How many of us have heard about Extracorporeal Membrane Oxygenation (ECMO) before Tamil Nadu, Chief Minister late J Jayalalithaa was put on it for recovery? Hardly a handful. Patients who are placed on the device have 50-50 chance of survival and while it could not help the late Chief Minister, her condition put a spotlight on ECMO.

What is ECMO?
ECMO is a life support device that is put in place when a patient's heart and lungs stop functioning completely post a cardiac arrest. When the patient does not respond to Cardio Pulmonary Resuscitation (CPR), the patient is put on ECMO.

Function of ECMO
The core function of the device is to separate carbon dioxide from the blood and add oxygen into it. It takes the load off from heart and lungs, providing critical time to the body organs for its treatment and recovery.
Patients are only put on ECMO, if there is a chance that the condition can be reversed.

How does ECMO work?
The device drains blood from a vein, which is attached to an oxygenator machine. The machine then removes carbon dioxide from the blood and adds oxygen to it. Depending upon the condition of the patient, the warm blood is either pumped into the body with the help of the machine or is transferred back into the body through an artery.

How long a patient can be on ECMO?
After seven days of being put on ECMO,there are chances of patient getting an infection.
In case the patient contracts an infection, it is recommended to take the patient off ECMO support.

All About ECMO - Extracorporeal Membrane Oxygenation 

In healthy individuals, the liver contains little or no fat. In overweight or obese people, gradual fat accumulation leads to significant liver disease. Interestingly, these individuals may be consuming minimal to no alcohol. So, alcohol, which is the main cause for liver damage, does not have a significant role to play.

The non-alcoholic fatty liver disease (NAFLD) has 4 significant stages as outlined below. It is a chronically progressive disease and may take years to reach the final stages of cirrhosis and fibrosis.

1. Simple fatty liver (steatosis): This is usually identified when diagnostic tests are done for some other suspected conditions. There are usually no symptoms obvious in this stage, other than the buildup of fat in the liver.

2. Non-alcoholic steatohepatitis (NASH): The second stage where the liver is inflamed to a greater extent due to fat accumulation.

3. Fibrosis: The next degree of inflammation where blood vessels may be narrowed leading to scarring in the liver with impaired liver functions.

4. Cirrhosis: This is the most severe stage that occurs due to years of cumulative inflammation. The liver shrinks in size, is scarred, and liver functions are markedly impaired and can also result in liver cancer.

Risk factors for NAFLD: The exact reason why a person develops NAFLD is not established, but some of the risk factors include

1. Obesity, with more weight concentrated around the abdomen

2. Type 2 diabetes

3. High blood pressure

4. High cholesterol levels

5. Age greater than 50

6. Smoking

Symptoms: This will depend on the stage in which it is identified. While there are no symptoms in the early stages, in some people there could be a dull, aching below the ribs, unexplained weight loss, weakness, and extreme tiredness. As it progresses to cirrhosis, there could be jaundice, fluid accumulation in the abdomen and feet, and itching of the skin.

Management: While there is no treatment aimed at curing the disease per se, there are ways to manage the symptoms, as noted below.

1. Weight loss: Reducing excess accumulated fat will help reverse symptoms and prevent further progression of the disease. A BMI of 18 to 26 is considered optimal.

2. Dietary changes: Modify your diet to a carbohydrates and protein rich and reduced fats and sugars. Increasing fiber through fruits and vegetables is highly recommended.

3. Exercise: Whatever your choice of workout, it will do wonders for NAFLD. Keep a target of an hour or two of moderate to intense exercise per day to reduce weight.

4. Smoking: This is another risk factor and can also help prevent other effects of NAFLD such as diabetes and heart disease.

NAFLD is highly controllable with these changes and other damages can be reversed too.

What is Nonalcoholic Fatty Liver Disease (NAFLD)?

