Adjustment disoders treatment causes and information

DEFINITION

Work problems, going away to school, an illness — any number of life changes can cause stress. Most of the time, people adjust to such changes within a few months. But if you continue to feel down or self-destructive, you may have an adjustment disorder.

An adjustment disorder is a type of stress-related mental illness. You may feel anxious or depressed, or even have thoughts of suicide. Your normal daily routines may feel overwhelming. Or you may make reckless decisions. In essence, you have a hard time adjusting to change in your life, and it has serious consequences.

You don't have to tough it out on your own, though. Adjustment disorder treatment — usually brief — is likely to help you regain your emotional footing.

SYMPTOMS

Adjustment disorders symptoms vary from person to person. The symptoms you have may be different from those of someone else with an adjustment disorder. But for everyone, symptoms of an adjustment disorder begin within three months of a stressful event in your life.

Emotional symptoms of adjustment disorders

Signs and symptoms of adjustment disorder may affect how you feel and think about yourself or life, including:

SadnessHopelessnessLack of enjoymentCrying spellsNervousnessJitterinessAnxiety, which may include separation anxietyWorryDesperationTrouble sleepingDifficulty concentratingFeeling overwhelmedThoughts of suicide

Behavioral symptoms of adjustment disorders

Signs and symptoms of adjustment disorder may affect your actions or behavior, such as:

FightingReckless drivingIgnoring billsAvoiding family or friendsPerforming poorly in school or at workSkipping schoolVandalizing property

Length of symptoms

How long you have symptoms of an adjustment disorder also can vary:

6 months or less (acute). In these cases, symptoms should ease once the stressor is removed. Brief professional treatment may help symptoms disappear.More than 6 months (chronic). In these cases, symptoms continue to bother you and disrupt your life. Professional treatment may help symptoms improve and prevent the condition from continuing to get worse.

Stressful events

One or more stressful life events may put you at risk of developing an adjustment disorder. It may involve almost any type of stressful event in your life. Both positive and negative events can cause extreme stress. Some common examples include:

Being diagnosed with a serious illnessProblems in schoolDivorce or relationship breakupJob lossHaving a babyFinancial problemsPhysical assaultSurviving a disasterRetirementDeath of a loved oneGoing away to school

In some cases, people who face an ongoing stressful situation — such as living in a crime-ridden neighborhood — can reach a breaking point and develop an adjustment disorder.

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TESTS AND DIAGNOSIS

Adjustment disorders are diagnosed based on signs and symptoms and a thorough psychological evaluation. To be diagnosed with adjustment disorder, you must meet criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual, published by the American Psychiatric Association, is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

For an adjustment disorder to be diagnosed, several criteria must be met, including:

Having emotional or behavioral symptoms within three months of a specific stressor occurring in your lifeExperiencing more stress than would normally be expected in response to the stressor, or having stress that causes significant problems in your relationships, at work or at school — or having both of these criteriaAn improvement of symptoms within six months after the stressful event endsThe symptoms are not the result of another diagnosis

Types of adjustment disorders

Your doctor may ask detailed questions about how you feel and how you spend your time. This will help pinpoint which type of adjustment disorder you have. There are six main types. Although they're all related, each type has certain signs and symptoms:

Adjustment disorder with depressed mood. Symptoms mainly include feeling sad, tearful and hopeless, and experiencing a lack of pleasure in the things you used to enjoy.Adjustment disorder with anxiety. Symptoms mainly include nervousness, worry, difficulty concentrating or remembering things, and feeling overwhelmed. Children who have adjustment disorder with anxiety may strongly fear being separated from their parents and loved ones.Adjustment disorder with mixed anxiety and depressed mood. Symptoms include a mix of depression and anxiety.Adjustment disorder with disturbance of conduct. Symptoms mainly involve behavioral problems, such as fighting or reckless driving. Youths may skip school or vandalize property.Adjustment disorder with mixed disturbance of emotions and conduct. Symptoms include a mix of depression and anxiety as well as behavioral problems.Adjustment disorder unspecified. Symptoms don't fit the other types of adjustment disorders, but often include physical problems, problems with family or friends, or work or school problems.

TREATMENTS AND DRUGS

Most people find treatment of adjustment disorder helpful, and they often need only brief treatment. Others may benefit from longer treatment. There are two main types of treatment for adjustment disorder — psychotherapy and medications.

Psychotherapy

The main treatment for adjustment disorders is psychotherapy, also called counseling or talk therapy. You may attend individual therapy, group therapy or family therapy. Therapy can provide emotional support and help you get back to your normal routine. It can also help you learn why the stressful event affected you so much. As you understand more about this connection, you can learn healthy coping skills to help you deal with other stressful events that may arise.

Medications

In some cases, medications may help, too. Medications can help with such symptoms as depression, anxiety and suicidal thoughts. Antidepressants and anti-anxiety medications are the medications most often used to treat adjustment disorders. As with therapy, you may need medications only for a few months, but don't stop taking any medication without talking with your doctor first. If stopped suddenly, some medications, such as certain antidepressants, may cause withdrawal symptoms.

Alcoholic hepatitis Symptoms Causes Diagnosis And Treatment and ALTERNATIVE MEDICINE

DEFINITION

Alcoholic hepatitis describes liver inflammation caused by        
drinking alcohol.
Though alcoholic hepatitis is most likely to occur in people who
drink heavily over many years, the relationship between drinking
and alcoholic hepatitis is complex. Not all heavy drinkers develop
alcoholic hepatitis, and the disease can occur in people who drink
only moderately.

SYMPTOMS

Yellowing of the skin and whites of the eyes (jaundice) and
increasing girth (due to fluid accumulation) are the most common
signs of alcoholic hepatitis that lead people to seek medical care.
People may also complain of:
Loss of appetite Nausea and vomiting Abdominal pain and
tenderness Weight loss

CAUSES

Alcoholic hepatitis occurs when the liver is damaged by the
alcohol you drink. Just how alcohol damages the liver -— and
why it does so only in a minority of heavy drinkers — isn't clear.
What is known is that the process of breaking down ethanol —
the alcohol in beer, wine and liquor — produces highly toxic
chemicals, such as acetaldehyde. These chemicals trigger
inflammation that destroys liver cells. Over time, web-like scars
and small knots of tissue replace healthy liver tissue, interfering
with the liver's ability to function. This irreversible scarring,
called cirrhosis, is the final stage of alcoholic liver disease.
Risk increases with time, amount consumed
Heavy alcohol use can lead to liver disease, and the risk
increases with the length of time and amount of alcohol you drink.
But because many people who drink heavily or binge drink never
develop alcoholic hepatitis or cirrhosis, it's likely that factors other
than alcohol play a role. These include:
Other types of hepatitis. Long-term alcohol abuse worsens the
liver damage caused by other types of hepatitis,
especially hepatitis C. If you have hepatitis C and also drink —
even moderately — you're more likely to develop cirrhosis than if
you don't drink.Malnutrition. Many people who drink heavily are
malnourished, either because they eat poorly or because alcohol
and its toxic byproducts prevent the body from properly absorbing
and breaking down nutrients, especially protein, certain vitamins
and fats. In both cases, the lack of nutrients contributes to liver
cell damage.Obesity.Genetic factors. Having mutations in certain
genes that affect alcohol metabolism may increase your risk of
alcoholic liver disease as well as of alcohol-associated cancers
and other complications of heavy drinking. The exact genetic
associations have not yet been identified.

TESTS AND DIAGNOSIS

Identifying alcoholic liver disease depends on two main things:
Evidence of excessive alcohol consumptionEvidence of liver
disease
Alcohol consumption
Your doctor will want to know about your history of alcohol
consumption. It is important to be honest in describing your
drinking habits. Your doctor may ask to interview family members
about your drinking. Many people will have signs of chronic
alcoholism, such as skin lesions known as spider nevi.
Liver disease
Your doctor will likely order the following tests to look for liver
disease:
Liver function tests (including international normalized ratio, total
bilirubin, and albumin)Complete blood cell countAn ultrasound,
CT or MRI scan of the liverBlood tests to exclude other causes
of liver disease

TREATMENTS AND DRUGS

Stop drinking alcohol
If you've been diagnosed with alcoholic hepatitis, you must stop
drinking alcohol. It's the only way of possibly reversing liver
damage or, in more advanced cases, preventing the disease
from becoming worse. Many people who stop drinking have
dramatic improvement in symptoms in just a few months.
If you continue to drink alcohol, you're likely to experience serious
complications.
If you are dependent on alcohol and want to stop drinking, your
doctor can recommend a therapy that's tailored for your needs.
This might include medications, counseling, Alcoholics
Anonymous, an outpatient treatment program or a residential
inpatient stay.
Treatment for malnutrition
Your doctor may recommend a special diet to reverse nutritional
deficiencies that often occur in people with alcoholic hepatitis.
You may be referred to a dietitian who can help you assess your
current diet and suggest changes to increase the vitamins and
nutrients you are lacking.
If you have trouble eating enough to get the vitamins and
nutrients your body needs, your doctor may recommend tube
feeding. This may involve passing a tube down your throat and
into your stomach. A special nutrient-rich liquid diet is then
passed through the tube.
Medications to reduce liver inflammation
Your doctor may recommend corticosteroids drugs if you have
severe alcoholic hepatitis. These drugs have shown some shortterm
benefit in increasing survival. Steroids have significant side
effects and are not recommended if you have failing
kidneys, gastrointestinal bleeding or an infection. About 40
percent of people do not respond to corticosteroids. Your doctor
may also recommend pentoxifylline, especially if corticosteroids
don't work for you. Some studies of pentoxifylline have shown
some benefit, others have not. You might also ask about clinical
trials of other therapies.
Liver transplant
For many people with severe alcoholic hepatitis, liver transplant
is the only hope to avoid death. Survival rates for liver transplant
for alcoholic hepatitis are similar to those for other forms of
hepatitis, greater than 70 percent five-year survival.
However, most medical centers are reluctant to perform liver
transplants on people with alcoholic liver disease because of the
fear they will resume drinking after surgery. For most people with
alcoholic hepatitis, the disease is considered a contraindication
for liver transplantation in most transplant centers in the U.S.
For transplant to be an option, you would need to find a program
that will consider you.

