Nails Can Speak Your Health

Good looking nails look nice in the fingers and attribute sexy look to hand. Nails can speak about diseases one is suffering from. Books on palmistry often describe diseases that one might be suffering from, depending on the character of nails. I have gone through such books in my adolescent days out of curiosity to predict the luck of people.
Nails can be studied basing on the shape, size, texture, color and strength etc..In disease states shape can be like

1. spoon
2. irregular towards ends
3. clubbed
4. ribbed

.Texture can be

1. bright
2. pale looking

. Color can be

1. Bluish
2. dark or black
3. yellow
4. small bleeding spots under nail

.It may be brittle.
Spoon shaped nail called Koilonychia, is the hallmark of anemia especially due vitamin B12 defiency. Nails also look pale in this condition. 
Irregular ends of nail indicate tooth bite, which in turn indicate personality disorders like a feeling of insecurity. 
Clubbing of fingers seen in

1. cyanotic heart diseases
2. pus forming lung diseases
3. chronic bronchitis
4. infective heart diseases
5. tuberculosis of lungs
6. cancer of lungs
7. liver diseases like cirrhosis and hepatoma
8. intestinal diseases like crohns disease

. Bluish coloration seen in

1. congenital cyanotic heart diseases
2. respiratory distress syndromes
3. heart and lungs failure

Yellow nails indicate jaundice from various causes. 
A dark nail may be due to fungal infection. 
Yellowish brittle nails are seen in psoriasis.
Splinter hemorrhages can be seen in cirrhosis of liver.
Brittle nails as such can be seen in calcium deficiency states. Ribbed nails are seen in malnutrition states. 
These are some of clues from nail to reach or suspect a disease. There can be many more, I might be missing.
Now, I say that our forefathers, actually have keenly observed the nails in different diseases and narrated in the books on palmistry, to predict fate of people. And, I hope those were scientific.

Fistula-In-Ano

                           This is a very nasty disease to me.Somehow I am not comfortable to treat this one.Patient comes with a painful swelling near to anus,fever and prostration .On examination a painful swelling will be found near the anal opening.Once drained a large amount of foul swelling pus will  come out and relief the patient to a considerable extent. And this cycle goes on unless the patient is not  throughly investigated for possibility of Fistula-In-Ano.
It is a condition where there is build up of a   tunnelled connection ,of course small in caliber between interior of lower gut and the exterior i.e. skin.This occurs from an infection of anal glands located inside the anus and rectum and gradually enlarge to burst to the out side.With  passing of time the inside of the fistula or tunnel matures and continuously discharges pus.That is why I call a nasty disease.
Fistula may also manifestation of some diseases like TB,Ulcerative Colitis,Chron's Disease ,A rectal cancer and some other diseases.These are of various types and classified in various manner.
                                                                         Most accepted being superficiel,deep,intershincteric,transphencteric and high etc.which is required for the treating doctors.Treatment of more complex fistulas are not very much satisfactioy.A fistulogram gives good idea of it's extension to help in operation.Besides trans rectal ultrasonogram is helpful.Tuberculosis if suspected should be searched for the primary site of infection .A simple per rectal examination is helpful to supect a cancer inside.
Surgery is the option for most of fistulas except TB and some other diseases.Here the whole tract is excised leaving a raw area to heal from the depth. And if dressing done properly and wound heals fromthe depth probably the surgeon should be able to sleep cmfortably.The excised specimen is to be subjected to histopathological study to exclude associated cancer and TB in the  tract.And in that case furhter treatment for the specific disease to be taken up.




















Most common complication of surgery is inardverent injury to the anal sphincture making the patient incompetent to hold faecal matter.And the next is recurrance.
So this surgey many times brings down the ranking of the surgeon's popualrity.People taking non-veg diet and suffering fron constipation are prone for this disease.

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Appendicular Lump

The slender ,hanging structure is appendix

Poor, most of the time bear the brunt of disease aggression.One of the serious complications of appendicitis is appendicular lump.After an acute attack if not treated adequately (without Surgery) body tries to contain the infection.In the process the near by intestine and omentum try to isolate the infected appendix by surrounding it from all the sides and in the process a mass or lump is formed in side the abdomen to be felt from lower abdomen.This may in turn progress to abscess (collection of pus) formation,perforation of apendix and even infection of blood called septicemia.

