Sunday, 5 October 2014

Chagas Disease

What is Chagas disease?

Chagas disease or American trypanosomiasis, is a tropical parasitic disease caused by the protozoan Trypanosoma cruzi and spread mostly by insects known as Triatominae or kissing bugs.

What are the symptom?

The symptoms change over the course of the infection. In the early stage, symptoms are typically either not present or mild and may include: fever, swollen lymph node, headaches, or local swelling at the site of the bite.
After 8–12 weeks, individuals enter the chronic phase of disease and in 60–70% it never produces further symptoms. The other 30 to 40% of people develop further symptoms 10 to 30 years after the initial infection. This includes enlargement of the ventricular of heart in 20 to 30% leading to heart failure. An enlarged oesophagus or an enlarged colon may also occur in 10% of people.

How does it spread?

T. cruzi is commonly spread to humans and other mammals by the blood-sucking “kissing bugs” of the subfamily Triatominae. These insects are known by a number of local names, including: vinchuca in Argentina, Bolivia, Chile and Paraguay, barbeiro (the barber) in Brazil, pito in Colombia, chinche in Central America, and chipo in Venezuela.
Rhodnius proxilus is principal vector in the principal vector in ColombiaVenezuela,GuatemalaHonduras, and some parts of Nicaragua and El Salvad

The disease may also be spread through blood transfusion, organ transplantation, eating food contaminated with the parasites, and from a mother to her fetus.

How is the diagnosis made?

Diagnois of early disease is by finding the parasite in the blood using a microscope. Chronic disease is diagnosed by finding antibodies for T. cruzi in the blood.

How do you prevent this disease from spreading?

Prevention mostly involves eliminating kissing bugs and avoiding their bites. Other preventative efforts include screening blood used for transfusions. NO vaccine has been developed as of 2014.

What is the treatment?

Early infections are treatable with the medication benznidazole ornifurtimox. They nearly always result in a cure if given early however become less effective the longer a person has had Chagas disease. When used in chronic disease they may delay or prevent the development of end stage symptoms. Benznidazole and nifurtimox cause temporary side effects in up to 40% of people  including skin disorders, brain toxicity, and digestive system irritation.

Saturday, 30 August 2014

ADHD - My website

 Is ADHD is ruining your family, you can get balanced information in my website

ADHD often hides in other illnesses and frequently left untreated

I found in my practice as a family physician more than 10 years that ADHD diagnosis hides behind other medical problem and it is extremely difficult to make the diagnosis and to provide early treatment . I have seen many families go through series of consultation with specialist and how the diagnosis has been delayed or missed.
Rarely will a patient  will see the symptom or present to the doctors . It is very important to give value to the family's opinion and I have seen that family's opinion is a great source to make the diagnosis.

When physicians see recurring infections, we check for diabetes. But when we see recurring accidents we don't think of ADHD — so we miss the ADHD diagnosis and  worse the patient misses the opportunity to  be treated  for ADHD and the problems it leads to medically, financially, socially and emotionally.

ADHD is associated with boredom eating, obesity and its complications — hypertension, diabetes, cardiac issues and more. And the inattentive ADHD that is common in women is a frequent cause of obesity.

The smoking rate among those with ADHD is twice that of those without the condition. Why? Nicotine turns on the bored brain and relieves its discomfort. We know what smoking causes bronchitis, pneumonia, hypertension and lung cancer

Restless Leg Syndrome (RLS) — sometimes referred to as “ADHD at Night” — is a subconscious way to satisfy a bored, hyperactive brain asked to lie still in a silent room with lights off and eyes shut. So, your brain compels you to roll around, move your legs, toss and turn — and not sleep deeply.  However, neurologists don't list ADHD among causes of RLS.

Insomnia is common in those who have ADHD. But for them, it would be more appropriate to refer to it as “Restless Brain Syndrome.” The brain revs up to combat the lack of sensory input, leading to insomnia. Rather than prescribe a sleeping pill, we should  treat the ADHD instead.

Fibromyalgia can also be tied to ADHD. Brains in people with ADHD run at night, protecting their owners from deadly boredom. But a running brain doesn't allow the deeper, restorative sleep we need. Muscles never loosen and trigger points form. ADHD is always there so the sleep defect stays, as do the aching trigger points. Rheumatologist diagnoses fibromyalgia though many of these patients have undiagnosed ADHD

How many unplanned pregnancies result from forgotten condoms, missed birth-control pills and plain impulsivity? I have seen all these problem are very common in ADHD patients.

For a moment, forget ADHD's classic signs:  Hyperactivity, impulsivity and inattention. Instead, seek ADHD hiding in medical conditions — and the medical conditions hiding in ADHD. Let's aim for reduced disease, better sleep, fewer accidents, less pain, less sick time, lower blood pressure, cleaner lungs and even reduced health costs.

How to give back?

I'm a GP in the UK and having left India over 15 years ago, I felt the need to give something back. I hope you will join me and participate in discussing some of the issues at home and away.