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CureFactor for Anxiety Neurosis

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Anxiety Neurosis:
Anxiety neurosis is common,most frequently seen in young adults especially college and school going students because of stress they have to undergo in schools and colleges and is pschiatric disorder more specifically neurotic disorder.
neurotic disorder is disorder that do not interfere with the ability of the patient in terms of insight,judgement,touch with the reality,behaviour,intelligence and perception.
neurotic disorder are often described as intermediate connecting link between various adaptive mechanisms unconsciously utilised on one hand and personality disorganisation on other.
Anxiety neurosis also called generalised anxiety disorder in which the patient suffers persistent free floating anxiety about everyday circumstances(not attached to any specific object or situation). example only the knowing the date of examination he starts getting anxiety even before the situation(examination) has occured.

ETIOLOGY

  • Familial predisposition present
  • Usually individual suffering from Anxiety neurosis is said be having anankastic(obsessive) personality.
  • Predisposing causes.
  • Loss of relationship from loved ones.
  • Financial strains.
  • Physical trauma.
  • Depression is associated with Anxiety neurosis .
  • Sociophobia not adapting well with the society.
  • Difficulties in married and sexual life.

Pathology behind anxiety
Main cause for development of Anxiety neurosis is because the patient is not able to suppress all unwanted thoughts,feelings and ideas into subconscious mind,resulting into failure to adapt to the on going changes around him. every individual gets anxious,child cries when separated from mother. therefore any kind of separation real or threatened can cause anxiety. one develops Anxiety neurosis because he is not able to adapt to the changes around him.

Clinical Features:
Core psychological features(mental symptoms) of Anxiety neurosis are:

  • Fear,feeling of great uneasiness,apprehension,restlessness,iriitability,cant concentrate,disturebed sleep due to continous thoughts in mind,startles easily,hypersensitivity to physical exertions.

Few of somatic features(effecting the body and expressed in the form of physical symptoms)

  • Increased rate of breathing,dizziness,blurring of vision,ringing in ears,numbness,faintness
  • Dryness of mouth due to mouth breathing,difficulty of swallowing,epigastric discomfort,faltulence,frequent urination.

General Symptoms are:

  • Muscular weakness,increased perspiration,body ache,extreme fatigue.

General Management:

  • Supportive therapy-listen to patient’s worries empathetically.
  • Assure the patient that his complaints are understood.
  • Explanation about his suffering.

Encouragement and practical guidance in rejection of false concepts and coping with problems.

  • Behavious therapy
  • Relaxation training
  • Exercises to relax skeletal muscles and regulate breathing.
  • Anxiety management training to reduce anxiety by meditation,relaxation,distraction and reassurance.

 

CureFactor for Pica (common disease seen in children’s)

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Pica:
Pica is common disease seen in children’s suffering with abnormal carving for undigestible foods.
Pica is defined as perverted appetite for eating non edible things like paint,clay,wall plaster,hair..etc.

ETIOLOGY:

  • Infants and childrens normally have strange habit of eating undigestible things upto tha age of 2 years,if it continues then its abnormal.

Persistence of habit beyond 2 years could be because of:

  • Parental neglect.
  • Poor supervision.
  • Lack of affection.
  • Deficiency like iron deficiency anemia.
  • Psychogenic disorder.
  • Parasitic infestations.

Common in low socio-economic childrens,malnourished children and mentally weak childrens.

Clinical Features:

  • Child eats non edible,undigestible things like hair,wall plasters,clay,paint…etc.
  • Craving only for undigestible food,having no desire to eat normal digestible food.
  • Due to the abnormal habit,

Child may suffer from poisoning like lead poisoning due to chewing of paint,which is alarming emergency
Trichobezoar is formation of ball swallowed hair in stomach. prognosis is good.

General Management:

  • Parents are advise to keep the child away from all non-edible things.