Photodynamic therapy or PDT is a relatively new and non-invasive treatment for non melanomaskin cancer. It is mostly used in cases where the cancer is superficial and has not spread too deep. PDT is used mostly to treat Actinic Keratoses on the face and scalp, Basal cell carcinomas, Bowen s disease, as well as other conditions such as head and neck, mouth, lung and gullet cancer.

How does it work?
This treatment involves the use of a drug known as photosensitize or a photosensitizing agent with a specific type of light. When the photosensitizing agents get exposed to a light of a specific wavelength, a form of oxygen is produced, which eliminates nearby cancer cells. Every photosensitizer gets activated by the special light. The wavelength of the light determines how much it can penetrate into the body.

Process of Photodynamic therapy
Skin cancer is cured by PDT in several steps. The first step involves the injection of a photosensitizer into the patient s bloodstream. The blood cells absorb the agent all over the body, but in the cancer cells, it stays for a longer duration. Within 72 hours after the injection is given, the skin is exposed to light. The photosensitizer agent present in the cancer affected cells absorbs the light. An active oxygen form gets produced, which kills the cancer cells.

Other than killing the cancer cells directly, PDT uses two other ways to destroy cancerous tumors. The blood vessels in the tumor are affected, which leads to its death. The immune system also gets charged up and activated for fighting the cancer cells.

The light used for PDT is usually in the form of a laser. LEDs are also used to treat tumors present on the surface of the skin. The primary photosensitizing agent used in PDT is called porfimer sodium or Photofrin.

PDT can be undertaken in the outpatient department in a hospital. After taking the treatment, you have to keep the cancer affected area of the skin dry and covered for 36 hours. The area should be treated with care while showering. In case of thick skin lesions, repeat treatments are required within 4 weeks.

When is PDT used for skin cancer
PDT can be undertaken instead of surgery for treating basal cell cancer, Bowen s disease and actinic keratosis. PDT is used in cases where surgeries are required. It is used to treat large skin cancers, which are not very deep and in the case when several cancers develop in an area. For many skin conditions, PDT is a better remedy than undergoing a surgery.

Advantages of PDT

    There are no long term side effects.
    The process is less invasive compared to surgery.
    A very short time is taken for this therapy to be undertaken.
    The process can be repeated several times in the same area.
    Very less scarring takes place in the affected area.
    The cost of this procedure is lesser than surgery.

Treating Skin Cancer with Photodynamic Therapy

Dealing with Migraine through Homeopathy

A migraine is a headache that causes a distinct pulsating pain, usually in one side of the head. It is different from normal headaches in the sense that the pain is much more intense and it may be accompanied by nausea or vomiting as well. Some patients have also complained about light sensitivity while others have also complained about pain in all areas of the head.

Some of the factors that separate a migraine from a normal headache are as follows:

While a headache may last at best a day, migraines may last longer, sometimes even up to 3 days.

- Feelings of nausea or actual vomiting
- Sensitivity to light
- Extreme sensitivity to changes in sound

Causes Behind Migraines

Some of the common and known causes, which may trigger migraines in people are:

- Hormonal changes in the body that may have adverse effects
- Dehydration is also known to trigger migraines
- Patients with hypoglycemia may also face migraines if the blood sugar level drops within their body
- Change in air pressure due to change in altitude may also cause migraines to appear
- Lack of sleep
- Stress
- Lifestyle issues such as smoking and excessive alcohol consumption.

Remedies for Migraine in Homeopathy

Migraine is treated in homeopathy by attacking the root causes that may trigger them. Rather than temporarily alleviating pain, homeopathic treatments aim at curing the problem completely.

Some of the medicines that are known to be effective are:

Natrum Mur: This provides great relief from migraines, which may have been caused by stress. Also, if a proper dosage is taken, it can help cure it as well.

Belladonna: This had been known to be a great provider of relief for people who regularly face throbbing headaches.

Glonoine: For people who frequently have migraines due to congestion of the sinuses, this medicine has been known to be very effective.

Spigelia: To treat migraines in the left side of the head.

Sanguinaria: Is highly effective for situations where the migraine is on the right side of the head.

