or six smaller, lighter meals per day are recommended.
Avoid fatty foods and processed foods, especially foods prepared with animal fats or hydrogenated oils. These types of foods put additional load on the liver.
Cirrhotic patients are also advised to eat only lean proteins (containing no fats) and in limited amounts.
Vegetable proteins are very beneficial in Cirrhotic patients. High protein intake causes increases of ammonia levels in the blood, possibly resulting in mental confusion, and in severe cases, coma. However, do not severely limit protein intake, as this may cause protein deficiency and impair the healing process.
Routinely increase consumption of fruits and steamed vegetables as fruits and vegetables are easy to digest, thus less work for the liver. In addition, they are good sources of vitamins, minerals, and antioxidants that help the liver detoxify and heal.
Cirrhotic patients are advised to practice intermittent fasting.
They are also advised to protect against hepatitis B, C and E.
Fundamentals of Management in Unani Medicine-

Identify the cause of the disease and treat it accordingly
Correct the digestive processes
Use hot dresses
Use mild and early digestible diet
In case of ascites treat it
Management/ Treatment-

In Unani medicine, very effective treatment is available for the Cirrhosis of Liver by strengthening the Liver cells and restoring normal size and functions of the Liver. In Unani medicine, there is a number of hepatoprotective drugs that protect the Liver either acute or chronic type.

SootshekharRas Swarna yukta 125 Mg twice a day
PittariAvleh 10 gm twice a Day
Duration of the treatment: 3 to 6 months or it depends upon the condition of the patients. If the patients with cirrhosis have diabetes, then the treatment may take long time for curing the disease. Diet plays a key role along with Unani Medicines. Hence, it is strictly advised to follow a proper diet plan.

Talayyuf - E - Kabid Or Cirrhosis Of The Liver - Know More About It!

Gonorrhea : Disease + Symptoms

Gonorrhea is a contagious disease that can affect both men and women. It is caused by a bacterium called Neisseria gonorrhoeae that can easily grow in the mucus membranes of the human body.

It is mostly transmitted when an uninfected person gets in sexual contact with an infected person. It can also be spread when a mother's infected body fluids come in contact with her newborn during childbirth.

It is a common infection and the symptoms vary for both men and women. The symptoms are:

Symptoms in Women:

- White or greenish-yellow vaginal discharge
- Burning sensation while urinating
- Pain in the lower abdomen and in the pelvic region
- Occurrence of Conjunctivitis
- Spotting or light bleeding after sexual intercourse
- Bleeding between periods
- Vulvitis

Symptoms in Men:

- White or greenish-yellow discharge from the penis
- Swelling and pain in the testicles
- Burning sensation while urinating

The symptoms come to notice usually within 2 to 10 days of the infection in case of women and it takes approximately 14 days for them to be recognized in the case of men. However in a few cases, the symptoms may take as long as 30 days to appear or they may appear so negligibly that they are hardly noticeable if they occur at all.



Gonorrhea is Contagious. But is it Only Sexually Transmitted?

Tinnitus is the ringing in the ears in the absence of any external sound and the ringing heard is not related to any external source. Tinnitus is a symptom due to underlying ear disease.

Epidemiology

Worldwide 10%-15% of the population suffer from tinnitus and those suffering from ear-related problems are 85% of the population.

How do we know whether it is subjective or objective tinnitus?

Subjective tinnitus is the sound which only the patient hears and objective tinnitus is the sound which others can hear as well along with the patient. Ninety-five percent of the people suffer from subjective tinnitus due to problems in the inner, middle, and outer ear whereas rest 5% suffer from objective tinnitus which is due to any structural defect in the ear, neuromuscular condition, or a tumor in the head, neck, and brain.

Causes

Prolonged exposure to loud sound for a long duration can cause permanent damage to the ear, whereas exposure to a sound for short duration may restore hearing back.
Middle ear infection.
Injury to ear.
Age-related hearing loss: Hearing gets hampered with age which starts around 60 years of age. Hearing loss can lead to tinnitus.
Meniere s disease: It is an inner ear disease; tinnitus is an early symptom
Earwax: Normally earwax protects ear canal from dirt. When it accumulates, wax gets built up causing blockage leading to hearing loss.
Emotional stress Diseases of the heart
Drugs, such as aspirin, antidepressants, quinine, cancer medications, and diuretics.
Temporomandibular joint disorder
Acoustic neuroma
How to deal with it?

