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CureFactor for Headache

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Headache:
Headache is term used to describe pains located in the head including unpleasant sensations in the region of cranial vault.

ETIOLOGY:
Causes of headache is divided into
1. Intracranial causes:

  • Space occupying lesions-tumour,abscess.
  • Meningeal irritation-meningitis,subarchanoid haemorrhage.
  • Vascular-cerebral haemorrhage,subdural haematoma.
  • Head injury.
  • Pseudotumour cerebri(benign intracranial hypertension).

2. Referred pain:

  • Eyes-glaucoma,iritis,hypermetropia,astigmatism,eye strain.
  • Ears- otitis media,mastoiditis.
  • Teeth-dental root abscess.
  • Paranasal sinuses-frontal or maxillary sinusitis.
  • Cervical spondylosis.

3. Miscellaneous-migraine,temporal arteritis,cluster headache,tension headache.

  • Mechanism of headache- brain itself is insensitive to pain as it is devoid of pain sensitive receptors. pain receptors are found in blood vessels at the base of brain,meninges,extracranial blood vessels,muscles of scalp,neck,face;paranasal sinuses,eyes,teeth. Pin sensitivity is dependent upon the nerves(sensory nerves).
  • Headache is caused by stimulation of pain receptors,which occurs by traction,displacement or dilatation of intracranial or extracranial vessels or venous sinuses by raised intracranial pressure,raised pressure in venous sinuses in emphysema.
  • Mechanical irritation eg intracranial lesions,head injury,chemical irritation eg migraine due to 5-HT histamine,inflammation eg temporal arteritis. meningeal irritation and traction eg meningitis,subarchanoid haemorrhage.
  • Compression,traction or intrinsic disease of cranial and spinal nerves eg tumour,inflammtion.
  • Prolonged contraction of cranial and cervical muscles eg cervical spondylosis,anxiety states.
  • Pain due to stretching of pain sensitive nerve endings within the muscle fascicles,compression and traction of scalp blood vessels.
  • Referred pain occurs via second and third divisions of 5th cranial nerve.

 

CureFactor for Cirrhosis

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Cirrhosis:
Cirrhosis is irreversible liver disease resulting in hepatic cell destruction,fibrosis and portal hypertension and characterised by shrunken liver,splenomegaly,haematemesis,jaundice and ascites. Cirrhosis affects the liver causes its destruction.

ETIOLOGY:

  • Cause of cirrhosis is unknown.
  • Chronic alcoholism,viral hepatitis,ICC(indian child cirrhosis).
  • Metabolic cause-haemochromatosis,wilson’s disease.
  • Iatrogenic cause-methotrexate,amiodarone.
  • Passive congestion-chronic cardiac failure,budd-chiari syndrome,sickle cell anaemia.
  • Age group above 30 years.
  • Common in males.

CLINICAL FEATURES:

  • Onset of symtoms are insidious and Clinically cirrhosis is characterised by anorexia,nausea,vomiting,diarrhea,weakness,weight loss,gradual swelling of feet or abdomen,bleeding piles,haematemesis,malaena,gynaecomastia,amenorrhea in females,impotence in males.
  • Signs of cirrhosis are hepatic face-prominent malar bone,complexion muddy,sunken eyes,yellow conjuctiva due to jaundice,ascites,oedema in severe stages of cirrhosis.

COMPLICATIONS:

  • Hepatocellular failure-severe haematemesis,malaena,severe jaundice,gross ascites,hepatic encephalopathy,hepatic coma,cardiac failure and renal failure.
  • Hepatocellular carcinoma,secondary infections.

GENERAL MANAGEMENT:

  • Complete bed rest in severe jaundice,patient over 50 years.
  • Eat well balanced,high carbohydrate diet.
  • Avoid eating food rich in proteins.
  • Fluid,salt restriction if ascites or oedema.

CureFactor for Viral hepatitis

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Viral hepatitis:
Viral hepatitis is infection caused due to hepatitis viruses,which affects the liver(hepatocytes) causing jaundice.
Viral hepatis is characterised by anorexia,nausea,vomiting,fever followed by jaundice. Different species of hepatitis virus are hepatitis A virus(HAV),hepatitis B virus(HBV),hepatitis C virus(HCV),hepatitis D virus(HDV),hepatitis E virus(HEV).