ALTERNATIVE MEDICINE

No alternative medicine treatments have been found to cure
alcoholic hepatitis. Some herbs and supplements are touted as
treatments for liver diseases. Herbs and supplements can't
replace your doctor's treatments or abstaining from alcohol. If
you'd like to try supplements, talk to your doctor about the risks
and benefits first.
Milk thistle
The leaves and seeds of the milk thistle plant are thought to
control inflammation in the liver. Milk thistle supplements are a
popular alternative treatment among people with liver disease.
But studies haven't found a benefit for people with alcoholic liver
disease who take milk thistle supplements.
Milk thistle is generally safe, but can cause diarrhea and nausea.
Talk to your doctor about milk thistle if you're considering taking
this supplement. Because milk thistle can interfere with
prescription medications, ask your doctor whether it's safe for you
SAMe
SAMe is a supplement that's thought to reduce liver inflammation
and help the liver repair itself. Your body naturally makes SAMe.
Some evidence suggests people with liver disease have a
deficiency of SAMe. In theory, taking a SAMe supplement might
restore levels of the substance in the liver. But there is insufficient
evidence to recommend use of SAMe for alcohol-related liver
disease.
SAMe is generally safe when taken as a supplement. Side effects
may include gas, nausea, vomiting and diarrhea. Because SAMe
can interfere with prescription medications, ask your doctor about  
whether SAMe is safe for you to take.

TRIPLE X SYNDROME DEFINITION SYMPTOMS CAUSES DIAGNOSIS AND TREATMENTS

DEFINITION

Triple X syndrome is an abnormality of the chromosomes that
affects about 1 in 1,000 females. Females normally have two X
chromosomes, one from each parent. In triple X syndrome, a
female has three X chromosomes — hence, the name.
Triple X syndrome usually results from an error in the formation
of a mother's egg cell or a father's sperm cell. Sometimes, triple
X syndrome occurs as a result of an error early in the embryo's
development.

SYMPTOMS

Triple X syndrome may not cause any signs or symptoms. If
symptoms do appear, they may include:
Tall stature Vertical skinfolds that may cover the inner corners of
the eyes (epicanthal folds)Delayed development of speech and
language skills Weak muscle tone (hypotonia)Curved pinky
fingers (clinodactyly)Behavior and mental health
problems Premature ovarian failure or ovary
abnormalities Constipation or abdominal pains

CAUSES

Most people have 46 chromosomes occurring in 22 pairs, plus
two sex chromosomes, one maternal and one paternal. These
chromosomes contain genes, which carry instructions that
determine everything from your height to your eye color.
One of these chromosome pairs determines your sex. You
receive one sex chromosome from your mother and another from
your father. Your mother can give you only an X chromosome,
but your father can pass on an X or a Y chromosome. If you
receive an X chromosome from your father, the XX pair makes
you genetically a female. If you receive a Y chromosome from
your father, then your XY pair means you're genetically a male.
Females with triple X syndrome have a third X chromosome.
Although this condition is genetic, it's typically not inherited.
Instead, what usually happens is that either the mother's egg cell
or the father's sperm cell has not formed correctly, resulting in an
extra X chromosome. This random error in egg or sperm cell
division is called nondisjunction.
When the cause is a malformed egg cell or sperm cell, as is
usually the case, all the cells in the offspring's body have the
extra chromosome. Occasionally, the extra chromosome doesn't
appear until early in the development of the embryo. If this is the
case, then the female is said to have a mosaic form of triple X
syndrome.
In the mosaic form, only some of the body's cells have the third X
chromosome. Because only some cells contain the extra X
chromosome, females with the mosaic form of triple X syndrome
may have less severe symptoms.
Triple X syndrome is also called trisomy X, triple X syndrome and
XXX syndrome. It's also referred to as 47,XXX syndrome
because of the existence of a 47th chromosome, which is the
extra X chromosome.

DIAGNOSIS

Because many girls with triple X syndrome are healthy and have
a normal appearance, they may remain undiagnosed all their
lives, or the diagnosis may be discovered while investigating for
other reasons.
Prenatal genetic testing, such as amniocentesis or chorionic
villus sampling, can provide a diagnosis of triple X syndrome
before birth.
After birth, triple X syndrome can be diagnosed by performing a
chromosome analysis on a blood sample taken from your
daughter.
Before genetic testing, it's important to receive genetic counseling
to provide you with all the information about triple X syndrome.

TREATMENTS AND DRUGS

If your daughter has triple X syndrome, treatment is based on her
symptoms, if any are present. For instance, if she has a learning
disability from the triple X, she would require the same
counseling as anyone else with that learning disability. This
counseling usually involves teaching new techniques and
strategies for learning, as well as providing motivation and help
with using these tips in daily life.
If your daughter has been diagnosed with triple X syndrome, her
doctor may recommend periodic screenings throughout
childhood. This would help ensure that any developmental delays
or learning disabilities that may occur receive prompt treatment.
Because girls with triple X syndrome may be more susceptible to
stress, it's important to make sure your daughter has a supportive
environment as well. Psychological counseling may help, both by
teaching you and your family useful methods of demonstrating
love and encouragement, and by discouraging behaviors that you
might not realize are negative.
The chromosome change that causes triple X syndrome cannot
be repaired, so the syndrome itself has no cure. However, given
the treatable nature of most symptoms and how frequently no
symptoms appear at all, it's quite possible to lead a full and
normal life with this syndrome.

Vitiligo CAUSES SYMPTOMS DIAGNOSIS TREATMENTS AND ALTERNATIVE MEDICINE

vitiligo

DEFINITION

Vitiligo  is a disease that causes the loss of skin color in blotches. The
extent and rate of color loss from vitiligo is unpredictable. It can affect the skin on
any part of body. It may also affect hair, the inside of the mouth and even the
eyes.
Normally, the color of hair, skin and eyes is determined by melanin. Vitiligo occurs
when the cells that produce melanin die or stop functioning.
Vitiligo affects people of all skin types, but it may be more noticeable in people with
darker skin. The condition is not life-threatening or contagious. It can be stressful or
make you feel bad about yourself. Treatment for vitiligo may improve the
appearance of the affected skin but does not cure the disease.

SYMPTOMS

The main sign of vitiligo is color (pigment) loss that produces light or white patches
on your skin. Usually, the discoloration first shows on sun-exposed areas, such as
the hands, feet, arms, face and lips.
Vitiligo signs include:
Skin discoloration Premature whitening or graying of the hair on your scalp,
eyelashes, eyebrows or beard (usually before age 35)Loss of color in the tissues
that line the inside of your mouth and nose (mucous membranes)Loss of or change
in color of the inner layer of the eyeball (retina)Discolored patches around the
armpits, navel, genitals and rectum
Vitiligo can start at any age, but most often appears before age 20.
Depending on the type of vitiligo you have, the discolored patches may cover:
Many parts of your body. With this most common type, called generalized vitiligo,
the discolored patches often progress similarly on corresponding body parts
(symmetrically).Only one side or part of your body. This type, called segmental
vitiligo, tends to occur at a younger age, progress for a year or two, then stop.One or
only a few areas of your body. This type is called localized (focal) vitiligo.
It's difficult to predict how your disease will progress. Sometimes the patches stop
forming without treatment. In most cases, pigment loss spreads and eventually
involves most of your skin. Rarely, the skin gets its color back.

CAUSES

Vitiligo occurs when melanin-forming cells (melanocytes) die or stop producing
melanin — the pigment that gives your skin, hair and eyes color. The involved
patches of skin become lighter or white. Doctors don't know why the cells fail or die.
It may be related to:
A disorder in which your immune system attacks and destroys the melanocytes in
the skin Family history (heredity)A trigger event, such as sunburn, stress or exposure
to industrial chemicals

COMPLICATIONS

People with vitiligo may be at increased risk of:
Social or psychological distress Sunburn and skin cancer Eye problems, such as
inflammation of the iris (iritis)Hearing loss Side effects due to treatment, such as dry
skin and itching

TESTS AND DIAGNOSIS

Medical history and exam
If your doctor suspects you have vitiligo, he or she will ask about your medical
history, examine you and try to rule out other medical problems, such
as dermatitis or psoriasis. He or she may use a special lamp to shine ultraviolet light
onto the skin to determine whether you have vitiligo.
Skin biopsy and blood draw
In addition to gathering your personal and family medical history and examining your
skin, your doctor may:
Take a small sample (biopsy) of the affected skin Draw blood for lab tests

TREATMENTS AND DRUGS

Many treatments are available to help restore skin color or even out skin tone.
Results vary and are unpredictable. Some treatments have serious side effects. So
your doctor may suggest that you first try improving the appearance of your skin by
applying self-tanning products or makeup.
If you and your doctor decide to treat your condition with a drug or other therapy, the
process may take many months to judge its effectiveness. And you may have to try
more than one approach before you find the treatment that works best for you.

