One of the more severe illnesses included in the larger group of diseases known as inflammatory bowel disease (IBD), Crohn's disease is typically a long-lasting, chronic condition. The intestine or bowel, most commonly the colon and the lower part of the small intestine, are either marked by sores or get inflamed and ulcerated. It is a common occurrence in adolescents and in young adults.

Crohn's disease is subdivided into five types, each having its own set of symptoms:
1. Ileocolitis: The most common type, it affects the colon and the ileum and results in considerable weight loss as well as diarrhea and cramps.
2. Gastroduodenal Crohn's disease: People who suffer from this type of disease have their stomach and duodenum affected and many experience symptoms like nausea, loss of appetite and weight loss.
3. Crohn's colitis: This involves only the stomach, and can cause joint pains, rectal bleeding, skin lesions and diarrheas,
4. Ileitis: This type affects the ileum and the symptoms are identical to those of ileocolitis.
5. Jejunoileitis: In this type, the jejunum gets affected and general symptoms include the formation of fistulas, diarrhea, intensive back pain as well as areas of inflammation.

Causes
Despite the uncertainty as to the nature of the specific causes of Crohn's disease, there have been a few possible causes which have been identified. These include:
1. Immune system problems
2. Genetic disorders
3. Environmental factors
a) Certain edibles
b) Viruses or harmful bacteria
c) Smoke

Symptoms
The primary symptoms of Crohn's disease include the following:
1. Diarrhea: This can occur for about 10 to 20 times a day in more severe cases.
2. In rare cases, there may be blood in your stool.
3. In more intense cases, you may even develop a fever.
4. Cramping and intermittent belly pain.
5. Anemia, due to a reduction in iron levels caused by bloody stools.
6. Weight loss.
7. Erratic appearance of small tears in the anus, called anal fissures.

Causes, Types and Symptoms of Crohn's disease

Neck pain is a very common problem found in people who are habituated with a wrong posture for extended periods in a day, day after day. While old age and arthritis contribute to neck pain, even younger individuals who sit for hours in front of a computer screen or just generally have a faulty posture, may be subjected to such pains. Neck pain is usually due to cervical spondylitis.

While most of the neck pains are cured by topical muscle relaxants, those who have a severe condition may not be able to touch their chest with their chin, may have a loss of strength in one arm, may have shooting pain in one arm or shoulder, or may experience a sudden change in the bowel habits. In these situations, it is best to consult a doctor at the earliest.

The homeopathic remedies for neck pain are as follows:

Cimicfuga: This remedy is usually recommended when the neck pain radiates out and is almost like an electric shock spreading to the left arm. Pain and stiffness is experienced by the individual undergoing such a condition, if the hand is pulled backwards. Damp and cold conditions are aggravating factors, whereas warmth, pressure, and rest provide relief.
Chelidonium: This remedy is usually recommended when the neck pain is associated with heaviness and tenderness. In such a condition, the pain may also affect the right arm, shoulder or wrist. Touching or moving the arm is an aggravating factor and relief is provided with warmth.
Gelsemium: This is the medication of choice when soreness and tenderness in the neck region along with a persistent headache is the condition. Pain intensity keeps changing and the patient feels very weak and lethargic. To relieve the pain, the patients are advised to lie down with their head raised. Aggravation of the pain happens due to cold and damp conditions.
Causticum: When the muscle and tendons undergo stiff contractions and the muscles of the neck are weakened, Causticum is the remedy of choice. Patients are unable to move their head to the right and find it extremely difficult to be able to bend it backwards. Pain in the neck is excruciating and accompanied with a tearing and burning sensation. Movements aggravate the pain and heat exposure provides relief.
Bryonia: A stitching sensation in the neck, which seems to extend upto the shoulders, is when Bryonia is prescribed. Swelling accompanied with a feeling of heat in the shoulders is also present. Movements increase the pain while relaxation of the shoulder and neck region brings relief.
The aforementioned options are the treatment lines of choice in case of a neck pain. They are universally accepted to be safe options, sans side effects, and that s why most patients prefer them.

Homeopathic Treatment For Neck Pain Symptoms 

The heart may sometimes face excessive fluttering or a throbbing sensation, which may make you feel uncomfortable. Such sudden throbbing sensations resulting in discomfort are called 'palpitations'. Homeopathy has some great remedies depending on the cause of these problems.