First, treat the underlying cause.A patient suffering from tinnitus should be counseled every 15 days. It reduces the stress onto those who are suffering from tinnitus and will boost up the patient.Tinnitus maskers/hearing aid is helpful in ignoring tinnitus frequency. Maintain your cardiovascular health with regular exercise, yoga, meditation, and medicines which control blood pressure. All these factors can help prevent tinnitus.

Can tinnitus be fatal?

It can vary from mild to severe which can cause distress such as interference with sleep and normal day to day routine activities. It can affect patient psychologically so much that patient goes into depression and can commit suicide.

How to evaluate tinnitus?

It can include an audiogram (hearing test), measurement of acoustic parameters and some of the imaging studies to be performed.

A pure tone hearing test is to be performed to find out the cause. Acoustic measurement of tinnitus includes measuring several parameters like frequency, the range of frequency, bandwidth, and loudness in dB above hearing threshold.
Residual inhibition helps indicate how useful tinnitus maskers would be.
Imaging studies like magnetic resonance angiography and Transcranial Doppler are to be performed to find out the underlying cause.

Tinnitus - What Causes It?

There can be a number of reasons that lead to infertility in women. Endometriosis is one of them. It is a benign condition where the endometrium, which includes the tissues that form the lining inside the uterus, grows outside the uterus. Apart from infertility, it may also cause pelvic pain in women.

There are no such symptoms of endometriosis apart from pelvic pain and it cannot be detected without surgery. Thus, it is very difficult to diagnose this disease and state how common it is. However, research says that the prevalence of this disease in women in their reproductive age is between 3 to 10 per cent.
It is found that endometriosis sometimes leads to infertility. Here is how:

Abdominal Adhesions and Infertility
Normally, the endometriosis implants develop in the abdomen. Then the body surrounds them with connective tissues. The reason for doing so is isolating the implants, so that they cannot harm your body.
Now, sometimes these adhesions can create a blockage in the opening of the fallopian tube or may also pinch off the fallopian tube. This will result in obstruction in the fertilisation of egg and the sperm and thus fertilization will not take place; so there are no chances of conceiving. These obstructions when diagnosed can be treated with surgery.

Secretions from implants
Endometrium plays a vital role in conception where the tissues secrete a wide variety of hormones and nutrients. Now, the endometrial implant also functions in the same way and secretes those hormones. The difference is that it does not deposit them in the lumen of the womb, and it is released in the abdominal cavity. In these substances, there may be some hormones that are responsible for infertility.

Prostaglandins
Prostaglandins are other hormones that are secreted by the endometrium normally. It helps in a lot of body processes that include various stages of menstrual cycle and pregnancy. This hormone is required for a lot of functions such as ovulation, sperm mobility, and regression of corpus luteum, immune interaction, menstrual cramps and contraction of the uterus at birth.

Just like the endometrium, the implants also secrete these hormones. And, the problem that is caused by the implant secreted prostaglandin hormone is that they are released in the abdomen and not in the womb. Moreover, they are not secreted at the right time, thus sending a wrong message to the brain.

A woman with a few days of pregnancy may face a miscarriage because the ovary will get a signal to start the menstrual cycle, and the womb lining where the egg is implanted will be expelled.

How Endometriosis Leads to Infertility and Miscarriages?

Blood in urine, medically known as Hematuria is not usually a cause of concern, but it can translate into an adverse condition if left unevaluated. The kidneys and other structures in the urinary tracts such as urethra (tube connecting the bladder to the outer part of the body); bladder (that stores the urine) and ureters (tube joining the bladder to the kidney) are the sources of blood flow to the urine. Hematuria can be accompanied by symptoms such as discharge of tea-colored, brownish-red or pink colored urine due to the presence of red blood cells, traces of which can only be detected under the microscope.

