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

Blemishes refer to the discolored patches on your skin left behind by skin disorders such as pimples, acne, pigmentation or due to skin pores clogged by excess oil secretion. Blemishes, pimples and acne are some of the skin problems, which keep on affecting your skin and are hard to keep at bay completely. If you are suffering from the distressing problem of blemishes and wondering whether it is possible for you to get rid of them forever, then the good news is that it is not absolutely impossible. But in order to do so, you have to persistently work hard on your skin care regime.

Following are some interesting ways to eliminate those blemishes forever:

1. Skin exfoliation: skin exfoliation is a very effective process for getting rid of blemishes permanently. Exfoliation helps to shed the upper layer of your skin or rather the affected layer of your skin. But after exfoliation, a strict skin care routine must be followed everyday, which should combine cleaning, toning and moisturizing, so that the pimples and acne do not get a chance of popping out again.

2. Avoid overexposure to sun: too much exposure to sun can worsen your blemishes and make them darker in color. It can also create difficulties to get rid of them. Sun exposure may lead to break out of more pimples and acne, which in turn will leave behind marks on your skin.

3. Cut down on sugar: research shows that consuming excess sugar can trigger the break out of acne on your skin. Therefore, cutting down on your sugar intake will prevent further acne breakouts, which, in turn, will help you to get rid of your blemishes forever.

4. Apply lemon juice: applying lemon juice to the affected areas on a regular basis is another great remedy.

5. Avoid oily and fried foods: excluding oily and fried foods from your diet can help reduce the excess oil secretion by the skin pores and also prevent clogging of the pores.

Can You Really Banish Those Blemishes From Your Face Forever?

Why Papaya is the God of Perfect Skin

Use a particular face wash and your face is free of all dead cells. it's not so simple. To dissolve the dead cells, the protein in the cells must be broken down. The only effective ingredients to do the job are AHAs or Alpha Hydroxy Acids. This is why many skin exfoliating products contain AHAs. 


Papain, which is found in Papaya has similar properties. Papaya is a safe and natural, plant-based alternative to chemical exfoliants. To remove dead cells, gently massage papaya pulp on your face for about 5-7 minutes. Rinse your face alternatively with warm and cold water.  Remember not to overdo it though! Papaya is an acidic fruit, so don’t let the mask sit on your face for too long as it might cause dryness and skin irritation.




Do You Know: Why Papaya is the God of Perfect Skin?

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

When endometrial tissue that usually grows inside the uterus, starts growing outside uterus, it is called Endometriosis. Pain during or before periods, pain during intercourse, pain while urinating or bowel movements, heavy bleeding, infertility are some of the symptoms of endometriosis.

Treatment of endometriosis usually depends on the following factors:

Age of female
Severity of symptoms
Duration of the symptoms
Future plans for children/ fertility
Associated pathologies
Accordingly the doctor might choose any of the treatment options like:

Medication for Pain: If the symptoms are mild, then the doctor will prescribe some pain  relieving medications like Nonsteroidal anti-inflammatory drugs (e.g. Diclofenac) or anti-spasmodics(e.g.drotaverine)
Hormone Therapy: Hormone therapy is effective, but once you stop them, your symptoms may recur. Some of the hormone therapies include: 
Hormonal Contraceptive pills: Useful in controlling the hormones that are responsible for endometrial tissue growing outside the uterine cavity.
Medroxyprogesterone: This helps to counter effect estrogen hormone which is responsible for endometrial tissue growth.
Gonadotropin-releasing hormone (GnRH) agonists: Gonadotropin hormones that stimulate ovaries are blocked by these. They bring down oestrogen levels and hence symptoms. It can cause absence of menstruation in some females which is reversible.
Danazol: It is synthetic androgen, suppresses growth of endometrial tissue temporarily.  However, Danazol may not be a favourable option because of its side effects. Females should avoid pregnancy while on this drug.
Dienogest: This newer progesterone molecule, which does not have major side effects and is apporved for use in endometriosis.
Other medications like selective progesterone receptor modulators, immunomodulators, anti angiogenic factors are being evaluated.
Conservative surgery: If you are trying to conceive, then surgical excision or ablation of endometrial tissue is one treatment option.Suboptimal surgery with conservation of maximum ovarian tissue is considered suitable in such cases.
Hysterectomy: In severe endometriosis cases where female has completed her family, hysterectomy is offered wherein the uterus, cervix & if required ovaries can be removed.

Endometriosis - Ways To Manage It Well!

Hives are a common allergic reaction that appears in the form of swollen, red bumps or patches on the skin. These usually appear suddenly and cause itchiness. In some cases, it may also sting or burn. Hives can affect any part of the body including the face, ears, tongue, lips and throat. Hives are usually small in size but may grow as large as the size of a dinner plate. In some cases, hives may also join together to form plaques.

Hives are caused as a result of the production of histamines in the body that make plasma leak out of blood vessels in the skin. These histamines are released as a result of an allergic reaction, exposure to chemicals, insect bites, sunlight or adverse reactions to certain medicines. There are four main types of hives:

Acute Urticaria: These hives usually last for less than 6 weeks. They are triggered by insect bites, allergic reactions to food, latex, medicines or by exposure to infections. The most common food items that trigger this type of hives are chocolates, nuts, fish, tomatoes, eggs, soy, wheat and milk. Aspirin and other medicines like ibuprofen, ACE inhibitors and codeine can also trigger these hives.

Chronic Urticaria: Hives that last for longer than 6 weeks fall into the category of chronic urticaria. IT is harder to find what triggers a case of chronic urticaria than it is for acute urticaria. Along with the triggers mentioned above, hormonal disorders, tumours, chronic infections and immune system disorders can also trigger these hives.

Physical Urticaria: Hives caused as a result of physically stimulating skin are called physical urticaria. This includes sudden exposure to heat or cold, sunlight, vibrations, pressure, exercise etc. These hives usually resolve themselves within an hour and only affect the part of the skin that has been stimulated.

Dermatographism: Hives caused by scratching or firmly stroking the skin fall under this fourth category.

Hives can also be genetic in nature. Some people suffer from hereditary angioedema which is a painful swelling under the skin.

Hives caused by an allergic reaction can recur and hence if you suffer from hives you should try and identify the allergen. This can be done by taking an allergen test in a hospital or by changing aspects of your diet and studying the results. Hives are usually treated with antihistamines but in some cases, steroids may also be needed. However, it is usually nothing to worry about.

What Are Hives? What Causes Hives?

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