ETIOLOGY:
Viral hepatitis caused due to hepatitis viruses(HAV,HBV,HCV,HDV,HEV).
Spread of Viral hepatitis depends on the type of virus

  • HAV-faeco-oral route
  • HBV-Sexually transmitted,blood,saliva,breast milk. high risk factors for HBV are health care workers,laboratory technicians,blood transfusion recipients,homosexuals,prostitutes,IV drug abusers,tattooing.
  • HCV-blood,saliva.
  • HDV-blood
  • HEV-faeco-oral route.

Incubation period of Viral hepatitis depends on the type of virus

  • HAV:2-4 weeks
  • HBV:4-24 weeks.
  • HCV:2-26 weeks.
  • HDV:6-9 weeks.
  • HEV:3-8 weeks.
  • Age group-HAV & HEV-is common in young adults and childrens.

CLINICAL FEATURES:
The onset of Viral hepatitis symptoms depends on the type of virus

  • HAV:sudden
  • HBV:insidious
  • HCV:sub-acute
  • HDV:insidious
  • HEV:acute

Clinically,Viral hepatitis is characterised by three stages

  1. Pre-icteric stage(duration:7 days).
  2. Icteric stage(duration:7 days).
  3. Convalescent stage(duration:7 days).

In pre-icteric stage,symptoms like low grade fever,arthralgia,myalgia,anorexia,nausea,vomiting,diarrhea,weakness,malaise,easy fatiguability,headache,dull,aching pain in the upper abdomen.
In icteric stage symtoms like anorexia,nausea,vomiting persists,fever subsides,dark yellow urine,light coloured stools,loss of weight.
In convalescent stage,patients feels better,appetite normal,jaundice disappears.

COMPLICATIONS:
Post hepatitis syndrome,haemorrhage,secondary infection,acute hepatic failure,recurrent hepatitis.

GENERAL MANAGEMENT:

  • Therapeutic aim is to promote natural recovery,prevent complications,provide symtomatic medical treatment..
  • Adequate intake of fluids,bed rest until symtoms and signs disappear.
  • Diet-nutritious diet,high protein,high carbohydrate diet.

CureFactor for Anal fistula

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Anal fistula:
Anal fistula is a track lined by granulation tissue which opens deeply in the anal canal or rectum and superficially on the skin around the anus. Mostly these fistula develop from ano-rectal abscess which burst spontaneously or was incised inadequately.

ETIOLOGY:
Rupture or drainage of anorectal abscess,secondary cause of Anal fissure are crohn’s disease,ulcerative colitis,carcinoma,tuberculosis.

CLINICAL FEATURES:
Clinically Anal fissure is characterised by pain,discomfort in anus with difficulty in sitting,better after pus discharge,irritation of skin around the anus.

GENERAL MANAGEMENT:
Maintain local hygiene,improve general health,drink plenty of water,avoid trauma to the affected part.

CureFactor for Anal Fissure

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Anal Fissure:
Anal fissures are common rectal condition caused due to trauma to the anal canal. Anal fissure is defined as elongated painful crack in skin lining the lower part of anal canal.

ETIOLOGY:
Anal fissure is caused mainly due to trauma to the lower part of anal canal especially due to passing of hard stools. Few conditions like ulcerative colitis,crohn’s disease,syphilis,tuberculosis are secondary cause Anal fissure.

CLINICAL FEATURES:

  • Clinically Anal fissure is characterised by pain in ano and bleeding per anus. Pain in ano,the character of pain is agonising,starts during defaecation,becomes severe after passing stools,lasts for hours. Bleeding per anus is slight,bright streak of fresh blood on stools.
  • Complication- chronic Anal fissure

GENERAL MANAGEMENT:
Correct the cause,avoid being constipation drink lots of fluid,have semi-solid,bland diet,local lubrication,sitz bath.

CureFactor for Piles (Haemorrhoids)

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Piles (Haemorrhoids):
Haemorrhoids is rectal condition caused due to varicosity of the veins(haemorrhoidal plexuses)of the anal canal.

ETIOLOGY:
Causes of Hemorrhoids are familial predisposition,obesity due to weight,pregnancy,constipation due to passing of hard stools,straining due to enlarged prostate,urethral stricture,cirrhosis,carcinoma of rectum.

