avicennahealth

Frequent Urination - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 21 Feb 2022 03:15:03 GMT

Definition of the illness

Frequent urination is the need to urinate many times during the day, 24-hour period, or only small amounts, and may occur both day and night.

This is a symptom of many conditions and can have multiple choices to treat.

İt is expected at some point in life, like during pregnancy, so that pregnant women may need to pee more frequently, and it usually stops after birth. However, frequent urination can be due to other health issues that are not normal parts of life and do not fade over time. It can be because of diabetes, overactive bladder syndrome, UTIs, or prostate problems.

However, this condition can affect work, sleep, and general well-being.

Symptoms

Fever
Chills
Uncontrollable bladder
Needing to urinate more than normal
Pain or burning when urinating
Strong-smelling urine
Pelvic pain
Blood in the urine

Causes

Frequent urination may be due to diseases related to the urinary tract.

The urinary tract includes:

Kidneys
Ureteral: two tubes link the kidneys to the bladder the bladder
Urethra: normally, urine flows through it from the bladder out of the body

So several factors may be linked to frequent urination, such as:

Diabetes: is often an early symptom of type 1 and type two diabetes because the body has to get rid of extra glucose by urination.
Pregnancy: Usually, during the early weeks of pregnancy, the bladder gets squished as the baby grows and takes more space inside the body, so frequent urination is a prevalent and typical pregnancy symptom.
Prostate enlargement: the prostate is a gland that makes some of the liquid of ejaculation.
The prostate grows as men get older, but it can cause issues if it gets too large because it places pressure on the urinary system and causes frequent urination.
Interstitial cystitis
Medications: Diuretics that are used to treat high blood pressure and flush excess fluid from the body.
Hypercalcemia: means that the calcium levels in the blood increased
Neurological diseases: like stroke because the damage to nerves that supply the bladder can lead to problems with bladder function
Pelvic organ prolapse in females
Bladder cancer
Ovarian cancer
Bladder dysfunction
Radiation therapy

Risk factors

These are some points that could be risk factors for people to get frequent urination:

Infection, disease, injury, or irritation of the bladder.
Diseases that increase urine production.
Changes in muscles, nerves or other tissues affect bladder function.
Cancer treatment
Drugs that increase urine production

When to see a doctor

You should see a doctor if you are urinating more frequently than usual. In other words, If you feel the need to pee more than four to eight times in one day, and there is no apparent cause, such as drinking more total fluids, alcohol, or caffeine.

Also, if it affects sleep or everyday activities.

However, see the doctor immediately if you have frequent urination along with any of these signs or symptoms:

Blood in urine
Red or dark brown urine
Painful urination
Pain in the groin, lower abdomen, back, or towards the sides
Difficulty urinating
A strong urge to urinate
Loss of bladder control
Fever
Vomiting
Discharge from the vagina or the penis

Diagnosis

To diagnose this condition, the doctor will need a physical exam and a medical history.

In addition, the doctor may order tests, including:

Blood Tests: to check the kidney function, electrolytes, and blood sugars.
Urinalysis: to detect and measure various compounds that pass through the urine.
Cystometry: to measures the pressure inside of the bladder to see how well the bladder is working
Neurological Tests: to detect any nerve disorder
Ultrasonography

Management

Monitoring fluid food intake: You should drink enough but avoid drinking just before bedtime to prevent nighttime urination.

Diet modification: You should avoid food that irritates the bladder or acts as a diuretic.

These may include caffeine, alcohol, carbonated drinks, tomato-based products, chocolate, artificial sweeteners, and spicy foods.

Kegel exercises: to make the muscles around the bladder and urethra stronger

Differential diagnosis

Benign Prostatic Hyperplasia
Bladder Cancer
Chronic Bacterial Prostatitis
Bladder Infection
Prostate Cancer
Simple Prostatectomy
Urinary Tract Infection
Pregnancy
Urinary Tract Obstruction
Uterine Prolapse
Vesicovaginal Fistula

References

Web med
Mayoclinic
Pubmed
Healthline

Hair Loss - Symptoms, Causes, and Treatment - Avicenna Health

Sun, 20 Feb 2022 03:15:03 GMT

Hair Loss

Hair loss may affect only the scalp or the whole body. Also, it could be temporary or permanent. Heredity, hormonal changes, and medical conditions could lead to hair loss.

Everyone can lose hair on the head, but it is spreading more in men.

However, treatment may help with some cases of hair loss.

Symptoms

Gradual thinning on top of head: This is the most common type, whichhappens among people as they age.
Circular or patchy bald spots: it could affect the scalp, beard, or eyebrows.
Full-body hair loss: Some diseases and medical treatments, like chemotherapy used in cancer, can cause loss of hair whole the body, but the hair mostly return.
Patches of scaling: are a sign of ringworm that may happen along with broken hair, redness, swelling, and, at times, oozing.
Sudden loosening of hair: After the physical or emotional shock, many people risk hair loss.

Causes

Everyone loses hair in the usual case, but between 50 and 100 hairs per day.

Also, many causes lead to hair loss.

Age: hair growth slows with age because hair follicles stop growing hair
Hereditary: Both genders develop this type of hair loss, the most common cause of hair loss worldwide. Men get male pattern hair loss, and Women get female pattern hair loss. Regardless of whether it develops in a man or a woman, the medical term is androgenic alopecia.
weight loss
stress
iron deficiency
cancer treatment

Risk factors

Family history
Age
Poor nutrition
Significant weight loss
Stress

When to see a doctor

If you have persistent hair loss, you should see a doctor and want to pursue treatment. For women experiencing a receding hairline, you should talk with a doctor about early treatment to avoid significant permanent baldness.

Diagnosis

There are many procedures to diagnose the case:

Blood test: This might reveal any disease that can cause hair loss.
Pull test: the doctor gently pulls several dozen hairs to see how many come out.
Scalp biopsy: the doctor scrapes samples from the skin or hairs to examine the hair roots under a microscope, so this can help determine whether an infection is causing hair loss.
Light microscopy: using a unique instrument to examine hairs trimmed at their bases.

Management

Usually, hair loss does not need treatment and is temporary, so it grows back or regular part of getting older.

Hair loss caused by disease usually stops or grows back after recovery.

However, Finasteride and Minoxidil are the most common treatments for male pattern baldness.

Moreover, Minoxidil can also be used to treat female pattern baldness.

Also, Women should not use finasteride.

Differential diagnosis

Thyroid disease
Alopecia areata
Scalp infections

References

Mayoclinic
Medscape
Healthline
AAD
NHS

Cough - Symptoms, Causes, and Treatment - Avicenna Health

Sat, 19 Feb 2022 03:15:03 GMT

Cough

Patient History:

Have you ever suffered from a chronic cough that never goes away?

Do you often think about the reason behind this bothering condition?

Have you ever been wondering what kind of drugs you should take? Or what type of treatments can help you relieve the cough?

If you have ever been asking yourself one of these questions, you should go ahead and read our new article about the cough.

Definition of cough:

Cough: is a normal reflex that helps clear your airway. It is often a response to irritating.

Coughing also helps dispose of phlegm and other substances that may block your airway and keep you from breathing.

However, it may often be a primary symptom of pulmonary, cardiac, or even digestive tract disease like gastroesophageal reflux disease (GERD), as an example.

How much time does it last?

A cough is often classified into one of three categories:

A cute cough: lasts about three weeks.
Subacute cough: often lasts between 3 to 8 weeks.
Chronic cough: usually lasts more than eight weeks.

Accompanied Symptoms:

There is a wide range of symptoms that can be accompanied by cough like:

Runny or stuffy nose, especially in flu or common cold
Sore throat
Postnasal drip
Hoarseness
Difficulty breathing
The cough itself may be productive; its product can be green, yellow, or bloody
Wheezing
Fever
Fatigue
Heartburn which often refers to gastroesophageal reflux disease (GERD)
Congestion with Swollen or watery eyes can refer to an allergic condition

Causes:

Conditions that are related to the respiratory tract are most common (especially respiratory infections), such as:

Common cold
Asthma
Chronic obstructive pulmonary disease (COPD)
Bronchitis or bronchiolitis
Covid-19
Pneumonia
Sinusitis
Sarcoidosis
Tuberculosis

Other causes that are related to cardiac or digestive tract diseases are less common, but they should be put into consideration, like:

Congestive heart failure (CHF)
Gastroesophageal reflux disease (GERD)

Other causes may include medications' side effects such as angiotensin-converting enzyme inhibitors (ACE-I) and irritants like smoking and perfumes.

When to see a doctor?

You may need to call a doctor if your cough does not get better after three weeks or even worsen.

Other accompanying signs and symptoms that require a medical consultation include:

Wheezing
Difficulty breathing
Chest pain
Coughing up blood
Coughing up green, yellow or bloody phlegm
Heartburn
Swollen neck
Weight loss
Fever

And, of course, if you have a cough that keeps you from sleeping.

Diagnosis:

The patient's history and good physical exams are essential for heading into a proper diagnosis.

Cough causes are widely ranged so that there are so many tests that can be performed to confirm the diagnosis.

Blood tests are often required routinely, while imaging procedures like x-ray or CT scans may be necessary if the doctor suspects a respiratory tract disease like pneumonia as an example.

Sputum tests can also play an essential role if the leading cause is an infection.

Other tests may be needed:

Allergy tests
Lung function tests
Acid reflux tests (PH)

Management:

The most crucial step toward healing is having the correct diagnosis.

And, of course, good management is by treating the cause, not the symptom. So a doctor often has a lot of treatment plans depending on the grounds, for example:

respiratory tract infection may need prescribed antibiotics
gastroesophageal reflux disease (GERD) patients are often given proton pump inhibitors (PPIs)
allergic condition may only need to avoid the triggers, while some patients may feel better by using antihistamines drugs
drugs-induced cough may require stopping the drug or using an alternative one with fewer side effects.
Inhaled bronchodilator for asthma cases can help you feel better

The healing process may take time, so patients may ask to be given relievers to help them hold against the cough.

In this case, home remedies like drinking hot fluids or having a honey spoon may help relieve the condition.

Over-the-counter medications, whether it was syrup or tablets, also can comfort the patient.

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

mayoclinic.org
webmd.com
medscape.com
nhs.uk
medlineplus.gov
emedicinehealth.com
osteopathy.colganosteo.com

Wheezing - Symptoms, Causes, and Treatment - Avicenna Health

Fri, 18 Feb 2022 03:15:03 GMT

Wheezing

Patient History:

Have you ever heard a whistling sound come off your or your baby's chest?

Have you ever felt worried or get panic from this sound?

Do you wonder if you should consult a doctor every time you hear it?

Go ahead and answer all of your questions by reading our new article about wheezing.

Definition of wheezing:

Wheezing: is a whistling sound that occurs during breathing; it is usually caused by narrowed airways and is most apparent when exhaling (breath out)

Wheezing is a symptom that indicates respiratory tract problems most often like asthma, allergy, and others.

How much time does it last?

The persistence of wheezing depends on the continuation of the causing disease itself.

For example: if the leading cause is an allergic response, wheezing can improve as soon as you stop the exposure to the allergen.

If the leading cause is respiratory tract disease, wheezing often improves by managing the disease itself.

Accompanied signs and Symptoms:

A variety of symptoms can be accompanied by wheezing, such as:

Fever
Difficulty breathing
Chest pain
Rapid breathing
Swollen lips or tongue
Bluish face or skin
Cough
Dizziness
Fatigue

Causes:

Asthma and chronic obstructive pulmonary disease (COPD) are the most common causes of wheezing, but other respiratory and cardiac causes should be put into consideration, like:

Allergies and severe allergic reactions like anaphylaxis
Bronchitis and bronchiolitis
Pneumonia
Obstructive sleep apnea (OSA)
Smoking
Vocal cord dysfunction
Lung cancer
Cystic fibrosis
Pulmonary edema
Heart failure
Heart defects
Heart myopathies
Some kind of medication like aspirin in addition to penicillin allergy
Gastroesophageal reflux disease (GERD)

When to see a doctor?

Wheezing can sometimes indicate a severe problem so that it requires a medical consultation most of the time.

Accompanying signs and symptoms that indicate a severe problem:

- Difficulty breathing

- Rapid breathing

- Bluish face and skin

- Swollen lips or tongue

Call 911 if:

You think your wheezing is caused by an allergic reaction to an insect bite or medication.
Your wheezing occurs suddenly
You cannot get enough air
Your wheezing occurs after chocking on a small foreign body

Diagnosis:

Physical exams are the most important to determine wheezing.

A doctor often uses a stethoscope to hear the whistling sound if it is not well-heard by ears.

However, the patient's medical history is also essential to guide for possible diagnosis.

Blood tests are often required routinely, while imaging procedures like x-ray or CT-scan may be done to roll out some cases like pneumonia, bronchitis, masses, or foreign bodies that may block your airways.

Lung functions tests are sometimes performed to assess the lungs' health.

Management:

As we have mentioned before, wheezing can be a symptom of many lung diseases. And to manage this symptom, you need to control the causing disease itself.

Asthma is an example that can be managed under the supervision of a doctor by using a bronchodilator or inhaled corticosteroids.

On the other hand, Bronchitis is often managed by prescribed antibiotics for bacterial infection cases and bronchodilator in other cases.

Home remedies like drinking hot fluid or using a humidifier to keep the air moist, in addition to avoiding smoking, can help relieve the condition.