Medications

No drug can stop the process of vitiligo — the loss of pigment cells (melanocytes).
But some drugs, used alone or with light therapy, can help improve your skin's
appearance.
Creams that control inflammation. A topical corticosteroid may help return color to
(repigment) your skin, particularly if you start using it early in the disease. You may
not see a change in your skin's color for several months.
This type of cream is effective and easy to use. But it can cause side effects, such
as skin thinning or the appearance of streaks or lines on your skin.
Milder forms of the drug may be prescribed for children and for people who have
large areas of discolored skin.
A form of vitamin D. Topical calcipotriene (Dovonex) is a cream that can be used
with corticosteroids or ultraviolet light. Possible side effects include dry skin, rash
and itching.Medications that affect the immune system. Ointments containing
tacrolimus or pimecrolimus (calcineurin inhibitors) may be effective for people with
small areas of depigmentation, especially on the face and neck. This treatment may
have fewer side effects than corticosteroids and can be used with ultraviolet B
(UVB) light. The Food and Drug Administration (FDA) has warned about a possible
link between these drugs and lymphoma and skin cancer.
Combined medication and light therapy. This treatment combines a drug called
psoralen with light therapy (photochemotherapy) to return color to the light patches.
After you take psoralen by mouth or apply it to the affected skin, you're exposed to
ultraviolet A (UVA) or UVB light. Because the drug makes your skin more sensitive
to the light, your skin turns pink. As the skin heals, a more normal skin color
appears. You may need to repeat treatments up to three times a week for six to 12
months.
Possible side effects include severe sunburn, blistering, itching, over darkening of
the skin, and an increased risk of cataracts and skin cancer. It may help if for one to
two days after each treatment you apply sunscreen, wear UV-protective sunglasses
and avoid direct sunlight. Oral psoralen with UVA radiation is not recommended for
children under 12.
Light therapy. This treatment uses narrow band UVB light. You may receive
treatment in a doctor's office up to three times a week. And unlike
photochemotherapy, it doesn't require psoralen, which simplifies the process. The
best results are achieved on the face, trunk and limbs.Laser therapy. This procedure
brings color back to patches of light skin by treating them with an excimer laser,
which uses a specific wavelength of UVB light. It can be used only on small areas,
and it's often used in combination with a drug applied to the skin. Side effects can
include redness and blistering.
Removing the remaining color (depigmentation). This therapy may be an option if
your vitiligo is widespread and other treatments haven't worked. A medication with
monobenzone is applied to unaffected areas of skin. This gradually lightens it so
that it blends with the discolored areas. The therapy is done twice a day for nine
months or longer. You'll need to avoid skin-to-skin contact with other people for at
least two hours after you've applied the drug, so you don't transfer it to them.
Side effects can include redness, swelling, itching and dry skin. Depigmentation is
permanent, and you'll always be extremely sensitive to sunlight.

Surgery

Surgery may be an option for you if light therapy and drugs don't work. Surgery can
also be used with those therapies. The goal of the following techniques is to even
out your skin tone by restoring color.
Skin grafting. In this procedure, your doctor removes very small sections of your
normal, pigmented skin and attaches them to areas that have lost pigment. This
procedure is sometimes used if you have small patches of vitiligo. Possible risks
include infection, scarring, a cobblestone appearance, spotty color and failure of the
area to recolor.Blister grafting. In this procedure, your doctor creates blisters on your
pigmented skin, usually with suction. He or she then removes the tops of the blisters
and transplants them to an area of discolored skin. Possible risks include scarring, a
cobblestone appearance and failure of the area to recolor. The risk of scarring is
less with this procedure than with other types of skin grafting.Tattooing
(micropigmentation). In this technique, your doctor uses a special surgical
instrument to implant pigment into your skin. It's most effective around the lips,
especially in people with darker skin. Drawbacks include difficulty matching the skin
color, the tendency of tattoos to fade and their inability to tan. Also, the skin damage
caused by tattooing may trigger another patch of vitiligo.

ALTERNATIVE MEDICINE

Limited studies show that the herb Ginkgo biloba may return skin color in people
with slow-spreading vitiligo. Other studies show that folic acid and vitamin B-12 plus
sunlight may restore skin color for some people.
As with any over-the-counter (nonprescription) treatment, check with your doctor
before trying alternative medicine therapies to be sure they won't interact badly with
other treatments you may be using.

SHINGLES SYMPTOMS CAUSES DIAGNOSIS AND TREATMENTS

shingles

DEFINITION

Shingles is a viral infection that causes a painful rash. Although
shingles can occur anywhere on your body, it most often appears
as a single stripe of blisters that wraps around either the left or
the right side of your torso.
Shingles is caused by the varicella-zoster virus — the same virus
that causes chickenpox. After you've had chickenpox, the virus
lies inactive in nerve tissue near your spinal cord and brain.

SYMPTOMS

signs and symptoms may
include:
Pain, burning, numbness or tingling Sensitivity to touch A red rash
that begins a few days after the pain Fluid-filled blisters that break
open and crust over Itching
Some people also experience:
Fever Headache Sensitivity to light and Fatigue
Pain is usually the first symptom of shingles. For some, it can be
intense. Depending on the location of the pain, it can sometimes
be mistaken for a symptom of problems affecting the heart, lungs
or kidneys. Some people experience shingles pain without ever
developing the rash.
Most commonly, the shingles rash develops as a stripe of blisters
that wraps around either the left or right side of your torso.
Sometimes the shingles rash occurs around one eye or on one
side of the neck or face.

CAUSES

Shingles is caused by the varicella-zoster virus — the same virus
that causes chickenpox. Anyone who's had chickenpox may
develop shingles. After you recover from chickenpox, the virus
can enter your nervous system and lie dormant for years.
Eventually, it may reactivate and travel along nerve pathways to
skin — producing shingles.
The reason for the encore is unclear. But it may be due to
lowered immunity to infections as you grow older. Shingles is
more common in older adults and in people who have weak
immune systems.
Varicella-zoster is part of a group of viruses called herpes
viruses, which includes the viruses that cause cold sores
and genital herpes. Because of this, shingles is also known as
herpes zoster. But the virus that causes chickenpox and shingles
is not the same virus responsible for cold sores or genital herpes,
a sexually transmitted infection.
Chickenpox can be dangerous for some groups of people. Until
your shingles blisters scab over, you are contagious and should
avoid physical contact with:
Anyone who has a weak immune system Newborns Pregnant
women

COMPLICATIONS

Complications from shingles can include:
Postherpetic neuralgia. For some people, shingles pain continues
long after the blisters have cleared. This condition is known as
postherpetic neuralgia, and it occurs when damaged nerve fibers
send confused and exaggerated messages of pain from your skin
to your brain.Vision loss. Shingles in or around an eye
(ophthalmic shingles) can cause painful eye infections that may
result in vision loss.Neurological problems. Depending on which
nerves are affected, shingles can cause an inflammation of the
brain (encephalitis), facial paralysis, or hearing or balance
problems.Skin infections. If shingles blisters aren't properly
treated, bacterial skin infections may develop.

PREPARING FOR YOUR APPOINTMENT

Some people have such mild symptoms of shingles that they
don't seek medical treatment. At the other extreme, severe
symptoms may result in a visit to the emergency room.

TESTS AND DIAGNOSIS

Shingles is usually diagnosed based on the history of pain on one
side of your body, along with the telltale rash and blisters. Your
doctor may also take a tissue scraping or culture of the blisters
for examination in the laboratory.

TREATMENTS AND DRUGS

There's no cure for shingles, but prompt treatment with
prescription antiviral drugs can speed healing and reduce your
risk of complications. These medications include:
Acyclovir (Zovirax)Valacyclovir (Valtrex)Famciclovir (Famvir)
Shingles can cause severe pain, so your doctor also may
prescribe:
Capsaicin cream Anticonvulsants, such as gabapentin
(Neurontin)Tricyclic antidepressants, such as
amitriptyline Numbing agents, such as lidocaine, delivered via a
cream, gel, spray or skin patch Medications that contain narcotics,
such as codeine injection including corticosteroids and local
anesthetics
Shingles generally lasts between two and six weeks. Most people
get shingles only once, but it is possible to get it two or more
times.

ACNE CAUSES SYMPTOMS TREATMENTS AND ANTIBIOTICS

ACNE DEFINITION

Acne is a skin condition that occurs when  hair follicles
become plugged with oil and dead skin cells. Acne usually
appears on face, neck, chest, back and shoulders.
Effective treatments are available, but acne can be
persistent. The pimples and bumps heal slowly, and when
one begins to go away, others seem to crop up.

CAUSES MAIN   

Depending on its severity, acne can cause emotional
distress and scar the skin. when earlier start treatment,
the lower  risk of lasting physical and emotional
damage.