Underlying causes behind this disorder might be

Urinary tract infections is where the bacteria enter the body through the urethra and begin to proliferate in the bladder.
Kidney infections (pyelonephritis) is when bacteria infiltrate into the kidneys from the bloodstream or travel up from the uterus to the kidneys.
A kidney or a bladder stone is marked by the minerals in the concentrated urine precipitating out and molding into crystals that deposit on the bladder or kidney walls.
Enlarged prostate is a condition in which the prostate gland, that is situated just below the bladder surrounding the upper part of the urethra, starts growing as males head towards their middle age.
Kidney disease such as glomerulonephritis causes swelling of the kidneys, thus disrupting the filtering system.
Bladder, kidney and prostate cancer are also possible causes.
Hereditary disorders such as sickle cell anemia (a hereditary disease of the red blood cells in the hemoglobin) can also pose as a cause behind this disorder.
Kidney injury as a result of heavy blows, accidents or injuries sustained while playing a spot can also contribute to this condition.
Medications such as penicillin or the anti-cancer drug  cyclophosphamide 
Strenuous physical exercises like intense workout or running may also result in Hematuria.
Treatments
There is no fixed cure for Hematuria; instead the doctor would work on treating the repressed conditions behind the symptoms, such as prescribing antibiotics to heal the urinary tract infection or a medicine to shrink and normalize the enlarged prostate or administer a shock wave therapy to destroy the kidney or bladder stones.

Blood in Urine - 10 Causes Behind It

Erectile dysfunction (ed) occurs when the man is unable to achieve or maintain his erection of penis to meet his or his partner's sexual satisfaction. 
The problem is often faced by newly married men. Fortunately with experience, most of them are able to overcome this problem. Again it is increasingly common with increased age. 

So, what are the causes. In some male, it is psychological, caused by anxiety, depression, stress, marital disharmony etc. Use of alcohol and smoking will aggravate the problem. Psychological causes can happen at any age but more common at younger age. But in some cases, it is associated with serious diseases, especially at old age. It has been seen that in apparently healthy male ed is the first sign of heart disease. So, if you have ed, make sure that i's not caused by your heart problem. Again diabetes is another important cause. Excessive weight gain will also cause hormonal imbalance and thus problems in erection. Some hormone may also cause ed like thyroid, prolactin and even testosterone (male sex hormone). If you have chronic diseases like liver or kidney disease, it may also lead to ed. Diseases of nerves and spines should also be kept in mind. Sometimes, infections or tumour in private parts (prostate, testis etc) will also add to ed. Other diseases of penis like abnormalities in blood vessels can also be responsible, especially in young guys. Apart from these, some surgeries in abdomen and some drugs (like drugs to lower blood pressure, antidepressants, hormonal drugs etc) will also cause ed.

Now, what you can do? if you want to suffer silently, you will land up in other problems like problem in sexual life, problem in family relationships, depression and even inability to make your partner pregnant. But do all men with ed have to go to doctor? initially, the men should try life style modifications like avoiding smoking and alcohol; avoiding stress and anxiety; making good understanding with partner and also reducing weight. The partner should also have sympathetic attitude to the husband who is having ed.

But if still the issue is not resolved you have to consult doctor. It's not a mater of hesitation or embarrassment, as you may think. Rather it is needed to ensure that you are healthy. So, your doctor will talk to you, will check you and try to find out if any cause is there or not (like heart disease, diabetes, hormones etc). He may order some basic tests to ensure that everything is alright. After that he will advise you the treatment. If the cause is found, treatment of the cause (like diabetes) may cure ed. Even if no cause is found, ed can be treated by various ways.

But should you try the drugs shown in television or newspaper? remember, drugs used in ed have important side effects and we advise drugs only when it is absolutely necessary. In most cases simple measures like stress reduction, exercise help. Sex counseling of both the partners helps a lot. And if still ed persists, we advise drugs. There are variety of drugs, all are having own advantages and disadvantages. Particularly sildenafil group of drugs can affect heart and retina. So, we always practice caution before prescribing such drugs. And when patients are advised such drugs we advise to inform us when he feels eye problems, chest pain, fainting or even painful persistent erection of penis (" priapism").

There are other drugs that can be applied directly over penis. Testosterone group of drugs are prescribed only in selective cases as they have serious side effects and even they can reduce the size of your testes. In some cases where drugs cannot be given or drugs fail, we advise penile implants or artiificial pump to maintain erection. Finally in very few cases, where blood vessels of penis is blocked, we can cure it by some operations. 

So, if you feel ed, don't get depressed. At the same time don't feel embarrassed to take medical help. Today's embarrassment may harm you in future. So, get cured and enjoy your personal life.

Erectile Dysfunction

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