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

mayoclinic.org
webmd.com
medscape.com
medlineplus.gov
healthline.com
clevelandclinic.org

Vaginal Bleeding - Symptoms, Causes, and Treatment - Avicenna Health

Thu, 17 Feb 2022 03:15:03 GMT

Vaginal bleeding

Vaginal bleeding is any bleeding unrelated to the period. This type of bleeding may include spotting small amounts of blood between periods when it is not expected, such as before age 9, during pregnancy, or after menopause.

Symptoms

1- Spotting or vaginal bleeding between periods.

2- Spotting or bleeding after a sexual relationship.

3- Spotting or bleeding after menopause (when there are no more periods).

4- Menstrual periods that last longer than seven days.

5- Soaking a tampon or pad in one hour or less during the period.

Causes

1- Cancers and precancerous conditions: cervical cancer, endometrialcancer, endometrial hyperplasia, ovarian cancer, uterine sarcoma, and vaginal cancer.

2- Endocrine system factors: such as Hyperthyroidism (overactive thyroid), hypothyroidism (underactive thyroid), Polycystic ovary syndrome (PCOS), and Stopping or changing birth control pills or menopausal hormone therapy. In other words, the level of the excess hormones may cause changes in the lining of the uterus.

3- Fertility and reproduction factors: include Ectopic pregnancy, abnormal hormone levels, Miscarriage before the 20th week of pregnancy, Pregnancy, Random ovulatory cycles, Sexual relationship, Perimenopause, and Vaginal atrophy

4- Infections: many infections affect the uterus, fallopian tubes, or ovaries, which can cause abnormal bleeding such as, Cervicitis, Chlamydia trachomatis, endometritis, Gonorrhea, Pelvic inflammatory disease, ureaplasma vaginitis, and Vaginitis.

5- Medical conditions: Some diseases lead to bleed including Celiac disease, kidney or liver disease, Thrombocytopenia, and Von Willebrand disease.

6- Medications and devices: many women may have bleeding due to forgotten tampons, Intrauterine device, Stopping or changing birth control pills, and Tamoxifen side effects.

7- Noncancerous growths and other uterine conditions: however, some cases could cause bleeding like Adenomyosis, Cervical polyps, endometrial polyps, uterine fibroids, and uterine polyps.

8- Trauma: Blunt trauma or penetrating injury to the vagina or cervix, and Sexual abuse.

Risk factors

Age >40 years.
Obesity.
PCOS.
Diabetes mellitus.
Nulliparity.
Early menarche or late menopause
Hypertension.
Chronic anovulation or infertility

When to see a doctor

You may need to see a doctor as soon as you have the following symptoms:

Pain in the lower abdomen
Fever
Any vaginal bleeding, including spotting

Diagnosis

The diagnosis is to determine the cause of abnormal bleeding, so the doctor will need a physical exam, including a generally pelvic exam, and may perform one or more of the following:

Blood tests
Hormonal tests
Tests for sexually transmitted diseases
A pregnancy test
Thyroid function tests
Ultrasound of the pelvis
Endometrial biopsy
Hysteroscopy
Pelvic MRI
Transvaginal ultrasound

Management

The best treatment is to treat vaginal bleeding first with medications. If these do not work, surgery may be the next option.

Medications

1- Hormonal birth control methods (pills, or vaginal ring): it helps periods become more regular.

2- Intrauterine device (IUD)

3- Gonadotropin-releasing agonists: include (medications that reduce the release of gonadotropin to stop the menstrual flow and reduce the size of fibroids.

4- Tranexamic acid

5- Non-steroidal anti-inflammatory drugs (NSAIDs): such as ibuprofen to control heavy bleeding.

Surgery

1- endometrial ablation

2- Hysterectomy

3- Myomectomy

4- uterine artery embolization

Differential diagnosis

malignant tumors
missed abortion
ectopic pregnancy
trophoblastic disease
placental polyp
infection such as endometritis

References

Mayoclinic
Web med
Radiology info
Cleveland clinic

Vaginal Discharge - Symptoms, Causes, and Treatment - Avicenna Health

Wed, 16 Feb 2022 03:15:03 GMT

Vaginal discharge

The Definition

Vaginal discharge is a mixture of both fluid and mucus shed through the vagina.

Normal vaginal discharge keeps vaginal tissues healthy and protects girls and women from infection.

However, the amount and color of vaginal discharge depend on the stage of the menstrual cycle.

Symptoms

Vaginal discharge usually is clear or milky and does not have a bad smell.

Usually, the color and thickness of the discharge change depending on the menstrual cycle.

The discharge is thicker when ovulating, breastfeeding, using birth control, and When the women are sexually active.

Causes

_ Antibiotic or steroid use

_ Bacterial vaginosis, especially in pregnant women

_ Birth control pills

_ Cervical cancer

_ Sexually transmitted diseases

_ Diabetic Mellitus

_ Douches, scented soaps or lotions, bubble bath

_ Pelvic infection after surgical procedure

_ Pelvic inflammatory disease

_ Trichomoniasis

_ Vaginitis, irritation in or around the vagina

_ Yeast infections

_ Pregnancy

Risk factors

_ Trichomonas vaginalis infection: This contamination entails the liner of the vagina’s membrane, in addition to the cervix.

_ Candida albicans infection: Causes intense itching with inside the vagina and creates a thick white vaginal discharge.

When to see a doctor

You should see a doctor if:

Your vaginal discharge changes color or smell
You turn out much discharge than usual
You are feeling restless or sore
You bleed between periods or once sex
You get pain when urination
You get pain within the space between your tummy and thighs

Diagnosis

The doctor will start asking about symptoms that may include:

When did the abnormal discharge start?
What color is the discharge appear?
Is there any specific smell?
Do you usually have any itching, pain, or burning?
Do you have more than one sexual partner?
Do you douche or apply perfume inside the vagina?

In addition, the doctor may take a sample of the discharge or do a Pap test by using cells from the cervix and send it to the lab for further examination.

Management

There are many management protocols related to the causes of vaginal discharge.

So here, we have some treatment programs:

Bacterial vaginosis is treated with antibiotic medicine.
Trichomoniasis is generally treated with oral antibiotics.
Yeast infection is usually treated with medicine inside the vagina or with oral medicine.
Sex partners should be treated sometimes, and you may need to avoid intercourse or use condoms until you have been treated.

Differential diagnosis

• Herpes simplex virus (HSV) infection

• Streptococcal Vaginitis in adults

• Genital schistosomiasis

• Entamoeba gingivalis plus intrauterine device (IUD)

References

• Mayoclinic

• Web med

• PubMed

• Paras hospital

• Best practice.BMJ

Osteoporosis - Symptoms, Causes, and Treatment - Avicenna Health

Wed, 24 Nov 2021 16:01:07 GMT

Osteoporosis

Definition of the illness

Osteoporosis could occur when bone density decreases, where the human body absorbs more bone tissue and produces less to replace the old tissue with the new one.

In people with osteoporosis, the bones become spongy and weaker, so many fractures might happen, especially in the hip, spinal vertebrae, and some peripheral joints, such as the wrists.

Our article will look at how to manage osteoporosis, what causes it, and how it is diagnosed by a doctor.

Symptoms

Usually, there are no osteoporosis symptoms. So, it is called the silent disease. However, you should be aware of the following symptoms:

Loss of height (nearly an inch or more)
Change of posture (bending down or leaning forward).
Shortness of breath (decreased lung capacity due to compressed intervertebral discs).
Bone fractures
Lower back pain

Causes

Our bones are generally in a constant state of renewal, so the new bone is forming, and the old bone is breaking down.

During youth, the body creates new bones faster than it destroys old ones and thus increases bone mass. In the 20s, this process became slower, and most people reached their peak bone mass by 30.

As people age, bone mass decreases faster than it increases. The likelihood of having osteoporosis depends on the bone mass you acquired when you were young. The peak in bone mass is partly hereditary.

Risk factors

1- Risks that will not change some risk factors for osteoporosis are not under your control, including:

Gender: Women are much more likely to have osteoporosis than men are. Age: The elderly have a higher risk of osteoporosis.

Race: You are at greater risk for osteoporosis if you are white or of Asian descent.

Family history: when the parent or sibling with osteoporosis puts you at greater risk, significantly if your mom or dad has fractured their hip.

Body frame size: men and women with a small body structure tend to be more likely to have osteoporosis because they may have less bone mass to build on, as they are getting older.

2- Hormone Level

Osteoporosis is widespread in people who have high or low of certain hormones in their bodies. That includes:

Sex hormones: reduction of sex hormone levels may lead to weakening bone.

Thyroid problems: excess thyroid hormone levels may create bone loss.

3- Dietary factors

Low calcium intake

Eating disorder

Gastrointestinal surgery

When to see a doctor

When you have some discomfort at one of the most common sites of osteoporotic bone damage can indicate an unexpected fracture.

In addition, People should see a doctor as soon as they experience this unique type of pain.

Diagnosis

Your doctor may order a test to give you information about the health of your bones before problems start. Bone mineral density (BMD) tests are also known as dual-energy x-ray absorptiometry (DEXA or DXA) scans.

These x-rays use minimal amounts of radiation to determine the strength of the bones in the spine, hip, or wrist. Regular x-rays will only show osteoporosis when the disease is very far along. All women after age 65 should be tested for bone density.

The DEXA test may be done for women with risk factors for osteoporosis. Men over 70 or younger men with risk factors should also consider having a bone density test.

Management

Here the management depends on both changing the lifestyle and medications:

Lifestyle changes
Stop smoking
Limit alcohol: people should not consume more than two alcoholic drinks per day because it may reduce bone formation.

Medication

- Vitamin D and mineral supplements

- Bisphosphonates: The most commonly prescribed osteoporosis medications are bisphosphonates

- Hormone therapy: estrogen, especially when started immediately after menopause.

- Drugs for bone reconstruction: includes

Abaloparatide, Romosozumab and Teriparatide

Differential Diagnosis

Leukemia
Lymphoma
Fractures secondary to bone metastases from cancer
Pediatric osteogenesis imperfecta
Renal osteodystrophy

References

Medscape
Mayo clinic
Medical News Today
Cleveland Clinic

Endometriosis - Symptoms and Treatment - Avicenna Health

Tue, 23 Nov 2021 16:00:59 GMT

Endometriosis

Definition of the illness

Endometriosis occurs typically when tissue similar to the uterus lining grows instead of inside the outside of the uterus.

It is a painful disorder, especially during menstrual periods, and a common problem in women.

The process is about acting the Endometrial-like tissue is normal endometrial tissue, so it thickens, breaks down, and bleeds with each period. Moreover, it can cause fertility problems. However, effective treatments are available.

Symptoms

- Painful periods

- Pain during or after intercourse

- Infertility

- Painful bowel movements

- Fatigue or lack of energy

- Having problems in work and social commitments

- Depression or isolation

Causes

1- Surgical scar implantation: After a surgery, including a hysterectomy or C-section, endometrial cells may also connect to a surgical incision.

2_ Endometrial cell transport: The blood vessels or tissue fluid (lymphatic) system may also transport endometrial cells to different components.

3_ Genetics: when there is a family history of the disease, the threat increases.

4_ retrograde menstruation: when some of the womb linings flow up via the fallopian tubes and embeds themselves on the pelvis organs, rather than leaving the body as a period.

5_ a problem with the immune system: the body's usual defense against illness and infection.

6_ endometrium cells spread through the body in the bloodstream or lymphatic system, a series of tubes and glands that shape a part of the immune device.

Risk factors

_ Never giving birth

_ Starting your period at an early age

_ Going through menopause at an older age

_ Short menstrual cycles: for example, when the menstrual period is less than 27 days as unusual

_ Heavy menstrual periods that are prolonged

_ Having higher levels of estrogen or exposure to estrogen

_ Low body mass index

_ Family history

_ Any condition that prevents the passage of blood from the body during menstrual periods

_ Disorders of the reproductive tract

When to see a doctor

See a doctor if you have symptoms of endometriosis, as we described above, especially if they are having a significant effect on life.

Endometriosis can be a challenging condition to diagnose and manage. However, the early diagnosis may result in better management and prevention of cancer.

Diagnosis

1- Pelvic exam: the doctor will examine any large cysts or scars behind the uterus.

2- Imaging test: the doctor may ask for an ultrasound to check for ovarian cysts from endometriosis or Magnetic resonance imaging (MRI) that provides a picture of the inside of the body.

3- Laparoscopy: In some cases, the doctor may ask for this procedure. Therefore, while you are under general anesthesia, the surgeon makes a tiny incision near the navel and inserts a slender viewing instrument, searching for signs of endometrial tissue outside the uterus.

Differential diagnosis

· Dysmenorrhea

· Pelvic adhesions

· Serositis

· Functional or neoplastic ovarian cyst

· Uterine malformation

· Adenomyosis

· Colon cancer

· Ovarian cancer

· Gonorrhea

· Pelvic Inflammatory Disease

· Diverticulitis

· Chlamydia (Chlamydial Genitourinary Infections)

· Urinary Tract Infection (UTI)

Management

There is no exact cure for endometriosis, and it can be challenging to treat. Treatment is given to make symptoms fewer, so the disease does not affect women's daily life. It is essential to help:

Reduce pain, slow the growth of endometriosis tissue, improve fertility, and stop the condition from returning

There are many options for management:

1_ Pain medication: Anti-inflammatories, such as ibuprofen or paracetamol, maybe tried to see if they help reduce your pain

2- Hormone treatment: The purpose is to prevent estrogen production in the body because estrogen encourages endometriosis tissue to grow and spread, so Limiting estrogen will reduce the amount of tissue in the body.

3- Surgery: it can get rid of endometriosis tissue, making symptoms and fertility better.