Let s have a look at these:

Palpitations caused by anxiety: This is one of the top causes for palpitations which occur before sitting for an exam, interview or before important events of your life. However, they may tend to stay longer and it is advisable that you control them with the use of Aconite or Arsenic Album.
Palpitations caused by Physical exertion: If you have a weakened heart or if you smoke and thus tend to feel a lot of exertion even with the slightest of physical efforts, then Spigelia, Iberis and Digitalis are good medications. Digitalis is especially good for palpitations caused by the slightest of movements, while spigelia is very good with palpitations that cause arm pain as well.
Anemia: Anemia or the lack of red blood cells can be very dangerous for your health as it can damage your vital organs. It can also cause palpitations along with other symptoms such as paleness, lack of strength and drowsiness. Natrum Mur and Ferrum Met are two of the most effective remedies in such cases.
Use of tobacco products: Another reason for palpitations developing is the use of tobacco products, such as cigarettes or chewing tobacco. In such cases, palpitations may occur even with the slightest of exertions or at rest. Medications effective in such situations are Kalmia, Tabacum and Convallaria. These variations may be required depending on the types of symptoms you may show such as a quick heart rate or a slow heart rate.
A palpitation caused by hyperthyroidism: Excessive secretion of thyroid is called hyperthyroidism and can cause a host of problems within the body including palpitation. Iodum and Spongia are two excellent medications in treating variations of palpitations caused by an over active thyroid gland.
Palpitations caused by acidity or gastric problems: This is possibly the most common cause for palpitations and Lycopodium as well as Abies Can are two very effective homeopathic medications, which can easily remedy the situation, depending on the type of problems you are having.

Palpitations - How Homeopathic Remedies Can Help You Manage Them?


- hiv testing in pregnancy should be done early so as standard care can be taken for the pregnant women.


- this hiv testing must be repeated in the third trimester, usually before 36 weeks of gestation. This should be done in women with hiv-seronegative and also in pregnant women who are at a high risk of developing hiv infection.


- expedited hiv tests should be performed at the time of delivery and labor and this is a must in women who have not been documented for hiv. The results of the test should be available in one hour of the test and the testing should be available 24 hours. In case the results are positive then, infant postnatal antiretroviral and intrapartum drug prophylaxis should be started immediately.


- women who have not been able to be tested for hiv at the time of labor and delivery are suggested expedited screening for hiv. Their screening can be done immediately postpartum or their babies should undergo screening. In case the infant and mother, both are positive, then infant antiretroviral drug prophylaxis should be started immediately. These mothers should avoid breastfeeding their babies, until the supplemental hiv tests are negative. In infants with positive hiv, prophylaxis should be discontinued and antiretroviral drug therapy should be started.


- in case of acute hiv infection during pregnancy, that is in the intrapartum period, or during breast feeding, initial testing can be performed with an antigen/antibody combination immunoassay. If the supplemental test is negative, then an additional test which is the virologic test (dna, rna) are necessary for the diagnosis of the hiv infection.
- if the mother is hiv positive then this information must be documented in the infant's medical record and also communicated to the infants care provider.
The knowledge of an antenatal maternal hiv infection allows the:
- women with hiv infection to get the correct antiretroviral therapy along with prophylaxis for the infections which might occur due to the immunocompromised state of the body. This also prevents and decreases the risk of transmission to their partners.
- when there is provision for antiretroviral therapy for the mother during pregnancy and labor along with antiretroviral drug prophylaxis for the baby there is less risk of perinatal transmission of the hiv.
- the hiv infected women should be counseled for a cesarean delivery. The option of an elective cesarean reduces the perinatal transmission of the hiv.
- the hiv women should be counseled about the risk of breastfeeding.

Identification and Management of Perinatal HIV Treatment

The mosquito may seem a very small creature, but can be deadly as they spread quite a few severe infections, with chikungunya being one of them. The disease got its name from an African language, which means to walk bent over.

Chikungunya is a viral disease that is carried by specific varieties of infected mosquitoes (Aedes aegypti and Aedes albopictus). It was originally confused for dengue, which is another mosquito-transmitted infection, but then called out as a separate disease. Both diseases start off with non-diagnostic symptoms including fever, rashes, fatigue, anaemia and headache. Dengue could be distinguished by the lowered platelet count, while the persistent joint pains and eye pain could be the distinguishing factor for the chikungunya.