CureFactor for Down syndrome

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Down syndrome:
Down’s syndrome is chromosomal anomaly characterised by mental retardation,small stature and hypotonia(reduced muscle tone). Down’s syndrome is also called mongolism due to its resemblance to mongolians.
Down’s syndrome is chromosomal anomaly due to extra chromosome 21 characterised by small stature,hypotonia and mental retardation.

ETIOLOGY:

  • Exact cause is not known
  • It is believed that Down’s syndrome is common in women who concieves in older age.
  • Accordding to incidence 1 in 600 live births you come across a Down’s syndrome baby.

Clinical Features:

  • Mental retardation.
  • Small stature.
  • Hypotonia.
  • Hyperflexibility of joints.

Signs of Down’s syndrome baby:
Skull

  • Small and round skull(brachycephalic).
  • Delayed fontanelles.

Face

  • Small nose,flat face with absence of or flat nasal bridge.

Eyes

  • Upward slant to palpebral fissures.
  • Inner epicanthic folds.
  • Strabismus.
  • Tendency to blepharitis.

Ears

  • Small,deformed ears.

Mouth

  • Small mouth,protruded tongue,fissured tongue(scrotal tongue).
  • Neck is short.

Hands

  • Broad hands,with short digits.
  • Small incurved little finger(clinodactyly) due to rudimentary Second phalanx.
  • Single palmar crease(simian crease-single palmar crease).

Feet

  • Toes widely spaced
  • Plantar crease between first and second toes.

Skin

  • Dry,soft skin
  • Soft,silky,sparse hair.

Abdomen

  • Umbilical hernia.

Genitalia

  • Small genitalia.
  • Cryptorchidism (absence of one or both testes).
  • Infertility in males.

Above all symptoms and signs are associated with congenital heart disease(CHD),oesophageal atresia and duodenal atresia.
Prognosis

  • Life expectancy rate does not reduces if the child survives neonatal period and is has no cardiac abnormality.
  • Muscle tone tends to improve with age
  • IQ tends to fall with age.

General Management:

  • Support the parents if they are ready to accept the child emotionally.
  • Early training of the child with specific limited objectives that would be helpful to child and mother like feeding,dressing,toilet training.
  • Older child requires special school.
  • Associated symptoms to be treated on individual merits.

CureFactor for Mental Retardation

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Mental Retardation:
Mental retardation is a condition characterised by reduced intellectual capacity to point of adaptive functioning,impaired learning ability and social inadequacy.

ETIOLOGY:

  • Prenatal causes
  • Chromosomal anomaly-down’s syndrome.
  • Cranial malformations-hydrocephalus.

Perinatal Causes:

  • Infections especially of TORCH-Toxoplasmosis,Rubella, Cytomegalovirus (CMV) and Herpes infections.
  • Maternal drug ingestion.
  • Prematurity.
  • Perinatal hypoxia.
  • Birth trauma.

Postnatal Causes:

  • Head injury
  • Infections like meningitis,encephalitis.
  • Malnutrition.

Clinical Features:
Look of mentally retarded person

  • The head is usually smaller than normal,with high palate
  • Jaw may protrude or recede.
  • The pinna(part of the ear) often deformed.
  • Eyes often abnormal,marked epicanthic folds.
  • Nose flattened usually.

Physiological problems:

  • Circulation poor resulting in cyanosis of extremities.
  • Convulsions frequently occur.
  • Delayed puberty with reproduction possible.
  • If the intelligence levels are very low
  • Poorly coordinated gestures,child runs around the room moving objects around him(hyperkinetic mental deficiency).
  • In severe cases

Child lies lifeless,dribbling of saliva,teeth grinding due to delayed dentition,masturbation especially seen in attention deficit personality disorder(ADHD) of the psychiatric disorder.

  • Mental development in a mentally retarded person depends from low backward to unable to do anything state.
  • Delayed milestones(milestones mean proper development and growth of growing childrens).
  • Repeated failure to learn in school,not able to keep up what he is learning,inefficiency in work,inadequate practical knowledge.

