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Carcinoid Health Feed

Risk Factors Of Bile Duct Cancer!

MCh - Surgical Gastroenterology/G.I. Surgery, MS - General Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery
Surgical Gastroenterologist, Delhi
Risk Factors Of Bile Duct Cancer!

The bile duct is a thin tube which collects bile from the liver, stores it in the gall bladder and carries it to the intestine. Cancer of the bile duct is also known as cholangiocarcinoma. It can either involve the upper part or lower part of the bile duct and is called intrahepatic, hilar or distal cholangiocarcinoma.

Anything causing inflammation in the bile duct increases the risk of this cancer. Examples include

  • smoking.
  • choledochal cyst.
  • infection with liver flukes.
  • recurrent pyogenic cholangitis.
  • primary sclerosing cholangitis.
  • ulcerative colitis.
  • chemical carcinogens.


Irrespective of site, these tumours block the flow of bile and may cause following signs and symptoms

  • Jaundice (yellowing of eyes, urine and skin).
  • Weight loss.
  • Itching.
  • Pain abdomen.
  • Recurrent fever.


Liver function test, ca 19-9, and high-quality triphasic ct scan are some of the investigations required to diagnose and stage the disease. If diagnosed early, it can be cured by surgery. Type of surgery depends upon the location of the tumour and could be liver resection or pancreaticoduodenectomy.

Dyslipidemia - How To Handle It?

Dr.Prashant Vazirani 89% (310ratings)
MD - Medicine, DNB Medicine, DNB - Cardiology (Gold Medalist)
Cardiologist, Ahmedabad
Dyslipidemia - How To Handle It?

Dyslipidemia is a condition in which the patient has high or low levels of lipid in the blood. Lipids are fatty substances in the blood like cholesterol and triglycerides. A balanced and healthy diet can help the patient regulate Dyslipidemia condition. However, medication is often recommended by doctors in most cases.

Dyslipidemia is caused due to various reasons. Some common reasons are the high level of bad cholesterol, low levels of good cholesterol, high levels of triglycerides in the blood, and high cholesterol overall. These substances give sustenance to the cells in the body and are also essential for impairment of cells. The high or low levels of fatty substances in the blood can cause a variety of problems.

Symptoms

In most of the cases, patient is unaware if he/she is suffering from Dyslipidemia. The levels of cholesterol in the routine blood report or checkup are diagnosed.

If the condition is not attended to, it may result in heart problems like coronary artery disease and Peripheral artery disease (PAD).

The most common symptoms of Dyslipidemia are:

● Pain in legs

Swelling

Shortness of breath

Dizziness
● Sleeping problems

Cold sweats

● Perspiration

Fatigue and exhaustion

● Fainting

Indigestion

Pain or tightness in jaw, thighs, and shoulders

Types of Dyslipidemia

Dyslipidemia can be categorized into two categories.

● Primary Dyslipidemia: This condition is inherited by the patients.

● Secondary Dyslipidemia: This type of Dyslipidemia is acquired by the patient. If this condition is developed due to other causes such as obesity or diabetes, it is Secondary Dyslipidemia.

Causes of Dyslipidemia

Genetic factors mostly cause primary Dyslipidemia. They are inherited by birth and develops in adulthood. The teenagers and adults having Dyslipidemia have high cholesterol. This condition also leads to a mutation in the LDL lipid proteins, which can improve the condition of familial hypobetalipoproteinemia. Secondary Dyslipidemia is commonly caused among people with a bad lifestyle. The leading causes for secondary Dyslipidemia are:

● Obesity

● Diabetes

● Heartburn

Alcoholism

● Inflammatory bowel problems

● Cushing’s syndrome

● Metabolism problems

HIV

● Infections in heart

● Indigestion

Treatment

The sedentary lifestyle and bad eating habits are a common cause for Dyslipidemia. The doctors generally suggest medication to patients having high cholesterol or triglycerides. The medication will regulate the blood lipid levels. Doctors also recommend a healthy lifestyle and regular exercise for better health. Conventional treatments recommended by the doctors for modifying LDL levels naturally are:

● Regular walks

● Exercise

● Eating a balanced diet

● Quitting drinking and smoking

● Include green leafy vegetables in the diet

● Regular check-ups and tests

● Avoid sitting at one place for a longer time

● Include more water in routine

● Lower the sugary food

● Sleep properly and adequately

● Avoid carbohydrates Patients with minor Dyslipidemia may face no problem.

