Carpal Tunnel Syndrome – RTS for the Wrists

The carpal tunnel syndrome (CTS) is a condition where the median nerve is compressed in the carpal tunnel. The carpal tunnel is a narrow and rigid passage of bones and ligament, located at the base of the hand. When the median nerve becomes pinched or impinged, it will cause pain, tingling, weakness and numbness in the part of the hand that receives signals from it (mostly hand and fingers, but it might radiate into the forearm). The reason why a median nerve becomes compressed is the swelling of the tendons or the nerve in the wrist.

History of Carpal Tunnel Syndrome

Carpal Tunnel SyndromeThe incidents of carpal tunnel syndrome appeared in the surgical literature during the mid 19th century, with the first compression of the median nerve being mentioned in 1854 by Sir James Paget. The term “carpal tunnel syndrome” was first used in the year 1939 and its incidence started being more commonplace after World War II. The pathology was identified by Dr. George S. Phalen after working with patients in the 1950s and 1960s.


The symptoms start gradually, and include the following:

  • Frequent tingling, burning or itching numbness of the palm and the fingers (especially thumb, index and middle finger)
  • Swelling
  • Symptoms often appear during the night first, and may affect one or both hands
  • Decreased grip strength
  • Difficulty to form a fist or grasp small objects
  • Muscle dystrophy in severe and/or untreated cases

Causes of carpal tunnel syndrome

There is no single cause that triggers carpal tunnel syndrome; it is most often triggered by a combination of factors that increase the pressure on the tendons of the carpal tunnel and the median nerve. The most common causes include:

  • A congenital disposition – individuals who have a smaller carpal tunnel are more susceptible to the condition.
  • Trauma and injury to the wrist that cause swelling, such as a sprain or a fracture
  • Work stress – repeated use of vibrating hand tools
  • Fluid retention – during pregnancy or menopause
  • Development of a cyst/tumour in the canal
  • Rheumatoid arthritis
  • Diabetes

Treatment options

Carpal tunnel syndrome might resolve on its own without utilizing any treatment, but most of times, this isn’t the case. Treatment should begin as early as possible, under a constant doctor’s supervision. Initial treatment involves resting and avoiding activities that worsen the symptoms. Further damage is avoided by immobilization, and inflammation is treated with cold packs,

Various drugs can ease the pain and swelling. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used as pain relievers, and diuretics can reduce swelling. Corticosteroid injections are administered directly to the wrist and provide immediate (but temporary) relief to individuals who display mild or intermittent symptoms. Exercise and stretching has beneficial effects, but it should be done under the supervision of a physical therapist. Acupuncture and chiropractic care have been beneficial in some cases, but their effectiveness varies from person to person.

Should the symptoms last for more than six months, a surgery may be the only choice left. To reduce the pressure on the median nerve, a band of tissue around the wrist is severed. The surgery is done under local anaesthesia. The symptoms often disappear immediately after surgery, but full recovery might take months.


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Macular Degeneration – Symptoms and Causes

Macular degeneration is the gradual loss of vision in the central visual field due to the breakdown of cells that make up the macula. The macula is a small area at the center of your retina that is responsible for clear vision, particularly in your direct line of sight. Macular degeneration is the major cause of visual impairment in adults above 50 years old.

macular degenerationThere are two types of macular degeneration: dry and wet. The less severe type, dry macular degeneration, occurs when the retinal pigment epithelial layer under the retina wastes away, which results in loss of vision through the loss of photoreceptors (rods and cones) in the central part of the eye. Cellular debris called drusen, accumulates in the eye. Drusen is the key to identifying the dry type.

Wet macular degeneration is the more severe type of MD. It occurs when there is an abnormal growth of blood vessels which leads to the loss of vision. Wet macular degeneration usually progresses from the dry type. However, only 10% of patients with macular degeneration have the wet type.

Symptoms of Macular Degeneration
Macular degeneration symptoms develop gradually. The condition may affect one eye or both eyes. This condition is not painful at all and this condition may be undiagnosed for some time. If only one eye is affected, visual changes are unnoticeable because the good eye compensates for the weak one.