4- Laparoscopy: keyhole surgery that is when small incisions are made in the abdomen so the endometriosis tissue can be destroyed or cut out.

5- Hysterectomy: the definite treatment if not all the above treatment works and the woman has decided not to have any more children in the future, removal of the womb can be an option.

References

· Medscape

· Mayo clinic

· NHS

· OASH

· Endometriosis UK

Vaginitis - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 22 Nov 2021 16:00:15 GMT

Vaginitis

Definition of the illness

Vaginitis is inflammation in the area of the vagina. Up to a third of women will have symptoms of vaginitis at some point in their life. This disease affects women of all ages but is most common in the reproductive years. It is often and generally treatable.

Symptoms

1_ abnormal discharge with change in odor

2_ burning feeling outside of the canal throughout urination

3_ itch round the outside of the vagina

4_ Discomfort during intercourse

Risk factors

1_ Hormonal changes: such as those associated with pregnancy, birth control pills, or menopause.

2_ Sexual activity: having a sexually transmitted infection

3_ Medicines: such as antibiotics and steroids

4_ Use of spermicides, IUDs, or high estrogen contraceptives for birth control

5_ Uncontrolled diabetes

6_ Use of products for hygiene: as a bubble bath, vaginal spray, or vaginal deodorant

7_ douching

8_ Wearing damp or tight clothes

9_ Pregnancy

10_ Immune system disorders: such as HIV and organ transplantation

11_ Thyroid or endocrine disorders

When to see a doctor

You should see a doctor if:

1_ you are having symptoms of vaginitis for the first time

2_ you have had vaginitis before, but the symptoms are bothering you a lot, are different from the usual or do not seem not improving

3_ you have vaginal discharge that is unusual for you

4_ you have symptoms of vaginitis after having sex with a new partner

5_ you have other symptoms such as feeling hot and chills or pain in the lower abdomen (pelvic pain)

Diagnosis

There are many procedures the doctor tend to perform after asking the patients about the medical history of vaginal or sexually transmitted infections:

1_ Perform a pelvic exam by the doctor to look inside the vagina to see if there is any inflammation and abnormal discharge

2_ Perform pH testing: because an elevated pH can indicate either bacterial vaginosis or Trichomoniasis

3_ Collect a sample for lab testing: the doctor will take a sample of the discharge from the vagina and send it to a laboratory for checking.

Management

Treatment for vaginitis depends on the type of causative, so hygiene detergents should be controlled. Women have to avoid anything that leads to irritations; some medications treat Yeast infections, Trichomoniasis, and Bacterial vaginosis.

For example, you may need:

1_ antifungal medicine for thrush

2_ antibiotics for a sexually transmitted infection

3_ vaginal moisturizer, lubricant, or hormone treatment for menopause symptoms

4_ steroid medicine for skin disorders

Differential diagnosis

· Candidiasis

· Cervicitis

· Chlamydia (Chlamydial Genitourinary Infections)

· Gonorrhea

· Herpes Simplex

· Trichomoniasis

· Vaginal Candidiasis

· Vaginitis

References

· Mayo clinic

· Medscape

· ACOG

· NHS

· Cleveland Clinic

COVID 19 and Pregnancy FAQ - Avicenna Health

Sat, 20 Nov 2021 16:00:06 GMT

COVID-19 and Pregnancy

What is pregnancy?

Pregnancy is the period when a woman carries a fetus inside her womb until it becomes a viable baby. Pregnancy usually lasts about nine months.

This period is considered sensitive because women often become more susceptible to infections due to hormonal and immune system function changes.

These infections include many known ones like influenza as an example, but what about the new coronavirus disease (COVID-19)?

Let us figure this out with the last reports.

Covid-19 impact on pregnancy:

Mainly, the chance of being infected with covid-19 as a pregnant woman is the same as anyone else.

Even though the overall risk is low, pregnant women can be at a higher risk of severe COVID-19 infection, especially with an underlying condition such as hypertension or diabetes.

So if you have a chronic condition, and you are planning to get pregnant, or you are already pregnant, you need to take precautionary measures seriously.

Researches say that symptomatic patients are more likely to be at a high risk than asymptomatic ones and more likely to be hospitalized or admitted to the intensive care unit.

Labour and delivery:

Researchers have not found any proof that the virus can cause birth problems like miscarriage or birth defects.

Infected women were found more likely to deliver their babies prematurely, before the 37th week of pregnancy, but there is no evidence if the virus is the main causing factor.

On the other hand, fever and other symptoms that the virus may cause during pregnancy may lead to birth defects if were neglected.

Whether if the birth was Cesarean or vaginal, no effect was noticed for both.

Postpartum:

After delivery, if the born baby was delivered from an infected mother, doctors recommend putting the baby on probation for a while to monitor his vital signs and notice any symptoms.

Talk to the doctor to schedule virtual visits or office visits if necessary to keep checking in.

If I have COVID-19, will my baby be infected?

After birth, some babies were tested positive for COVID-19, but there is no clue if they were infected in the womb or after the delivery by droplets from their mothers or other people.

According to reports, the breast milk of a few women was tested for COVID-19, and fortunately, no virus was detected. So, breastfeeding itself does not pass COVID-19 to your baby. Still, you should never forget that coughing, sneezing, and even the droplets remaining on the surfaces can cause the baby to be infected.

So that baby should be taken care of by others who are not infected.

If you insist on taking care of the baby yourself, consult your doctor first, and consider taking precautionary measures, especially washing hands and wearing a mask during breastfeeding.

Vaccines and recommendations:

Mainly, being pregnant is not a contraindication of getting vaccinated.

According to the last researches, vaccines have no harmful effects on pregnant women or even their babies, on the contrary; Antibodies that are produced due to the vaccine may help protect the baby from COVID-19.

So if you are planning to get pregnant or already pregnant, consider getting vaccinated to keep yourself and your baby safe as possible.

When to consult a doctor:

Call your doctor right away if:

- You can't feel your baby's movement, or you feel unusual movement.

- Noticing blood traces in your vagina

- You have a severe headache that is not improving with painkillers

- You have shortness of breath

- You have a fever

When to call 911:

- If you have severe chest pain or hardly breathing

- If you cough up blood

- If you are so tired and you may be getting fainted

- In addition to any other symptom that requires emergent care.

Remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References :

- Mayoclinic.org

- Webmd.com

- Nhs.uk

- Medscape.com

Cushing's Syndrome - Symptoms and Causes - Avicenna Health

Fri, 19 Nov 2021 16:00:10 GMT

Cushing's Syndrome

Patient History:

A 37-years-old woman with Cushing's syndrome said: "three years ago, my doctor diagnosed me with hypertension. I thought that my weight was the main cause, but my hypertension got worse two months later, and it was hardly responding to the medication. I started to struggle much more, my depression beat me, and my body was acting weird. I became so hairy, and I have got pink marks around my breast."

Definition of Cushing's syndrome:

Cushing's syndrome: is a chronic disorder in which the cortisol hormone in your body elevates above the normal average.

It may be due to oral use of corticosteroids or glands malfunction such as adrenal and pituitary gland.

The elevated levels of cortisol can lead to hypertension, diabetes and result in widely diversified symptoms.

How much time does it last?

Cushing's syndrome is a chronic condition that develops over time.

And it can be a fatal case if it is neglected, but with good treatment, patients often improve within a few months.

Symptoms:

Symptoms and signs may vary a lot in this condition due to the hormonal changes that happen.

These symptoms may include:

- High blood pressure

- High blood sugar

- Weight gain

- Tiredness and muscle weakness

- Depression and cognitive dysfunction

- Anxiety and sleep problems

- Osteoporosis – a condition in which the bones become weak and more likely to break

- Low sex drive and fertility in addition to erectile dysfunction

- Acne

Characteristic signs of Cushing's syndrome include:

- Buffalo hump – a pad of fat tissue between your shoulders

- purple Striae – a stretch marks, often on the abdomen and breast

- Moon face – a unique rounded face due to the weight gain

- Hirsutism – a male-like pattern of hair distribution

- Thin skin

Causes:

Cushing's syndrome, as we have mentioned, is caused by high levels of cortisol.

It can be either an exogenous or endogenous condition.

Exogenous Cushing's syndrome is usually due to oral use of corticosteroids over time.

On the other hand, endogenous Cushing's syndrome can be caused by the overproduction of cortisol from the body.

This overproduction may be caused by:

- pituitary adenomas that produce ACTH excessively lead to oversecreting of the cortisol hormone.

- Ectopic ACTH-secreting tumors that often found in the pancreas or lungs

- Cancerous or noncancerous Adrenal cortex

Risk Factors:

- Patients with long-time use of the corticosteroids like lupus, asthma, and organ transplant patients

- Patients with Adrenal gland tumors

- Patients with Pituitary gland tumors

- Patients with hormone-secreting tumors

When to see a doctor?

Cushing's syndrome cases are diagnosed and followed up by a doctor to ensure the best improvement.

Some new signs or symptoms may appear and require a medical consultation to ensure it is not serious.

Call your doctor if you have:

- Infection

- Depression or mood swings that affect your daily life

- Newly hypertension or diabetes

If you have had a heart attack or stroke, you should be telling your doctor right after you get better.

Diagnosis:

In most cases, physical exam and patient history play the primary role, especially when patients have characteristic signs and long-term corticosteroid use history.

In this exogenous case, your doctor may not need any test.

Endogenous cases may also be suspected by patient history, but it has to be confirmed by measuring the cortisol levels in your body.

There are several tests to do it:

- Urine test. In this test, you need to collect your urine over 24 hours.

- Blood tests.

- Saliva tests.

Diagnostic imaging procedures like CT or MRI may be requested if the doctor suspects the tumors to be the primary cause.

Differential Diagnosis:

- Pseudo-Cushing's syndrome

- Obesity

- Alcoholism

- Psychiatric disorders

- Anorexia nervosa

- Bulimia nervosa

Management:

The mechanism of management depends on lowering the cortisol hormone levels in your body.

So that if the leading cause was long-term corticosteroid use, your doctor might ask you to lower the dose gradually but NEVER stop it immediately.

Tumor as a leading cause may demand a removal surgery, radiotherapy, or both.

Medicines should be considered, especially when the patient has to undergo surgery, but his medical health condition is inappropriate. Or the patient has already undergone surgery, but the improvement was less than expected.

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- Webmd.com

- Nhs.uk

- Medscape.com

Diabetes Mellitus (DM) - Symptoms and Causes - Avicenna Health

Thu, 18 Nov 2021 16:00:06 GMT

Diabetes Mellitus

Patient History:

A 16-years-old boy with Diabetes says: "I found out I had Diabetes a few days after my 5th birthday. I used to drink too much water and had to go to the bathroom more than usual. I also used to wake up very thirsty. After I was diagnosed with type 1 diabetes, the doctor prescribed insulin injections for my case, it wasn't fun initially, but after I received thousands of shots, I started to get used to them."

Definition of Diabetes Mellitus (DM):

Diabetes Mellitus: a group of conditions characterized by insulin-producing problems leading to elevated blood sugar.

There are two main types of Diabetes:

- Type 1 diabetes: is when the pancreatic cells that produce insulin are being destroyed.

- Type 2 diabetes: is when the pancreatic cells produce less insulin, or the body cells do not respond effectively due to an insulin resistance condition.

Gestational Diabetes is a diabetes condition that occurs during pregnancy when the blood glucose becomes higher than the body production ability of insulin.

Sometimes the glucose (sugar) levels can be elevated but not enough to be diagnosed with Diabetes Mellitus; this condition is often known as prediabetes.

How much time does it last?

Diabetes mellitus is a lifelong condition. Although Diabetes cannot be cured, it can go into remission with no symptoms or signs for a while. But the disease itself still exists.

Symptoms:

Symptoms can vary depending on the type of Diabetes that patients have. Type 1 diabetes symptoms are often more severe and appear more quickly, while type 2 diabetes symptoms tend to be minor in severity.

Type 1 and 2 diabetes symptoms often include:

- Polyuria – frequent urination due to producing a large amount of urine

- Polydipsia – feeling thirsty

- Hunger

- Weight loss

- Irritability or tiredness

- Blurred vision

- Slow healing of sores or cuts

- Paresthesia, especially in the lower extremity

- Feeling itchy, usually around the vagina or penis

Causes:

Before we get to the causes, we should first know how insulin and blood glucose work.

Mainly, when we eat too much sugar, the glucose gets elevated in the bloodstream, causing the pancreas gland to produce the insulin hormone that helps lower the amount of glucose in our bloodstream. So that any factor that may cause insulin secretion problems will, in turn, affect the blood glucose levels and may lead to diabetes mellitus.

The exact cause of Diabetes is often uncertain. Still, the mechanism can be explained by an immune disorder, whether the destruction of pancreatic cells caused it as in type 1 or caused by the insulin-resistance cells as in type 2.

It is believed that environmental and genetic factors play a significant role, but unfortunately, these factors are still unclear.

Researches have linked overweight with type 2 diabetes; still, being within normal does not mean you will not have Diabetes.

Risk Factors:

- Patients with a family history

- Environmental factors, like viral infections

- Positivity of some autoantibodies (particularly type 1)

- Age. Type 1 is more likely to affect patients during childhood, while type 2 often affects patients over 40.

- Gestational Diabetes. That can be a risk factor for type 2 diabetes

- Overweight and polycystic ovary syndrome (in type 2)

- Hypertension and elevated cholesterol levels can also be risk factors for type 2 diabetes.

When to see a doctor?

Diabetes mellitus should be monitored by a doctor. So if you think you might have Diabetes or have already been diagnosed with Diabetes, you have to see a doctor to follow up on your condition.