SYMPTOMS

Acne signs and symptoms vary depending on the severity
Whiteheads
Blackheads —
Small red, tender bumps
Pimples
which are papules with pus at their tips Large, solid, painful
lumps beneath the surface of the skin (nodules)Painful,
pus-filled lumps beneath the surface of the skin

The Food and Drug Administration warns that some
popular nonprescription acne lotions, cleansers and other
skin products can cause a serious reaction. This type of
reaction is quite rare, so don't confuse it with the redness,
irritation or itchiness where you've applied medications or
or tongueTightness of the throat

CAUSES IN DETAIL 

Four main factors cause acne:
Oil production Dead skin cells Clogged pores Bacteria
Acne typically appears on face, neck, chest, back and
shoulders. These areas of skin have the most oil
 glands. Acne occurs when hair follicles
become plugged with oil and dead skin cells.
Hair follicles are connected to oil glands. These glands
secrete an oily substance (sebum) to lubricate your hair
and skin. Sebum normally travels along the hair shafts and
through the openings of the hair follicles onto the surface
of your skin.
When body produces an excess amount of sebum
and dead skin cells, the two can build up in the hair
follicles. They form a soft plug, creating an environment
where bacteria can thrive. If the clogged pore becomes
infected with bacteria, inflammation results.
Pimples are raised red spots with a white center that
develop when blocked hair follicles become inflamed or
infected. Blockages and inflammation that develop deep
inside hair follicles produce cyst-like lumps beneath the
surface of your skin. Other pores in your skin, which are
the openings of the sweat glands, aren't usually involved in
acne.

Factors that may worsen acne

These factors can trigger or aggravate an existing case of
acne:
Hormones. Androgens are hormones that increase in boys
and girls during puberty and cause the sebaceous glands
to enlarge and make more sebum. Hormonal changes
related to pregnancy and the use of oral contraceptives
also can affect sebum production. And low amounts of
androgens circulate in the blood of women and can worsen
acne.Certain medications. Drugs containing
corticosteroids, androgens or lithium can worsen
acne.Diet. Studies indicate that certain dietary factors,
including dairy products and carbohydrate-rich foods —
such as bread, bagels and chips — may trigger acne.
Chocolate has long been suspected of making acne
worse. A recent study of 14 men with acne showed that
eating chocolate was related to an increase in acne.
Further study is needed to examine why this happens or
whether acne patients need to follow specific dietary
restrictions.Stress. Stress can make acne worse.

RISK FACTORS

Risk factors for acne include:
Hormonal changes. Such changes are common in
teenagers,  and people using certain
medications, including those containing corticosteroids,
androgens or lithium.Family history. Genetics plays a role
in acne. If both parents had acne, you're likely to develop
it, too.Greasy or oily substances. You may develop acne
where your skin comes into contact with oily lotions and
creams or with grease in a work area, such as a kitchen
with fry vats.Friction or pressure on your skin. This can be
caused by items such as telephones, cellphones, helmets,
tight collars and backpacks.Stress. This doesn't cause
acne, but if you have acne already, stress may make it
worse.

TREATMENTS AND DRUGS

If over-the-counter (nonprescription) products haven't
cleared up your acne, your doctor can prescribe stronger
medications or other therapies.
Control your acne Avoid scarring or other damage to your
skin Make scars less noticeable
Acne medications work by reducing oil production,
speeding up skin cell turnover, fighting bacterial infection
or reducing inflammation — which helps prevent scarring.
With most prescription acne drugs, you may not see
results for four to eight weeks, and your skin may get
worse before it gets better. It can take many months or
years for your acne to clear up completely.
The drug your doctor recommends depends on the type
and severity of your acne. It might be something you apply
to your skin (topical medication) or take by mouth (oral
medication). Often, drugs are used in combination.
Pregnant women will not be able to use oral prescription

medications for acne.

Talk with your doctor about the risks and benefits of
medications and other treatments you are considering.

Topical medications

These products work best when applied to clean, dry
skin about 15 minutes after washing. You may not see the
benefit of this treatment for a few weeks. And you may
notice skin irritation at first, such as redness, dryness and
peeling.

Retinoids. 

These come as creams, gels and lotions.
Retinoid drugs are derived from vitamin A and include
tretinoin (Avita, Retin-A, others), adapalene (Differin) and
tazarotene (Tazorac, Avage). You apply this medication in
the evening, beginning with three times a week, then daily
as your skin becomes used to it. It works by preventing
plugging of the hair follicles.Antibiotics. These work by
killing excess skin bacteria and reducing redness. For the
first few months of treatment, you may use both a retinoid
and an antibiotic, with the antibiotic applied in the morning
and the retinoid in the evening. The antibiotics are often
combined with benzoyl peroxide to reduce the likelihood of
developing antibiotic resistance. Examples include
clindamycin with benzoyl peroxide (Benzaclin, Duac,
Acanya) and erythromycin with benzoyl peroxide
(Benzamycin).Dapsone (Aczone). This gel is most
effective when combined with a topical retinoid. Skin side
effects include redness and dryness.

Oral medications

Antibiotics. 

For moderate to severe acne, you may need
oral antibiotics to reduce bacteria and fight inflammation.
Choices for treating acne include tetracyclines, such as

minocycline and doxycycline.

doctor likely will recommend tapering off these
medications as soon as your symptoms begin to improve
or as soon as it becomes clear the drugs aren't helping —
usually, within three to four months. Tapering helps
prevent antibiotic resistance by minimizing undue
exposure to these medications over a long time.
You will likely use topical medications and oral antibiotics
together. Studies have found that using topical benzoyl
peroxide along with oral antibiotics may reduce the risk of
developing antibiotic resistance.
Antibiotics may cause side effects, such as an upset
stomach and dizziness. These drugs also increase your
skin's sun sensitivity. They can cause discoloration of
developing permanent teeth and reduced bone growth in
children born to women who took tetracyclines while
pregnant.
Combined oral contraceptives.

Combined oral

contraceptives are useful in treating acne in women and
adolescent girls. The Food and Drug Administration
approved three products that combine estrogen and
progestin (Ortho Tri-Cyclen, Estrostep and Yaz).
The most common side effects of these drugs are
headache, breast tenderness, nausea, weight gain and
breakthrough bleeding. A serious potential complication is
a slightly increased risk of blood clots.
Anti-androgen agent. The drug spironolactone (Aldactone)
may be considered for women and adolescent girls if oral
antibiotics aren't helping. It works by blocking the effect of
androgen hormones on the sebaceous glands. Possible
side effects include breast tenderness, painful periods and
the retention of potassium.

Isotretinoin. 

his medicine is reserved for people with the
most severe acne. Isotretinoin (Amnesteem, Claravis,
Sotret) is a powerful drug for people whose acne doesn't
respond to other treatments.

Oral isotretinoin 

is very effective. But because of its
potential side effects, doctors need to closely monitor
anyone they treat with this drug. The most serious
potential side effects include ulcerative colitis, an
increased risk of depression and suicide, and severe birth
defects.
In fact, isotretinoin carries such serious risk of side effects
that women of reproductive age must participate in a Food
and Drug Administration-approved monitoring program to
receive a prescription for the drug.

Therapies

These therapies may be suggested in select cases, either
alone or in combination with medications.
Light therapy. A variety of light-based therapies have been
tried with success. But further study is needed to
determine the ideal method, light source and dose. Light
therapy targets the bacteria that cause acne inflammation.
Some types of light therapy are done in a doctor's office.
Blue-light therapy can be done at home with a hand-held
device.
Possible side effects of light therapy include pain,
temporary redness and sensitivity to sunlight.
Chemical peel. This procedure uses repeated applications
of a chemical solution, such as salicylic acid. It is most
effective when combined with other acne treatments,
except oral retinoids. Chemical peels aren't recommended
for people taking oral retinoids because together these
treatments can significantly irritate the skin.
Chemicals peels may cause temporary, severe redness,
scaling and blistering, and long-term discoloration of the
skin.
Extraction of whiteheads and blackheads. Your
dermatologist uses special tools to gently remove
whiteheads and blackheads (comedos) that haven't
cleared up with topical medications. This technique may
cause scarring.Steroid injection. Nodular and cystic lesions
can be treated by injecting a steroid drug directly into
them. This improves their appearance without the need for
extraction. The side effects of this technique include
thinning of the skin, lighter skin and the appearance of
small blood vessels on the treated area.

Treating children

Most studies of acne drugs have involved people 12 years
of age or older. Increasingly, younger children are getting
acne as well. In one study of 365 girls ages 9 to 10, 78
percent of them had acne lesions. If your child has acne,
you may want to consult a pediatric dermatologist. Ask
about drugs to avoid in children, appropriate doses, drug
interactions, side effects, and how treatment may affect a

child's growth and development.

Treatment of children with acne is often complicated by
their family situation. For example, if a child moves
between two homes due to divorced parents, it may help to
use two sets of medications, one in each home.

Q fever symptom diagnosis and treatment

what is q fever

Q fever is a disease caused by infection with Coxiella burnetii, a bacterium that affects humans and other animals. This organism is uncommon, but may be found in cattle, sheep, goats, and other domestic mammals, including cats and dogs. The infection results from inhalation of a spore-like small-cell variant, and from contact with the milk, urine, feces, vaginal mucus, or semen of infected animals. Rarely, the disease is tick-borne.The incubation period is 9–40 days. Humans are vulnerable to Q fever, and infection can result from even a few organisms.The bacterium is an obligate intracellular pathogenic parasite

signs and symptom 

The most common manifestation is flu-like symptoms with abrupt onset of fever, malaise, profuse perspiration, severe headache, muscle pain, joint pain, loss of appetite, upper respiratory problems, dry cough, pleuritic pain, chills, confusion, and gastrointestinal symptoms, such as nausea, vomiting, and diarrhea. About half of infected individuals exhibit no symptoms

Treatment

Treatment of acute Q fever with antibiotics is very effective and should be given in consultation with an infectious diseases specialist.

Commonly used antibiotics 

include doxycycline, tetracycline, chloramphenicol, ciprofloxacin, ofloxacin, and hydroxychloroquine. Chronic Q fever is more difficult to treat and can require up to four years of treatment with doxycycline and quinolones or doxycycline with hydroxychloroquine.