The mosquito is the vector, which picks up the virus from one infected person and spreads it to another person. The virus does not spread directly from one person to the other. Once it reaches the blood stream, it multiplies in the body, and over a period of 1 to 12 days, the symptoms begin to appear.

Symptoms: The symptoms of chikungunya are listed below, which reflect the effects on the body.
The symptoms are generally nondiagnostic and generic including fever, rashes, joint pain, muscle aches, eye pain, fatigue, tiredness, lethargy, headaches, nausea, and vomiting. The eye pain which occurs behind the eyes and the joint pains are the indicative symptoms, which point to chikungunya. In fact, the joint pains make the patient assume a stooped posture, and that is where the name chikungunya was originally derived from.

Most of the above symptoms subside over a period of 10 to 15 days but the joint pain continues. In fact, in many, it can continue to exist for months and even years and eventually develop into rheumatoid arthritis.
Though chikungunya is not a fatal disease by itself, it can produce long-term symptoms which can be severely disabling and affect the quality of life.

Anybody who is bitten by the infected mosquito can develop the disease, but there are some groups of people at a higher risk. These include newborns, the elderly people, and people with chronic conditions like diabetes, hypertension, and chronic heart disease.

However, once infected, the person develops immunity and future infections do not happen unless their immunity is severely compromised.

Treatment: There is no specific treatment, and symptom relief is provided through rest, hydration, pain killers for joint and muscle, antipyretics for fever, and avoiding aspirin.
While there is no vaccine for chikungunya, preventing exposure to mosquito bites when you are travelling and preventing mosquito breeding and reducing exposure to mosquitoes by using repellents and nets are advisable.

Chikungunya  - How It Affects Your Body?

Liver transplant in the only curative option available for patient who develop cirrhosis of liver due to any cause ( Chronic Hepatitis B , Chronic Hepatitis C, Alcoholic Cirrhosis, NASH etc). Once patient has been diagnosed with cirrhosis it can not be reversed with any non-surgical treatment . Over a period of time patient may develop worsening in liver function resulting in complications of cirrhosis (bloody vomitus, black stools, jaundice , altered sensorium, renal dysfunction, abdominal swelling etc) labeled as  decompensated cirrhosis . These patients require Liver transplant at the earliest and should be reffered to a liver transplant centre immediately. Ideally all patient diagnosed with cirrhosis should be under the follow-up of a gastroenterologist/Hepatologist. The source of graft liver can be from two sources namely from a deceased brain-dead donor or a Living-related donor and termed respectively as DDLT ( Deceased donor liver transplant) and LDLT ( Living Donor Liver Transplant) . However both DDLT and LDLT have nearly 90% success rate and both the procedures have their own benefits and lacunaes. Also the decision to go for DDLT and LDLT may vary for any particular patient. 

Before the Liver transplant 

All recipient and Living donor go thorough evaluation before the transplant process that includes blood investigations, Imaging studies, Cardiac and pulmonary fitness tests, multidisciplinary consultation before the clearance for liver transplant is achieved. The healthcare provider will explain the entire procedure. The healthcare provider is also supposed to answer all your questions. You would be needed to sign a consent form that allows the doctor to do the surgery. Eating food is not allowed at least 8 hours before the surgery. If you cannot stay relaxed before the surgery, a sedative will be given. 

After the Liver Tranplsant 
The recipient surgery lasts for anywhere between 12-16 hrs and donor surgery for 8-12 hrs. After the surgical procedure is complete, you will be taken to the intensive care unit (ICU)and will be closely watched for several days. 

Immediately After the Surgery 
You will most likely have a tube in your throat. This is so that you can breathe with the help of a machine (a ventilator) until you can breathe on your own. The ventilator tube will be removed on next morning when all parameters are found to be satisfactory. All parameters are monitored by round the clock critical care doctors and staff for a few days. The recipient has to stay in the hospital for three weeks and the donor is discharged in one week. 

Blood samples will be collected on a regular basis to check the functioning of the new liver. Antibiotics will be infused via IV channels to prevent you from infections. The area where the operation was done should always be kept clean after you have reached home. Any stitches or surgical sutures will be removed at a follow-up visit.

Complications that may arise 
Blocked blood vessels to the new liver, bleeding, an infection, leakage of bile or blocked bile ducts, or the new liver not working for a short time right after surgery are a few complications that may arise. Not to aggravate the condition, in the case of a complication, it is imperative to visit your doctor.

Liver Transplant - What To Expect Before & After The Procedure?

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