Signs and symptoms that indicate a serious condition include:

- Loss of consciousness

- Kussmaul respiration – heavy breath due to hyperventilation caused by acidosis.

- Newly numb or burning feeling in the top of your toes or fingers

- Urination less than normal

- Blurred vision

Diagnosis:

Diagnosis mainly depends on the laboratory test, but the patient's history and physical exam are as necessary as lab tests.

The most frequent lab test is the fasting blood sugar test; when the blood sugar levels are over 126 mg/dl, the patient is considered diabetic, and if it is between 100-125 mg/dl, we call it this case prediabetes. In comparison, the expected levels of fasting blood sugar are often below 100 mg/dl.

Random blood sugar tests can be performed at any time without being fasting. Like the previous, the blood sugar levels indicate the condition; when the blood sugar levels are over 200 mg/dl, Diabetes is often diagnosed.

An oral glucose tolerance test can be performed by giving the patient a sugary liquid after overnight fasting, then measuring blood sugar levels. The normal range is often below 140 mg/dl.

Glycated hemoglobin (A1C) can be diagnostic if its level is higher than 6.5%.

Imaging procedures are rarely used to look for tumors as a primary cause of Diabetes.

Differential Diagnosis:

- Diabetes insipidus

- Steroids therapy

- Glucose-secreting tumor

- Cushing syndrome

- transient hyperglycemia

- renal tubular acidosis

Management:

The main idea in the management is to lower blood sugar levels.

A doctor may ask you to stick to a diet of healthy food and do daily exercise. Still, these tips alone cannot help if you are diagnosed with type 1 or 2 diabetes. So that doctor often prescribes oral hypoglycemic drugs (for type 2) or insulin injections (for type 1)

A pancreas transplant is also an option, but it may hide some severe conditions due to the immune-suppressing drug use that will shut down your immune system.

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- Webmd.com

- Nhs.uk

- Medscape.com

Diverticulitis - Symptoms and Causes - Avicenna Health

Wed, 17 Nov 2021 16:06:06 GMT

Diverticulitis

Our article is about an important and common gastrointestinal disease called diverticulitis. It is common in the elder ages and seldom causes symptoms. Its importance comes from the complications that we’ll highlight in this article. Let’s figure out what diverticulosis is and have an idea about this common disease.

Definition of diverticulitis

Firstly, diverticula are small pouches that can form in the digestive system lining, most commonly in the colon (the large intestines).

Diverticulitis is when one or more of these small pouches become inflamed or get infected. Diverticulitis can cause severe abdominal pain, nausea, fever, and changes in bowel movements.

Symptoms

Symptoms happen when diverticula get inflamed. These symptoms include:

1. Pain: which can be constant for several days. It is more common in the lower left side of the abdomen

2. Nausea and vomiting

3. Fever and chills

4. bloating

5. Constipation, and sometimes could be diarrhea

6. There can be blood in the stools (poop)

Causes

Diverticula develop in the weak places of the colon under pressure. This pressure causes small pouches to protrude through the wall of the colon.

Risk Factors

There are many factors that can increase the risk of developing this disease, and they include:

- Age: the risk of having this disease increases with age

- Obesity and overweight: this also can increase the risk of having this disease

- Smoking

- Not doing exercise

- A High-fat and low-fiber diet

- Some medications such as NSAIDs (non-steroidal anti-inflammatory drugs), steroids, and opioids.

When to see a doctor?

- Anyone with the symptoms above should seek medical advice to get better treatment because this disease has some bad complications that include:

· Forming an abscess

· Blocking the bowel

· Forming fistula (an abnormal passageway between the bowels and different organs)

· Peritonitis, which is a medical emergency that requires immediate care.

Diagnosis

Doctors will order these tests to rule out the other causes of the symptoms and to confirm the diagnosis:

- Full Blood Count (FBC)

- Urea and electrolytes: to assess the kidney function and see if we could perform a contrast CT scan

- CRP: to identify inflammation

- Abdominal Contrast CT scan: we can see thickening of the bowel wall, an abscess, or a mass

- Abdominal Ultrasound: to see if there is a sign of abscess, perforation, or obstruction

- MRI: the same findings of the CT scan

- Chest X-ray: it can give us an idea if there is a perforation

- Colonoscopy: we can see the diverticula

- Diagnostic laparoscopy

- Sigmoidoscopy

Differential Diagnosis

- Endometriosis

- Colorectal cancer

- Appendicitis

- Ulcerative colitis

- Crohn’s disease

- Urinary tract infection

- Pyelonephritis

- Ischemic colitis

- Pelvic inflammatory disease

- Irritable bowel syndrome

Management

Treatment of this disease depends on the severity of its signs and symptoms.

- Mild diverticulitis can be treated at home with antibiotics and a liquid diet for several days.

- The Complicated disease will most likely require surgery.

References

Mayo Clinic – BMJ – Healthline - WebMD

Rheumatoid Arthritis (RA) - Symptoms and Causes - Avicenna

Tue, 16 Nov 2021 16:00:10 GMT

Rheumatoid Arthritis

Our article is about a widespread disease called rheumatoid arthritis. It is more common in women than in men, and it mostly begins in middle age. This disease can damage, in addition to joints, a wide variety of the body organ. Let’s have an idea about this disease and how we can diagnose it and manage it.

Definition of rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory autoimmune disease that can affect the lining of the joints, causing pain, swelling, stiffness, and loss of function in the joints. The other parts of the body that this disease can affect: the eyes, skin, lungs, blood vessels, and heart.

Symptoms

Warm joints
Swollen joints
Tender joints
Joint stiffness in the morning after rest
Fatigue
Fever
Loss of appetite

We need to bear in mind that the early stage of rheumatoid arthritis can affect the small joints. In particular, the joints that attach the fingers to the hands and the toes to the feet. Symptoms tend to occur in the same joints on both sides of the body (symmetrical).

And while the disease progresses, the symptoms can spread to wrists, elbows, ankles, hips, shoulders, and knees. In addition to that, the disease can affect different organs other than the joints, as we previously stated.

Causes

It is an autoimmune disease. That means the immune system attacks by mistake the body’s tissue.

Risk Factors

Sex: women are more likely to develop rheumatoid arthritis
Age: it can occur at any age, but most commonly starts in the middle age
Family history: If there is a family member who has rheumatoid arthritis, you may have an increased risk of having the disease.
Smoking: Smoking increases the risk of having the disease
Obesity and overweight: People who are overweight are at a higher risk of developing rheumatoid arthritis.

When to see a doctor?

People should seek medical advice if there is persistent discomfort and swelling in the joints.
This disease needs managing as soon as it’s diagnosed as it has really serious complications:

· Osteoporosis

· Rheumatoid nodules

· Infections

· Heart problems

· Carpal tunnel syndrome.

· Lung disease

· Lymphoma.

Diagnosis

Ronography: we’ll see synovitis of the joints

Differential Diagnosis

Psoriatic arthritis
Infectious arthritis
Gout
Systemic lupus arthritis
Osteoarthritis

Management

There is no cure for this disease. But according to clinical studies, remission of symptoms can happen if we start the treatment in the early stage of the disease using DMARDs (disease-modifying anti-rheumatic drugs).

We can also use:

NSAIDs to relieve pain and reduce inflammation
Steroids to r educe inflammation and pain and slow joint damage
Biologic agents

References

Mayo Clinic – BMJ – Healthline – WebMD

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Gallstones - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 15 Nov 2021 16:00:11 GMT

Gallstones

Gallbladder, which is a small organ in the right abdomen below the liver. It stores and releases bile, which is a green-yellow digestive fluid that helps with digestion. Gallstones disease is a very common disease that needs to be treated as soon as it’s diagnosed. Otherwise, it’ll cause bad complications. Let’s figure out what gallstones disease is and how we diagnose it and treat it.

Definition of Gallstones

Diseases happen to the gallbladder when something blocks its bile duct, such as gallstones. Most gallstones are created when substances that are found in bile, like cholesterol and bilirubin, harden. Gallstones may range from the size of grains of sand to that of golf balls.

Symptoms

Gallstones can be asymptomatic. But, if the gallstones block the duct, the resulting symptoms would be:

1. Sudden intensifying pain in the right of the upper abdomen, under the rips

2. Pain in the right shoulder

3. Nausea and vomiting

4. Jaundice – the color of the skin and the eyes become yellow

5. pale-colored poop

6. Dark urine

7. Itchy skin

8. Fever and chills

9. Diarrhea

10. Loss of appetite

Causes of gallstones

It is not really clear what causes gallstones to form. But doctors think that gallstones can result when:

The bile has too much cholesterol
The bile has too much bilirubin
The gallbladder doesn’t empty well

Risk Factors

Female
Age 40 or older
Native Americans
Hispanic of Mexican origin
Overweight or obese
Pregnancy
High-fat diet
High-cholesterol diet
Low-fiber diet
Family history of gallstones
Diabetes
Certain blood disorders, such as leukemia or sickle cell disease
Losing weight in a short time
Medications that contain estrogen, such as oral contraceptives or hormone therapy drugs
Liver disease
Intestinal diseases like Crohn’s

When to see a doctor?

You should see your doctor if there are any signs and symptoms that indicate gallstones
You should seek medical advice right away if there are severe symptoms, for example:

· Jaundice

· Really bad pain

· Chills and high fever

Diagnosis

Abdominal ultrasound: we can see stones in the gallbladder
Serum liver function tests: to see if there is a complicated disease
Full blood count (FBC): to see if there is elevated WBC
Serum lipase or amylase: to see if there is pancreatitis
MRCP (magnetic resonance cholangiopancreatography)
Abdominal CT scan

Differential Diagnosis

Peptic Ulcer Disease
Gallbladder Cancer
Gallbladder polyps
Acalculous Cholecystitis
Sphincter of Oddi dysfunction
Non-biliary acute pancreatitis

Management

Most patients with gallstones that don't cause symptoms don’t need treatment. Doctors determine if treatment for gallstones is indicated based on the symptoms and the results of diagnostic tests.

Treatment options of gallstones disease are:

A surgery called cholecystectomy, which means removing the gallbladder
Medicine to dissolve gallstones: it isn’t usually used.

References

Mayo Clinic – BMJ – Healthline – WebMD

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Alzheimer's Disease - Symptoms and Causes - Avicenna Health

Sat, 13 Nov 2021 16:01:36 GMT

Alzheimer

Definition of the illness

Alzheimer's disease is a kind of dementia that affects the brain, memory, thinking skills, behavior, and other mental Ability.

Symptoms affect severely with time to interfere with daily tasks, and the exact cause is not yet known. However, there are things that are thought to increase the risk of developing Alzheimer's.

Symptoms

The most crucial sign of Alzheimer's disease is almost memory problems, including difficulty remembering recent events or conversations or family members and friends.

As the disease continues, memory problems get worse and more symptoms could appear, such as:

- Confusion, disorientation, and getting lost in familiar places

- Difficulty planning or making decisions

- Problems with speech and language

- Problems moving around without assistance or performing self-care tasks

- Personality changes, such as becoming aggressive, demanding, and suspicious of others

- Hallucinations (seeing or hearing things that are not there) and delusions (believing untrue things)

- Low mood or anxiety

However, there are preserved skills that include reading, telling stories, singing, listening to music, dancing, drawing, or doing crafts.

These skills may stay longer because they are controlled by parts of the brain damaged at advanced levels.

Causes

Alzheimer's disease affects people badly because of the abnormal growth of specific proteins in and around brain cells that are clustering and destroy the brain system.

1- Beta-amyloid protein is a large protein that forms plaques around brain cells, so it has a toxic effect on neurons inside the brain.

2- Tay protein, deposits of which form tangles within brain cells.

In addition, it is not crucially the causes, but scientists nowadays realize that it begins many years before signs and symptoms appear.

As brain cells become affected, there is also a decrease in neurotransmitters that send messages, or signals, between brain cells.

Also, it's known that Levels of one neurotransmitter, acetylcholine, are usually decreased in the brains of people with Alzheimer's disease.

Risk factors

- Age: the older are you, the more likelihood of developing Alzheimer's disease you have

- Head injuries

- Down's syndrome: The genetic changes that cause Down's syndrome can also cause amyloid plaques.

- Family history

- Air pollution

- Lack sleep

- Sex: women are more likely to have the disease because they generally live longer.

- Excessive alcohol consumption

- Low education levels

When to see a doctor

Remember that some conditions are treatable.

If you have any concerns about memory or other thinking skills, see your doctor.

Also, if you are worried about someone else around you, so encourage them to make an appointment, and it is better to go with them to the clinic.

Diagnosis

1- Mental status and neuropsychological testing: like testing the Reflexes, Muscle tone, and strength, Ability to get up from a chair and walk across the room, Sense of sight and hearing, Coordination.

2- Brain imaging: Magnetic resonance imaging (MRI) and Computerized tomography (CT).

3- Lab tests: Blood tests may reveal other potential causes of memory loss and confusion, such as a thyroid disorder or vitamin deficiencies.

Management

Drug treats memory symptoms and other cognitive changes such as Memantine (Namenda) and Cholinesterase inhibitors.
creating a safe and supportive environment: so it is a beneficial idea to keep keys, wallets, mobile phones, and other valuables things in the same place at home.

