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What is Insomnia?

Insomnia is a condition in which you have trouble falling or staying asleep. Some people with insomnia may fall asleep easily but wake up too soon. Other people may have the opposite problem, or they have trouble with both falling asleep and staying asleep. The end result is poor–quality sleep that doesn't leave you feeling refreshed when you wake up.


Types of Insomnia

There are two types of insomnia. The most common type is called secondary insomnia. More than 8 out of 10 people with insomnia are believed to have secondary insomnia. Secondary means that the insomnia is a symptom or a side–effect of some other problem. Some of the problems that can cause secondary insomnia include:

Certain illnesses, such as some heart and lung diseases
Pain, anxiety, and depression
Medicines that delay or disrupt sleep as a side–effect
Caffeine, tobacco, alcohol, and other substances that affect sleep
Another sleep disorder, such as restless legs syndrome; a poor sleep environment; or a change in sleep routine
In contrast, primary insomnia is not a side–effect of medicines or another medical problem. It is its own disorder, and generally persists for least 1 month or longer.


Posted on 12/1/2007 10:15:03 PM

Overview

Insomnia is a common health problem. It can cause excessive daytime sleepiness and a lack of energy. Long–term insomnia can cause you to feel depressed or irritable; have trouble paying attention, learning, and remembering; and not do your best on the job or at school. Insomnia also can limit the energy you have to spend with friends or family.

Insomnia can be mild to severe depending on how often it occurs and for how long. Chronic insomnia means having symptoms at least 3 nights per week for more than a month. Insomnia that lasts for less time is known as short–term or acute insomnia.


Outlook

Secondary insomnia often resolves or improves without treatment if you can eliminate its cause. This is especially true if the problem can be corrected soon after it starts. Better sleep habits and lifestyle changes often help relieve insomnia. You may need to see a doctor or sleep specialist to get the best relief for insomnia that is persistent or for which the cause of the sleep problem is unclear.


What Causes Insomnia?

Causes of Secondary Insomnia

Secondary insomnia is often a symptom of an emotional, neurological, or other medical disorder, or of another sleep disorder.

The emotional disorders that can cause secondary insomnia include depression, anxiety, and posttraumatic stress disorder. Alzheimer's disease and Parkinson's disease are examples of common neurological disorders that can cause secondary insomnia.

A number of other diseases and conditions can cause secondary insomnia, including:

Conditions that cause chronic pain, such as arthritis and headache disorders
Conditions that cause difficulty breathing, such as asthma or heart failure
Overactive thyroid
Gastrointestinal disorders, such as heartburn
Stroke
Sleep disorders, such as restless legs syndrome, also can cause secondary insomnia. In addition, secondary insomnia can be a side–effect of certain medicines or commonly used substances, including:

Caffeine or other stimulants
Tobacco or other products with nicotine
Alcohol or other sedatives
Certain asthma medicines (for example, theophylline) and some allergy and cold medicines
Beta blockers (medicines used to treat heart conditions)
Causes of Primary Insomnia

Primary insomnia is not due to another medical or emotional condition and typically occurs for periods of at least 1 month. Whether some people are born with a greater chance of having insomnia is not clear yet. A number of life changes can trigger primary insomnia, including:

Major or long–lasting stress and emotional upset
Travel or other factors such as work schedules that disrupt your sleep routine
Even after these causes go away, the insomnia might stay. Trouble sleeping may persist because of habits formed to deal with the lack of sleep. These habits include taking naps, worrying about sleep, or going to bed early.


Posted on 12/1/2007 10:16:48 PM

Who Is At Risk For Insomnia?

Insomnia is a common disorder. One in 3 adults occasionally has insomnia. One in 10 adults has chronic insomnia. Insomnia affects women more often than men, and it can occur at any age. However, older adults are more likely to have insomnia than younger people. People especially prone to insomnia include those who are:

Under a lot of stress
Depressed or who have other emotional distress
Working at night or having frequent major shifts in their work hours
Traveling long distances with time changes (jet lag)

What Are the Signs and Symptoms of Insomnia?

The main symptom of insomnia is trouble falling and/or staying asleep, which leads to lack of sleep. The lack of sleep can cause others symptoms, such as:

Waking up feeling tired or not well rested
Feeling tired or very sleepy during the day
Having trouble focusing on tasks
Feeling anxious, depressed, or irritable

How Is Insomnia Diagnosed?