  • You need more bright light when you read or work with objects that you need to look at close range.
  • Your eyes find it more and more difficult to adjust to low light levels.
  • Your overall vision is becoming increasingly hazy.
  • There is a blind spot or a distortion at the center of your visual field.
  • Colors become less intense and bright.
  • Straight lines appear to be distorted.
  • Printed words become increasingly blurred.
  • You find it hard to recognize faces.

What Causes Macular Degeneration?
The exact cause of macular degeneration is unknown, but there are factors that put you at risk for the condition. The following is a list of predisposing factors for macular degeneration:

  • Age: Macular degeneration mostly affects people over the age of 50. The older you are, the higher your risk for MD.
  • Gender: Women are at a higher risk than men for MD.
  • Heredity: If one of your family members had macular degeneration, you are more likely to develop MD.
  • Race: Macular degeneration affects more Caucasians than people of other races.
  • Diet: If you do not eat enough fruits and vegetables or your diet is filled with crap, you are putting yourself at a greater risk for MD.

Other risk factors include smoking, obesity, hypertension, elevated blood cholesterol level and early menopause.

What to Do When You Have Macular Degeneration
You should immediately let your ophthalmologist know when you notice any changes in your vision especially when these changes are consistent with the symptoms of MD. Unfortunately, there is no treatment available to reverse MD. Treatment only delays visual deterioration. It cannot restore vision. However, MD often progresses slowly. Annual eye exams may be necessary to see how the condition is progressing.

You may also have to make some dietary changes. Including fruits and vegetables in your diet will contribute to your eye health. Colorful fruits and vegetables have antioxidants that prevent cell damage. Healthy unsaturated fats, such as olive and palm oil, may reduce the risk of vision loss. Omega-3 fatty acids found in fish such as salmon, sardines and tuna may help protect your eyesight. Be sure to avoid smoking and manage your weight by eating a healthy diet and getting enough exercise.

Aids For Macular Degeneration
Macular degeneration is not life-threatening. However, it does threaten to reduce your quality of life. This condition affects your central vision which you need for common daily tasks such as reading and driving. Fortunately, there are some vision aids for macular degeneration that can help you function to the best of your ability and maintain your independence. Here are some aids for Macular Degeneration that can help improve your quality of life:

  • Macular Degeneration Magnifiers – As macular degeneration progresses, the need for magnification increases. When choosing a magnifier, you need to choose the right power for your eyesight and consider the tasks that you need to do. The focal length is also important. Remember, the closer the magnifier is to the object, the greater the magnification. Magnifiers come in different types such as pocket magnifiers, reading magnifiers, 5 diopter floor lamp magnifiers, electronic magnifiers and many more.
  • JORDY glasses (Joint Optic Reflective Display) – JORDY glasses are goggles that allow you to see at any distance and in any visual conditions. These glasses can magnify up to 50 times the original size.
  • Low Vision Lighting – The lighting needs also increase as macular degeneration progresses. That means you will need more lamps and brighter bulbs at home. However, the light from a standard light bulb is usually not bright enough to help you see objects in clearer detail. Luckily, there are types of lighting that are well-suited for patients with MD.
  • One type of lighting that works best with patients with macular degeneration is Ott lighting. Ott lighting simulates natural light, enhances contrast and reduces glare helping you see things more clearly. Aside from Ott lighting, you can also use magnifying lamps. Just be sure to read reviews, as there’s loads of types and styles . This lamp increases your area of vision and gives you the brightness and magnification that you need.
  • Computer Screen Magnifier – Computer magnifiers are easy to attach to your computer screen. They usually offer features such as full screen magnification and anti-reflective coating for sharper images. It is a must if you do not want to give up using your computer and surfing the Internet despite having MD.
  • Low Vision CCTV (closed circuit television) – Low Vision CCTV is a device that uses a camera and a monitor to magnify objects. This is for people who have moderate to severe vision loss. To use this device, you place the object under the camera and view it on the screen at a desired level of magnification. Some low vision CCTVs even have mirrors so you can shave better or put on your makeup without any problem at all.
  • Electronic reading devices – When you suffer from MD, it does not mean that you have to give up reading the books you love or to miss out on the new bestsellers from your favorite authors. There are reading devices that scan printed text and convert it to speech.
  • Amazon Kindle is a good electronic reading device for those who suffer from MD. Not only does the Kindle offer a text-to-speech conversion feature, it also offers options for font magnification and contrast. The screen rotates to landscape. It is portable, light weight and easy to use.