Differential diagnosis

Aphasia
Carotid Artery Stenosis Imaging
Chronic Myelogenous Leukemia (CML)
Corticobasal Syndrome and Corticobasal Degeneration
Dementia in Motor Neuron Disease
Lewy Body Dementia
Depression
Frontotemporal Dementia and Frontotemporal Lobar Degeneration
Huntington Disease Dementia
Normal Pressure Hydrocephalus
Parkinson Disease
Prion-Related Diseases
Vascular Dementia
Wilson Disease

References

Mayo clinic
Medscape
NHS

Snoring - Causes and Treatment - Avicenna Health

Mon, 08 Nov 2021 16:00:09 GMT

Snoring

Patient History:

Have you ever heard a hoarse sound from your partner that keeps you from sleeping?

Do you have sleep deprivation because of this sound?

Have you ever been told that you make a bothering sound while you sleep?

If you have ever experienced one of these situations, you may need to read our new article about snoring.

Definition of snoring:

Snoring: a whistling sound caused by the airflow through the throat tissue while sleeping.

Snoring can bother your partner in most cases, especially when it is a chronic problem.

It can affect anyone at any age, and usually, it is not a severe problem.

But in some cases, it can hide a serious condition behind this hoarse sound.

How much time does it last?

Mainly, most people snore from time to time. But in some cases, it can be a chronic condition due to a lot of possible causes. Some of these causes can be well-managed using home remedies or lifestyle-changing advice.

Symptoms :

Snoring by itself is a symptom of other conditions.

People may only snore while sleeping. But sometimes, snoring can be accompanied by other symptoms that help doctors determine the problem.

These symptoms may include:

- Breathing-stops attack

- Choking - during sleeping

- Drowsiness at the daytime

- Headaches – especially in the morning

- Difficulty concentration

Causes:

Snoring mainly occurs when the tissue like the tongue or the airway gets narrow or enlarge, or any other cause that partially blocks the airflow.

So that there are so many factors that can be considered as a reason for snoring, like:

- Enlarged tonsils or adenoids

- Nasal congestion

- Sinusitis

- Deviated nasal septum

- Nasal polyps

Sleep deprivation also plays a role; when people cannot get enough sleep, their muscles may over relax, leading to airflow blocking that will eventually cause snoring.

Risk Factors:

- Overweighed patients

- Alcohol consumption

- Male patients more than female ones

- Smoking

- Sleeping on the back

- Patient who has relatives with obstructive sleep apnea (OSA) or snoring history

When to see a doctor?

As we have already mentioned snoring is not a critical problem. Still, it becomes a real one when it bothers your partner or is accompanied by other symptoms that indicate a hided condition that seeks a medical consultation.

Other signs and symptoms that indicate a severe condition include:

- High blood pressure

- Breathing pauses or choking while sleeping

- Chest pain

Diagnosis:

Full medical history with good physical exams will help determine the cause of snoring.

A doctor may ask you a few questions and run some imaging procedures like x-ray or CT scan to exclude anatomical causes like deviated septum as an example.

Furthermore, polysomnography can be performed in sleep centers.

Polysomnography is a sleep study that measures many things while you sleep, like breathing rate, heart rate, oxygen levels, brain waves, and body movements.

Polysomnography is often used when the patient is likely to have obstructive sleep apnea (OSA).

Differential Diagnosis:

As we have mentioned above, snoring is a symptom, not a disease by itself, and the differential diagnosis of the possible causes often include:

- Tonsillitis

- Deviated septum

- Congestion and blocked nasal airways

- Long soft palate

- Sleeping pills

- Alcohol consumption

Management:

Managing snoring conditions depends on the cause.

Your doctor may recommend some lifestyle changes like quitting smoking or reducing the amount of alcohol you drink.

Losing weight can also help you if you are overweight.

Getting enough sleep and avoiding sleeping on the back may solve the problem in some cases.

Decongestant could be a solution if you have congestion.

Surgery should be in consideration if you have an anatomical problem.

Last but not least, if you were diagnosed with obstructive sleep apnea, you might need to use a continuous positive airway pressure device (CPAP device) which is a mask that pumps air into your airway to keep it from closing or narrowing while you sleep.

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- Webmd.com

- Nhs.uk

- hopkinsmedicine.org

Pneumonia

Sat, 06 Nov 2021 15:00:06 GMT

Pneumonia

Patient History:

A 35-year-old patient with pneumonia said: "It started by the winter, I had a cough, and my lungs began to hurt. I assumed it was a cold or maybe flu. But a friend convinced me that I needed to see a doctor.

After the examination, the doctor diagnosed me with viral pneumonia. He prescribed some medication like pain relievers and fever reducers and asked me to get some rest."

Definition of pneumonia:

Pneumonia: is an inflammation in the air sacs (alveoli) of the lung caused by infection, causing pus-filled alveoli leading to productive cough, difficulty breathing, and many other symptoms.

It can affect people of all ages, but children and older people are the most likely to be affected due to the weak immune system they would have.

Pneumonia is more likely to be caused by a bacterial infection. But viruses and fungi can also be the reason for this infection.

How much time does it last?

There is no specific time for recovery.

Mainly, it depends on the type of pneumonia and the person itself.

It may only take one week to recover in some people, and in others, it may take more than a month.

Symptoms :

Symptoms can be vary depending on the cause, age, immune system condition. These symptoms may include:

- Chest tightness – A discomfort or heaviness feeling in your chest.

- Cough – usually productive; its product can be purulent, mucoid and in some cases, it may be bloody

- Fever – often accompanied with chills

- Breath shortness – Medically known as dyspnea, which is the difficulty of getting enough air.

Other symptoms may include:

- Fatigue

- Appetite loss

- Nausea and vomiting

- Diarrhea

Causes:

There is a lot of causes that can cause pneumonia. Determine the infectious factor helps the doctor to choose the cure accurately

the leading causes often include

- Bactria – the most common bacteria that causes pneumonia is streptococcus pneumoniae. But chlamydia, Haemophilus influenza, and other types should always be in consideration.

- Viruses – cold and flu viruses are the most common in addition to the new coronavirus type or COVID-19

Other less common causes:

- Fungi - often affect the patient who has a chronic disease or a weakened immune system.

- Aspiration pneumonia, often because of food or vomit substances that are inhaled into the lungs.

Risk Factors:

- Young children less than two years

- Older people over 65 years

- Pollutant exposure

- Smoking and alcohol consumption

- Patient with respiratory conditions, like asthma

- Patient with a weak immune system or with a chemotherapy

When to see a doctor?

Pneumonia could be a life-threatening condition. So that patient should better watch out for his symptoms and take care of his health.

Call your doctor if:

- You have difficulty breathing with or without chest pain

- You have Persistent fever or persistent cough, especially with pus or blood

- You are at a high-risk group that is mentioned above.

Diagnosis:

Medical history and physical exams are as important as tests in diagnosing pneumonia.

A doctor usually Uses a stethoscope to hear the bubbling sound in your chest.

Lab tests. Especially blood tests are also essential to detect the inflammation and determine the infectious cause in the bacterial pneumonia case.

Diagnostic procedures. Like x-ray or CT scan are sometimes enough to diagnose pneumonia.

Pulse oximetry. It is often used to exclude hypoxemia.

Differential Diagnosis:

- Bronchitis

- Bronchiectasis

- Asthma

- Chronic obstructive pulmonary disease (COPD)

- Foreign body

- Respiratory failure

- Respiratory distress syndrome (RDS)

- Croup

- Epiglottitis

Management:

Mainly, well management depends on the type of pneumonia and the patient's health condition.

Viral pneumonia often improves with home remedies and getting enough rest, while bacterial pneumonia demands doctor-prescribed antibiotics that will affect the infectious factor.

And on the other hand, fungal pneumonia requires antifungal medications.

Patients classified in the high-risk group may need to be hospitalized or admitted to the intensive care unit (ICU), depending on how bad the condition is.

The patient at the (ICU) often gets oxygen therapy by a ventilator, and doctors will monitor his condition closely.

Finally, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References :

- Mayoclinic.org

- Webmd.com

- Nhs.uk

- Medscape.com

- Medlineplus.gov

Heavy Menstrual Bleeding - Causes and Treatment - Avicenna Health

Fri, 05 Nov 2021 15:00:06 GMT

Heavy Menstrual Bleedingh

Do you have any vaginal bleeding lately?

Do you suffer from bleeding between periods?

Do you have irregular periods?

In our article below, we will talk; about a widespread case: menorrhagia (heavy menstrual bleeding).

Definition of illness

Menorrhagia is menstrual bleeding that lasts, unlike usual greater than 7 days. It can also be bleeding when it comes heavily.

How could women know when they have heavy bleeding? If you need to use a tampon or pad, every 2 hours or pass clots the size of 1 / 4 or larger, this is heavy bleeding.

Symptoms

Soaking by using one or more sanitary pads or tampons every hour.
Need to apply double hygienic safety to control your menstrual flow.
Need to awaken to change clean protection throughout the night.
Bleeding for longer than a week.
Passing blood clots large than a quarter in most cases.
Restricting daily work because of heavy menstrual flow.
Symptoms of anemia, which include tiredness, fatigue, or shortness of breath.

Causes

Problems related to the uterus:

Uterine fibroids or polyps inside the uterus
cancer of the uterus or cervix
Certain types of contraception, for example, an intrauterine device (IUD)
Problems related to pregnancy period, such as miscarriage or ectopic pregnancy

Risk factors

The risk factors vary among young and old women and if there are any medical conditions or diseases that could cause someway menorrhagia. In a regular cycle, releasing an egg from the ovaries stimulates the body to produce progesterone. This female hormone is more essential for maintaining a normal period.

Heavy menstrual bleeding in adolescent girls is because of anovulation. Teenage girls are particularly prone to anovulatory cycles in the first year after their first menstruation.

Whereas in older women is due to uterine pathology, including fibroids, polyps, and adenomyosis; however, other problems such as uterine cancer, bleeding disorders, drug side effects, and liver or kidney disease can contribute.

When to see a doctor

You may see a doctor if you have any symptoms:

vaginal bleeding so hard that at least one pillow or tampon per hour has soaked for more than two hours
bleeding between periods or irregular vaginal bleeding

Diagnosis

Your doctor may ask you questions about your medical history and your menstrual cycles. You may be asked to register the bleeding days and the bleeding days, including notes on how important your blood flow is and the level of health protection needed to control it.

Therefore, your doctor may do a physical exam and may recommend one or more tests or procedures such as:

Blood tests: to check for iron deficiency or anemia
Pap smear
Endometrial ultrasound
Biopsy.

Differential diagnosis

Coagulation disorders
Endometrial polyps
Genitourinary infection
Intrauterine device
Liver disease/failure
Medications
Renal disease/failure
Steroid hormones
Uterine fibroids
Vascular imbalance
Adenomyosis

Management

The way patients will receive treatment depends on what leads to bleeding and how severe it is. Your doctor will also examine your age, general health, and medical history; how well it responds to a particular medication, procedure, or therapy.

Here are many of the most recommended treatments:

Iron Supplements: to get more iron into the blood and help it carry more oxygen when you have signs of anemia.

Ibuprofen: used to relieve pain, menstrual cramps, and bleeding. However, in some women, NSAIDs can increase the risk of bleeding.
Birth Control Pills: To make periods come regularly and reduce bleeding.
Intrauterine Contraception (IUC): To increase the regularity of your period and reduce the amount of bleeding from medication administered into the uterus.
Hormone therapy (drugs containing estrogen and/or progesterone) - to bleeding less.
Desmopressin nasal spray: to stop bleeding among people with certain bleeding disorders, such as B. von Willebrand's disease and mild hemophilia, by releasing a clotting protein or "factor" that is stored in the lining of the blood vessels that help the blood to clot and temporarily increases the level of these proteins in the blood.
Antifibrinolytics: is used to reduce bleeding by preventing a clot from breaking up.

References

Mayoclinic
CDC
NHS
Medscape

Obstructive Sleep Apnea - Causes and Treatment - Avicenna Health

Thu, 04 Nov 2021 15:00:08 GMT

Obstructive sleep apnea

Patient History:

A 40-years-old female with obstructive sleep apnea said: “two years ago, I had a loud snore and developed a constant headache. I started falling asleep quickly and could hardly stay awake. Unfortunately, things got worse; I began to fall asleep during work times. And my blood pressure became high, so I had to see a doctor.

The doctor diagnosed me with obstructive sleep apnea and asked me to do some lifestyle changes, which helped me a lot actually, and my condition improves within a few months.”

Definition of obstructive sleep apnea (OSA):

Obstructive sleep apnea (OSA): is a disorder that causes the breath to stop while sleeping.

This kind of apnea occurs when the airway muscles over relax and block the airway during sleep.

Older people are most susceptible, but it can affect young ones too.

How much time does it last?

This disorder is a long-term condition that may never improve without surgery, especially if the primary cause is anatomic. Otherwise, lifestyle changes and some medical devices may help a lot in improving the condition.

Symptoms :

Signs and symptoms may include:

Snoring – usually loud
Daytime tiredness and headaches
Difficulty concentrating
Depression and forgetfulness
Chocking during sleep (the most distinguished symptom)
Sore throat and dry mouth
Nocturia – which is waking up during the night to pee
Sweating or feeling wetness in the bed

Childs can also present with learning problems due to the lack of getting enough rest.

Causes:

Mainly, Sleep apnea occurs when the airways get narrow, causing the breathing to stop dozens of times during sleep. So that Causes can be widely differing. It may include:

Enlarged tonsils or adenoids
Nasal congestion
Sinusitis
Deviated nasal septum
Nasal polyps

Some rare cases can be accompanied by obstructive sleep apnea like:

Dawn syndrome
Prader-Willi syndrome
Pierre robin syndrome
Marfan syndrome

Risk Factors:

Overweighed patients
Alcohol consumption
Male patients more than female ones
Smoking
Sleeping on the back
Patient who has relatives with obstructive sleep apnea (OSA)
Postmenopausal state
Older people
Rapid eye movement sleep (REM sleep)
Being a black, Hispanic, or native American patient
Having a large tongue

When to see a doctor?