However, it is essential that the condition is treated naturally by adopting a balanced lifestyle. With little changes and care, you can live a long healthy life.

1400 people found this helpful

Nephrotic Syndrome - 9 Causes Of It That Will Surprise You!

Dr.Sanjiv Saxena 90% (46ratings)
DNB (Nephrology), MD, MBBS
Nephrologist, Delhi
Nephrotic Syndrome - 9 Causes Of It That Will Surprise You!

Nephrotic syndrome is a type of kidney disorder wherein, the body passes out excess amount of proteins through urine, owing to the damage caused to the tiny clusters of blood vessels in the kidneys. The symptoms include putting on excessive weight as a result of fluid retention, foamy urine and severe swelling around the region of the feet, ankles and eyes.

Common causes behind it:

  1. Minimal change disease (also known as nil disease) leads to the abnormal functioning of the kidneys
  2. Excess deposit of amyloid proteins in the organs, thus taking a toll on the filter mechanism of the kidneys.
  3. Diabetes affecting the glomeruli (capillaries present in the nephrons of the kidneys).
  4. Systemic lupus erythematous causing chronic swelling of your kidney.
  5. Membranous nephropathy wherein the membranes in your glomeruli thicken.
  6. Infections such as malariahepatitis Chepatitis B and HIV.
  7. Medications to combat infections and nonsteroidal anti-inflammatory drugs.

Treatment Available:

  1. Kidney Biopsy is an essential part of disease assessment.
  2. Angiotensin-converting enzyme inhibitors bring down blood pressure levels as well as the amount of protein discharged from the urine.
  3. Water pills help control sweating, thus, increasing the fluid flushed from the kidneys.
  4. Statins reduce cholesterol levels.
  5. Blood thinners such as anticoagulants lower the risk of blood clots.
  6. Corticosteroids regulate the immune system and ease the inflammation that results from kidney disorders.
  7. Incorporating certain lifestyle changes such as opting for lean proteins, cutting on the intake of fat in the diet and consuming lesser amounts of salt can treat inflammation and swelling.
939 people found this helpful

I have hand problems, to undersimplify. I have dequervain’s bilateral, dupuytrens on the rh (radiated, no more issues) and cyst on the top of my wrist on lh. My physiatrist told me I have a slight carpal tunnel syndrome (no symptoms) and the beginnings of osteoarthritis bi lateral (not enough to cause symptoms). Apart from dequervains pain, I have pain in my index finger rh especially when I flex it. It feels, I can’t describe it any better, like I have a tight glove on and it is hard to flex (i had to switch the mouse button side). I had an mri more than 5 years ago and it revealed tenosynovitis of the said index finger and some fluid deposited around the tendons of all my fingers. But here is the real puzzling affliction, I seem to have some kind of generalized tendonitis bi lateral and the pain seems to occur for no reason. Also I get injured too easily. For example, today, while I was sweeping the floor the inside of my left thumb and under my index finger down to my palm, started to hurt badly. Every so often when I grab something with force (or just in an awkward way) the knuckles at the base of my fingers in the palm of my hands hurt. I thought it was the osteoarthritis but I finally realized it was actually the tendons being compressed. I’ve looked everywhere for something that could explain this strange “all tendons inflamed” disease to no avail. I had a failed dequervains surgery, physiotherapy and all kinds of nsaid”s and methylprednisolone course twice. They’ve only injected once bilateral for dequervain’s. I’ve been trying to get them to inject me in the other problem areas but they simply ignore me. Any ideas?

