dr.divya dixit

What is Baldness?

Baldness is the partial or complete lack of hair growth, and part of the wider topic of "hair thinning". The degree and pattern of baldness varies, but its most common cause is androgenic alopecia, alopecia androgenetica, or alopecia seborrheica, with the last term primarily used in Europe.

Pattern balding is distinct from alopecia areata, which commonly involves patchy hair loss. Extreme forms of alopecia areata are alopecia totalis, which involves the loss of all head hair, and the most extreme form, alopecia universalis, which involves the loss of all hair from the head and the body.

Sign and Symptoms

Excessive daily hair loss

It is generally accepted that each person has between 100,000 and 150,000 hairs on their head. Information on how many strands are normally lost in a day varies, but recent studies suggest an average of 100.In order to maintain a normal volume, hair must be replaced at the same rate at which it is lost. The first signs of hair thinning that people will often notice are more hairs than usual left in the hairbrush after brushing or in the basin after shampooing. Styling can also reveal areas of thinning, such as a wider parting or a thinning crown.

Skin conditions

A substantially blemished face, back and limbs could point to cystic acne. The most severe form of the condition, cystic acne arises from the same hormonal imbalances that cause hair loss, and is associated with DHT production.Seborrheic dermatitis, a condition in which an excessive amount of sebum is produced and builds up on the scalp (looking like an adult cradle cap) is also a symptom of hormonal imbalances, as is an excessively oily or dry scalp. Both can cause hair thinning.

What is Psoriasis?

To put it simply, Psoriasis is a chronic disorder that results in red, thickened patches on the skin with shedding of silvery scales. The condition may be accompanied with discomfort and/or pain.

Skin cells normally have a life cycle of about 28 days each - which means that each of these cells is shed off and another comes up in place every 28 days. Now imagine if the cells start growing very rapidly without waiting for the earlier ones to shed out. It would lead to a build up of a thick layer of cells leading to the thickening of the skin in the affected area. This results in red patches with scaling.

Psoriasis can vary in intensity from mild cases with only nuisance-value to some extremely debilitating cases. The disease can also progress to affect other areas of the body such as nails, joints, scalp, etc. A tendency to come and go periodically is commonly seen in many cases – there are phases of worsening of the symptoms (relapse) and periods when the condition spontaneously resolves (remission).

Almost 2-3 % of the general population is affected by Psoriasis and it is increasingly becoming more and more common. The incidence is higher amongst young adults though it can strike at any age. No gender predilection is seen in the cases largely.

In addition to all this, it’s very important to bear in mind that Psoriasis is not infectious – it cannot be passed from person to another through physical contact.

Sign and Symptoms

Quality of life

Severe cases of psoriasis have been shown to affect health-related quality of life to an extent similar to the effects of other chronic diseases, such as depression, hypertension, congestive heart failure or type 2 diabetes.Depending on the severity and location of outbreaks, individuals may experience significant physical discomfort and some disability. Itching and pain can interfere with basic functions, such as self-care, walking, and sleep. Plaques on hands and feet can prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home. Plaques on the scalp can be particularly embarrassing, as flaky plaque in the hair can be mistaken for dandruff.

Individuals with psoriasis may also feel self-conscious about their appearance and have a poor self-image that stems from fear of public rejection and psychosexual concerns. Psychological distress can lead to significant depression and social isolation.

In a 2008 National Psoriasis Foundation survey of 426 psoriasis sufferers, 71 percent reported the disease was a significant problem in everyday life. More than half reported significant feelings of self-consciousness (63 percent) and embarrassment (58%). More than one-third said they avoided social activities and limited dating or intimate interactions.

Many tools exist to measure quality of life of patients with psoriasis and other dermatalogical disorders. Clinical research has indicated individuals often experience a diminished quality of life.[20] A 2009 study looked at the impact of psoriasis by using interviews with dermatologists and exploring patients viewpoint. It found that in cases of mild and severe psoriasis, itch contributed most to the diminished health-related quality of life (HRQoL).

According to a study published in 2010 in the Journal of the American Academy of Dermatology, the reliability of a simple six-point Likert scale for self-assessment of pruritus (itching) by patients was validated in patients with moderate to severe plaque psoriasis.[22] This will allow better communication, assessment, as well as staging and management of itching. It could also allow future studies to objectively evaluate the effectiveness of therapy directed towards itching, with consequent improvement in quality of life.