Macular degeneration is a progressive, irreversible loss of vision that could lead to blindness. However, you need not despair if you suffer from MD. There are treatments that can significantly slow down the deterioration of your eyesight. With dietary and lifestyle adjustments and with the right vision aids for macular degeneration, it is possible for you to live a relatively normal and productive life.

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Diabetes – The Curse of the Sweet Tooth?

Diabetes mellitus is also known as diabetes. It’s a group of metabolic diseases where there are high blood sugar levels over a long period of time. Diabetes happens because the pancreas doesn’t produce enough insulin or the body’s cells do not respond to the insulin that is produced. There are three types of diabetes: Type 1, where the body doesn’t produce enough insulin, Type 2, with insulin resistance and a lack of insulin possibly developing later, and gestational diabetes, which happens when pregnant women develop a high blood glucose level. 387 million people have diabetes in the world as of 2014, about 8.3% of the population. That number is expected to raise to 592 million by 2035. The economic cost globally has been estimated at $612 billion. Diabetes can be prevented to some degree with exercise, a healthy diet, avoiding rich foods, and not using tobacco while remaining at a normal body weight.

History of Diabetes

Diabetes was among the first diseases ever described. An Egyptian manuscript dated from 1500 BCE mentioned too much urinating as a symptom and the first cases described are thought to be diabetes. Indian doctors identified the disease and called it “honey urine” because the urine would attract ants. Diabetes means to pass through, first used in 230 BCE by Appollonius of Memphis, a Greek. Aretaeus of Cappadocia in the 2nd or 3rd century CE described the symptoms and course of the disease. He thought there might be a correlation of diabetes with other diseases.

Indian physicians Sushruta and Charaka identified type 1 and 2 diabetes as different conditions in the year 400-500 CE. Type 1 was attributed to youth and Type 2 due to being overweight. Diabetes mellitus(mellitus meaning “from honey” was added in the late 1700s by Briton John Rolle to distinguish the condition from diabetes insipidus. Effective treatment was developed when Frederick Banting and Charles Herbert Best of Canada isolated as well as purified insulin in 1921 and 1922, with long-acting insulin NPH developed in the 1940s.

Symptoms of Diabetes

  • Frequent urination
  • Increased thirst and hunger
  • Weight loss
  • Diabetic ketoacidosis
  • Nonketoic hyperosmolar coma
  • Cardiovascular disease
  • Stroke
  • Kidney failure
  • Foot ulcers
  • Eye damage
  • Blurry vision
  • Headache
  • Fatigue
  • Slow wound healing
  • Itchy skin
  • Skin rashes

Causes of Diabetes

Scientists do not know what causes the immune system to attack beta cells but believe that other factors are involved, having to do with autoimmune, environmental, and genetic. Type 1 diabetes makes up about 5-10% of diagnosed cases in the United States and appears in children and young adults most commonly. Type 1 diabetes is caused by the body’s immune system destroying its beta cells in the islet tissue area of the pancreas. Since the beta cells produce the insulin, people with this type of diabetes cannot make their own insulin. Diabetes 2 can be caused by excess weight, a high body weight, obesity, eating junk food, and not exercising enough.

Diabetes can also be caused by high or low blood sugar.

Causes of high blood sugar:

  • Not enough insulin
  • Eating too much food
  • Stress
  • Being sick
  • Taking blood sugar raising medicines
  • Somogyi effect, early morning high blood sugar
  • Adolescence
  • Pregnancy

Causes of low blood sugar:

  • Too much insulin
  • Skipping meals or snacks
  • Exercising without eating enough
  • Too much alcohol
  • Blood sugar lowering medications
  • Menstrual period

Treatment for Diabetes

Diabetes must first be diagnosed, so consult your doctor. He will probably use a fasting plasma glucose test but a diagnosis can be made from various tests, including an oral glucose tolerance test. Treatment can include taking insulin, a healthy lifestyle, medications, and possibly a pancreas transplant for serious Type 1 diabetes patients.

