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Pancreas Division (Dominal Dorsal Duct Syndrome): - This problem occurs in up to 10% of the whole population. It results from dorsal and ventral pancreas to unite. Consequently most of the pancreas is drained through accessory papilla that is proximal to papilla of Vater. These types of patients are more prone to pancreatitis for condition appears to be associated with stenosis of opening of one or other papilla.
Diagnosis in made via endoscopic retrograde cholangiopancreatography (ERCP).

Annular Pancreas: - Ventral pancreas surrounds the second part of duodenum and it is frequently associated with other congenital defects such as mal-rotation of intestine, artesian and cardiac defects. Pancreas may constrict duodenum causing obstruction soon after the birth or in adult life. This may predispose to duodenal ulcer and acute pancreatitis. Diagnosis is made by barium studies and treatment is surgical bypass of constriction.

Ectopic Pancreatic Tissue: - It may occur in gastric antrum or duodenum and it takes the form of smooth nodule. It is normally asymptomatic and it does not require any treatment. If it is found coincidentally during surgery, the nodule is excised for it is subject to same conditions including carcinoma, as the pancreas itself.

Pathology: - The pathological findings and clinical features result from obstruction by abnormal viscid secretion of the ducts in salivary glands, digestive and biliary tracts and pancreas causing atrophy
Clinical Features: - The exocrine insufficiency leading to steatorrhoea and diarrhea is almost universal in childhood. If patient survives to adulthood, malabsortion tends to be less troublesome. The intestinal obstruction, commonly called “meconium ileus equivalent”, may occur in the children and in the adults, caused by inspissated food and secretions. Rectal prolapse is frequent in children because of the large bulky stools and frequent coughing. The recurrent episodes of the acute pancreatitis may also occur. The incidence of the diabetes mellitus increases with the age. Chronic pancreatitis may supervene. The disease of liver or biliary tract may occur.
Investigation: - The gastrointestinal problems are investigated according to suspected problems. There may be disorder in the gut epithelium and pancreas. 80% of the patients with cystic fibrosis have both pulmonary disease and pancreatic disease. But 15% patients have lung sepsis with clearly normal pancreatic function.

Management: - Optimal treatment in adolescent and adult depends on a team approach to the complicated respiratory, nutritional and hepatobiliary problems. Many treatment centers have established special clinics for such kind of patients with specialist care. Read more…

Researchers have long known that the “sunshine vitamin” boosts bone strength by encouraging the body to absorb calcium. But a slew of new studies published in 2007 suggests that the vitamin has a lot of other benefits:Diets high in D may ward of diabetes , gum diseases and multiple sclerosis- and may even cancer. Though some findings linking vitamin D and cancer showed questionable benefit, the news on colon cancer was promising. In one large trial , men in the Health Professionals Follow -Up Study and women in the Nurses’ Health Study with the highest blood levels of vitamin D were half as likely to develop colon cancer as their peers with less circulating vitamin D. To squeeze the most value out of vitamin D, aim for taking a supplement with 1,0000IU daily.

Dyspnoea or breathlessness can be defined as the unpleasant subjective awareness of sensation of breathing. It is the common symptom of the cardiac disease and the respiratory disease. In physiological terms, the patients usually perceive discomfort either from the increased ventilatory rate or drive, that can be provoked by the variety of factors or from a disease that causes enough reduction of ventilatory capacity. Other factors, including stimulations of J receptor leading to the amplification of ventilatory response in asthma or restrictive disorders, can also contribute.

It is obvious that diseases having dyspnoea may have a multifacteral etiology e.g., acute respiratory infections can stimulate respiratory rate as a result of fever, hypoxaemia and in serious cases, by acidoemia or hypercapnia. They can also reduce ventilatory capacity by increasing the bronchial resistance and also by restricting the ventilation because of pleural pain.

Different diagnosis in Patients with chronic Exertional Dyspnoea: -

Chronic obstructive pulmonary disease (COPD): -Very often there is a history of exertional dyspnoea over many years or months, with steady chronic decline exercise capacity. Chronic persistence cough and the daily production of sputum is the common rule and they can be a history of recurrent acute exacerbations of bronchitis. Wheezing on exercise can be prominent. In the late disease, especially if corpulmonale develops, orthopnoea, nocturnal breathlessness and ankle swelling many also supervene.

On Investigation, cyanosis may be at rest or on the trivial exertion, together with the expiratory wheeze, pursing of lips and intercostals indrawing, Antero-posterior diameter of chest may be increased and they may also be a reduced crico-sternal distance with ‘tracheal tug’ on inspiration. Chest radiograph shows signs of hyperinflation and bullae, arterial blood gases may expose hypoxaemia, hypercapnia and the raised plasma bicarbonate. There will often be the severe obstructive defeat on the spirometry which may or may not improve after the inhaled bronchodilators.

Heart Disease: - Sometime it is difficult to differentiate dyspnoea due to the heart disease. History of cough, wheezing and the nocturnal breathlessness may also occur in the cardiac failure as well as chronic obstructive pulmonary disease. History of angina or hypertension can be useful in implicating the cardiac cause. On investigation an increase in the heart size as judged by a displaced apex beat, the raised JVP and the cardiac murmurs may implicate cardiac disease. Chest radiograph and the ECG may provide the evidence of left ventricular or the arterial enlargement. Read more…

For performance of various functions, human body needs energy. It is food that supplies that energy. Carbohydrate is turned into glucose as a result of digestion of food. The primary source of energy that is absorbed into our bloodstream is glucose. When this glucose is absorbed in our bloodstream, it is insulin that comes into action. Insulin is the name of a hormone secreted by an organ situated near the stomach which is called pancreas. It is insulin that helps in removing excess glucose from blood and allows its easy entry into the cells of the body. In this way, glucose that enters the body cells is broken down to produce energy that is required for our body. This is the process of a normal body.