A patient may not feel any symptoms except daytime headaches, tiredness, and difficulty concentrating; in this case, the patient’s partner may observe night signs like loud snoring or gasping.

Anyway, the signs and symptoms that require a medical consultation include:

Loud snoring that disturbs others sleep
Chocking while sleeping
Extreme drowsiness that prevents you from doing daily work
Repeatedly gasping while sleeping

These signs and symptoms should be taken seriously because neglected obstructive sleep apnea can cause you a severe health condition.

Diagnosis:

Medical history and physical exams often help diagnose obstructive sleep apnea. If you have a partner, you may need to bring him so that the doctor can ask him about your sleep pattern and habits.

A doctor may ask you to do polysomnography in sleep centers.

Polysomnography is a sleep study that measures many things while you sleep, like breathing rate, heart rate, oxygen levels, brain waves, and body movements.

Imaging procedures like x-ray can be done to determine the anatomical cause in some cases.

Differential Diagnosis:

Central sleep apnea
Chronic obstructive pulmonary disease (COPD)
Asthma
Gastroesophageal reflux disease (GERD)
Hypothyroidism
Pulmonary edema

Management:

Lifestyle change plays an essential role in managing mild obstructive sleep apnea, especially when you have a risk factor.

These changes often include:

Losing weight
Quitting smoking
Avoid sleeping on the back
Reducing the amount of alcohol you drink

A doctor may prescribe a decongestant if you have congestion; it often improves the condition.

For more severe conditions, you might need to use a continuous positive airway pressure device (CPAP device), a mask that pumps air into your airway to keep it from closing or narrowing while you sleep.

When none of these solutions helps you, surgery would be the last option.

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

Mayoclinic.org
Webmd.com
Medscape.com
Nhs.uk

Ovarian Cancer - Symptoms and Treatment - Avicenna Health

Wed, 03 Nov 2021 15:01:15 GMT

Ovarian Cancer

Do you feel continuously bloated?

Do you have a swollen tummy?

Do you get any discomfort in the tummy or pelvic area?

Or do you feel full quickly when eating?

Do you need to pee more frequently than usual?

Definition of the illness:

Ovarian cancer, or cancer of the ovaries, is one of the most common cancers in females.

The ovaries are a couple of small organs located low in the tummy linked to the womb and save a woman's supply of eggs.

Ovarian cancer mainly influences females who have been through menopause (commonly over the age of 50); however, it could occasionally affect women that are more youthful.

Symptoms:

When ovarian cancer first develops, it may not cause significant signs or symptoms. When symptoms of ovarian cancer do occur, they are usually attributed to other, more common conditions.

The signs and symptoms could also include:

Flatulence or gas
Feeling bloated when eating
Weight loss
Pelvic discomfort
Fatigue
Back pain
Changes in bowel habits, including constipation

Causes:

It's identified what causes ovarian cancer, though doctors have determined things that may increase the possibility of the disease.

Doctors Say that ovarian cancer begins as soon as cells close to the ovaries develop changes in their DNA.

A cell's DNA include the instructions that tell the cell how to work. The changes mean the cells grow and multiply quickly, creating cancer cells' mass (tumor).

The cancer cells continue working when healthy cells would die. They could invade nearby tissues and break off from an initial neoplasm to unfold (metastasize) to different areas of the body.

Risk Factors:

Many factors that could increase the risk of getting ovarian cancer consist of:

1- Older age Inherited gene changes: The genes that increase the risk of ovarian cancer are BRCA1 and BRCA2.

2- Family background of ovarian cancer.

3- Overweight or obese.

4- Postmenopausal hormone replacement therapy.

5- Endometriosis.

6- Age when the menstrual period starts and ends: Beginning earlier or starting menopause at a later age, or both, may also increase the risk.

7- Never having been pregnant.

When to see a doctor

Make an appointment with a physician when you have any signs or symptoms that worry you.

Diagnosis:

Tests and strategies used to diagnose ovarian cancer consist of:

1- Pelvic exam: During a pelvic exam, your physician inserts gloved fingers into the vagina and concurrently presses a hand in Belly with the purpose to feel (palpate) pelvic organs. The physician additionally visually examines external genitalia, vagina, and cervix.

2- Imaging tests. Tests, including ultrasound or CT scans of the abdomen and pelvis, may also assist in determining the size, form, and structure of ovaries.

3- Blood tests. Blood tests may include organ function tests which can assist decide standard health.

Your physician may also check your blood for tumor markers that imply ovarian cancer. For example, a cancer antigen (CA) 125 check can discover a protein frequently located on the surface of ovarian cancer cells. These tests cannot inform a physician whether you have cancer, but they will make clues about diagnosis and prognosis.

4- Surgery: Sometimes, your physician cannot be sure of prognosis until you undergo a surgical operation to get rid of an ovary and have it examined for signs of cancer.

5- Genetic testing: Your physician may also suggest testing a blood sample to search for gene modifications that increase the danger of most ovarian cancers.

Differential Diagnosis:

Appendiceal tumors
Benign lesions of the uterine corpus
Bladder distention/urinary retention
Bowel omental adhesions
Colon cancer
Embryologic remnants
Fecal impaction
Gastric adenocarcinoma
Low-lying cecum
Metastatic gastrointestinal carcinoma
Ovarian torsion
Pelvic abscess
Pelvic kidney
Peritoneal cyst
Retroperitoneal mass
Urachal cyst
Uterine anomalies
Uterine fibroids

Management:

The treatment relies upon how far it has spread, your general health, and whether you are still capable of having babies. Most people have a mixture of both surgical and chemical treatment. Surgery is the principal treatment. The purpose is to get rid of all cancer, or as much of it as possible.

1- Surgical treatment usually includes removing:

ovaries
the fallopian tubes
metrectomy
a layer of fatty tissue inside the tummy

2- Chemotherapy is where medication is used to kill cancer cells. Most females with ovarian cancer have chemotherapy similar to surgery.

3- Radiotherapy: Radiotherapy uses cautiously directed beams of radiation to kill cancer cells.

4- Targeted therapies: Targeted therapies are drugs that change the way cells work and stop cancer from developing and spreading. Not all kinds of ovarian cancer may be handled with targeted therapies.

References:

Mayoclinic
NCBI
Medscape

Pericarditis - Symptoms, Causes, and Treatment - Avicenna Health

Tue, 02 Nov 2021 15:00:06 GMT

Pericarditis

Our article is about an important cause of chest pain; Pericarditis. Though it is not really as serious as angina pectoris, it can lead to bad complications if left untreated or not diagnosed in the early stages.

Definition of Pericarditis

Pericarditis is inflammation and irritation of the pericardium, which is a thin, sac-like tissue that surrounds the heart. The pericardium has two layers which have a small amount of fluid between them. This fluid is to lubricate the heart. The pericardium helps to keep the heart in place inside the chest wall. Pericarditis can cause sharp chest pain and other symptoms that we will see below.

Symptoms

- Chest pain: which is the most common symptom of pericarditis. It is usually a sharp, stabbing pain. It occurs behind the breastbone or on the left of the chest. It gets worse while coughing, lying down, or taking a deep breath. It gets better while sitting up or leaning forward.

- Cough

- Fatigue

- Fever

- Heart palpitations

- Shortness of breath

Causes

Sometimes, doctors cannot determine the cause of pericarditis, and that is called idiopathic pericarditis. Causes can include:

- Heart surgery or heart attack

- Infection

- Systemic inflammatory diseases, such as rheumatoid arthritis or lupus

- Trauma

- Radiation treatment

- Other diseases may include kidney failure, tuberculosis, AIDS, or gout.

Risk Factors

The risk factors are the same as the causes above.

When to see a doctor?

As we always say, any patient with chest pain should seek medical advice as soon as possible. Because the sooner we diagnose the disease, the better the response to the treatment will be.

Diagnosis

- ECG: to see if there are changes that indicate pericarditis

- Serum troponin: to see if there is acute coronary syndrome or myocarditis

- Pericardiocentesis: to do lab tests on the pericardial fluid

- CRP: it can be elevated

- Full blood count: we can see elevated white blood cells

- Liver function tests: elevated if there is liver congestion

- Serum urea: to rule out the uremic cause

- Electrolytes

- Chest X-Ray

- Echocardiograph

- Autoimmune screen: to see if there is any immune disease

- Viral screen

- Chest CT or cardiac MRI

- Pericardial biopsy

Differential Diagnosis

- Pulmonary embolism

- Myocardial infarction

- Pneumonia

- Pneumothorax

- Costochondritis

Management

The treatment of pericarditis depends on the severity and the cause of the disease. Medications are often described to reduce swelling and inflammation.

- Medications can include:

- Colchicine

- Corticosteroids

- Pain relievers: such as Aspirin or Ibuprofen

If the cause of the pericarditis is bacterial, antibiotics will be described, and even drainage if necessary.

Most patients recover in two to four weeks.

· Surgery or other procedures:

- Pericardiocentesis: doctors use a sterile needle or small catheter to drain the excess fluid from the pericardium cavity.

- Pericardiectomy : in this surgery, we remove the entire pericardium.

References

Mayo clinic – BMJ – Healthline – WebMD – American Heart Association

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Endocarditis - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 01 Nov 2021 15:15:06 GMT

Endocarditis

Endocarditis, a rare but severe cardiac disease. Its importance comes from the causes and the risk factors of the disease. People can get this disease in different ways. Some of these ways are weird, such as after going to the dentist!. Let’s figure out the causes of endocarditis and what we should do when susceptible to this disease.

Definition of Endocarditis

Endocarditis is a life-threatening and severe inflammation of the inner lining of the heart valves and chambers (the endocardium). It’s often caused by bacteria, fungi, or other germs from other parts of the body, such as the mouth. These germs can travel and spread through the bloodstream and damage different areas of the heart.

Symptoms

We need to know that endocarditis can develop slowly or suddenly, and that depends on the germs that are causing the disease and if the patient has underlying heart problems. Signs and symptoms of the disease can vary from one person to another.

Signs and symptoms can include:

1. Chest pain

2. Muscle and joint pain

3. High fever and chills (flu-like symptoms)

4. Fatigue

5. Night sweats

6. Shortness of breath

7. Abnormal heart sound (a murmur)

8. Unexplained weight loss

9. Red spots on the soles of the feet or the palms of the hands (they’re called Janeway lesions)

10. Red, tender spots under the skin of the fingers or toes (they’re called Osler's nodes)

Causes

Endocarditis occurs when germs or fungi enter the bloodstream and travel to the heart. And these bacteria and fungi can enter the bloodstream through:

- inadequate dental care: If a person doesn’t take care of his teeth, brushing could cause unhealthy gums to bleed, and that will give bacteria a chance to enter the bloodstream.

- Catheters: Bacteria can enter the patient’s body through a thin tube that doctors use to inject or remove fluid from the body (catheter).

- Illegal IV drugs

Risk Factors

People with these risk factors are more likely to have endocarditis than other healthy people:

- Old age: often over the age of 60

- Artificial heart valves

- Congenital heart defects

- Implanted heart device

- History of endocarditis

- History of illegal IV drug use

- Using catheters for a long time

- Bad dental health

When to see a doctor?

Any patient with chest pain should seek medical advice right away.

In addition to that, everyone who has any of the risk factors above with any of the previously stated signs and symptoms should see a doctor ASAP.

Diagnosis

- Blood culture: to see if there is bacteremia or fungemia

- Echocardiography: to see valvular vegetations

- Full blood count: to see if there is anemia

- CRP: it is elevated

- Serum urea

- Serum electrolytes

- Serum glucose

- Liver function test

- ECG

Differential Diagnosis

- Rheumatic fever

- Atrial myxoma

- Libman-sacks endocarditis: it is a disease that happens in patients with lupus

- Non-bacterial thrombotic endocarditis

Management

Many patients with endocarditis can be treated successfully with antibiotics. Surgery could be needed to fix the damaged heart valves.

References

Mayo Clinic – BMJ – Healthline – American Heart Association

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Polycystic Ovarian Syndrome - Avicenna Health

Sat, 30 Oct 2021 15:00:04 GMT

Polycystic Ovarian Syndrome

Definition of Illness

A polycystic ovarian syndrome is a widespread case related to hormones that happen among women of reproductive age. Women with PCOS may have infrequent or unnormal menstrual periods or increasing androgen hormone levels. The ovaries may develop many follicles and fail to regularly release eggs.

Symptoms

Irregular periods: that are Infrequent, irregular, or prolonged. Therefore, women might have fewer than nine periods a year, more than 35 days between periods, and heavy periods.

Increased androgen: high levels of these male hormones might cause physical signs, such as facial and body hair (hirsutism) and sometimes-severe acne and male-pattern baldness.

Polycystic ovaries: ovaries might get more enlarged and contain follicles surrounding the eggs, failing to function regularly.

Causes

Excess insulin: it might increase androgen production, so it may be the reason that makes ovulation more difficult.

Low-grade inflammation: This indicates white blood cells' production of necessary substances to fight infection.

Heredity: there are specific genes that might be linked to PCOS.

Excess androgen: when the ovaries produce abnormally high androgen levels, it results in hirsutism and acne.

Risk factors

_ Familial history of previous PCOS

_ Overweight

_ Obesity

_ Insulin resistance

_ Hyperinsulinemia

_ Hyperandrogenism

_ Over consumption of diets and drinks containing high rich in sugar, fructose, transfat, animal fat, and processed foods

When to see a doctor

You should see the doctor if you have any of the following cases:

Menstrual periods disorders

Having signs of excess androgen such as worsening hirsutism, acne, and male-pattern baldness.