How do you investigate a case of mental retardation:
Mental retardation is assisted based on intelligent quotient(I.Q)
IQ is defined as mental age by actual age multiplied by 100
IQ= mental age x 100/actual age.
Grading of IQ
IQ >120: super intelligence
IQ 80-100: normal
IQ 50-80: low backward
IQ 30-50: trainable
IQ <30: imbecile

General Management:

  • Inform the guardian’s about the diagnosis
  • Parent’s are to be educated telling them what the patient is suffering from and how he is suppose to be taken care.
  • Investigations to be done to assess the mental power of the patient
  • Based on his IQ level the parents are adviced to send their kids to that particular schools

IQ level 50-80:special schools
IQ level 30-50:trained schools
IQ level below 30:custodial care.

  • Sympathetic attitude from parents,relatives,neighbours.

 

 

CureFactor for Indian Childhood Cirrhosis (ICC)

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Indian Childhood Cirrhosis (ICC):
ICC is a rare PAEDIATRIC condition commonly seen in India hence the name Indian childhood cirrhosis.
cirrhosis means liver disease characterised by irreversible liver damage resulting in hepatic cell destruction,fibrosis and portal hypertension and results in splenomegaly,haematemesis,jaundice and ascites.

ETIOLOGY:

  • Exact cause is not known.
  • Genetic predisposition is common.
  • It is believed to be autu-immune(production of antibodies towards its own body).
  • Viral hepatitis.
  • Common in vegetarians.
  • Use of copper utensil for cooking and boil milk.
  • Commonly seen in indian sub continent.
  • Age group 1-4 years.
  • Common in males.

Clinical Features:

  • ICC has a insidious onset.
  • ICC is classified into three stages
  1. Precirrhotic stage.
  2. Cirrhotic stage.
  3. Hepato-cellular stage.

Pre-cirrhotic stage

  • Symptoms like low grade fever,failure to thrive(failure to gain weight),irritability,excessive crying,loss of appetite,sticky diarrhea.

Cirrhotic stage

  • Symptoms like loss of appetite,vomiting,diarrhea,loss of weight,dark coloured urine,colour of stools light coloured.

Look of the patient-emaciated face,puffiness of face,marked anaemia,pitting oedema,yellowish discolouration of skin and eyes.
Hepatocellular stage

  • Extreme loss of weight,growth retardation,anorexia,swelling of abdomen due to ascites.

Look of the patient-great emaciation,deep jaundice,severe ascites,marked anaemia.

  • Complications
  • Hepatic coma.
  • Severe haemorrhage.
  • Intercurrent infection.

General Management:

  • Improvement of general health.
  • Correct anaemia.
  • Avoid usage of copper utensils.

 

CureFactor for Enuresis

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Enuresis:
Enuresis is a common PAEDIATRIC condition that occurs in grown up childrens.Enuresis means bed wetting in grown up children who should have gained control over the bladder but have not done so resulting in involuntary bed-wetting.

ETIOLOGY:
Cause of Enuresis is usually classified into primary cause(localised within the bladder) and secondary cause(outside the bladder).
Common cause for Enuresis are

  • Psychological disturbances-emotional disturbances.
  • Excessive enthusiastic attempts at toilet train and fail to achieve it can cause Enuresis

Organic cause(rare):

  • Urinary infection
  • Developmental abnormality

Urinart tract.

  • Spina bifida occulta.
  • Diabetes insipidus or diabetes mellitus
  • Chronic renal failure.
  • Neurological lesions.
  • Mental deficiency/mental retarded.

Clinical Features:
Enuresis is classified into

  1. Primary Enuresis.
  2. Secondary Enuresis.

Primary Enuresis:

  • Generally child starts gain control over his bladder by with 18-24 months and 4 years in case of night control. In primary Enuresis child has not at all gained control over his bladder by birth. because of which the child my suffer from emotional stress due to his habit of bed wetting especially in school going kids.