Dr.Chirag V. Thakkar 89% (141ratings)
MBBS, MS - Orthopaedics, F. KUMC, Fellowship in Joint Replacement, Fellowship in Arthroscopy, Cadaveric workshop in Knee and Shoulder Arthroscopy, Cadaveric Workshop in Knee Arthroscopy
Orthopedic Doctor, Vadodara
I have hand problems, to undersimplify. I have dequervain’s bilateral, dupuytrens on the rh (radiated, no more issues...
1. For your dq's, you can get operated and tendons can be released instantly. It's a short procedure, not so costly and very effective. 2. For your forefinger pain, I think carpal tunnel syndrome could be the cause. Get your never conduction velocity and electromyography of that upper limb done. 3. Also get yourself checked for diabetes and thyroid, uric acid, rheumatoid arthritis 4. Osteoarthritis is not common in young individuals except post trauma.
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Diabetic Nephropathy - Know More About It!

Dr.Ravinder Singh Bhadoria 88% (15ratings)
DNB (Nephrology), M.D ( Internal Medicine), MBBS
Nephrologist, Noida
Diabetic Nephropathy - Know More About It!

What is Diabetic Nephropathy?

Diabetic nephropathy (Diabetic Kidney Disease) is defined as the progressive damage to the kidneys caused by diabetes. It is characterised by the scarring of the glomeruli in the kidneys due to prolonged diabetes mellitus.

What Causes Diabetic Nephropathy?

Diabetes is a condition characterized by high concentration of blood sugar. Although the cause of Diabetes Nephropathy is not yet well defined, it is likely that the high sugar levels in the blood damage the blood vessels present in the kidneys that help to filter waste products, thus resulting in decreased kidney function and ultimately, kidney failure.

Not everyone with diabetes suffers from diabetic nephropathy. Although, factors that can increase your chances of getting diabetic neuropathy are-

  1. Smoking

  2. Poor control of blood glucose

  3. High blood pressure

  4. History of kidney diseases

What are the symptoms of diabetic nephropathy?

In the early stages, there may be no symptoms at all, but as the disease progresses, you may notice swelling in the extremities like your feet. Thus it is recommended to get your blood albumin levels tested on a regular basis. If it is diagnosed in the early stages, the damage can be reversed. Other symptoms that can indicate damage to the kidneys are-

  1. Severe malaise

  2. Headaches

  3. Nausea

  4. Lack of appetite

  5. Frequent voiding

  6. Itchiness of skin

  7. General feeling of illness

Diagnostic tests that can confirm diabetic nephropathy are-

Routine urine test (urinalysis) - Kidney diseases are detected by the presence of a protein in the urine called albumin and this condition is called albuminuria. Other parameters that must be regularly monitored are-

  1. Blood pressure

  2. Cholesterol levels in your blood

How can you treat/ manage diabetic nephropathy?

If this type of nephropathy is diagnosed in the early stages, the damage to the kidneys can be reversible. The key to managing diabetic nephropathy are-

  1. Diet: Reduce the dietary intake of salt, phosphorous and potassium in the advanced stages.

  2. Glycemic Control: Monitor your blood glucose levels regularly

  3. Management of Hypertension: It is important to manage your blood pressure as it can have a direct effect on the coronary blood vessels which in turn pump blood to the various blood vessels of the body

  4. Renal Replacement Therapy: In chronically ill patients, renal replacement therapy is the best option. This can include haemodialysis (a procedure to flush out toxins from the blood, such as urea), peritoneal dialysis or ultimately renal transplantation.

1447 people found this helpful

Contrast Induced Nephropathy - Know Complications Of It!

Dr.Ashok Sarin 87% (47ratings)
MD, MBBS, FRCP - Nephrology
Nephrologist, Delhi
Contrast Induced Nephropathy - Know Complications Of It!

Contrast-induced nephropathy (CIN) is a serious complication that may arise during angiographic procedures and is elaborated as the impairment of renal function. It is estimated as either a 25% increase in the serum creatinine (SCr) from baseline or a 0.5 mg/dL (44 µmol/L) increase in absolute creatinine value within two to three days after intravenous contrast administration of intravascular radiographic contrast material that is not attributable to other causes.