Your doctor will usually diagnose insomnia based on your medical history, sleep history, a physical exam, and a sleep study if the cause of your insomnia is unclear.

Medical History

Your doctor will ask questions to find out whether there is a medical cause for your insomnia. These include questions about whether you:

Have any new or ongoing health problems
Have painful injuries or health conditions (such as arthritis)
Take any medicines (over–the–counter or prescription)

Posted on 12/1/2007 10:18:12 PM

What is pancreatitis?

Pancreatitis is an inflammation of the pancreas. The pancreas is a large gland behind the stomach and close to the duodenum. The duodenum is the upper part of the small intestine. The pancreas secretes digestive enzymes into the small intestine through a tube called the pancreatic duct. These enzymes help digest fats, proteins, and carbohydrates in food. The pancreas also releases the hormones insulin and glucagon into the bloodstream. These hormones help the body use the glucose it takes from food for energy.

Normally, digestive enzymes do not become active until they reach the small intestine, where they begin digesting food. But if these enzymes become active inside the pancreas, they start "digesting" the pancreas itself.



Acute pancreatitis occurs suddenly and lasts for a short period of time and usually resolves. Chronic pancreatitis does not resolve itself and results in a slow destruction of the pancreas. Either form can cause serious complications. In severe cases, bleeding, tissue damage, and infection may occur. Pseudocysts, accumulations of fluid and tissue debris, may also develop. And enzymes and toxins may enter the bloodstream, injuring the heart, lungs, and kidneys, or other organs.



Posted on 12/8/2007 10:10:52 PM

What are the causes of acute pancreatitis?

Some people have more than one attack and recover completely after each, but acute pancreatitis can be a severe, life–threatening illness with many complications. About 80,000 cases occur in the United States each year; some 20 percent of them are severe. Acute pancreatitis occurs more often in men than women.

Acute pancreatitis is usually caused by gallstones or by drinking too much alcohol, but these aren't the only causes. If alcohol use and gallstones are ruled out, other possible causes of pancreatitis should be carefully examined so that appropriate treatment—if available—can begin.


What are the symptoms of acute pancreatitis?

Acute pancreatitis usually begins with pain in the upper abdomen that may last for a few days. The pain may be severe and may become constant—just in the abdomen—or it may reach to the back and other areas. It may be sudden and intense or begin as a mild pain that gets worse when food is eaten. Someone with acute pancreatitis often looks and feels very sick. Other symptoms may include

swollen and tender abdomen
nausea
vomiting
fever
rapid pulse
Severe cases may cause dehydration and low blood pressure. The heart, lungs, or kidneys may fail. If bleeding occurs in the pancreas, shock and sometimes even death follow.


How is acute pancreatitis diagnosed?

Besides asking about a person's medical history and doing a physical exam, a doctor will order a blood test to diagnose acute pancreatitis. During acute attacks, the blood contains at least three times more amylase and lipase than usual. Amylase and lipase are digestive enzymes formed in the pancreas. Changes may also occur in blood levels of glucose, calcium, magnesium, sodium, potassium, and bicarbonate. After the pancreas improves, these levels usually return to normal.

A doctor may also order an abdominal ultrasound to look for gallstones and a CAT (computerized axial tomography) scan to look for inflammation or destruction of the pancreas. CAT scans are also useful in locating pseudocysts.


Posted on 12/8/2007 10:12:26 PM

Complications

Acute pancreatitis can cause breathing problems. Many people develop hypoxia, which means that cells and tissues are not receiving enough oxygen. Doctors treat hypoxia by giving oxygen through a face mask. Despite receiving oxygen, some people still experience lung failure and require a ventilator.

Sometimes a person cannot stop vomiting and needs to have a tube placed in the stomach to remove fluid and air. In mild cases, a person may not eat for 3 or 4 days and instead may receive fluids and pain relievers through an intravenous line.

If an infection develops, the doctor may prescribe antibiotics. Surgery may be needed for extensive infections. Surgery may also be necessary to find the source of bleeding, to rule out problems that resemble pancreatitis, or to remove severely damaged pancreatic tissue.

Acute pancreatitis can sometimes cause kidney failure. If your kidneys fail, you will need dialysis to help your kidneys remove wastes from your blood.