Severity

Distribution of severity among people with psoriasis

Psoriasis is usually graded as mild (affecting less than 3% of the body), moderate (affecting 3–10% of the body) or severe.[24] Several scales exist for measuring the severity of psoriasis. The degree of severity is generally based on the following factors: the proportion of body surface area affected; disease activity (degree of plaque redness, thickness and scaling); response to previous therapies; and the impact of the disease on the person.

The Psoriasis Area Severity Index (PASI) is the most widely used measurement tool for psoriasis. PASI combines the assessment of the severity of lesions and the area affected into a single score in the range 0 (no disease) to 72 (maximal disease).[25] Nevertheless, the PASI can be too unwieldy to use outside of trials, which has led to attempts to simplify the index for clinical use.

What is Utereni Fibroide?

A uterine fibroid is a leiomyoma (benign (non-cancerous) tumor from smooth muscle tissue) that originates from the smooth muscle layer (myometrium) of the uterus. Fibroids are often multiple and garner the designation of diffuse uterine leiomyomatosis if they are randomly located and many in numbers. There is a malignant form of a fibroid and fibroids can rarely (0.1-0.5%), undergo malignant degeneration into leiomyosarcoma. Additionally there are rare forms of fibroids where the lesions are capable of metastasising without malignant transformation and this process is called benign metastasising leiomyoma.

Other common names are uterine leiomyoma,myoma, fibromyoma, fibroleiomyoma.

Fibroids are the most common benign tumors in females and typically found during the middle and later reproductive years. While most fibroids are asymptomatic, they can grow and cause heavy and painful menstruation, painful sexual intercourse, and urinary frequency and urgency. Some fibroids may interfere with pregnancy although this appears to be very rare.

In the United States, symptoms caused by uterine fibroids are a very frequent indication for hysterectomy.

Sign and Symptoms

Fibroids, particularly when small, may be entirely asymptomatic. Symptoms depend on the location of the lesion and its size. Important symptoms include abnormal gynecologic hemorrhage, heavy or painful periods, abdominal discomfort or bloating, painful defecation, back ache, urinary frequency or retention, and in some cases, infertility. There may also be pain during intercourse, depending on the location of the fibroid. During pregnancy they may also be the cause of miscarriage, bleeding, premature labor, or interference with the position of the foetus.

While fibroids are common, they are not a typical cause for infertility accounting for about 3% of reasons why a woman may not have a child.Typically in such cases a fibroid is located in a submucosal position and it is thought that this location may interfere with the function of the lining and the ability of the embryo to implant. Also larger fibroids may distort or block the fallopian tubes.

What is Eczema?

Eczema often referred to as atopic dermatitis is a form of chronic inflammation of the skin.

The term eczema is broadly applied to a range of persistent skin conditions. These include dryness and recurring skin rashes that are characterized by one or more of these symptoms: redness, skin edema (swelling), itching and dryness, crusting, flaking, blistering, cracking, oozing, or bleeding. Areas of temporary skin discoloration may appear and are sometimes due to healed injuries. Scratching open a healing lesion may result in scarring and may enlarge the rash. The word eczema comes from Greek, meaning "to boil over". Dermatitis comes from the Greek word for skin – and both terms refer to the same skin condition. In some languages, dermatitis and eczema are synonymous, while in other languages dermatitis implies an acute condition and "eczema" a chronic one.[3] The two conditions are often classified together.

Sign and Symptoms

Varied in its presentation, eczema can show up in diverse forms in different individuals. Some key features that are common to most forms of eczema are as follows:

• Dry itchy skin
• Redness, heat and swelling of the affected part
• Skin eruptions - usually multiple small ones
• Occasionally there may be oozing of thin watery fluid from the eruptions
• Chronic scratching may lead to thickening of the skin in the affected area
• Darkening of the skin in long standing cases
• Crust formation may be seen
• Scaling

The lesions may appear on any part of the body but are commonly seen to affect:

• Knees, elbows, ankles - especially inner sides
• Face and neck
• Arms and legs
• Folds of skin

In children, nappy region, scalp, face and neck and forearms are commonly affected.
Sometimes the symptoms may exist for a short period of time (less than 4 weeks) and then disappear completely, this is called acute eczema. However, in most cases, the features persist for a long period and tend to be recurring in nature leading to 'Chronic eczema'.