If a person has diabetes, his pancreas either fail to produce sufficient insulin or produce insulin that is ineffective to carry out its function. Because of insufficiency or ineffectiveness of insulin, glucose that is built up in the blood stream is unable to enter the cells of our body. That is why, the body starves from energy. So, diabetes may be understood as a metabolic disorder which results in elevated blood glucose levels because of impairment of insulin secretion or action.

Diabetes is mainly of three types:-

Type -1:- This type of diabetes generally develops in early life and is known as juvenileonset diabetes or insulin dependent diabetes mellitus (IDDM). Actually it is an autoimmune disorder. Very often virus infections may happen in this type of diabetes while the body’s own immune system or defense mechanism attacks and destroys the ?-cells of the pancreas what produce insulin hormone. The symptoms of this type of diabetes are severe. It can be life threatening if it is not well treated in proper time.

Type -2:- The second type of diabetes happens because of several factors, the most important being obesity. This is adult onset diabetes or non-insulin dependent diabetes mellitus (NIDDM). Usually this type of diabetes cannot be identified for years unless it is diagnosed. Its symptoms are milder. If it is not properly treated in proper time, it can be of life threatening case.

Read more…

Headache hits most of us and almost everybody gets it at one time or another during their lifetime. In fact general practitioners say it is a very common cause of concern. Head pain can be described as debilitating, humming, vague, rhythmic, throbbing, and steady. They can interfere with your ability to work and to play, but rarely life threatening, if they exist by themselves. Headaches can also be because of some medications like dilators or nitrates for heart disease; anti-hypertensive; calcium channel blocker; acidity and ulcer H2 blocker; hormone replacement drugs; contraceptives and many others.
However, headaches can also be caused by serious organic disorder which is why one needs to go through proper evaluation by competent doctors.

Different types of headache:

Tension Headache:
It is the most common type. Tension headache causes mild to moderate pain and feels like tightening of a band around the head. It can last from 30 minutes to 7 days and affect the whole head. But it does not cause nausea or vomiting. Physical activity does not worsen the pain.
This type of headache can be controlled with OTC pain relievers, anti-depressant, muscle relaxant, ice packs, heat treatment, massage, meditation or yoga.

Migraine:
It hits women more than the men between the age of 20 and 45. It may cause moderate to severe pain and usually the pain is felt on one side of the head. The pain gets worsened by sound, light, physical activity. It can also cause nausea and vomiting. It occurs after many weeks, months or even years and may last four hours to three days.
It can be controlled by avoiding trigger foods, stress and with OTC pain relievers like paracetamol and anti-nausea medication. Ultrasound physiotherapy and Biofeedback is also helpful.

Cluster Headache:
This occurs specially among men between 30 and 50 years of age. Such headache causes severe and piercing pain focused around a single eye. It lasts for 15 minutes to 3 hours and occurs in clusters, separated by pain free periods. On the same side of the pain, the nostril runs, the eye waters, eyelid drops, lower eye area swells. But it does not cause nausea or vomiting and is not worsened by lights or sounds.
If you have it consults your physician.

There are other types of headaches as well.

Hypertension:
It causes severe high blood pressure (over 160/110), occurs in spasms and felt at the back or top of the head. The pain is most severe in the morning. If it happens to you, consult with a specialist.

Eye Disorders:
Eye disorders might also cause headache. In this case the pain can be moderate to severe and worsen after using the eyes. The pain is felt at the front of the head or in/over the eyes.
Consult an eye specialist.

Sinusitis:
This is a condition when inflammation happens on hollowed out areas of bone at the front of the skull with openings into the back of the nose. The pain is severe, dull or sharp and felt around nasal area, one or both eyebrows. It may happen suddenly and last for few minutes or may happen gradually and be persistent. The pain worsens when you look down and in day time.
One can try steam inhalation or hot towel over eyes to shrink or unblock sinuses along with using some painkillers. Surgical drainage is the last option.

Brain Tumor:
The pain initially is mild but as the tumor grows, it gets from severe to unbearable. It occurs frequently and with time becomes constant.
The only way for relief is to see specialists.

Brain Abscess:
The pain and patterns are much like brain tumor except if it ruptures when meningitis occurs. The pain may be felt on one spot or all over the head.
Surgery is the only way for permanent relief.

Meningitis:
It is a condition when inflammation of the thin membrane that covers brain and spinal cord. Intense and constant pain is felt all over the head and it travels to neck which becomes stiff and makes bending to rest chin on neck difficult. It is accompanied by high fever and vomiting.
Immediately consult your physician and get admitted into hospital if possible.

Temporal Arthritis:
It happens when inflammation occurs on large arteries on the side of the scalp. It usually hits older people. This might cause disturbances or loss of vision. One might feel the pain while brushing hair or the jaw may hurt when eating or talking.
Steroids, Prednisone can be used to stop inflammation and prevent blindness.

There are many other conditions and disorders like TB, Syphilis, Sarcoidosis, Cryptococcosis that can affect the brain and cause headache. Best way to get relief is to see a doctor as early as possible and get proper diagnosis and treatment. Remember, early detection or diagnosis of a disease at its nascent stage might save a lot of trouble.