Down syndrome symptoms causes Diagnosis and treatment

what are Down syndrome

Down syndrome or trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is typically associated with physical growth delays, characteristic facial features and mild to moderate intellectual disability. The average IQ of a young adult with Down syndrome is 50, equivalent to the mental ability of an 8- or 9-year-old child, but this can vary widely
There is no cure for Down syndrome. Education and proper care have been shown to improve quality of life. Some children with Down syndrome are educated in typical school classes, while others require more specialized education.Some individuals with Down syndrome graduate from high school and a few attend post-secondary education.In adulthood, about 20% in the United States do paid work in some capacity with many requiring a sheltered work environment. Support in financial and legal matters is often needed.Life expectancy is around 50 to 60 years in the developed world with proper health care

Signs and symptoms

Those with Down syndrome nearly always have physical and intellectual disabilities.As adults, their mental abilities are typically similar to those of an 8- or 9-year-old. They also typically have poor immune function and generally reach developmental milestones at a later age.They have an increased risk of a number of other health problems, including congenital heart defect, epilepsy, leukemia, thyroid diseases, and mental disorders, among others

Physical

Feet of a boy with Down syndrome
People with Down syndrome may have some or all of these physical characteristics: a small chin, slanted eyes, poor muscle tone, a flat nasal bridge, a single crease of the palm, and a protruding tongue due to a small mouth and relatively large tongue.These airway changes lead to obstructive sleep apnea in around half of those with Down syndrome. Other common features include: a flat and wide face. a short neck, excessive joint flexibility, extra space between big toe and second toe, abnormal patterns on the fingertips and short fingers.Instability of the atlantoaxial joint occurs in about 20% and may lead to spinal cord injury in 1–2%. Hip dislocations may occur without trauma in up to a third of people with Down syndrome

Neurological

Most individuals with Down syndrome have mild (IQ: 50–69) or moderate (IQ: 35–50) intellectual disability with some cases having severe (IQ: 20–35) difficulties.[1][30] Those with mosaic Down syndrome typically have IQ scores 10–30 points higher. As they age, people with Down syndrome typically perform less well than their same-age peers. Some after 30 years of age may lose their ability to speak. This syndrome causes about a third of cases of intellectual disability.Many developmental milestones are delayed with the ability to crawl typically occurring around 8 months rather than 5 months and the ability to walk independently typically occurring around 21 months rather than 14 month
Down syndrome is caused by having three copies of the genes on chromosome 21, rather than the usual two.The parents of the affected individual are typically genetically normal.Those who have one child with Down syndrome have about a 1% risk of having a second child with the syndrome, if both parents are found to have normal karyotypes.

Genetics

The extra chromosome content can arise through several different ways. The most common cause (about 92–95% of cases) is a complete extra copy of chromosome 21, resulting in trisomy 21. In 1.0 to 2.5% of cases, some of the cells in the body are normal and others have trisomy 21, known as mosaic Down syndrome.The other common mechanisms that can give rise to Down syndrome include: a Robertsonian translocation, isochromosome, or ring chromosome. These contain additional material from chromosome 21 and occur in about 2.5% of cases. An isochromosome results when the two long arms of a chromosome separate together rather than the long and short arm separating together during egg or sperm development

Diagnosis

After birth

The diagnosis can often be suspected based on the child's physical appearance at birth.An analysis of the child's chromosomes is needed to confirm the diagnosis, and to determine if a translocation is present, as this may help determine the risk of the child's parents having further children with Down syndrome.Parents generally wish to know the possible diagnosis once it is suspected and do not wish pity.

Management

Efforts such as early childhood intervention, screening for common problems, medical treatment where indicated, a good family environment, and work-related training can improve the development of children with Down syndrome. Education and proper care can improve quality of life.Raising a child with Down syndrome is more work for parents than raising an unaffected child.Typical childhood vaccinations are recommended

What are common treatments for Down syndrome?

There is no single, standard treatment for Down syndrome. Treatments are based on each individual's physical and intellectual needs as well as his or her personal strengths and limitations.1 People with Down syndrome can receive proper care while living at home and in the community
Early Intervention and Educational Therapy

Treatment Therapies

Physical therapy includes activities and exercises that help build motor skills, increase muscle strength, and improve posture and balance.
Speech-language therapy can help children with Down syndrome improve their communication skills and use language more effectively
Occupational therapy helps find ways to adjust everyday tasks and conditions to match a person's needs and abilities
Emotional and behavioral therapies work to find useful responses to both desirable and undesirable behaviors.

Drugs and Supplements

Some people with Down syndrome take amino acid supplements or drugs that affect their brain activity. However, many of the recent clinical trials of these treatments were poorly controlled and revealed adverse effects from these treatments. Since then, newer psychoactive drugs that are much more specific have been developed. No controlled clinical studies of these medications for Down syndrome have demonstrated their safety and efficacy, however
Treatment for Down syndrome can include:

Regular checkups and screening
Medications
Surgery
Counseling and support.

People with Down syndrome are at increased risk for certain medical problems, such as:

Congenital heart disease
Leukemia and other cancers
Immune system problems
Thyroid problems
Bone, muscle, nerve, or joint problems
Hearing problems
Eye problems
Seizure disorders
Developmental delay
Mental retardation
Premature aging
Alzheimer's disease

Hair Loss and Balding Causes Symptoms prevention and Treatments

Hair Loss and Balding

by general definition are

Hair loss is typically considered the domain of aging men,
but this equal-opportunity condition — which has many
causes — can affect virtually anyone.
hair loss may occur at any age of adult
because of many  verses factor are affected by hair
loss like ageing tension and many other hormonal and
metabolic factor
Everyone sheds about 100 hairs each day as part of the
normal hair growth cycle, but excess loss is usually a
distressing .

Symptoms & causes

Most people’s hair grows about a half-inch per month, and
about 90 percent of your hair is actively growing at any
given time, with the other 10 percent in dormant phase.
After two or three months, this dormant hair falls out and
its follicles begin growing new hair as other follicles begin a
dormant phase.
Shedding hair is different from hair loss, when a hair falls
out and doesn't grow back. People often shed hair during
stressful events, such as childbirth, a breakup or divorce or
during times of grief.
"It still doesn’t feel good, and it takes the hair to reach a
certain length where you perceive its presence,"
 "So it feels like a hair loss, but it's not a hair loss."
Alopecia is the medical term for hair loss, and it doesn’t
only happen on the scalp. Some illnesses and medications
can trigger balding over the entire body, though genetics
account for most cases on the head, according to
the Cleveland Clinic.
Aside from heredity, noticeable hair loss can be caused by
wide variety of factors, including:

Harsh hairstyles or treatments: 

Hairstyles that consistently
use rubber bands, rollers or barrettes, or pull hair into tight
styles such as cornrows, can inflame and scar hair
follicles. So can incorrectly used chemical products such
as dyes, bleaches, straighteners or permanent wave
solutions. Depending on the degree of damage, resulting
hair loss can be permanent.
Hormone imbalances: In women, hormonal shifts from
birth control pills, pregnancy, childbirth, menopause or
hysterectomy can induce more hair follicles than normal to
enter the dormant phase.

Illness or surgery: 

The stress from sickness or surgery
may prompt the body to temporarily cease nonessential
tasks such as hair production. Specific conditions can also
trigger it, including thyroid disorders, syphilis, iron
deficiency, lupus or severe infection. An autoimmune
condition called alopecia areata, which has no cure,
causes rapid body-wide hair loss.

Medications and vitamins: 

Cancer chemotherapy, which
attacks hair follicles in its attempt to kill all fast-growing
cells around the body, is a well-known reason for hair loss.
Other medications’ side effects include hair shedding as
well, such as some that treat high blood pressure and gout
(a painful joint condition caused by a buildup of uric acid).
Excessive levels of vitamin A also contribute.
Nutritional deficits: Heavy dieting or eating disorders such
as bulimia and anorexia can temporarily stun hair follicles
to cease growth. This can also occur from insufficient
protein, vitamin or mineral intake.

Aging: 

A natural effect of growing older is slowed hair
growth.
Women usually don't go completely bald, but loss hair on
the top of the head or the temples. Men tend to lose hair
on their temples, and are more likely than women to go
completely bald, Day said.

Diagnosis

doctor  will examine the person's scalp and take a
history of medical or stressful events "to see what's been
going on in their life and their world
The physician may take a biopsy — a small patch of
skin that includes the hair follicle — and send it to a
pathologist to determine if an autoimmune disease, such
as lupus, is the cause of the hair loss.
Examining the hair and follicle can also determine whether
someone has a bacterial or fungal infection, Day said.

Treatment & medication

Hair loss remedies range from the mild to the extreme and
the inexpensive to the costly. Much depends on how much
hair is gone and how high a priority it is to mask its
absence or replace it.
 treatments include:
Hair weaves or wigs: Typically expensive, wigs and hair
weaves either completely cover the head or add to existing
hair, restoring the appearance of a full head of hair. They
are especially practical for cancer patients and those
whose hair loss is temporary.
Topical creams and lotions: Over-the-counter minoxidil can restore
some hair growth, especially in those with hereditary hair
loss. It is applied directly to the scalp. Prescription-strength
finasteride (Propecia) comes in pill form and is only for
men. it may take up to six months to tell if
these medications are working.
Anti-inflammatory medications: Prescription steroid-based
creams or injections can calm follicles damaged or
inflamed by harsh chemicals or excessive pulling.