To simplify, contrast-induced nephropathy (CIN) is a form of kidney damage in which there has been recent exposure to medical imaging contrast material without another apparent cause for acute kidney injury. CIN is considered the 3rd most common cause of hospital-acquired renal dysfunction. There are emerging concerns that the importance of CIN has been greatly overstated. Here discussed are the risk factors with concerns comprised in (CIN) Contrast-induced nephropathy.

Complications in consideration of Contrast-induced nephropathy
One of the leading causes of hospital-acquired acute kidney injury (AKI), CIN is associated with longer hospital stay and while the incidence is low (0-5%) in patients with normal renal function, trials report that it is as high as 26% in patients with impaired renal function. Also, studies report that about 15% of the affected patients needed dialysis.

There is a complex association between CIN, mortality, and comorbidity. Majority of patients who receive CIN do not die from renal failure. Death, if a patient at all dies, is more usually from a procedural complication or a pre-existing non-renal complication.

Risk concerns
Many physicians who refer patients for contrast procedures and some who perform the procedure themselves are not entirely informed about the risk of CIN. Individuals with diabetes mellitus, chronic kidney disease, hypotension, reduced intravascular volume, or who are over 75 years of age are at increased danger of evolving CIN after exposure to iodinated contrast. A survey found that most of the referring physicians were not aware of potential risk factors, including ischemic heart disease and diabetes mellitus. However, acute kidney injury (AKI) can happen from a variety of causes, or their succession, during severe illness and no trial which is randomized has established the risk of contrast-induced nephropathy.

The overblown risk factor
When there is a need to diagnose a suspected arterial thrombus, pulmonary embolism, or intra-abdominal catastrophes, treatments and tests require intravenous contrast and these are often suspended in patients with raised creatinine levels. The diagnostic rift leaves their physicians with less than the best knowledge to make decisions regarding the treatment.

A notable percentage of hospitalized patients experience AKI and an even greater percentage gain IV contrast during their stay in the hospital. There will thus forever be the explanation for observed anecdotal instances of "contrast-induced nephropathy." Whether or not contrast-induced acute kidney injury persists, or has been exterminated by the use of lower-osmolarity contrast agents, would require a comprehensive randomized analysis to sort out.

In most cases, the condition is self-limiting with the creatinine levels peaking for 2-3 days and returning back to baseline within 7-10 days, there are indeed concerns due to the limitation in treatment options.

1488 people found this helpful

Sciatica - Do You Need Surgery?

Dr.Anurag Saxena 89% (17ratings)
M.Ch - Neuro Surgery, FRCS (Ed) Neurosugery
Neurosurgeon, Gurgaon
Sciatica - Do You Need Surgery?

Sciatica pain can be mild to intense. Many with lumbar herniated disc and sciatica often wonder whether or not they require a surgery. Needless to say, it is never an easy decision. But the good news is that micro discectomy surgery has a higher rate of success when it comes to relieving sciatica pain. When compared to many other options, this one is relatively minimally invasive. It doesn’t alter the structure of the spine permanently since it works by removing a small portion of the disc, which has herniated or extruded out of the disc.

When your sciatica pain stems from lumbar disc herniation, a small open surgery with the help of magnification is the prevalently opted surgical approach. On the other hand, a laminectomy is done when the bone or disc pinching the nerve root is required to be removed.