Secondary Enuresis:

  • In secondary Enuresis the child previously had control over his bladder but has lost control. sudden wetting of bed in child of age 3-5 years due to infection or emotional stress,especially in night.
  • Whether the child is wet everyday depends on circumstances like if the child is staying away from home say in aunties place or grandparents place.

Prognosis:

  • Majority of children improve as they grow old with or without treatment.

General Management:

  • Reassurance to parents about the problem,and make them understand that the condition will improve as the child grows old.
  • If the child wets the bed be soft with him dont ounish or make the child feel ashamed about.
  • Child should be given assurance from the aprents if they scold or punish him the child me become tense and anxious,may result with persistance of Enuresis.
  • Avoid drink more water in night time.
  • Child should be made to pass urine before getting to bed.
  • Bladder training.
  • Child is taught to control his bladder.

CureFactor for Diarrhea

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Diarrhea:
Diarrhea is common gastrointestinal condition characterised by frequent losse stools.
Diarrhea is a condition characterised by frequent loose,watery stools causing generalised weaking due to loss of fluids.

ETIOLOGY:

  • Dietetic diarrhea(diarrhea due to im properdiet)
  • Lactose intolerance(enzyme lactase deficiency)
  • Overfeeding
  • Excessive intake of fat
  • Infective diarrhea
  • Bacterial cause-e.coli,salmonella,shigella.
  • Viral-enteroviruses.
  • Worm infestations.

Other Causes:

  • Malabsorption syndrome.
  • Thyrotoxicosis.
  • Iatrogenic causes.
  • Psychological disturbances.

Diarrhea due to constipation which is because of irritation of rectum(pseudo-diarrhea).

Clinical Features:
Diarrhea is of two types acute and chronic type. In acute type we have mild type and severe type
In mild case of Diarrhea the onset is usually insidious.

Symptoms:

  • Passage of stools more than 2-3 times per day.

Character of stools:

  • At the beginning the colour and consistency of stools dont change,but as the suffering continues stools become more fluid.
  • Colour of stool yellowish to green,containing curds and offensive.
  • Mild fever
  • Loss of appetite
  • Weakness.
  • Vomiting may precede or follow diarrhea.
  • In severe case of Diarrhea,onset is usually sudden.
  • Stools are frequent,copious,loose watery stools,contains little amount of faecal matter and offensive stools.

Character of vomitus:

  • Usually after every meal,copious,projectile type,violent
  • Mild fever
  • Irritability

Complications:

  • Dehydration due loss of vital fluids.
  • Anaemia
  • Infection
  • Circulatory collapse

Chronic diarrhea(irritable bowel disease)

  • This is described as causeless diarrhea with all types investigations not eliciting any cause
  • Other wise the individual is perfectly alright
  • Diarrhea immediately after every meal

General Management:

  • Treat the underlying cause.
  • Stop feeds for 24 hours.
  • Diluted milk,rice,milled cereals,mashed bananas can be given.
  • If diarrhea does not recur,strengthen the feed..
  • Maintain fluid,electrolyte balance.
  • Reassurance and explaining the patient about his suffering especially in irritable bowel disease.

 

CureFactor for Constipation

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Constipation:
Constipation is common condition of defecation system,characterised by difficulty in passing stools.
Constipation is defined as condition characterised by difficulty in passing hard stools accompanied pain and straining on defecation.
Criteria for Constipation

  • Passing of hard stools for months together.
  • Not passing stools for more than 3 days is considered to be constipated.

ETIOLOGY:

  • Organic cause

Obstructive Cause

  1. Intestinal stresia.
  2. Pyloric stenosis.

Metabolic Cause:

  • Hypothyroidism
  • Faulty diet
  • Mental conditions like cretinism,the individual cant appreciate loaded rectum.
  • Irregular sleep habits can cause constipation.
  • Psychogenic disturbances.
  • Eating solid foods without liquid diet can cause constipation.