Surgery:

 Men tend to be better candidates for surgical hair replacement
techniques because their hair loss is often
limited to one or two areas of the scalp. Procedures
include grafting, which transplants from one to 15 hairs per
disc-shaped graft to other locations. Scalp reduction
removes bald skin from the scalp so hair-covered scalp
can be stretched to fill in the bald areas. Side effects
include swelling, bruising and headaches.
Hair-growth laser treatment can also help stimulate hair
follicles and improve growth,

Natural and alternative therapies

alternative
therapies may not help hair regrow and many are not
supported by medical research. However, other treatments
that reportedly improve alopecia areata include Chinese
herbs, acupuncture, zinc and vitamin supplements,
evening primrose oil and aroma therapy.
Viviscal, a natural supplement, has also shown more hair
growth in men compared to those who took fish extract in
clinical trials

Diabetes mellitus types cause diagnosis and treatment

what is Diabetes mellitus

Diabetes mellitus is the most common of the endocrine disorders.
It is a chronic condition, characterised by hyperglycaemia
and due to impaired insulin secretion with or without
insulin resistance

types 

Type 1 (β-cell destruction, usually leading to absolute insulin
deficiency)
Type 2 (may range from predominantly insulin with relative insulin
deficiency to a predominantly secretory defect with or without
insulin resistance)

Definition of type 1

Type 1 diabetes mellitus is a chronic disorder of carbohydrate,
fat and protein metabolism with hyperglycaemia
resulting in most cases from autoimmune destruction of
pancreatic β cells.

Definition of type 2

Type 2 diabetes mellitus is a chronic disorder of carbohydrate,
fat and protein metabolism with hyperglycaemia
as its principal feature. It is characterised by impaired
insulin secretion and insulin resistance.

Pathophysiology of 2

Insulin resistance in the liver, skeletalmuscle and adipose
tissue secondary to a decrease
in the number of insulin receptors, decreased receptor
tyrosine kinase activity and post-receptor defects
causing impaired glucose transport.
Defective insulin secretion due to islet cell dysfunction
with increased secretion of proinsulin and cleavage
products. Amylin, an amyloid protein, is found in
increased amounts in the islets cells. It may disrupt
the normal insulin secretion.
Reduced effective insulin causes increased gluconeogenesis
by the liver and reduced peripheral uptake,
leading to hyperglycaemia.However, there is sufficient
insulin to suppress lipolysis and ketogenesis, so that
ketosis and ketoacidosis do not occur.

Clinical features

Patients may present with a history of polyuria, polydipsia
and weight loss often despite increased appetite.
Young patient often present acutely in diabetic ketoacidosis
Pathophysiology of type 1
In type 1 diabetes, there is hyperglycaemia due to failure
of glucose uptake and uncontrolled gluconeogenesis,
glycogenolysis, lipolysis and proteolysis:
Osmotic diuresis – there is a renal threshold for glucose
reabsorption, once the levels in the blood rise
above 10 mmol/L the kidney is no longer able to completely
reabsorb it from the proximal tubule resulting
in glycosuria and an osmotic diuresis.

Diagnosis

1. Diabetes symptoms (i.e. polyuria, polydipsia and
unexplained weight loss) plus:
• a fasting serum glucose concentration ≥7.0 mmol/L
• or serum glucose concentration ≥11.1 mmol/L 2 h after
75 g anhydrous glucose in an oral glucose tolerance test
(see later).
2. With no symptoms, diagnosis should not be based on a
single glucose determination but requires confirmatory
serum venous determination. At least one additional
glucose test result, on another day with the value in the
diabetic range, is essential, either fasting or from the 2-h
post-glucose load. If the fasting value is not diagnostic,
the 2-h value should be used.
Current recommendations are that the diagnosis is confirmed
by a glucose measurement performed in an accredited
laboratory on a venous serum sample. A diagnosis
should never be made on the basis of glycosuria or a stick
reading of a finger prick blood glucose alone, although such
tests are being examined for screening purposes. Glycated
haemoglobin (HbA1c) is also not currently recommended
for diagnostic purposes, although this is currently being
considered.

Treatment

the following medicines are helpful  in  Diabetes mellitus types 1 AND 2
Metformin (Glucophage, Glumetza, others). Generally, metformin is the first medication prescribed for type 2 diabetes. ...
Sulfonylureas. ...
Meglitinides. ...
Thiazolidinediones. ...
DPP-4 inhibitors. ...
GLP-1 receptor agonists. ...
SGLT2 inhibitors. ...
Insulin therapy.
Treatment for people with diabetes includes advice on nutrition,
physical activity, weight loss and smoking cessation if
appropriate. Drug therapy is prescribed where necessary
Fats
Since obesity is a major problem in type 2 diabetes and fats
contain more than twice the energy content per unit mass than
either carbohydrate or protein, consumption of fats should
be limited. Monounsaturated fats have a lower atherogenic
potential and are therefore recommended as the main source
of dietary fat. Intake of fat should be less than 35% of total
energy consumption, with saturated and trans-unsaturated
fats accounting for less than 10% of energy intake and monounsaturated
fats providing 10–20%.
Insulin therapy in type 1 diabetes
All patients with type 1 diabetes require treatment with insulin
in order to survive. Exogenous insulin is used to mimic the
normal physiological pattern of insulin secretion as closely
as possible for each individual patient. However, a balance is
required between tight glycaemic control and hypoglycaemia
risk. If the risk of hypoglycaemia is high, then it may be necessary
to aim for less tight glycaemic control. There is a wide
variety of insulin preparations available which differ in species
of origin, onset of action, time to peak effect and duration
of action
Protein
For adults without nephropathy, protein intake is recommended
as less than 1 g/kg of body weight, equivalent to
about 10–20% of total energy intake. For those with nephropathy,
protein intake may need to be further restricted, but this
requires expert dietetic advice and supervision
Fibre
There is no quantitative dietary recommendation for fibre
intake. Dietary fibre has useful properties in that it is physically
bulky, and it delays the digestion and absorption of
complex carbohydrates, thereby minimising hyperglycaemia.
For the average person with type 2 diabetes, 15 g of soluble
fibre from fruit, vegetables or pulses is likely to produce a 10%
improvement in fasting blood glucose, glycated haemoglobin
and low-density lipoprotein cholesterol (LDL-C). Insoluble
fibre from cereals, wholemeal bread, rice and pasta has no
direct effect on glycaemia or dyslipidemia, but it has an overall
benefit on gastrointestinal health and may help in weight
loss by promoting satiety
Salt
Sodium chloride should be limited to a maximum of 6 g/day.
A reduction in salt intake from 12 to 6 g/day has been shown
to produce a reduction in systolic blood pressure of 5 mmHg
and a reduction of 2–3 mmHg in diastolic pressure.

Alternative medicine

No treatments — alternative or conventional — can cure diabetes. So it's critical that people who are using insulin therapy for diabetes don't stop using insulin unless

Stroke Cause Management Prevention and Treatment

what is stroke 

Stroke

A stroke is defined as a sudden onset of non-traumatic
focal neurological defect of a vascular aetiology, that either
causes death or lasts more than 24 hours

or

a stroke or a (cva)occurs when blood supply to part of the brain is disrupted,causing brain cell to die
types there are two types of the stroke
the most common are called ischemic and 2nd is hemorrhagic stroke
Incidence
Third commonest cause of death in Western World (1–2
per 1000 per year).

effect of  Age 

Uncommon under 40 years.

Aetiology

20% of strokes are haemorrhagic and 80% are ischaemic,
of which two-thirds arise from extracranial lesions and
one-third arise from intracranial lesions. Strokes may
also be due to subarachnoid haemorrhage. Risk factors
for stroke can be divided into
Intra- or extra-cranial atherosclerosis: In particular
hypertension, smoking, hyperlipidaemia, family history
of stroke or ischaemic heart disease and diabetes
mellitus.
Heart disease: Valvular heart disease such as mitral
stenosis, infective endocarditis, and any condition
which predisposes to mural thrombus such as atrial
fibrillation or myocardial infarction.
Less common causes: Hyperviscosity or prothrombotic
states, e.g.polycythaemia, oral contraceptive pill;
vasculitis; clotting disorders

Pathophysiology

Haemorrhagic strokes are discussed elsewhere. Ischaemic
strokes are due to the interruption of arterial blood
supply, and the clinical picture depends on the size of
artery and hence extent of territory affected, the area
affected, and whether there is temporary or permanent
ischaemia and hence infarction

Clinical features

Anterior circulation (carotid territory) strokes are the
most common, in particular those involving a branch of
the middle cerebral artery. This causes infarction of the
motor pathways (at the level of the motor cortex or the
internal capsule) and usually results in a contralateral
hemiparesis. This is an upper motor neurone (UMN)
deficit, i.e. increased tone, reduced power and brisk tendon
reflexes, although acutely there may be a flaccid,
areflexic paralysis. The arm tends to be affected more
than the leg (the motor cortex for the leg is supplied by
the anterior cerebral artery).
Other features of an MCA territory infarct include
an ipsilateral UMN lesion of the face (weakness of
the lower facial muscles), hemianopic visual field
loss and if the dominant hemisphere is affected
dysphasia may occur due to infarction of areas governing
speech (Wernicke’s and Broca’s areas).
Posterior circulation (the vertebral, basilar arteries and
their branches) strokes affect the brainstem, cerebellum
and occipital lobes. One characteristic but uncommon
pattern is lateral medullary syndrome which can
be caused by thromboembolism of the posterior inferior
cerebellar artery (PICA) or the vertebral artery. It causes
sudden vertigo and vomiting. On examination there is
ipsilateral ataxia (loss of co-ordination), contralateral
loss of pain and temperature sensation and there may
be nystagmus, diplopia and an ipsilateral Horner’s syndrome

Macroscopy

In the first 24 hours, there is little macroscopic change.
The tissue may look paler and lose differentiation between
white and grey matter.
The normal pattern of tissue change within the
brain following a stroke is liquifactive necrosis. Structural
breakdown takes place, the infarcted tissue becomes
soft and is at risk of reperfusion haemorrhage

Management

Patients who present within 3 hours of onset of symptoms
who have no evidence of haemorrhage or large
infarct on CT head scan should be considered for
thrombolysis.
Acutely, treat any exacerbating factors such as hypotension,
hypoglycaemia, hyperglycaemia, or severe
hypertension (with caution, to prevent sudden loss
of perfusion pressure, particularly in the acute stages,
when the brain is unable to autoregulate BP well).
Prevent and treat any complications such as deep vein
thrombosis due to immobility, aspiration pneumonia
due to disordered swallow, pressure sores and limb
contractures.
Inpatient or outpatient rehabilitation is used to regain
maximal functional improvement, and so reduce
the impact on the patient’s life, including physiotherapy,
speech therapy, and occupational therapy. Patients
who are admitted to a dedicated stroke unit have
been shown to have improved functional outcomeand
reduced mortality.