When should you consider undergoing surgery for sciatica?
Typically, neurosurgeons recommend considering surgery for sciatica in a host of situations which include the following:

  1. Severe pain in the leg lingering for more than six weeks, which mainly affects one side of the leg or buttock
  2. Intense pain in the low back and buttock, which continues through the course of the sciatic nerve andextends to the lower leg and even foot. This pain can be described as sharp and searing rather than a dull thud.
  3. When pain has not alleviated even after non-surgical treatments that may include non-steroidal anti-inflammatory drugs (NSAIDs),oral steroids, injections, manual manipulations, and physical therapy
  4. When the patient is not able to take part in the day to day activities due to intense lower back pain and the symptoms tend to become severe during movements like sneeze and cough.
  5. When the symptoms are continuing to worsen, thereby indicating nerve damage, particularly when the progressive signs have their root in neurological issues
  6. It is important to note here that surgical intervention may only be needed when the patient experiences progressive weakness in the lower portion of the body or sudden loss of bladder or bowel movement, which may stem from cauda equina syndrome. Two surgeries, namely lumbar laminectomy and microdiscectomy are performed on the basis of the cause as well as the duration of the sciatica pain.
  7. In some cases, the symptoms are unique on the basis of the underlying causes of sciatica. For instance, trying to bend the body backward or walking a longer distance than normal may trigger unbearable symptoms. On the other hand, when the affected individual tries to bend the body forward, it can lead to symptoms stemming from the lumbar herniated disc.
  8. In case sciatica occurs after an accident, injury or trauma, or if it happens in tandem with other symptoms, then it requires an immediate medical attention.

Thus, choosing to go for a surgery depends on several factors that only your doctor can assess and decide upon.

1622 people found this helpful

IgA Nephropathy - Causes & Symptoms!

Dr.Garima Sharma 93% (462ratings)
MBBS
General Physician, Fatehabad
IgA Nephropathy - Causes & Symptoms!

IgA nephropathy is also called Berger’s disease. This kidney disease happens when your body produces too much of the antibody immunoglobulin A (IgA) and it builds up in the kidneys. As a result, the kidneys swell up and eventually, affect the functionality of these organs. The progression of the illness is slow but relentless. The pace depends from one person to the next.

What are the symptoms of IgA nephropathy?

In the very early stages, IgA nephropathy does not reveal any symptoms. In the later stages, you may experience these signs –

  • Urine that is the colour of tea (because of the presence of red blood cells)
  • Frequent urination
  • Traces of blood in the urine
  • The urine may also be foamy because IgA nephropathy causes proteins to seep into the urine
  • High blood pressure
  • Backache (usually below the rib cage)
  • Swelling of the hands and feet

What causes IgA nephropathy?

Immunoglobulin is vital for your body’s defence mechanism. It hunts down and destroys pathogens that have entered the system. But sometimes, too much of immunoglobulin A is produced and it collects in the glomeruli that are responsible for filtering your blood and sending the toxic wastes to the bladder for expulsion. The accumulated immunoglobulin A does not allow the kidneys to do their job.

However, the exact cause that triggers the overabundance of IgA is not known. Scientists believe that the following could be the reasons for IgA nephropathy –

Apart from these, the factors that raise your chances of contracting IgA nephropathy include –

Gender- men are more likely to get this illness than women

Ethnicity- it is more common in Asians and Caucasians than other ethnic groups

Age of the person- a person is likely to come down with this disorder between the teen years and the late 30s/early 40s

There is no cure for IgA nephropathy. Treatment seeks to control the symptoms and prevent the escalation of the illness or stop future complications.

You will also be recommended to eat fatty fishes that are loaded with Omega 3 fatty acids, which have the capacity to reduce kidney inflammation. Moreover, you will have to cut down on proteins and constantly monitor your blood pressure.

IgA nephropathy cannot be prevented, as it is a hereditary disorder. If someone in your family who you are linked to by blood has this disease, talk to a doctor to know how you can keep your kidneys healthy.

Diabetic Nephropathy - Tips To Manage It!

Dr.B Ramya 88% (45ratings)
MBBS, Fellowship in Diabetology CCEBDM , CCGDM
Diabetologist, Mumbai
Diabetic Nephropathy - Tips To Manage It!

Diabetes is not an isolated disease but a syndrome. It brings with it a host of issues, affecting almost all organs, and that is the reason it is a dreaded issue. Diabetes is the result of chronic inflammation and this inflammation gradually spreads to all other organs. One of the main organs adversely affected is the kidneys. The kidneys are essential filtration agents, and impaired kidney function can have a series of bad effects on the body.