Posted on 12/8/2007 10:13:45 PM

Pancreatitis in children

Chronic pancreatitis is rare in children. Trauma to the pancreas and hereditary pancreatitis are two known causes of childhood pancreatitis. Children with cystic fibrosis, a progressive, disabling, and incurable lung disease, may also have pancreatitis. But more often the cause is not known.

Pancreatitis At A Glance
Pancreatitis begins when the digestive enzymes become active inside the pancreas and start "digesting" it.
Pancreatitis has two forms: acute and chronic
Common causes of pancreatitis are gallstones or alcohol abuse.
Sometimes no cause for pancreatitis can be found.
Symptoms of acute pancreatitis include pain in the abdomen, nausea, vomiting, fever, and a rapid pulse.
Treatment for acute pancreatitis can include intravenous fluids, oxygen, antibiotics, or surgery.
Acute pancreatitis becomes chronic when pancreatic tissue is destroyed and scarring develops.
Treatment for chronic pancreatitis includes easing the pain; eating a high–carbohydrate, low–fat diet; and taking enzyme supplements. Surgery is sometimes needed as well.

Posted on 12/8/2007 10:15:07 PM

What is Diabetes?
Diabetes is a life-long disease marked by high levels of sugar in the blood.


Causes and risk factors of Diabetes:
Diabetes can be caused by too little insulin (a hormone produced by the
pancreas to control blood sugar), resistance to insulin, or both.The lack of
insulin results in an inability to metabolize glucose, and the capacity to store
glycogen (a form of glucose) in the liver and the active transport of glucose
across cell membranes are impaired.

There are two distinct types of diabetes.

Insulin-dependent
Noninsulin-dependent
Insulin-dependent Diabetes
Insulin-dependent diabetes (Type I), also called juvenile-onset diabetes, is
the more serious form of the disease; about 10% of diabetics have this form.

Causes of Insulin-dependent Diabetes:
It is caused by destruction of pancreatic cells that make insulin and usually
develops before age 30. Type I diabetics have a genetic predisposition to the
disease. There is some evidence that it is triggered by a virus that changes the
pancreatic cells in a way that prompts the immune system to attack them.

Symptoms of Insulin-dependent Diabetes:
Increased thirst
Increased urination
Weight loss in spite of increased appetite
Fatigue
Nausea
Vomiting
Patients with type Insulin-dependent Diabetes usually develop symptoms
over a short period of time, and the condition is often diagnosed in an
emergency setting.

Treatment of Insulin-dependent Diabetes:
Treatment includes a diet limited in carbohydrates and saturated fat,
exercise to burn glucose, and regular insulin injections, sometimes administered
via a portable insulin pump. Transplantation of islet cells has also proved
somewhat successful since 1999, after new transplant procedures were developed,
but the number of pancreases available for extraction of the islet cells is far
smaller than the number of Type I diabetics. Patients receiving a transplant
must take immunosuppressive drugs to prevent rejection of the cells, and many
ultimately need to resume insulin injections, but despite that transplants
provide real benefits for some whose diabetes has become difficult to control.

No insulin-dependent diabetes
No insulin-dependent diabetes (Type 2), also called adult-onset diabetes,
results from the inability of the cells in the body to respond to insulin. About
90% of diabetics have this form, which is more prevalent in minorities and
usually occurs after age 40.

Causes of no insulin-dependent diabetes:
Although the cause is not completely understood, there is a genetic factor
and 90% of those affected are obese.

Symptoms of type insulin-dependent diabetes:
Increased thirst
Increased urination
Increased appetite
Fatigue
Nausea
Vomiting
Patients with insulin-dependent diabetes usually develop symptoms over a
short period of time, and the condition is often diagnosed in an emergency
setting.


Posted on 2/15/2008 12:14:33 AM

Treatment of insulin-dependent diabetes:
As in Type I diabetes, treatment includes exercise and weight loss and a diet
low in total carbohydrates and saturated fat. Some individuals require insulin
injections; many rely on oral drugs, such as sulphonylureas, metformin, acarbose,
or a dipeptidyl peptidase–IV (DPP-IV) inhibitor.