Prevention of recurrence

Any risk factors present
should be treated. All patients with ischaemic (not
haemorrhagic) stroke should ideally be on an antiplatelet
agent such as aspirin. Cholesterol-lowering
agents (statins) and anti-hypertensive agents have also
been shown to reduce recurrence. Anti-coagulants are
indicated in certain conditions such as atrial fibrillation
and valvular heart disease, but only after approximately
2weeks andwhen blood pressure is controlled,
to reduce the risk of haemorrhage into infarcted
tissue

Prognosis

Overall, 40% of patients die as the result of their stroke
(mainly in the first month), 40% are left significantly
disabled and 30% have reasonable recovery

treatment 

A stroke is medical emergency .immediate treatment can save lives and reduce disability,
so it is very important for people who are having stroke symptoms to get hospital as a quickly
as  possible
treatment depend upon type of stroke .in hospital a ct scan or MRI must be done to see
whether the stoke is from a clot or from bleeding .clot-busting drugs such is
(thrombolytic therapy)
and blood thinner such as heparin are prescribed for treatment

psychoactive drug uses effect Addiction and treatment

what are  psychoactive drug

A psychoactive drug, psychopharmaceutical, or psychotropic is a chemical substance that changes brain function and results in alterations in perception, mood, or consciousness.These substances may be used recreationally, to purposefully alter one's consciousness, or, as entheogens, for ritual, spiritual, or shamanic purposes, as a tool for studying or augmenting the mind. Some categories of psychoactive drugs, which have medical therapeutic value, are prescribed by medical doctors and other healthcare professionals. Examples include anesthetics, analgesics, hormonal preparations, anticonvulsant and antiparkinsonian drugs or drugs used for the treatment of neuropsychiatric  disorders, as hypnotic drugs, anxiolytic and some stimulant medications used in ADHD and some sleep disorders. There are also some psychoactive substances used in the detoxification and rehabilitation programs for psychoactive drug users.

main  psychoactive drug 

cocaine
crack cocaine
methylphenidate (Ritalin)
ephedrine
MDMA (Ecstasy)
mescaline (cactus)
LSD blotter
psilocybin mushroom (Psilocybe cubensis)
Salvia divinorum
diphenhydramine (Benadryl)
Amanita muscaria mushroom
Tylenol 3 (contains codeine)
codeine with muscle relaxant
pipe tobacco
bupropion (Zyban)
cannabis
hashish

Psychoactive substances often bring about subjective (although these may be objectively observed) changes in consciousness and mood that the user may find rewarding and pleasant (e.g. euphoria or a sense of relaxation) or advantageous (e.g. increased alertness) and are thus reinforcing. Substances which are both rewarding and positively reinforcing have the potential to induce a state of addiction – compulsive drug use despite negative consequences – when used consistently in excess.

Purposes

Psychoactive substances are used by humans for a number of different purposes to achieve a specific end. These uses vary widely between cultures. Some substances may have controlled or illegal uses while others may have shamanic purposes, and still others are used medicinally

Psychoactive drugs are divided into different groups according to their pharmacological effects. Commonly used psychoactive drugs and groups:

Anxiolytics

Example: Benzodiazepine

Euphoriants

Example: MDMA (Ecstasy), MDA, 6-APB, Indopan

Stimulants ("uppers"). This category comprises substances that wake one up, stimulate the mind, and may even cause euphoria, but do not affect perception.

Examples: amphetamine, caffeine, cocaine, nicotine

Depressants

 ("downers"), including sedatives, hypnotics, and narcotics. This category includes all of the calmative, sleep-inducing, anxiety-reducing, anesthetizing substances, which sometimes induce perceptual changes, such as dream images, and also often evoke feelings of euphoria.

Examples: ethanol (alcoholic beverages), opioids, barbiturates, benzodiazepines.

Hallucinogens, including psychedelics, dissociatives and deliriants. This category encompasses all those substances that produce distinct alterations in perception, sensation of space and time, and emotional states

Examples: psilocybin, LSD, Salvia divinorum and nitrous oxide.

uses of psychoactive drug 

Anesthesia

General anesthetics are a class of psychoactive drug used on people to block physical pain and other sensations. Most anesthetics induce unconsciousness, allowing the person to undergo medical procedures like surgery without the feelings of physical pain or emotional trauma.

To induce unconsciousness, anesthetics affect the GABA and NMDA systems. For example, halothane is a GABA agonist.and ketamine is an NMDA receptor antagonist

Pain management

Psychoactive drugs are often prescribed to manage pain. The subjective experience of pain is primarily regulated by endogenous opioid peptides. Thus, pain can often be managed using psychoactives that operate on this neurotransmitter system, also known as opioid receptor agonists

Mental disorders

Psychiatric medications are psychoactive drugs prescribed for the management of mental and emotional disorders, or to aid in overcoming challenging behavior.There are six major classes of psychotropic medications

Antidepressants 

treat disparate disorders such as clinical depression, dysthymia, anxiety, eating disorders and borderline personality disorder.

Stimulants, which are used to treat disorders such as attention deficit disorder and narcolepsy and to suppress the appetite.

Antipsychotics, which are used to treat psychotic symptoms, such as those associated with schizophrenia or severe mania.

Mood stabilizers, 

which are used to treat bipolar disorder and schizoaffective disorder.

Anxiolytics, which are used to treat anxiety disorders.

Depressants, which are used as hypnotics, sedatives, and anesthetics, depending upon dosage.

In addition, several psychoactive substances are currently employed to treat various addictions. These include acamprosate or naltrexone in the treatment of alcoholism, or methadone or buprenorphine maintenance therapy in the case of opioid addiction

Effects on human  

Psychoactive drugs operate by temporarily affecting a person's neurochemistry, which in turn causes changes in a person's mood, cognition, perception and behavior. There are many ways in which psychoactive drugs can affect the brain. Each drug has a specific action on one or more neurotransmitter or neuro receptor in the brain.

Drugs that increase activity in particular neurotransmitter systems are called agonists. They act by increasing the synthesis of one or more neurotransmitters, by reducing its reuptake from the synapses, or by mimicking the action by binding directly to the postsynaptic receptor. Drugs that reduce neurotransmitter activity are called antagonists, and operate by interfering with synthesis or blocking postsynaptic receptors so that neurotransmitters cannot bind to them

Addiction and dependence

Psychoactive drugs are often associated with addiction or drug dependence. Dependence can be divided into two types: psychological dependence, by which a user experiences negative psychological or emotional withdrawal symptoms (e.g., depression) and physical dependence, by which a user must use a drug to avoid physically uncomfortable or even medically harmful physical withdrawal symptoms.Drugs that are both rewarding and reinforcing are addictive; these properties of a drug are mediated through activation of the mesolimbic dopamine pathway, particularly the nucleus accumbens. Not all addictive drugs are associated with physical dependence, e.g., amphetamine, and not all drugs that produce physical dependence are addictive drugs, e.g., caffeine.

hypertension Symptoms causes and Treatment

hypertension treatment

Hypertension: Symptoms and Treatment
High blood pressure is a serious disease that can, over time, damage the blood vessel
walls and increase a person's risk of heart attack, stroke and other conditions
Blood pressure is the force of your blood against the blood vessel walls. Having high
blood pressure means that this force is higher than it should be, and could lead to health
problems.

There are two types of blood

pressure measurements:Systolic blood pressure, which is a measure of the force of
the blood when the heart beats, and
diastolic blood
pressure, or the force of the blood between heart beats. A person is considered to have
high blood pressure when their systolic pressure is 140 mmHg or higher most of the time, or
when their diastolic pressure is 90 mmHg or higher most of the time, according to the
National Institutes of Health About one-third of U.S. adults or 70 million people, have high
blood pressure, and only about half have it under control according to a 2013 report
from the Centers for Disease
Control and Prevention.
Adopting healthy lifestyle behaviors can help prevent high blood pressure, also known as hypertension,experts say High blood pressure is really a disease of the Western world
and if we can do our best to work on diet and exercise and stress relief, we could take a huge amount of this burden down

Causes

Most of the time, doctors cannot find a specific cause of hypertension, and this is known as essential hypertension. Certain factors increase the risk of developing
hypertension, including being obese, drinking too much alcohol, eating a lot of salt,smoking and having diabetes Aging also increases the risk of hypertension because blood vessels become stiffer with age, the NIH says. About 65percent of U.S. adults ages 60 and older have high blood
pressure, according to the National Heart, Lung and Blood Institute (NHLBI).Being under stress can also increase your blood pressure temporarily, but stress is not a proven risk factor for
hypertension. Still, some studies have linked mental stress and depression with risk of high blood pressure. A 2003 study published in the Journal Of the American Medical Association found that people who felt pressed for time or were inpatient had higher odds of developing high blood
pressure over a 15-year period, than people who did not feel such time pressure.