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Too Much Rich Food? Read this NOW

Gout is a medical condition that features recurring attacks of acute inflammatory arthritis. It is also known by the term podagra when involving the big toe. The most commonly affected in half the cases is the phalangeal joint, at the big toe’s base. Gout can also show up in the body as cases of kidney stones, topi, or urate nephropathy. It has become increasingly common and has affected up to 2% of the population in the West. This is due to increasing risk factors, diet changes, longer overall life expectancy and metabolic syndrome.

History of Gout

Gout used to be known as “rich man’s disease” and the “disease of kings”. It comes from the Latin word “gutta”, which means a drop of liquid. Gout was first used around 1200 A.D. By Randolphus of Bocking. It has been known since antiquity and the first documenting of gout was in Egypt, in 2600 B.C. To describe arthritis in the big toe. Hippocrates mentioned gout in his book Aphorisms, describing how it was absent in premenopausal women and eunuchs. In 30 A.D., Aulus Cornelius Celsus wrote about the connection of gout with kidney problems, alcohol, and setting on later in women. The English physician Thomas Sydenham in 1683 described how gout would occur in older males and in the early morning hours, and Antonie van Leeuwenhoek, a Dutch scientist, described the appearance of urate crystals in 1679. Gout was realized to be caused by an excess of uric acid in the blood by English physician Alfred Baring Garrod, in 1848.

Symptoms of Gout

  • Attacks of inflammatory arthritis
  • Joint pain that lasts for two to four hours or overnight
  • Fatigue
  • Fever
  • Chronic arthritis due to bone erosion from too much tophi(hard deposits of uric acid crystals)
  • Stone formation or urate nephropathy due to elevated uric acid levels
  • Elevated uric acid levels
  • Warmth, swelling, pain, extreme tenderness in a joint
  • Red or purple skin around affected joint
  • Joint gives appearance of being infected
  • Limited movement for affected joint
  • Itching, peeling skin as gout gets better

Causes of Gout

Gout footGout is caused by having elevated levels of uric acid in the blood. When the uric acid crystallizes, the crystals go on to deposit in the joints, the tendons, and tissues. Crystals in the joint fluid confirms a case of gout. The crystallization is the cause of gout, but the crystallization can be caused by lifestyle, diet, a genetic predisposition, lead, or not enough urate, uric acid salts being excreted. Diet is responsible for over a tenth of gout cases. Diets that include drinks sweetened with fructose, alcohol, meat, and seafood are all not good for gout. Physical trauma and surgery may also cause gout.

Gout also commonly occurs in combination with medical problems. These can be metabolic syndrome, polycythemia, renal failure, lead poisoning, psoriasis, hemolytic anemia, and organ transplants. Having a body mass index that is greater or equal to 35 can increase a risk of gout for a male three times. Lead contaminated alcohol and chronic lead exposure can be increase risk for gout, as can Lesch-Nyhansyndrome. Diuretics may also increase risk for gout, as can niacin, aspirin, immunosuppressive drugs such as ciclosporin and tacrolimus.

Treatment for Gout

Gout is diagnosed by a doctor frequently using blood and urine tests. Fluid may be drawn from the suspected joint that is affected to see if the crystals associated with gout are present. X-rays can also be used to confirm chronic or long term gout.

Treatments for gout can include nonsteroidal anti-inflammatory drugs, colchicine, or steroids. Lifestyle changes can lower levels of uric acids, febuxostat, and allopurinol or the drug probenecid can give you long term prevention. Other health problems being treated are also important, and lowering the levels of uric acid in your body can cure gout. Pegloticase is a drug that is used to treat gout that is an option for the rare person that is intolerant to other prescribed medications. Prophylaxis are also prescribed to treat goat and tea has been proven to help, too.

Your doctor may advise cutting down on alcohol, beer, spinach, fatty fish, asparagus, shellfish, anchovies, organ meats, dried beans, and red meats. Drinking liquids may be advised, as well as losing weight for the morbidly obese.

New medications are being studied for their potential to treat gout. These include anakinra, canakinumab, and rilonacept. Canakinumab costs up to five thousand times more what a steroid would. Rasburicase is a recombinant uricase enzyme that is available but causes an autoimmune response. Other, less antigenic versions, are currently being developed.

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