The good news is that not everybody with diabetes will have diabetic nephropathy. However, risk factors for developing diabetic nephropathy are:

  1. Severe, uncontrolled diabetes
  2. Family history
  3. Prior kidney disease, even chronic infection
  4. Race or ethnicity (native Americans, African Americans, etc.)
  5. Preexisting hypertension or high cholesterol levels
  6. Obesity

If you have these risk factors, then all efforts should be aimed at keeping blood sugar at highly optimal level. Once it reaches beyond a certain level, it is very difficult to get it under control.

Symptoms

There would be no symptoms in the initial stages

  1. If you suspect that increased sugar levels could be damaging the kidneys, it is imperative to do renal functions annually to test for onset of kidney malfunction
  2. There could be swelling of the feet and ankles
  3. Urine tests may indicate increased levels of protein in the body (serum albumin in particular)

Management

The idea is to arrest or stop damage to the kidneys.

  1. Reduce and maintain blood pressure within the recommended levels. This will depend on the age and overall health status. Using angiotensin converting enzymes or angiotensin receptor blockers is the most effective way to control hypertension and related kidney damage
  2. Keeping blood sugar within the recommended levels helps reduce or stop damage to the blood vessels in the kidneys and thereby, prevent progression
  3. Maintain optimal levels of cholesterol, as this only adds to hypertension, which further worsens kidney function.
  4. Eat a heart-healthy diet and exercise regularly. It is a vicious cycle with components including hypertension, high sugar levels, increased heart disease, which all only continues in a circle nonstop. Breaking this cyclical trend is very important.
  5. Diet should not be too rich in protein, as the kidney function is impaired and may not be able to handle too much protein. Talk to a nutritionist as to how much protein is required and follow it strictly.
  6. Reduce salt levels in the diet, and strictly do not add extra salt onto your plate
  7. If you are a smoker, this is a great reason to quit, as it affects all the above conditions.
  8. Maintain weight under optimal levels.
4206 people found this helpful

Are You Worried Of Hair Thinning?

Dermatologist
Dermatologist, Noida
Are You Worried Of Hair Thinning?

Losing strands of hair can be rather unpleasant and at the same time very embarrassing too. There are many people who find strands of hair in their bathroom drain or even on their pillows after a night’s sleep.

If you too happen to fall in that category of people, you need not be alarmed although the situation might be alarming.

Most of the time, it is just the normal shedding of hair although you might feel otherwise. Any average individual loses about 100 strands of hair every day and that is quite natural.

The shed hair is replaced by the new growth of hair and the cycle starts over again.

But if you happen to notice that there is excessive hair fall happening every day, it’s high time to look for professional intervention or for solutions that will help you in averting the alopecia or premature baldness of hair.

Alopecia or baldness can affect any person, irrespective of gender and age. It is not always determined by the genes but there are several other causes behind baldness.

The most common cause of alopecia is the pattern baldness or the androgenetic alopecia. It can either be hereditary or it can also be caused because of a higher level of androgens.

If you are a male, you might notice an M shaped thinning of the hair, and if you are a female, the hair can thin down from the front and the central scalp.

If you notice a bald spot on the scalp, it might be caused by the alopecia areata. When you suffer from this condition, the immune system of your body produces such antibodies that fight off the harmful microorganisms begin to damage the hair follicles instead thereby leading to hair loss in small patches of baldness.

It is important to know and learn about the causes of hair loss since only when you are aware of your condition will you be able to get proper guidance from a hair specialist or a dermatologist so as to get appropriately treated for the same.

There are several options to prevent the loss of hair like consuming oral medication and applying topical medication, or you can also opt to undergo certain surgical procedures like the hair transplantation, laser hair therapy or the hair replacement and weaving.

Thus even if you have thinning hair, you can always choose technology to fight hair loss and get back your original appearance.

4 people found this helpful
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