There are different kinds of presentations of eczema and it is important to know your type to understand the treatability of the same. Discussed here are some common types:

1) Atopic dermatitis:

This is also commonly known as infantile eczema since it develops during the first year after birth in most cases. 90% of atopic dermatitis patients develop symptoms before the age of five.
Symptoms largely include reddish, dry or oozing scaly eruptions at the bend of elbows, back of knees, neck, face, etc. The skin is extremely dry and very itchy. Infants usually find it very difficult to control the itching and excessive scratching may lead to secondary infection.

The condition develops as an allergic reaction to a number of things such as foods, environmental allergens, etc. (see causes of eczema for details). The condition tends to be hereditary and often family history of some form of allergy, asthma, hay fever, etc. is seen in such cases. Atopic dermatitis is often accompanied by other allergic and hypersensitive conditions like rhinitis, asthma, etc. In certain cases, the two conditions may alternate with each other i.e. one flares up when the other subsides.

2) Contact dermatitis:

As the name itself suggests, this type is marked by symptoms of eczema that develop in localized regions where the skin comes into direct contact with an allergen (allergic contact dermatitis) or an irritant (irritant contact dermatitis).

Irritants take longer period and increased amount of contact to trigger an eczematous reaction as compared to allergens (food allergens, environmental allergens). Even a brief exposure to a small amount of allergen can trigger a fast eczematous response.

One of the commonest forms of Contact dermatitis is the allergy that is caused by contact with nickel (which is a component of artificial jewellery). Contact with watches, ear rings, rings, chains or other items of this kind causes red, itchy rashes followed by tiny blisters and peeling of skin.

3) Seborrheic dermatitis:

Commonly seen to affect the scalp, margins of the head and area behind the ears, this condition is characterized by reddish rashes with yellowish, oily scales. This is common in people who have an oily skin and scalp and it varies according to seasons. When seborrheic dermatitis occurs in infants, it is known as 'cradle cap'.

4) Exfoliative dermatitis:

A great amount of scaling and flaking is typically seen in this type of eczema.

5) Stasis dermatitis:

This type of eczema occurs in the portions of the body where the blood circulation is poor (like the area around the ankles) and it has a tendency to form ulcers. It is often associated with some circulatory disorder like varicose veins, etc.

6) Nummular dermatitis:

The eruptions are coin shaped in this type of eczema.

7) Neuro-dermatitis:

This is characterized by eruptions which show close relation to psycho-somatic stress. The patient usually develops an intensively itchy skin especially when the person is resting or relaxed. A vicious itch-scratch-itch cycle develops. This type of eczema usually limits itself to areas that are easily accessible to the person such as lower legs, ankles, back and sides of the neck, wrists, forearms, and genitals.

8) Dyshidrotic dermatitis:
Small fluid-filled and itchy blisters appear on the hands and feet. These are most common along the edges of the fingers, toes, palms and soles and tend to appear during certain times of the year. The blisters cause intense itching and thickening of the skin after excessive scratching.

What is Kidney Stones?

A kidney stone, also known as a renal calculus (from the Latin rēnēs, "kidneys" and calculus, "pebble") is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine.

Urinary stones are typically classified by their location in the kidney (nephrolithiasis), ureter (ureterolithiasis), or bladder (cystolithiasis), or by their chemical composition (calcium-containing, struvite, uric acid, or other compounds). About 80% of those with kidney stones are men.

Kidney stones typically leave the body by passage in the urine stream, and many stones are formed and passed without causing symptoms. If stones grow to sufficient size (usually at least 3 millimeters (0.12 in)) they can cause obstruction of the ureter. Ureteral obstruction causes postrenal azotemia and hydronephrosis (distension and dilation of the renal pelvis and calyces), as well as spasm of the ureter. This leads to pain, most commonly felt in the flank (the area between the ribs and hip), lower abdomen, and groin (a condition called renal colic). Renal colic can be associated with nausea, vomiting, fever, blood in the urine, pus in the urine, and painful urination. Renal colic typically comes in waves lasting 20 to 60 minutes, beginning in the flank or lower back and often radiating to the groin or genitals. The diagnosis of kidney stones is made on the basis of information obtained from the history, physical examination, urinalysis, and radiographic studies. Ultrasound examination and blood tests may also aid in the diagnosis.