CLINICAL FEATURES:

  • Haemorrhoids is usually classified into internal Haemorrhoids and external Haemorrhoids. Internal Haemorrhoids are covered by mucus membrane and external Haemorrhoids is covered by skin.
  • Clinically Haemorrhoids is asymptomatic,majority of the Haemorrhoids cases show no symptoms.
  • When Haemorrhoids is symptomatic,symptoms like bleeding per rectum which is intermittent,bleeding especially during defaecation,character of blood is bright red.
  • Degree of Haemorrhoids depends on the Degree of prolapse of Haemorrhoids.
  • First degree Haemorrhoids-no prolapse of Haemorrhoids outside the anal canal.
  • Second degree Haemorrhoids-slight protrusion,only during defaecation,straining,spontaneous reduction,later on to be replaced manually.
  • Third degree of Haemorrhoids-permanenet prolapse,sensation of heaviness in rectum,mucoid discharge,pruritis,pain,if inflammed.

COMPLICATIONS:
Complications of Haemorrhoids are profuse haemorrhage,strangulation,thrombosis.
GENERAL MANAGEMNET
Correct the underlying cause,avoid straining during defecation,local lubrication,sitz bath,cold compresses.

CureFactor for Acute Appendicitis

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Acute Appendicitis:
Acute Appendicitis is acute inflammatory condition of appendix,and is common abdominal condition characterised by constant pain in right lower abdomen,vomiting and fever.

ETIOLOGY:
The cause of Acute appendicitis is not clearly known. however,diet(low residue diet),social status(middle and high class),familial susceptibility,obstruction to the lumen of appendix by faecolith,stricture,worms,excessive use of purgatives. Causative organism of Acute appendicitis are E.coli,enterococci,streptococci. Acute appendicitis increasingly common during childhood and adolescene and the maximum incidence is seen in the age group of 30-40 years.

CLINICAL FEATURES:
Clinically Acute appendicitis is classified into

  1. Non obstructive type(slow developing)
  2. Obstructive type(fast developing)

Symptoms of Acute appendicitis are pain,vomiting,fever,abdominal pain. Acute appendicitis has a abrupt onset. Abdominal pain is more over the umbilicus(key point),then localises to the right iliac fossa. The character of pain is contant,severe type of pain,which is worse on coughing. Anorexia,constipation,vomiting-short duration,stops immediately after stomach is empty.

COMPLICATIONS:
Complications of Acute appendicitis-appendicular abscess,perforation,gangrene,peritonitis.

GENERAL MANAGEMENT:

  • Acute appendicitis is acute condition.
  • Diet-initially nothing by mouth,followed by fluid,easily digestible diet,gradual progression to solid foods,maintain fluid,electrolyte balance.

CureFactor for Malabsorption Syndrome

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Malabsorption Syndrome:
Malabsorption syndrome is a common gastrointestinal syndrome,in which the body fails to absorb essential constituents of food. The defect lies in the gastrointestinal tract which is the main source where all of the important constituents of food is absorbed. Malabsorption syndrome is characterised by malnutrition,chronic diarrhea and steatorrhea.

ETIOLOGY:

  • Cause of Malabsorption syndrome is divided into two main headings,one is due to inadequate digestion and the second one is impaired digestion.
  • Cause of inadequate digestion-chronic pancreatic disease,cirrhosis,gastrectomy,zollinger-ellison syndrome,jejunal diverticulosis,diabetes mellitus.
  • Cause of impaired digestion-coeliac disease,tropical sprue,intestinal tuberculosis,crohn’s disease,protein losing enteropathy,parasitic infestation,diabetes mellitus,thyrotoxicosis,addison’s disease,systemic sclerosis,AIDS,iatrogenic(chemotherapeutic drugs).