Infected appendix

These patients are usually treated conservatively as surgery at this stage is riskier. But still if the lump progresses the conservstive treatment is abandoned in favor of intervention (Surgery).Again here it may not be possible for the surgeon to treat for cure of disease .He has to amelorate the potentially grave situation and defer a definitive surgery to a later date.

All these carry risk for the patient.And in this part of India there are poor people who do not have any other option rather than to accept the situation.They come late because of various reasons.One important aspect being their financial status.Initially they they expect this pain in abdomen may not be severe and go away automatically,better to wait rather than to go to a doctor and spend money which is a wastage .That amount can be used to feed themselves.But in the long run when it aggravates they even sell all their property to get treated.
Treatment facilities in terms of man power and infrastructure is lacking in this part .Added to it is the high pricing of drugs and indifferent attitude of Govt. service providing agencies compels the poor to sit at home expecting auto cure , go to quack or indulge in folk remedies.

This grim situation should improve to claim that India is a welfare state.

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A STEP TOWARDS PREVENTING CERVICAL CANCER

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Cancer cervix of uterus seen mostly in elderly ladies.It is a treatable cancer if detected early.Whitish watery discharge, post menopausal bleeding and thereafter pain back are some of the symptoms of it.But are usually late.The disease occurs from bad hygiene,multiple child birth and as a result of papilloma and herpes virus infection apart from other causes.These aforesaid causes can be treated leading to a step in preventing the disease.At present screening tests base upon taking out scrapping of  the cells from cervix and examining what is called PAP smear.Also can be tested for the presence of virus but has not been performed in large scale.Recently a DNA test is coming up. After screening test the patient is subjected to cone biopsy of cervix and a host of other imaging studies for conformation of disease and planning of treatment.
Now researchers say ladies can be vaccinated against Human Papilloma Virus(HPV) so that immunity develops and a fraction of disease can be prevented in this way.Maintaining hygiene which is not practiced in India very much mainly due to poverty. and limiting child birth will also go a long way in preventing a further chunk of this disease.
So early detection through the srreening tests and the preventive  
measures will save or enhance the quality of life of these victims.  

Removed cancer cervix with uterus

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SICKLE CELL DISEASE IN ORISSA,INDIA.

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Red blood cells(RBC) in blood are responsible for carrying oxygen to the cells and bring out carbondioxide from  there.The protein iron complex in it called haemoglobin is the carrier of oxygen and carbondioxide.Normal hemoglobin is termed as HbA.But many abnormalities do occur.One is HbS ( Sickle haemoglobin) derived the name from sickle as it transforms the RBC in a oxygen deprived condition . It is hereditary and mostly circulates in a closed area and consanguineous marriage spreads it in a local population.Western Orissa is the storehouse of this disease.

RBC is a microscopic cell of discoid shape and is biconcave.This means if a RBC will be likened to a coin the sides of coin should cave in to resemble a RBC.This shape facilitates it to deform while passing through a narrow road inside the smallest calibered blood vessel called capillary.This quality lacks in a RBC containing HbS.It may sometimes occurs in conjunction with other abnormal type of Hb such as HbF which is the cause of Thalassaemia.So what happens when these RBCs negotiate through a capillary and delivered

Sickle cell RBC

oxygen to cause a  oxygen deprived environment where these get deformed to a sickle shape and become rigid to conglomerate with each other  blocking the blood flow causing more oxygen deprived environment to form more sickles and the cascading effect.The blocked site hampers blood flow causing death of cells beyond the segment.So commonly this effect is seen in spleen,bone marrow,lungs,kidneys and liver etc. This causes various symptoms such as pain arising from the organ,blood in urine,anaemia and infection of bone and lungs etc.
This can be screened by sickling test in a oxygen deprived environment and conformed by electrophoresis of haemoglobin.
Treatment is not very satisfactory.It can be prevented by marriage counselling and diagnosis of condition in utero where the parents may like to discontinue the pregnancy.
Folate deficiency precipitates this condition as well as acidosis .So folate supplementation and avoiding oxygen deprived situation are two important steps .Prevention of infection by different vaccinations against infectious diseases and prophylaxis for malaria will enable the patient to lead a near normal life.

Glutamic acid is changed to valine in the position  6 in B chain in the protein in HbS.

Marriage counselling should be based on blood  matching tests and not merely basing on horoscopes.