Clinical Features:

  • Pain on passing stools
  • Sometimes melaena due to laceration of anus.
  • Colic and distension of abdomen.
  • Discomfort around the abdomen.
  • If severe it can cause intestinal obstruction,vomiting and visible peristalsis movement.
  • Symptoms like foul breath,irritability,tiredness.
  • Passage of hard stools can cause pain during defecation.
  • Due to continues passage of hard stools can cause fissure in ano(cracks around the anus).
  • Accumulated faeces in rectum can cause irritation in rectum causing diarrhea.

Complications:

  • Due to excessive straining,prolapse of anus can occur.
  • Constipation has a good prognosis if precautions are taken.

General Management:

  • Drink plenty of water,fresh fruit juice.
  • Add fibre to your regular diet like apple,banana
  • Avoid having solid diet.
  • Drink plenty of water after every diet.

 

CureFactor for Tonsillitis

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Tonsillitis:
Tonsillitis is ENT condition where in the tonsils located in throat get inflamed .
Tonsillitis is acute or chronic condition of inflammation of tonsils.

ETIOLOGY:

  • Tonsillitis is caused due to bacteria especially beta hemolytic streptococcus and staphylococcus aureus.
  • Predisposing causes.
  • Tonsillitis is common problem in childrens.
  • Drinking of infected water or milk.
  • Post nasal drip.
  • General ill health.
  • Over crowding.
  • Ill ventilated rooms.
  • Season common in winter seasons.

Clinical Features:
Tonsillitis is commonly categorised into

  1. Acute Tonsillitis
  2. Chronic Tonsillitis

Acute Tonsillitis

In acute Tonsillitis symptoms like fever,pain in throat with radiating pain to ear. worse on swallowing.Change of voice,malaise,anorexia and thirst. Chronic Tonsillitis is recurrent attacks of acute Tonsillitis  ,irritating cough,voice becomes thick.

  • Compliactions
  • Quinsy(peritonsillar abscess)
  • Rheumatic fever
  • Sub acute bacterial endocarditis.

Prognosis:

  • Acute attack lasts for 3-7 days.
  • Prognosis good if treated early.

General Management:

  • Bed rest during fever time.
  • Warm water gargles.
  • Adequate fresh air and sunlight.
  • Improvement of general health.
  • Diet rich in vitamin c.
  • If Tonsillitis is uncontrolleable Tonsillectomy(removal of tonsils).

 

 

 

CureFactor for Dental caries

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Dental caries:
Dental caries is Dental (teeth) problem,a condition characterised by decay,decalcification and disintegration of teeth.

PATHOGENESIS(how dental caries develop)
The sequence of dental caries

  • Bacteria in mouth cause fermentation.
  • Formation of acids from carbohydrates inservices around the teeth.
  • Acids decalcify inorganic enamel.
  • Proteolytic organisms destroy organic matrix left after decalcification.
  • Cavity formed extends into pulp.
  • Secondarily infection and decay.
  • Suppuration with abscess formation.

ETIOLOGY:
Predisposing Causes

  • Food stagnation.
  • Ingestion of fermentable carbohydrates eg bread,honey,sweets especially not brushing in the night which is protective meanS for not suffering from dental caries.
  • Lack of roughage.
  • Abnormal development of teeth and jaw
  • Deficient calcification.
  • Common in age group of 4-8 years.

Clinical Features:
Site of affection-place where food can stagnate.
Symptoms

  • Toothache.
  • Foul odour from mouth.

Signs:

  • Plaque

Consists of food debris,bacteria,epithelial cells and mucin
Tough,difficult to remove,grows back after it is removed quickly.

  • Yellowish brown discolouration.
  • Pieces of enamel break away during chewing.
  • Cavities form in the teeth which has dark brown surface and progressive increases in size.

General Management:

  • As a rule brush your teeth after meals.