CLINICAL FEATURES:

  • Clinically Malabsorption syndrome is characterised by symptoms which have a insidious onset.
  • Malabsorption syndrome depends on malabsorption of particular food constituent. Symptoms are different for different food constituent.
  • Malabsorption of Fat-weight loss,steatorrhea is key symptom of malabsorption of fat. Character of stool is pale,bulky,frothy stools,stools contain fat. Difficult to flush out stools in toilet is characteristic of steatorrhea.
  • Malabsorption of protein-progressive emaciation and pitting oedema.
  • Malabsorption of carbohydrates-flatulence,abdominal distension,belching.
  • Malabsorption of vitamin A-night blindness,keratomalacia,follicular hyperkeratosis,xerosis.
  • Malabsorption of of vitamin D,calcium-muscular and bone pains,muscular irritability,tetany.
  • Malabsorption of vitamin k-haemorrhages,weakness,cheilosis,glossitis,dermatitis,polyneuritis.
  • Malabsorption of of vitamin B12,folic acid and iron-anaemia,glossitis,neurological disturbances.
  • Malabsorption of of vitamin C-bleeding tendency.

GENERAL MANAGEMENT:
Treat the cause,avoid spicy,fried food,avoid eating outside foods especially tinned products.
Correct the underlying defective constituent.

CureFactor for Duodenal Ulcer

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Duodenal Ulcer:
Duodenal ulcer is common gastrointestinal disorder characterised by dyspepsia,pain(hunger pain). Duodenal ulcer is caused due to ulceration of mucosal lining of duodenum which is because of excess of secretion of HCL acid more than normal level.

ETIOLOGY:
Cause of duodenal ulcer is classified according to the clinical types of duodenal ulcer that is acute cause and chronic cause.
Acute cause-severe burns,septicaemia,surgery,iatrogenic cause like drug abuse of steroids.
Chronic cause-exact cause is not known.
Predisposing causes are genetic predisposition,infection with helicobacter pylori,hormonal irregularity especially in womens,anxiety prone personality,mental stress,irritants like smoking,alcohol,spicy food,irregular meals,miscellaneous cause like cirrhosis,hyperparathyroidism.
Age group-duodenal ulcer is common in the age group of 40 years and below.

Symptoms:

  • Upper abdominal pain
  • Onset 1-3 hours after food,location is epigastrium towards the right,radiation to chest,character grawing and burning,worse at night,empty stomach,better by food, milk and antacids, haematemesis,melena ,weight gain due to frequent eating to relieve pain, periodicity,exacerbation in winter,remission during summers.

COMPLICATIONS:

  • Acute-Perforation, severe haemorrhage.
  • Chronic-Pyloric stenosis, penetrations into pancreas, gastric carcinoma.

GENERAL MANAGEMENT:
Correct the cause, bed rest during acute phase,regular hours of rest and sleep, avoid excessive fatigue, avoid undue mental stress.

CureFactor for Peptic ulcer

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Peptic ulcer:
Peptic ulcer is common gastrointestinal  disorder caused due to gastrointestinal mucosal ulceration in acid bearing regions,formed and maintained by acid pepsin digestion and characterised by dyspepsia and upper abdominal pain.

ETIOLOGY:
Cause of Peptic Ulcer is classified according to the clinical types of Peptic Ulcer that is acute cause and chronic cause.
acute cause-severe burns,septicaemia,surgery,iatrogenic cause like drug abuse of steroids.
chronic cause-exact cause is not known.
Predisposing causes are genetic predisposition,infection with helicobacter pylori,hormonal irregularity especially in womens,anxiety prone personality,mental stress,irritants like smoking,alcohol,spicy food,irregular meals,miscellaneous cause like cirrhosis,hyperparathyroidism.
age group-peptic ulcer is common in the age group of 40-60 years. chronic Peptic Ulcer is common in males.

CLINICAL FEATURES:
Acute Peptic Ulcer is clinically characterised by symptoms which have sudden onset,haematemesis and malaena,mild tenderness in the epigastric region are few of the symptoms of Peptic Ulcer
chronic Peptic Ulcer is clinically characterised by pain which comes on immediately after eating food. Location of pain is epigastric region towards left side,which radiates to chest,back. character of pain is dull aching. pain is better by vomiting,missing meals,antacids,milk. heartburn,weight loss,haematemesis,malaena.
Person suffering with Peptic Ulcer looks lean,thin and poor nutrition.

GENERAL MANAGEMENT:
Correct the cause, bed rest during acute phase,regular hours of rest and sleep, avoid excessive fatigue, avoid undue mental stress.