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COMPLICATIONS OF BURN

Burn is a dangerous condition and a pathetic looking disease.The victim always feels shrunk.A lot of complications follow a moderate to severe burn.In hospitalized patient nosocomial infection plays a major deteriorating factor .Isolation and careful choosing of antibiotics and a good dressing will help to a great extent if not full to control infection.Pain has to be addressed.Good nutrition with protein supplementation is important for recovery.
The main long term effects are scar formation,disfigurement,scar retraction and deformity,keloid formation,recurrent infection of keloid and a cancer called marjolin's ulcer.To minimize the scar formation skin grafting and if not available, in a major burn synthetic skin substitutes will play a good role.Now-a-days cultured skin cells are being developed but not available everywhere for use.Still, to minimize scar formation different stockings( compression bandages) are in use.
Once scar is formed it comes with it's inherent problems of retraction causing disfigurements of different types as imaginable to imagine depending on the site.Scars may hypertrophy and lead to ugly keloid formation.Keloids are unorganized growth of scar tissue and encroach on to the healthy surrounding tissue.Again that is difficult to treat.The treatment range from application of silicon gel to local injection of steroids.but nothing is satisfactory.
Contractures due to scar tissue may limit the movement if located near a joint and has to be released and skin grafted.
The most dreaded long term complication is a cancer on the scar tissue called Marjolin's ulcer and fortunately it is a little bit easier to treat.
So some precautions at some dangerous places may prevent these cascading effect of burn.

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COMPLICATIONS OF MEASLES.

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Measles a communicable disease spreading in air from the patient, usually affects children below 5 ears of age.Begins as symptoms of common cold or flu without a clue to the disease in particular.Around 5th day of fever patient develops rashes first behind the ear ,inside the mouth on on cheek mucosa and gradually spreads to chest and trunk.Patient feels great prostration due to high fever.The characteristic rashes are diagnostic.It may subside without much problem but may become dangerous.The main complications are bleeding from the conjunctiva,respiratory infection,diarrhea ,pancreatitis and   much dreaded encephalitis.Here patient has to be hospitalised and treated in isolation.Outcome may become fatal sometimes.
Good vaccine coverages is available in single or in combination and should be given around the age of 9 to 11 months.In India measles vaccine is a part of Universal Immunization Programme and provided  free. Sometimes some adverse reaction do occur after the immunization and baby should be observed at least for two hours after immunization for immediate reaction.
Sometimes measles may affect the immunized but in that case it is in much of it's minor form called abortive measles. 
Maintainance   of cold chain is the key to successful immunization.But in India measles do occur may be for non immunization of babies for various reasons.
So prevention is better than cure.

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Surgical complication of Typhoid

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Typhoid an infection by Salmonella Typhi/Paratyphi of intestinal lymphoid collection also called Enteric fever is transmitted through contaminated food and drink .There are also human carriers of the disease.The disease is characterized by fever of long duration with rigors,cough and great prostration usually fatal if untreated. Diagnosis is based on clinical and Widal test .If treated adequately it is cured .Whether treated or untreated usually in pediatric age group patient may land up in perforation of intestine towards the end of second week or beginning of third week. It is invariably fatal. I have seen patients not doing well many years back.But not seen cases in the recent past perhaps due to advent of newer drugs.
Another community problem is healthy carrier status.This occurs due to inadequate treatment of the disease, the bacteria houses in the gall bladder and infects that.Here the asymptomatic patient distributes disease as makes own hands infected .
That is why it should be treated adequately.It also remains viable long time in the ice/icecreams made using contaminated water.

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LEFT TESTIS DOWN/SELF EXAMINATION

Frequently young adults aspiring for a recruitment especially where strict medical examination is conducted come to me with a complain that the left side testis is bigger than it's counter part.
Invariably I could find it to be cent percent normal.The mystery is that is that the right side testis normally remains in a little higher position than the left and so the asymmetry.The cause is developmental rather than an abnormality.The testes develop in the abdomen of fetus while still in the mother's womb. They come out to make scrotum their latest and permanent home.The left one descends first and the right one later ,a few weeks before birth and so maintains a little higher position.
And that is the cause sometimes some weakness remains in closing of the path in the abdominal wall and may give rise to a hernia sooner or later in the life, to be seen more commonly in the right side.
Testes being accessible organ are to be self examined for abnormalities and early detection of development of tumour where cure is possible.
I think later on we will discuss other abnormalities in descend of testes.

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