Signs and tests for insulin-dependent diabetes
A urine analysis may be used to look for glucose and ketones from the
breakdown of fat. However, a urine test alone does not diagnose diabetes. The
following blood glucose tests are used to diagnose diabetes:

Fasting blood glucose level — diabetes is diagnosed if higher than 126 mg/dL
on two occasions. Levels between 100 and 126 mg/dl are referred to as impaired
fasting glucose or pre-diabetes. These levels are considered to be risk factors
for type 2 diabetes and its complications.
Random (non-fasting) blood glucose level — diabetes is suspected if higher than
200 mg/dL and accompanied by the classic symptoms of increased thirst,
urination, and fatigue. (This test must be confirmed with a fasting blood
glucose test.)
Oral glucose tolerance test — diabetes is diagnosed if glucose level is higher
than 200 mg/dL after 2 hours (This test is used more for type 2 diabetes.)
You should also ask your doctor how often to you need your hemoglobin A1c
(HbA1c) level checked. The HbA1c is a measure of average blood glucose during
the previous 2 to 3 months. It is a very helpful way to determine how well
treatment is working.

Ketone testing is another test that is used in type 1 diabetes. Ketones are
produced by the breakdown of fat and muscle, and they are harmful at high
levels. The ketone test is done using a urine sample. High levels of blood
ketones may result in a serious condition called Treatment.

Self-Testing for diabetes
If you have diabetes, your doctor may tell you to regularly check your blood
sugar levels at home. There are a number of devices available, and they use only
a drop of blood. Self-monitoring tells you how well diet, medication, and
exercise are working together to control your diabetes and can help your doctor
prevent complications.


Posted on 2/15/2008 12:15:26 AM

informative stuff

Posted on 2/20/2008 12:30:13 PM

very informative

Posted on 2/23/2008 1:27:25 PM

nice topic
good going guys, well done!

Posted on 3/7/2008 5:54:31 AM


Posted on 3/14/2008 1:40:04 PM


Posted on 3/14/2008 9:56:51 PM

Fatty Liver (STEATOSIS)
--------------------------

Liver is the commonest site for accumulation of fat because it plays central role in the fat metabolism.

Fatty Changes may be Mild and reversible or severe producing irreversible cell injury and cell death.

--Causes (Etiology)--

1. Excessive consumption of Alcohol
2. Starvation
3. Malnutrition
4. Obesity
5. Diabetes Mellitus
6. Chronic illness
7. Late Pregnancy
8. Hypoxia
9. Hepatotoxins
10. Drugs
11. Reyes Syndrome

--Pathogenesis--

Depends upon the Stage at which the individual etiologic agent acts in Normal fat transport and metabolism

--Lipid Source--
1. From Diet as Chylomicrons (Triglycerides and Phospholipids) and Free Fatty Acids
2. From Adipose Tissue as Free Fatty Acids
3. From Acetate of Liver Cells
Most of the Fatty Acids is esterified into Triglycerides by Alpha Glycerophosphate and small part of Free Fatty Acid is Changed into Cholesterol, Phospholipds, Ketone Bodies.

Lipoproptien is the Form of Lipid excreted by Hepatocytes.

Fatty Liver occurs on excessive accumulation of Triglycerides which can occur by

1. Increased entry of Free Fatty Acids into Liver.
2. Increased synthesis of Free Fatty Acids by Liver.
3. Decreased conversion into Ketone Bodies thus, increased formation of Triglycerides.
4. Increased alpha glyceroPhosphate causing increased esterification of fatty acids to Triglycerides.
5. Decreased synthesis of Lipo Amino Protien - decreased formation of Lipoprotien from Triglycerides.
6. Block in excretion of Lipoprotien from the Liver into Plasma.

--Pathological Changes--

Gross -

1. Enlarged with a tense, glistening capsule and rounded margins
2. Cut surface bulges slightly and is pale yellow to yellow.
3. Greasy to tuch

-Microscopically -
1. Numerous lipid vacuoles in the cytoplasm of Hepatocytes.
2. Initially small and present around the nucleas which progress.
3. May contain Lymphocytes, Macrophages, multinucleated giant cells.