Symptoms

People with high blood pressure usually have no symptoms, and so patients can have the condition for years without knowing it
according to NHLBI.
"We call it the 'silent killer,'"
because patients are often
asymptotic, Freeman said. In
rare cases, some people with
high blood pressure
experience headaches.
Although many patients may
not have symptoms at first,
over time, high blood pressure
can lead to "wear and tear" on
the body, Freeman said. For
example, high blood pressure
can stretch and damage blood
vessels, which in turn, can
increase the risk of health
problems, according to the
American Heart Association.
Stretched blood vessels can
have weak spots that are more
likely to rupture, leading to a
hemorrhagic strokes or
aneurysms, AHA says.
Stretching of the blood vessels
can also cause tears and
scars that create places for
cholesterol or blood to build
up.

Diagnosis

High blood pressure is
diagnosed from a blood
pressure test. Typically,
doctors place a blood pressure
cuff on the arm, which has a
gauge that measures pressure
in the blood vessels. Patients
should avoid drinking coffee or
smoking cigarettes for 30
minutes before the test,
because such behaviors can
increase blood pressure
temporarily, the NHLBI says.
Because a person's blood
pressure can vary depending
on a number of factors,
including the time of day, a
doctor will usually check blood
pressure several times and
different appointments before
diagnosing someone with high
blood pressure.
Freeman said that he will often
have patients use a device
called an ambulatory blood
pressure monitor, which
patients wear at home, and
which takes a blood pressure
reading about every 30
minutes. This device can show
whether a person really does
have hypertension, and how
well they are responding to
treatment, he said. If a patient
doesn't want to use an
ambulatory blood pressure
monitor, they can also use a
home blood pressure monitor
to manually check their blood
pressure. "You get a lot better
idea of what's going on," if you
track blood pressure with one
of these devices, Freeman
said.
Doctors may measure blood
pressure in both arms to see if
there is a difference in
readings, the Mayo Clinic
Doctors may also recommend
other tests to look for
indicators of heart disease,
such as high cholesterol,

Treatment & medication

The goal of treatment is for patients to keep their blood pressure in the normal range
below 140/90 mmHg. For Patients who have diabetes or chronic kidney disease,
doctors recommend that they keep their blood pressure under 130/80 mmHg
Lifestyle changes — including
changes in diet and physical
activity — and medications are
recommended for treating high
blood pressure.
People with pre-hypertension
— that is, those with blood
pressure readings higher than
120/80, but lower than 140/90
— are usually treated with
lifestyle changes alone,
according to the National
Institutes of Health.
But many people with true
hypertension will need take
medications, as well as make
lifestyle changes
Lifestyle changes that can help lower blood pressure include eating a healthy diet — such
as a diet that cuts down on salt, and boosts fruit and vegetable intake — increasing
physical activity, reducing weight (if the patient is overweight or obese), and quitting smoking
In addition, stress relief practices, such as meditation or other relaxation techniques,
can also be helpful in lowering blood pressure, especially when combined with other
lifestyle changes
medications include:
Diuretics: These medications remove some salt from the body, which reduces fluid in
the blood vessels and causes blood pressure to go down.Beta-blockers Allow the
heart to beat slower with less force, which results in lower.
blood pressure Angiotensin converting enzyme inhibitors (also called ACE inhibitors):
Blocks the formation of a hormone that narrows blood vessels, allowing blood
vessels to open up Angiotensin II receptor blockers (ARBs):These medications are newer,
but work in a way similar to ACE inhibitors to widen blood vessels Calcium channel
blockers: Stop calcium from entering muscle cells in the heart and blood vessels, which
relaxes the blood vessels Side effects from blood pressure medication tend to be
minor, and can include cough diarrhea, dizziness, feeling tired, headaches, and
unintentional weight loss and skin rash

sorry to say that but we can't explain it briefly due to some problems
note the the above post is just for education only not for treatment 

Stomach Ulcers Causes Symptoms and Treatments

stomach ulcers

also known as a Peptic ulcers are open sores

that develop in the lining of the

esophagus, stomach or the

first part of the small intestine,

known as the duodenum. Over

25 million Americans will suffer

from an ulcer at some point

during their lifetime, according

to the Centers for Disease

Control and Prevention (CDC).Most ulcers are caused by an infection by Helicobacter

pylori bacteria (H. pylori), and can be treated in about two weeks with

antibiotics, according to the CDC."The two most common causes of ulcers are H. pylori,

a bacterial infection, and medications, most commonly aspirin and other nonsteroidal

anti-inflammatory medicines(NSAIDs), and iron tablets,.

"Psychological stress probably has no role in the development of ulcers, though biological

stress like being a very ill patients in the intensive care unit can definitely contribute to

ulcers," Swaminath said."Foods aren’t really thought to contribute to ulcers, but they

may make patients with already present inflammation or ulcers feel worse depending

on what’s eaten.

Symptoms

The most common symptom of peptic ulcers is a burning pain in the stomach, according to

the NIH. Typically, the pain starts between meals or during the night, and may stop if you

eat or take antacid

medications. The pain comes and goes for several days or weeks, and can be felt

anywhere from your navel up

to your breastbone, according

to Mayo Clinic.

Although the most common

symptom of ulcers is pain, the

condition can also present as

bleeding, or anemia,

Swaminath said. "There are a

lot of other organs around the

area of the stomach. Part of

the challenge of figuring out

what is causing the 'abdominal

pain' is to rule in or out things

like:

pancreatitis, gallstones, Crohn’s

s disease, or stomach cancer."

Psychological stress can

cause symptoms that mimic

the symptoms of ulcers,

Swaminath said. But because

stressed out people are at the

same risk for factors that really

can result in ulcers, they

should consult their doctor if

they have persistent

symptoms, he said.

Causes

Peptic ulcers happen when the

acids that help digest food

damage the walls of the

stomach or duodenum. The

insides of the digestive tract is

coated with a mucus layer that

protects against stomach acid,

but in some people who are

infected with H. pylori, the

bacteria get into the mucosal

lining in the stomach, creating

holes and exposing more

sensitive tissue to stomach

acid.

H. pylori is a common

infection, and it is possible that

the bacteria is spread between

people through contact with

infected stool, vomit or saliva.

It also may be contracted from

contaminated water or food.

According to the Mayo Clinic,

one in five young adults is

actually infected with the

bacteria. Still, for unknown

reasons it does not result in

ulcers in everyone.

Another cause is the regular

use of certain pain relievers,

specifically, NSAIDs such as

aspirin and ibuprofen (Advil).

These medications, as well as

naproxen (Aleve) and

ketoprofen, can irritate or

inflame the lining of the

stomach and small intestine.

Peptic ulcers are more

common in older adults who

take these pain medications

frequently or in people who

take these medications for

osteoarthritis.

Cigarettes, alcohol, and stress

can exacerbate symptoms by

further irritating the stomach

lining.

Diagnosis & tests

Doctors most commonly

diagnose ulcers using

endoscopy, Swaminath said.

This involves "taking a camera

directly into the stomach to

look for ulcers and taking

biopsies to make sure the

'ulcers' aren’t really cancer or

something else," he said.

There are several other tests

for the diagnosis of stomach

ulcers. A physician may use a

blood, stool, or breath test to

detect the presence of H.

pylori or antibodies to H. pylori,

according to the Mayo Clinic.

A breath test consists of

drinking a glass of liquid that

contains a radioactive

substance. This substance

reacts with H. pylori so that

when an individual with

stomach ulcers blows into a

bag, the breath will contain the

radioactive carbon in the form

of carbon dioxide.

Sometimes an X-ray exam

may be performed to visualize

the ulcer. A liquid containing a

metal element called barium is

ingested for this procedure. If

an ulcer is found, the physician

may then do an endoscopy in

which a flexible tube w

Treatment & medication

Treatment of stomach ulcers

consists of killing H. pylori and

decreasing the amount of acid

in the stomach. This requires

several types of medications.

Physicians may prescribe

several antibiotics at once, or

use a combination drug such

as Helidac to kill H. pylori.

Helidac contains two

antibiotics along with an acid reducing

drug and a

medication that protects

stomach tissue.

The doctors will also try to stop

other medications the patient

is taking and might have a role

in worsening the ulcers.

"Most of the time, we try to

withdraw the offending

medication, but that is not

always possible, for example

patients on aspirin who have

heart arrhythmias, or recent

heart stents," Swaminath said.

"We put patients on high

doses of the drug for eight

weeks by which time the area

will typically heal," Swaminath

said. "A low dose is continued

indefinitely if the offending

medication can’t be

discontinued."

Drugs called acid blockers (for

example, Pepcid) and antacids

may be recommended to

decrease the levels of

stomach acid. Other

medicines, called proton pump

inhibitors, such as Prilosec

and Prevacid, are another

option. They work by blocking

cellular pumps that release

acid into the stomach.