When a stone causes no symptoms, watchful waiting is a valid option. For symptomatic stones, pain control is usually the first measure, using medications such as nonsteroidal anti-inflammatory drugs or opioids. More severe cases may require surgical intervention. For example, some stones can be shattered into smaller fragments using extracorporeal shock wave lithotripsy. Some cases require more invasive forms of surgery. Examples of these are cystoscopic procedures such as laser lithotripsy or percutaneous techniques such as percutaneous nephrolithotomy. Sometimes, a tube (ureteral stent) may be placed in the ureter to bypass the obstruction and alleviate the symptoms, as well as to prevent ureteral stricture after ureteroscopic stone removal.

Sign and Symptoms

The hallmark of stones that obstruct the ureter or renal pelvis is excruciating, intermittent pain that radiates from the flank to the groin or to the genital area and inner thigh.This particular type of pain, known as renal colic, is often described as one of the strongest pain sensations known.Renal colic caused by kidney stones is commonly accompanied by urinary urgency, restlessness, hematuria, sweating, nausea, and vomiting. It typically comes in waves lasting 20 to 60 minutes caused by peristaltic contractions of the ureter as it attempts to expel the stone.The embryological link between the urinary tract, the genital system, and the gastrointestinal tract is the basis of the radiation of pain to the gonads, as well as the nausea and vomiting that are also common in urolithiasis.Postrenal azotemia and hydronephrosis can be observed following the obstruction of urine flow through one or both ureters.

What is Kidney Stones?

A kidney stone, also known as a renal calculus (from the Latin rēnēs, "kidneys" and calculus, "pebble") is a solid concretion or crystal aggregation formed in the kidneys from dietary minerals in the urine.

Urinary stones are typically classified by their location in the kidney (nephrolithiasis), ureter (ureterolithiasis), or bladder (cystolithiasis), or by their chemical composition (calcium-containing, struvite, uric acid, or other compounds). About 80% of those with kidney stones are men.

Kidney stones typically leave the body by passage in the urine stream, and many stones are formed and passed without causing symptoms. If stones grow to sufficient size (usually at least 3 millimeters (0.12 in)) they can cause obstruction of the ureter. Ureteral obstruction causes postrenal azotemia and hydronephrosis (distension and dilation of the renal pelvis and calyces), as well as spasm of the ureter. This leads to pain, most commonly felt in the flank (the area between the ribs and hip), lower abdomen, and groin (a condition called renal colic). Renal colic can be associated with nausea, vomiting, fever, blood in the urine, pus in the urine, and painful urination. Renal colic typically comes in waves lasting 20 to 60 minutes, beginning in the flank or lower back and often radiating to the groin or genitals. The diagnosis of kidney stones is made on the basis of information obtained from the history, physical examination, urinalysis, and radiographic studies. Ultrasound examination and blood tests may also aid in the diagnosis.

When a stone causes no symptoms, watchful waiting is a valid option. For symptomatic stones, pain control is usually the first measure, using medications such as nonsteroidal anti-inflammatory drugs or opioids. More severe cases may require surgical intervention. For example, some stones can be shattered into smaller fragments using extracorporeal shock wave lithotripsy. Some cases require more invasive forms of surgery. Examples of these are cystoscopic procedures such as laser lithotripsy or percutaneous techniques such as percutaneous nephrolithotomy. Sometimes, a tube (ureteral stent) may be placed in the ureter to bypass the obstruction and alleviate the symptoms, as well as to prevent ureteral stricture after ureteroscopic stone removal.

Sign and Symptoms

The hallmark of stones that obstruct the ureter or renal pelvis is excruciating, intermittent pain that radiates from the flank to the groin or to the genital area and inner thigh.This particular type of pain, known as renal colic, is often described as one of the strongest pain sensations known.Renal colic caused by kidney stones is commonly accompanied by urinary urgency, restlessness, hematuria, sweating, nausea, and vomiting. It typically comes in waves lasting 20 to 60 minutes caused by peristaltic contractions of the ureter as it attempts to expel the stone.The embryological link between the urinary tract, the genital system, and the gastrointestinal tract is the basis of the radiation of pain to the gonads, as well as the nausea and vomiting that are also common in urolithiasis.Postrenal azotemia and hydronephrosis can be observed following the obstruction of urine flow through one or both ureters.