Demonstration by Frozen section followed by fat stains like

1. Sudan Dyes - Sudan III, Sudan IV, Sudan Black.
2. OilRed O
3. Osmic Acid

--Clinical Features of Fatty Liver--

1. Often no symptoms or Signs
2. Vague Abdominal symptoms of nausea, vomiting and Diarrhoea.
3. Chronic Liver Disease.

--Investigations--

1. Elevated MCV - Heavy Drinking
2. Liver Biochemistry - Mild Abnormalities with elevation of Serum Amino Transferase enzyme.
3. Gamma GT levels - Sensitive test to determine whether patient is taking Alcohol
4. Changes in All Liver Biochemical Parameters -
- Severe Fatty infiltration
- Determined by USG, CT Scan, Liver Histology

--Management and Prognosis--

-General Management-
- Advise to Stop drinking.
- Delerium Tremens (Give Diazepam)
- Intravenous Thiamine to prevent Wernick-Korsakoff' s Encephalopathy
- Bed Rest
- Protein Rich diet and Vitamins supplement.

Posted on 3/23/2008 8:23:15 PM

nice

Posted on 3/25/2008 1:33:58 PM


Posted on 3/26/2008 9:32:56 AM

GOOD INFO

Posted on 3/28/2008 12:50:31 PM

thanx guyz

Posted on 4/3/2008 5:31:15 AM

gud   


Posted on 4/6/2008 7:33:59 AM

Miss mine:
gud   



thx for reading

Posted on 4/6/2008 12:58:54 PM

more tasha

Posted on 4/7/2008 10:34:30 PM


Posted on 4/8/2008 8:58:44 AM

rapunzel:
more tasha


sure

will update soon

Posted on 4/8/2008 9:06:01 AM

sun_shine:


thx ss

Posted on 4/8/2008 9:06:25 AM

waiting...

Posted on 4/8/2008 12:31:04 PM

Most welcome

Posted on 4/9/2008 8:54:29 AM

"Excessive computer use 'threat to eyesight'"

Watching a computer screen for nine or more hours a day might be linked to a progressive eye disease that can blind without treatment, researchers warned yesterday.

The risk of developing glaucoma this way was highest for those with short sight, they said in a study which provided more bad news for male office workers and professionals.

They were told by New York eye specialists last year that wearing a tightly knotted tie could make the condition more likely.

The potential dangers of the booming use of new technology in the office and at home were outlined by researchers at the Toho University school of medicine in Tokyo, Japan, in the Journal of Epidemiology. They tested 10,000 workers with an average age of 43 as part of a general medical check-up as well as collecting their histories of computer use and eye disease.

Just over 5% had visual field abnormalities and there appeared to be a significant link between these and heavy computer use among those with long or short sight. But detailed eye tests revealed that a third of these had suspected glaucoma, and this was more obvious in those with myopia.

A link with short sight has already been established for glaucoma, a disease in which fluid cannot flow out of the eye because meshwork in the coloured part, the iris, has become blocked. Pressure then builds up, threatening damage to nerve fibres in the back of the eye and the optic nerve.

But the added ingredient of heavy computer use, while long debated as a possible risk factor for short sight, has not been studied for glaucoma, according to David Wright, chief executive of the International Glaucoma Association (IGA), who said the researchers "have provided a fascinating study that needs to be followed up".

About 2% of people over 40 develop glaucoma, which if diagnosed early can usually be treated with eyedrops. "Anyone over 40 should have regular, routine and comprehensive eye tests," said Mr Wright.

There were comparatively few women in the Japanese study because men comprise most of the workforce there. The researchers also said it was difficult to establish exactly who might have had a family history of glaucoma because it often went undiagnosed for a long time.

They suggested, however, that the optic nerve in myopic eyes might be much more susceptible to computer stress. "Computer stress is reaching higher levels than has ever been experienced before. In the next decade, therefore, it might be important for public health professionals to show more concern about myopia and visual field abnormalities in heavy computer users."

The type of chronic glaucoma that was a concern in the Japanese study is the most prevalent in Caucasian and African-Caribbean populations.

Close blood relatives of people who have glaucoma are at far higher risk, and the IGA says such people should be tested from the age of 35, rather than 40. For African-Caribbeans, for whom the risk is four times as high as whites, or for those with diabetes, testing should be done even earlier.

If the condition is advanced, or drops fail to reduce eye pressure, surgery might be needed to make an extra drainage channel in the white of the eye. Alternatively, laser treatment might be used to improve the flow of fluid through the meshwork around the iris.

Posted on 4/9/2008 12:37:07 PM

v nice info

Posted on 4/10/2008 1:25:14 PM

Thnx Dear

Posted on 4/10/2008 4:40:24 PM