Dr. Anita Yadav

Non Hodgkin Lymphoma is when the cells in your lymphatic system become cancerous. The lymphatic system is responsible for fighting off diseases, which may attack your body. Initially, tumors develop from the lymphocytes in your body. Non-Hodgkin lymphoma is much more common than the other type of lymphoma which is Hodgkin lymphoma. There are various types of Non-Hodgkin lymphoma; the most common of which are diffuse large B-cell lymphoma and follicular lymphoma. Here is everything you need to know about Non-Hodgkin lymphoma.

Symptoms
1. Swollen lymph nodes: A swollen lymph node in the neck, underarm and armpit which comes about without any pain is a very common symptom of Non-Hodgkin lymphoma.
2. Fever: When you have a sudden unexplained fever, it may be due to Non-Hodgkin lymphoma.
3. Night sweats: Night sweats are simply when you sweat excessively in the night.
4. Fatigue: Feeling extremely tired can be due to Non-Hodgkin lymphoma.
5. Weight loss: A sudden unexplained loss of weight is a very common symptom of Non-Hodgkin lymphoma.
6. Itchiness: An itchy skin is a rather serious indicator of Non-Hodgkin lymphoma.

Causes
Just like other forms of cancer, it is not known what causes Non-Hodgkin lymphoma, but there are factors, which put you more at risk compared to others.

Risk factors
1. Immunosuppressive drugs: You are most likely to develop Non-Hodgkin lymphoma, especially after taking immunosuppressive drugs after a major organ transplant.
2. Bacteria and viruses: Certain bacterial and viral infections cause Non-Hodgkin lymphoma including the HIV and Epstein-Barr virus as well as the Helicobacter pylori bacteria.
3. Pesticides: Research suggests that overexposure to the pesticides which kill weeds increases your likelihood of developing Non-Hodgkin lymphoma.
4. Age: Elder people are also more likely to suffer from Non-Hodgkin lymphoma.

Treatment
1. Chemotherapy: Chemotherapy comprises of administering drugs to kill the cancerous cells, either through injection or orally which kill cancer.
2. Radiation therapy: Radiation therapy deals with radiation which is directed at the parts of your body affected by cancer.
3. Medications to enhance the immune system: There are many medications which fight off cancer by boosting the immune system. If you wish to discuss about any specific problem, you can consult an Oncologist.

A fistula is an abnormal connection between two hollow spaces (epithelial surfaces), such as blood vessels, intestines, or other hollow organs. Fistulas are usually caused by injuries or surgeries resulting in infection or inflammation. Also sometimes fistulae are created for therapeutic purpose.

Types of fistulas include:

1. Blind - with only one open end. Also known as sinus tracts
2. Complete - with both external and internal openings
3. Incomplete - a fistula with an external skin opening, which does not connect to any internal organ

Location:

1. Eye, adnexa, ear, and mastoid process: Lacrimal fistula, carotid cavernous fistula, mastoid fistula, craniosinus fistula, labyrinthine fistula, perilymph fistula, and preauricular fistula
2. Circulatory system: Coronary arteriovenous fistula, arteriovenous fistula of pulmonary vessels, pulmonary arteriovenous fistula, cerebral arteriovenous fistula, arteriovenous fistula, and fistula of artery
3. Respiratory system: Pyothorax with fistula and tracheoesophageal fistula
4. Digestive system: Duodeno biliary fistula, salivary gland fistula, fistula of stomach and duodenum,  gastrocolic fistula, gastrojejunocolic fistula, enterocutaneous fistula, gastric fistula, fistula of appendix, anal and rectal fissures and fistulas, anal fistula, anorectal fistula, fistula of intestine, enteroentral fistula, fistula of gallbladder, biliary fistula, and pancreatic fistula
5. Musculoskeletal system and connective tissue: Fistula of joint
6. Urogenital system: Vesicointestinal fistula, urethral fistula, vesicovaginal fistula, cervical fistula, enterovaginal fistula, and rectovaginal
7. Congenital malformations, deformations and chromosomal abnormalities: Congenital preauricular fistula, Portal vein-hepatic artery fistula, congenital fistula of lip, Congenital fistula of salivary gland, congenital absence, atresia and stenosis of the rectum with fistula, congenital fistula of rectum and anus, congenital fistulae between uterus and digestive tract, and congenital rectovaginal fistula

Causes:

1. Inflammatory bowel disease causes of anorectal, enteroenteral, and enterocutaneous fistulas.
2. Complications from gallbladder surgery can lead to biliary fistula.
3. Radiation therapy, obstructed labor can lead to vesicovaginal and rectovaginal fistulas. Also, vesicovaginal and rectovaginal fistulas may also be caused by rape with foreign objects.
4. Obstetric fistula develops when the blood supply to the tissues of the vagina, bladder (and/or rectum) is cut off during prolonged obstructed labor.
5. Head trauma can lead to perilymph fistulas.
6. Trauma to other parts of the body can cause arteriovenous fistulas.
7. External causes include traumatic arteriovenous fistula and persistent postoperative fistula.

Physical examination: to determine the extent and pathway of the fistula

Treatment:

1. Treatment for fistula depends on the cause and extent of the fistula.
2. Surgery is often required to assure adequate drainage of the fistula. Surgical intervention combined with antibiotic therapy is usually required
3. In some cases, fistula is temporarily covered e.g. cleft palate fistula is treated with a palatal obturator to delay the need for surgery to a more appropriate age.
4. Surgical procedures commonly used are fistulotomy, placement of a seton (a cord that is passed through the path of the fistula to keep it open for draining)
5. Filling the fistula with fibrin glue

In case you have a concern or query you can always consult an expert & get answers to your questions!

Wearing heels disturbes the body's centre-of-mass and major part of body weight is transferred on the forefoot. It changes the normal biomechanics of body and leads to problems like: foot pain, knee pain and low back pain.