Diagnosis

Pelvic exam: the doctor checks the whole reproductive system for masses, growths, or other abnormalities.

Blood tests: blood analysis will measure hormone levels to exclude possible causes of menstrual irregularities or androgen excess that mimics PCOS. In addition, there is additional blood testing to measure glucose tolerance and fasting cholesterol and triglyceride levels.

Ultrasound: which check the appearance of ovaries and the thickness of the lining of the uterus.

Management

Lifestyle changes: weight loss through a diet and sport practicing

Medications

1- Combination of birth control pills: Pills that contain estrogen and progestin decrease androgen production and regulate estrogen.

2- Progestin therapy: Taking progestin for 10 to 14 days every one to two months can regulate periods and protect against endometrial cancer.

To help to ovulate, the doctor might recommend:

Gonadotropins
Metformin
Clomiphene

To reduce excessive hair growth, the doctor might recommend:

Birth control pills: These pills decrease androgen production, which leads to excessive hair growth.

Spironolactone (Aldactone): is a medication that stops the effects of androgen on the skin.

Letrozole

Eflornithine (Vaniqa): it is a cream slowing facial hair growth

Electrolysis: A process that uses a tiny needle inserted into hair follicles, emitting a pulse of electric current to destroy the follicles.

Differential diagnosis

Ovarian hyperthecosis
Congenital adrenal hyperplasia
Medication (eg, danazol, androgenic progestins)
Hypothyroidism
Familial hirsutism
Masculinizing tumors
Cushing syndrome
Hyperprolactinemia
Exogenous anabolic steroid use
Stromal hyperthecosis (valproic acid)

References

Medscape
mayo clinic
Peertechz

Menopause - Symptoms, Causes, and Treatment - Avicenna Health

Tue, 19 Oct 2021 15:00:03 GMT

Menopause

Do you suffer from changing periods - shorter or longer, lighter or heavier, with more or less time in between?

Do you have any sleeping problems

Do you have mood swings lately?

If yes, you may have menopause, so that we will explain it in our article.

Definition of menopause

Menopause is the condition when a woman's lifestyles change, so the menstrual period stops. It usually happens, most usually after age 45.

Menopause includes stopping ovaries from producing both hormones (estrogen and progesterone).

It is diagnosed after you have gone twelve months without a period.

Symptoms :

Irregular periods

Vaginal dryness

Hot flashes

Chills

Night sweats

Sleep problems

Mood changes

Weight gain and slowed metabolism

Thinning hair and dry skin

Loss of breast fullness

Causes:

Menopause is caused by a modification in the balance of the body's sex hormones, which happens, as you get older.

It happens once your ovaries stop manufacturing as much of the hormone estrogen and no longer release an egg every month.

Premature or early menopause may occur at any age, and there' no apparent cause in several cases.

Sometimes it's caused after a treatment such as surgery to get rid of the ovaries (oophorectomy), some breast cancer treatments, chemotherapy or radiotherapy, or it may be brought on by an underlying condition, such as Down' syndrome or Addison' disease.

Risk factors:

Previous cases in the family
Surgery to remove the ovaries
Radiation therapy
Chemotherapy
Taking medicines that lower estrogen levels
Smoking
Problems with the immune system

When to see a doctor:

It is recommended to a doctor if you have any symptoms of menopause that worry you or if you experience symptoms of menopause before the age of 45.

They can usually confirm whether you are going through menopause based on your symptoms. Still, a blood test to measure hormone levels can be done if you are under 45.

Diagnosis

The signs and symptoms are usually enough to tell most women that they have started going through menopause. If you have some concerns about irregular periods or hot flashes, talk to your doctor. In some cases, a more in-depth assessment may be recommended.

Tests are generally not necessary to diagnose menopause, but in certain circumstances, your doctor may recommend blood tests to check the level of:

Follicle-stimulating hormone (FSH) and estrogen (estradiol): Your FSH levels increase and your estrogen levels decrease as you have menopause.

Thyroid-stimulating hormone (TSH): When women have hypothyroidism, it leads to cause symptoms similar to those of menopause.

Differential diagnosis:

Adjustment Disorders

Anemia

Depression

Dysthymic Disorder

Hypothyroidism

Dementia

Secondary depression

Endocrine disorder

Substance abuse

Medications

Treatment:

Hormone replacement therapy (HRT) tablets, skin patches, gels, and implants that relieve symptoms of menopause by replacing estrogen creams, lubricants, or moisturizers for vaginal estrogen for vaginal dryness

cognitive-behavioral therapy (CBT) - a type of verbal therapy that can help with moodiness and anxiety

Eating healthily, balanced diet, and exercise regularly: Maintaining a healthy weight and staying fit and strong can improve some symptoms of menopause

References

Mayo clinic

Medscape

Medline plus

Hepatitis A - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 18 Oct 2021 15:00:03 GMT

Hepatitis A

Jennifer was 17 years old when she went out for Mexican food to celebrate her friend’s birthday. A few weeks later, she developed fever, stomachaches, weakness, muscle pain, nausea and, vomiting. Her urine turned dark brown, and her skin turned yellow. She couldn't breathe without feeling like she was being stabbed in her abdomen, below her rib cage. The girl's parents took her to the doctor, where a blood test revealed the diagnosis, which was hepatitis A virus.

Definition of Hepatitis A

It is a contagious liver infection that is caused by a virus called The Hepatitis A Virus.

This type is one of several types of hepatitis viruses that can cause inflammation and affect the liver’s ability to function.

Symptoms

The signs and symptoms of Hepatitis A appear after getting the virus for a few weeks.

Many patients don’t develop them, but the common symptoms and signs are:

1. Nausea

2. Vomiting

3. Fatigue

4. Abdominal pain – beneath the lower ribs

5. Loss of appetite

6. Joint pain

7. Itching

8. Fever

9. Dark urine

10. pale-colored poop

11. Jaundice – the color of the skin and the eyes become yellow

12. Diarrhea

Causes of Hepatitis A

Patients get the virus after drinking or eating something contaminated with the virus (fecal matter).

Hepatitis A virus may also be spread by close contact with an infected patient.

Patients can also contract the virus in several ways, for example:

- Eating food prepared by hepatitis A patient

- Eating sewage-contaminated raw shellfish

- Having sex with a patient who has Hepatitis A virus.

Risk Factors

- Traveling to countries where hepatitis A is common

- Having close contact with a hepatitis A patient

- Having sex with a hepatitis A patient

- HIV positive

- A man who has sex with men

- Injecting or using illegal drugs

- Homeless people

- Having a blood-clotting disorder like Hemophilia

When to see a doctor?

- You need to see your doctor if you have any of the signs and symptoms of Hepatitis A.

- Ask the doctor about receiving the hepatitis A vaccine if you have any of the risk factors.

Diagnosis

- Serum transaminases – it is elevated

- Serum bilirubin – it is elevated

- Blood urea – it is elevated in a severe liver disease

- Serum creatinine - it is elevated in a severe liver disease

- Prothrombin time – it can be mildly prolonged

Differential Diagnosis

- Acute hepatitis B

- Hepatitis E

- Acute Hepatitis C

- Epstein-Barr Virus infection

- Coxsackievirus infection

- Cytomegalovirus infection

- Herpes simplex virus infection

- Biliary atresia

- Auto-immune hepatitis

- Alpha-1 antitrypsin disease

- Alcoholic hepatitis

- Ischemic hepatitis

- Drug-induced hepatitis

- Wilson’s disease

Management

There isn’t any specific treatment for hepatitis A.

In most cases, the liver heals within six months.

There is no lasting damage in most cases of Hepatitis A.

Patients of Hepatitis A need to:

1. Rest – because many patients feel tired and have less energy

2. Manage nausea

3. Avoid alcohol

4. Use medications with care

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

References

Mayo Clinic

BMJ

Healthline

WebMD

Angina Pectoris - Symptoms, Causes, and Treatment - Avicenna Health

Sun, 17 Oct 2021 15:00:06 GMT

Angina Pectoris

When people have pain in their chest, they start to panic and freak immediately because they know that chest pain is a bad indicator of something serious happening in their bodies. Heart dying, maybe! Or something less dangerous. Let’s figure out cardiac chest pain and how to describe it and differentiate it from other causes of chest pain.

Definition of Angina

It is a chest pain that is felt when the heart doesn’t get enough blood. It is often described as squeezing, tightness, pressure, heaviness, or pain in the chest. Some people describe it as if there is a heavyweight lying on their chest. People may also feel discomfort in the neck, jaw, arm, and shoulder.

Symptoms

- Chest pain or discomfort: it occurs when the heart needs to work harder, like when doing exercise. This pain does not come as a surprise. It usually lasts for 5 minutes or less. It can be relieved by medicine or rest.

- Dizziness

- Fatigue

- Nausea

- Shortness of breath

- Sweating

Causes of Angina

As previously stated, angina happens because the heart does not get enough blood to pump and work properly. The most common cause of that is atherosclerosis, when the heart arteries become narrowed by fatty deposits.

Risk Factors

- Smoking: it damages the walls of the arteries and allows deposits of cholesterol to build up and block the blood flow

- Diabetes: it can increase the risk of having atherosclerosis

- High blood pressure: it can damage the arteries

- High blood cholesterol

- Family history

- Old age

- Obesity

- Stress

When to see a doctor?

- Anyone who feels pain in the chest should see their doctor and seek medical advice as soon as possible.

Diagnosis

- Resting ECG: it may show some changes that suggest ischemia or prior infarction

- Cardiac enzymes

- Hemoglobin: patients can have anemia

- Lipid profile: to see if there is a high cholesterol level

- Fasting blood glucose: it is elevated if the patient has diabetes

- Exercise tolerance test: it is doing ECG while the patient is running on a treadmill

- Cardiac CT angiography: to see if there is a narrowing of the arteries

- Invasive coronary angiography

- Chest X-Ray

- Rest echocardiography

- Thyroid-stimulating hormone

Differential Diagnosis

- Aortic dissection

- Pericarditis

- Pulmonary embolism

- Pneumothorax

- Pneumonia with pleurisy

- Esophagitis

- Esophageal spasm

- GERD

- Biliary colic

- Cholecystitis

- Cholangitis

- Peptic ulcer disease

- Acute pancreatitis

- Fibromyalgia

- Herpes zoster virus infection

- Sternoclavicular arthritis

- Anxiety disorders and panic attacks

Management

The main purpose of the management is to reduce the severity and frequency of the symptoms and to lower the risk of having heart attacks and death.

· Lifestyle changes: stop smoking – daily sport – managing diabetes and high blood pressure – managing stress – managing obesity – dietary adjustment

· Medications: and that can include:

- Nitrates

- Beta-Blockers

- Calcium channel blockers

- Statins

- Aspirin

- Blood-pressure lowering medications

· Surgery: for more advanced cases

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

References

Mayo clinic – BMJ – Healthline – American Heart Association

Wilsons Disease - Symptoms, Causes, and Treatment - Avicenna Health

Sat, 16 Oct 2021 15:00:04 GMT

Wilson’s Disease

Have you ever heard about a disease in which people have more copper than anyone else!?

Our article is about an interesting rare disease called Wilson’s disease.

This disease is often diagnosed between the age 5 and the age 35, but it can affect older and younger people, as well.

Definition of Wilson’s disease

It is a rare genetic condition that causes the liver, the brain, and other vital organs to retain excess copper. In this disease, the liver of a patient doesn’t release copper into the bile, and because of that, copper builds up in the liver and begins to damage the organ.

Symptoms

We need to know is that this disease is present at birth, but signs and symptoms do not appear until the copper accumulates and builds up in the organs. Some people with Wilson’s disease might not develop signs and symptoms of liver disease until they develop acute liver failure. Signs and symptoms of this disease may include:

1. Fatigue

2. Loss of appetite

3. Weight loss

4. Nausea and vomiting

5. Muscle cramps or stiffness

6. Abdominal pain

7. Jaundice – the color of the skin and the eye become yellow

8. Edema – it is when fluid buildup in the abdomen or legs

9. Kayser-Fleischer ring – it is a golden or greenish-brown ring in the eye

10. There are also neurological symptoms such as depression, having problems with swallowing and speech, and changes in mood

Causes of the disease

It is an inherited condition, so the cause is genetic.

Risk Factors

A person can be at increased risk if his parents or siblings have the disease.

When to see a doctor?

If your parents or siblings have the condition, you need to ask your doctor whether you should get tested to determine whether you have the disease. Early diagnosis increases the chances of successful treatment. Still, untreated Wilson’s disease can be fatal or has serious complications that may include:

- Cirrhosis (scarring of the liver)

- Liver failure

- Blood problems

- Psychological problems

- Kidney problems

- Persistent neurological problems

Diagnosis

1. Liver function tests – they are abnormal in this disease

2. 24-hour urine copper

3. Full blood count

4. Slit-lamp examination – to see Kayser-Fleischer rings

5. Blood ceruloplasmin

6. Liver biopsy

7. MRI brain

8. Blood free copper

9. DNA testing for ATP7B mutations

Differential Diagnosis

- Viral hepatitis B

- Viral hepatitis C

- Hemochromatosis

- Alpha-1 antitrypsin deficiency

- Auto-immune hepatitis

- Steatohepatitis

- Alcoholic hepatitis

- Hemolytic anemia

Management

Doctors can recommend taking medications called chelating agents, which can bind copper and then prompt the organs to release the copper into the bloodstream. Then copper is filtered by the kidneys and then released into the urine.

