The bones and joints orchestrate very well with each other for smooth movements of various joints and the spine. However, due to various reasons, some identified and others unknown, there could be inflammation of the areas where the bones join the muscles leading to impaired movement. The range of motion could be reduced or it could be painful, thereby, limiting movement. Spondyloarthritis includes a group of inflammatory diseases that involves the bones and joints and enthuses which are areas where the ligaments and tendons attach to the bones. This causes conditions like plantar fasciitis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. The term spondyloarthritis is a blanket term to describe any of the above-mentioned conditions.

Read on to know a little more in detail about it:

Causes: While the exact etiology is not identified for sure, most patients with spondyloarthritis have an autosomal dominant gene (HLA-B27). Chronic infections could trigger the onset of the disease too.

Symptoms:

1. In all forms of spondyloarthritis, there is always inflammation of the spine, joints and entheses. If the fingers or toes are involved, there could be swelling leading to what are typically known as 'sausage digits'.

2. There is sacroiliitis which is inflammation of the joint between the pelvis and the spine, and spondylitis which is inflammation of the joints between the spines. 3. Family history and autosomal dominant gene.

Diagnosis:

A detailed medical history and physical examination form the cornerstone of a confirmed diagnosis. In addition, radiographic examination and diagnostic blood tests also could be done to confirm the diagnosis. Radiographs, especially, of the spine and the low back show typical changes including sacroilitis in suspected cases of spondyloarthritis. If the spine does not show these changes, but there is a high likelihood of spondyloarthritis, then MRI (magnetic resonance imaging) can be used to confirm the diagnosis.

As a final step, a blood test for the HLA-B27 gene can also be confirmatory. However, it is not true that a person with the gene will definitely develop the disease.

Treatment:

The most important aspect of treatment is the use of pain medications and anti-inflammatory drugs (NSAIDs) which help manage pain and inflammation.
Corticosteroid injections may sometimes be given directly into the joint spaces or the membranes to provide quick relief of these symptoms.
ESWT / RSWT has a definite role to cure enthesopathy. Plantar fasciitis, and achillodynia can be cured with ESWT. Even small joints of hand and feet are amenable to treatment with RSWT. It is nonoperative and noninvasive treatment and has no side effects.
Very rarely, stronger drugs such as methotrexate or sulfasalazine may be used.
Another set of drugs known as TNF-blockers (tumor necrotizing factor blockers) are also shown to be highly effective in controlling the pain of the spine and joints.
In very severe cases, surgery may be required to correct joint damages or correct severe degenerative changes.
Exercise plays a very vital role in controlling the issue and improving range of motion.

What You Should Know About Spondyloarthritis?

Extramedullary intradural tumours are a rarity. Of all the tumours of the nervous system, fewer than 15% are of the spine. And around 45% of them are intradural. And 40% of intradural tumours are extramedullary.

What are some common Intradural Extramedullary Spinal Tumours? 

Some forms of intradural extramedullary spinal tumours are-

Schwannomas

Meningiomas

Gliomas

Neurofibromas

What are the Symptoms of Intradural Extramedullary Spinal Tumours?

Some symptoms of this condition are-

Back pain

Cramps

Loss of feeling along the back

Loss of spinal flexibility

Weakness of the limbs

Slight degrees of paralysis

Hunched-over spine

If treatment is not sought immediately, the effect of the tumours would penetrate all levels of the spine and may lead to complete paralysis.

How are Intradural Extramedullary Spinal Tumours diagnosed?

A basic physical examination will reveal that there are tumours on the spine. Before treatment commences, the person will have to opt for these tests-

An MRI scan

A CT scan

X-rays

biopsy

Treatment of Intradural Extramedullary Spinal Tumours diagnosed?

Doctors do not usually suggest surgery right away. They will first try to vanquish the tumours with chemotherapy and radiation therapy. Sometimes a combination of both might be required.

If therapy does not work, surgery will be suggested. During the surgery, resection is done with the aim to assuage pain and stabilize the spine. Preoperative embolization is performed. A catheter is inserted into a vessel of the groin and directed to the tumour. Then a glue-like agent is administered to the vessels that carry blood to the tumour. When this supply is cut off, the tumour will shrink.

After the surgery, a person will be required to stay on in the hospital for a couple of weeks after which rehabilitation may be required to help the patient get back to a normal lifestyle.

Spinal tumours can be fatal. That is why it is important to pay heed to the symptoms and consult a doctor right away.

Intradural Extramedullary Spinal Tumour - In Depth!

Abdominal pain can be triggered by a number of factors. Sometimes, it's mild enough to be overlooked while at others, the pain can be debilitating. Most abdominal problems start with the same symptoms and hence the cause of this pain can be a little difficult to pin point. In many cases, the location of the pain can help understand the factors that are triggering it.

Generalized pain can be simply be triggered by indigestion. On the other hand, it could also be a symptom of a number of illnesses like irritable bowel syndrome, appendicitis, viral gastroenteritis and intestinal obstructions etc. However, the former are more common. This type of pain resolves itself without medical intervention.

In other cases, abdominal pain can be localized to the upper or lower abdomen on the right or left side or in the centre of the abdomen. This sort of pain is usually sporadic and comes and goes with great intensity. In most cases, this sort of pain is a symptom of a serious problem and should not be ignored. One of the most common examples of localized abdominal pain is the pain caused by appendicitis in its later stages. Severe pain that is located just above the centre of the belly button could be a sign of pancreatitis. A burning sensation and severe cramps in the center of the stomach could point towards stomach ulcers that could cause perforations if left untreated. Other causes for this type of pain include endometriosis, ovarian cysts, angina, kidney infections and a spleen infection.