If you would like to consult with me privately, please click on 'Consult'.

Dealing with Migraine through Homeopathy

PMS or premenstrual syndrome affects women exactly prior to their menstrual cycle. This syndrome may have affects manifold, impacting a woman s physical health, behavior and emotions. The condition is very common and affects more than 80% of the women before their monthly cycles begin.

Causes-

The exact cause of PMS is not yet ascertained. It is believed that changes in hormones in the body can lead to PMS. Before the menses start, progesterone and estrogen levels tend to dip in the body. This hormonal dip results in anxiety, anger and irritability issues. Levels of serotonin, a chemical in the brain which affects your moods and thoughts, in the body also decrease at this time. Here are certain factors which make you prone to PMS  

Family history of PMS
Being subject to domestic violence
Emotional and physical trauma
Substance abuse
Past history of mood disorders
Symptoms-

The menstrual cycle lasts for 28 days. On the 14th day, egg is released from the ovaries; this is known as ovulation. The bleeding or menstruation occurs on the 28th day of the cycle. Symptoms of PMS start to show up from around the 14th day of the cycle.

PMS includes signs such as abdominal cramps, bloating, acne and sudden craving for sweet foods. Stomach disorders such as constipation and diarrhea are also common. Mental disorders such as anxiety and mild depression have also been observed.

Managing PMS Symptoms-

With PMS, one can take these steps to deal with the various signs of discomfort. Here are some remedies to deal with PMS symptoms:

Eat a balanced diet consisting of fruits and vegetables to get Vitamins and minerals in the required amounts.
Keep yourself hydrated to ease symptoms of bloating.
Consuming supplements of folic acid, Vitamin D and calcium can help easing the symptoms.
Sleep for 6-8 hours on a regular basis.
Exercise regularly to beat stress and avoid bloating.
Try relaxation techniques to get rid of stress or at least limit stress levels.
Some pain killers can help combat the pain resulting from muscle aches.

Dealing With Premenstrual Syndrome (PMS)

Dementia refers to the progressive loss of memory in a human being. It does not refer to any particular disease. It is rather a cumulative representation of symptoms which signify that the person is losing his or her memory. Dementia occurs in seven stages. Read on to read more about them:

In the first stage, there is no cognitive decline and the person is mentally sound. There is no memory loss as well.
In the second stage, there is a very mild cognitive decline leading to normal forgetfulness that is often associated with progressing age.
In the third stage, there is a mild cognitive decline. The person has an increased forgetfulness and may find it difficult to concentrate on things.
In the fourth stage, there is moderate cognitive decline and the person starts forgetting even the most recent events. They cannot even travel alone or manage their own finances.
In the fifth stage, there is moderately severe cognitive decline. The person going through this stage often requires help even with their daily activities. People tend to forget even the most common things like phone and email passwords.
In the sixth stage, there is severe cognitive decline. This stage is also called middle dementia and there is prominent memory loss. People cannot even count from 1 to 10. Their speech becomes slurry. They also start having delusions.
In the seventh stage, there is very severe cognitive decline. This stage is also called late dementia. The psychomotor skills are also lost at this stage and the person may not even be able to walk properly.
Some of the early signs of dementia are listed below:

In the initial days of dementia, the person usually tends to get confused when it comes to choosing the right words. This makes them take much longer time to conclude their speech.
There might also be a change in the mood of the person.
Depression is also one of the early signs.

The person will have a tendency to forget even the most recent events that took place in his or her life. This means that they might remember what happened ten years before but they might not remember what they did in the morning.
Early signs also include failure to sense directions. People often tend to forget their addresses and the landmarks and thus become lost when they travel alone.
Confusion is also one of the common signs and this is directly correlated to the loss of memory because when a person cannot remember familiar faces, it leads to a lot of confusion within his own mind.
So, if you suspect that someone in your house is suffering from dementia, then you must look out for these early signs and seek medical help immediately. Early treatment can keep the condition from worsening.

Dementia - Stages and Early Signs!

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