Mild stomach pain whether localized or general can be relieved using home remedies and does not often require medication. However, if the pain is severe or if it comes on suddenly, you must immediately consult a doctor. Another reason to consult a doctor is if the pain persists for more than 24 hours. If the pain is accompanied by black or bloody stools or vomiting and nausea, do not ignore it. Black stools are often an indicator of the presence of blood in the digestive tract. Abdominal pain that worsens with movement or is tender to touch is also something that should be shown to a doctor. Other reasons to consult a doctor are abdominal pain with persistent vomiting following meals and unexplained weight loss and a loss of appetite.

The bottom line is, that when it comes to abdominal pain, it's better to consult a doctor and be told that there's nothing to worry about rather than self medicate and wait for it to worsen.

Abdominal Pain & When To Consult A Doctor

Asthma is the most common chronic condition for women in pregnancy. While Asthma control can affect pregnancy, pregnancy too can affect Asthma. Yet while pregnancy does not beget Asthma, neither does it abate.

Nevertheless, Asthma management during pregnancy is very important. Improper Asthma management, especially in difficult Asthma, during pregnancy may imperil both the mother and the child.

Along with taking the right medications, Asthma patients also need to avoid exposure to Asthma triggers.

Avoiding Asthma Triggers

Asthma triggers may be different for different people. In general, one or a few of the following act as Asthma triggers:

Allergens like pollen, dust mite etc.

Smoking

Certain exercises

Certain occupational exposure

Pollution

Certain drugs like  blockers, aspirin etc.

Alcohol, dairy products, orange juice, peanuts etc.

Additives like tartrazine, monosodium glutamate etc.

Certain medical conditions like gastric reflux, rhinitis etc.

Apart from avoiding these Asthma triggers, she would also need to follow the instructions of her gynecologists. She should always be concerned that if the treatment is not working or if she is experiencing any trouble, she must consult with the gynecologists. She can also do some exercises to stay active and healthy.

However, she should always consult a doctor before doing any exercise, especially for those who have experienced Asthma attacks in the past.

Effects of Asthma on Pregnancy

Poor Asthma management and difficult Asthma before pregnancy are associated with increased risk of hypertension during pregnancy, which can beget Preeclampsia. Studies have also shown that women with Asthma tend to undergo Caesarean sections more than others. It has also been observed that Asthma may restrict the growth of the fetus leading to low birth weight.

However, this is more due to poor Asthma control such as persistent breathing difficulty or poor lung function etc., than Asthma per se.

Effects of Pregnancy on Asthma

Certain physiological factors during pregnancy do affect Asthma. In difficult Asthma, control usually deteriorates between 24 and 36 weeks of pregnancy, mainly due to poor adherence to corticosteroids. This is why pregnant women with Asthma should be monitored closely irrespective of the severity of Asthma.

Breathlessness in Pregnancy

Breathlessness during pregnancy is common. In fact, even pregnant women with no Asthma symptoms may feel breathless at times. It reflects some normal physiological and anatomical changes during pregnancy. Even anxiety may precipitate breathlessness. This indicates that pregnant women with difficult Asthma may feel breathless, not just because of Asthma, but also because of normal changes during this period. However, new incidents of Asthma can also be a cause of breathlessness.

Respiratory Distress in Pregnant Women

Respiratory distress in pregnant women may not always be due to asthma. There may be a whole host of reasons that include Anxiety, Hyperventilation, chest infection, dysfunctional breathing, pneumonia, interstitial lung disease, thromboembolic disease, amniotic fluid embolism, pneumothorax, ischemic heart disease, arrhythmias, cardiomyopathy and a variety of endocrine, hematological and renal disorders.

Preventing Respiratory Distress During Pregnancy

Apart from avoiding Asthma triggers, pregnant women with Asthma or difficult Asthma need to strictly adhere to Asthma control. This indicates that they need to adhere to their corticosteroids religiously. However, before that, they also need to make sure that the corticosteroid is safe to be taken during pregnancy.

Asthma may or may not affect pregnancy. However, it is always a great idea to go for Asthma management. This will help women deal with complications related to Asthma during pregnancy.

Apart from that, always consult a doctor before going for any medication related to Asthma control, or actual treatment of Asthma.

Difficult Asthma - All You Should Know!

Easy home remedies for sore throat

An itchy, scratchy and burning throat is something we all experience, at least once a year, if not more. Depending on your body's immunity, it occurs more often. While there is good medication to cure the problem, there also exist home remedies which can cure it. Keep a note of these things also to prevent a bad throat.

Fix sore throat with:

1. Salt water gargle - this might not be new to you as it is the first remedy elders in the family advice about - to gargle with salt water. The warm water with salt in it relieves the discomfort in the swollen tissues and pulls the mucous out.

2. Over-the-counter throat lozenges: these are extremely convenient and dependable. On days when the throat won't stop itching and you have a lot of speaking to do, these lozenges help calm the itching. They contain menthol which makes the throat tissues numb. Cough drops and candies ensure constant production of saliva in the mouth. These have choking hazards though, so avoid giving to children.

3. Ginger, clove, tulsi - chewing on pieces of ginger is beneficial. Ginger juice soothes the throat and calms the itching. Especially helpful during the nights, so that one can sleep peacefully. Cloves and tulsi leaves when chewed individually also give similar soothing effects to a sore throat.

4. Drink loads of water - it is important to stay hydrated because dehydration leads to decrease in production of mucous and saliva in the mouth. More fluids in the mouth help deal with sore throat better.

5. Warmth of honey - warm tea with honey is an ideal way to soothe the irritated throat. Honey is said to be effective in suppressing coughs. 

6. Avoiding cold drinks - whatever you drink, make sure it is warm or even better, hot. Avoid drinking or eating anything cold as they will only aggravate the condition of the throat.

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Peace with Sore Throat - How Many of These Remedies Do You Already Know?

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?

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