Medications can include: Penicillamine – Trientine - Zinc acetate.

Liver transplantation can be necessary for severe liver damage.

References

Mayo Clinic – BMJ – Healthline

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Inflammatory Bowel Disease IBD - Avicenna Health

Fri, 24 Sep 2021 14:00:02 GMT

Inflammatory Bowel Disease (IBD)

Our article will be about an important disease in Gastroenterology; it is called Inflammatory bowel disease (IBD). IBD is divided into two main diseases; Crohn’s disease and ulcerative colitis.

This disease is widespread and has bad effects and complications if left untreated.

Definition of IBD

IBD is a chronic inflammation of the lining of the digestive tract. If the inflammation and ulcers are in the superficial lining of the colon and rectum, that would be Ulcerative Colitis, and if the inflammation is in the deeper lining, that would be Crohn’s disease.

Symptoms

Symptoms of IBD depend on the location and severity of the inflammation. It can vary from mild to severe symptoms.

There are periods of active disease (flares) and periods of remission.

The most common symptoms are:

- Diarrhea – it can be bloody

- Weight loss and loss of appetite

- Fatigue

- Abdominal pain and cramps

- Rectal bleeding – and this can cause iron deficiency anemia

- Ulcers in the mouth and around the genital area or the anus

In addition to that, people with IBD can have other problems and symptoms that are unrelated to the digestive system, such as skin disorders, eye inflammation, and arthritis.

Causes of IBD

The real cause of IBD is still unknown. But one plausible cause is an immune system malfunction.

Risk Factors

- Age – most IBD patients are diagnosed before they are 30 years old

- Ethnicity – whites have a higher risk of having IBD

- Family history

- Smoking

- NSAIDs overuse (like ibuprofen and naproxen)

When to see a doctor?

If you have severe symptoms and any of the complications of the disease.

For example:

1. Colon cancer

2. Eye, skin, and joints inflammation – arthritis, uveitis, and skin lesions

3. Blood clots

4. Bowel obstruction

5. Malnutrition

6. Fistulas – which mean an abnormal connection between different body parts

7. Anal fissures

8. Toxic megacolon

9. Colon perforation

Diagnosis

- FBC – we can find anemia

- Serum vitamin B12 and B9 (serum folate) – to see if there is a deficiency in these vitamins because of malabsorption.

- CRP and ESR – they are elevated

- Stool testing

- Abdominal X-Ray – it can show colonic dilatation, calcification, sacroiliitis, and abdominal abscesses.

- Colonoscopy and tissue biopsy

- Upper GI Endoscopy

- CT abdomen

- MRI abdomen\pelvis

Differential Diagnosis

- Infectious Colitis

- Pseudomembranous colitis

- Ischemic colitis

- Radiation colitis

- Intestinal tuberculosis

- Diverticular disease

- Pelvic inflammatory disease

- Irritable Bowel Syndrome

Management

The main purpose is to reduce inflammation, induce long-term remission and reduce the risk of complications.

- Drug therapy:

Anti-inflammatory drugs
Immune system suppressors
Biologics
Antibiotics
Anti-diarrheal medications
Pain relievers
Vitamins

- Nutritional Support – if the weight loss is severe.

- Surgery – if drug therapy and lifestyle changes don’t relieve the IBD symptoms.

References

Mayo clinic

BMJ

WebMD

Healthline

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Covid 19 - Symptoms, Causes, and Treatment - Avicenna Health

Thu, 23 Sep 2021 14:00:07 GMT

Patient History

A 30-year-old patient with COVID-19 said: “yesterday I felt a little tired; I had a dry cough with mild fever. And today, I feel pressure in my chest, and my breathing becomes harder over time. I wasn’t taking the precautionary measures seriously. Do I have COVID-19?”

So what is COVID-19?

Definition of COVID-19

COVID-19: is a disease caused by a new type of coronavirus that leads to an outbreak in China in late 2019 and quickly spreads worldwide.

Coronavirus is a family of viruses that usually infect the respiratory system causing the common cold, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and others.

How much time does it last?

It usually takes about two weeks to recover, especially in mild cases. But in some severe cases, it may last for more than six weeks.

Anyway, symptoms take about 2-14 days to develop from the moment of infection. So if you think you have been exposed to the virus, quarantine yourself for at least two weeks.

Symptoms

COVID-19 causes symptoms that can differ from one person to another; often include:

- Fever

- Coughing – usually dry

- Breath shortness - Medically known as dyspnea, which is the difficulty of getting enough air.

- Sore throat – A scratchy feeling in the throat. It often worsens when you swallow.

- Chest tightness – A discomfort or heaviness feeling in your chest.

Other symptoms may include:

- Loss of smell or taste

- Headache

- Tiredness

- Nausea

- Diarrhea

- Runny nose

- Rash

In rare cases, COVID-19 may cause neurological disorders as a complication that seek medical care such as strokes, brain inflammation, and others.

Causes

As we already mentioned, COVID-19 is caused by a virus from the coronavirus family. Unfortunately, its RNA can quickly mutate, making it harder for vaccines and antibodies to work effectively. And like other viruses, their ability to spread easily makes things worse. It can mainly spread by inhaled droplets of coughing or sneezing or transmitted by airborne transmission from aerosol that stays in the air for hours.

Risk Factors

COVID-19 can infect people of all ages and races, but older people are more likely to be at risk.

Other risk factors may include:

- People with Chronic kidney diseases

- People with chronic obstructive pulmonary disease (COPD), asthma, and other pulmonary conditions

- People with hypertension and cardiovascular conditions

- People with diabetes

- People with a weak immune system

- Pregnancy

And we should not forget that the lack of precautionary measures plays the primary role in getting COVID-19, such as social distancing (about one meter at least), wearing masks, washing hands, and many others.

When to see a doctor?

In mild conditions, symptoms may improve within two weeks.

But if you have a severe condition or one or more chronic diseases, as in the risk factors above, you need to call a doctor right away to get medical care.

Other signs and symptoms that indicate a severe condition include:

- Difficulty breathing

- Bluish face or lips

- Chest tightness

- Confusion

Diagnosis

Unfortunately, Clinical exams are not sufficient to tell if the patient has COVID-19 or other respiratory conditions, so the lab test is crucial.

- Lab test. The most important lab test is the polymerase chain reaction (PCR) using a nasopharyngeal or throat swap. In most cases, it takes about 24 hours to get the result. If the test is positive, it means you have the virus in your body, but unlike expected, if the result is negative, it does not always mean that there is no virus; it may mean that there are no enough viruses to measure. Detection of antibodies also can be performed, which can tell if you have ever been exposed to the virus.

- Diagnostic procedures. Like chest x-ray and CT scan.

Differential Diagnosis

- Common cold

- Influenza

- Parainfluenza

- pneumonia

- atypical pneumonia

Management

The mild condition requires self-quarantine, basically, and home remedies that help in relieving the symptoms.

A serious condition, in addition to mild one with risk factors, often seek medical care.

Unfortunately, there is no specific treatment for covid-19, but researchers are working day by day and improving vaccines to eliminate this virus.

And as they say, prevention is better than cure, and to prevent the infection; you need to take precautionary measures like:

- keep a social distancing (one meter at least)

- avoiding crowds

- wear a mask, use a medical one if you are in a high-risk group

- keep using sanitizers each time you touch a suspected surface

- take your doses of the vaccine if you do not get it yet

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References

mayoclinic.org

webmd.com

who.int

drugs.com

Medscape.com

Health.com

COPD - Symptoms, Causes, and Treatment - Avicenna Health

Wed, 22 Sep 2021 14:00:03 GMT

Patient History

A 68-year-old man with a smoking history of one pack per day for 40 years has been diagnosed with COPD.

He came to the clinic with progressive shortness of breath and chronic cough, productive of yellowish sputum. On examination, he appears cachectic. His neck veins are mildly distended. Lung examination reveals a barrel chest with moderate inspiratory and expiratory wheezing.

So what is COPD?

Defintion of COPD

COPD or chronic obstructive pulmonary disease is a group of conditions that affect the lung, causing difficulty breathing and other progressive respiratory symptoms that worsen over time.

There are two main conditions that can be found in COPD:

- Emphysema – destruction in the alveoli (air sacs) due to irritating gases such as smoking

- Chronic bronchitis – an inflammation that affects the bronchial tubes, characterized by a long-term secreting mucus, coughing, and wheezing

How much time does it last?

Unfortunately, COPD is a long-term condition that cannot be cured or even reversed. Even though in most cases, its symptoms can be well controlled by using the right treatments.

Symptoms

Some patients may not feel any symptoms initially, but sooner or later, symptoms will start to appear as the lung damage gets worse. Anyway, symptoms often include:

- Breath shortness - Medically known as dyspnea, which is the difficulty of getting enough air. Especially after exercises or tiring activities.

- Cough – often productive; its product can be yellow, green, or clear.

- Wheezing – A whistling sound happens when the airways are tightened.

- Chest tightness – A discomfort or heaviness feeling in your chest.

In addition to:

- Frequent respiratory infections

- Bluish fingers

- Weight loss

- Swollen feet or ankles

- Fatigue

Causes

Mainly, tobacco smoke is the most common cause of COPD. Secondhand smoking is also considered as one of the causes.

Smoker patients have to cut off smoking immediately because the more you smoke, the longer you have smoked, the worst your condition will be.

Smoking seems to be not the only cause; there is a lot of others that can be considered:

- Irritating substances, whether chemical or environmental, like dust, fuels’ fumes, and many others.

- Genetics causes such as Alpha-1-antitrypsin deficiency (AAT).

Risk Factors

- Smoker patients

- Patients with asthma

- Pollutant exposure, for dust or chemicals

- Patients older than 40

And we should put into consideration that frequent respiratory infections in childhood increase the risk of getting COPD in adulthood.

When to see a doctor?

COPD can be a life-threatening condition and demand medical care in some cases. Call your doctor if your symptoms are persistent or getting worse over time.

Other signs and symptoms that indicate a severe condition include:

- A severe breath shortness

- Fast breath

- Fast heartbeats

- Bluish face or lips

Diagnosis

A doctor will ask you to do some tests besides a physical examination and take a complete medical history.

Lung functions tests play the leading role in diagnosing. Often include Spirometry. A test performs using a small machine called a spirometer to measure how much air you can breathe in and out and how fast.

Diagnostic procedures , such as chest X-rays or CT scans, are essential too. Mainly, they can show emphysema, one of the leading causes of COPD, in addition to ruling out other pulmonary diseases like pneumonia or heart diseases like heart failure.

Lab tests also can be considered even though they cannot be used to diagnose COPD. A unique lab test that is sometimes performed is detecting Alpha-1-antitrypsin deficiency (AAT), which can cause COPD, especially at a young age.

Differential Diagnosis

- Congestive heart failure

- Chronic asthma

- Bronchiectasis or bronchitis

- Emphysema

- Alpha-1-antitrypsin deficiency (AAT)

- Pulmonary embolism (PE)

Management

Generally, patients should know that COPD cannot be cured. And what makes things worse is that COPD is a progressive condition, and its symptoms worsen over time without good management.

First things first, a patient has to quit smoking to reduce the exacerbations of COPD.

A doctor may prescribe medications like bronchodilators or inhaled steroids to help relieve the symptoms and reduce inflammation.

Theophylline can be prescribed in some cases when other medications are not improving your symptoms.

Surgery can be an option in some severe cases.

And remember, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References

Mayoclinic.org

Webmd.com

Medscape.com

Nhs.uk

Health.com

Cervical Cancer - Symptoms, Causes, and Treatment - Avicenna Health

Tue, 21 Sep 2021 14:00:04 GMT

Cervical Cancer

Do you have pelvic pain?

Do you observe any bleeding or vaginal discharge?

Maybe these are some of the most common symptoms of cervical cancer, so we will discuss this in our article.

Definition of Illness

Cervical cancer is a disorder in which cells inside the body develop out of control. Cancer is consistently named for the part of the body where it starts, even if it later spreads to other components. All ladies are in danger of cervical disease. It frequently happens in ladies over age 30. Enduring disease with specific sorts of human papillomavirus (HPV) is the primary cause of cervical cancer, which passes after sex.

Screening tests and HPV immunization can assist with forestalling cervical malignant growth. When cervical malignancy is found early, it is profoundly treatable and related to long endurance and great personal satisfaction.

Symptoms

Beginning phase cervical malignancy mainly creates no signs or side effects.

Signs and indications of further developed cervical malignant growth include:

- Vaginal draining after intercourse, between periods, or after menopause

- Watery and wicked vaginal release

- Pelvic agony or torment during intercourse

Causes

Most cervical cancers start with uncommon modifications to your tissue. Most instances are connected to infecting with human papillomavirus (HPV). Different styles of HPV can lead to pores and skin warts, genital warts, and skin disorders. Others are related to cancers regarding the vulva, vagina, penis, anus, tongue, and tonsils.

Risk Factors

You are probably at significant danger of cervical cancers if you:

- Started having intercourse earlier than age sixteen or inside 12 months of beginning your period

- Have more than one sexual partners

- Take contraceptives, mainly for longer than five years

- Smoking

- Have a weakened immune system

- Having diseases after sexual relationships

When to see a doctor?

You should know that bleeding after menopause is not normal at all. Therefore, visit your doctor immediately. Tell your doctor if you have terribly prolonged periods or usually bleed between periods.

Some ladies have hemorrhages after intercourse, particularly after vigorous sex. However, you may need to let your doctor know, especially if it happens a lot. If you have any bleeding in conjunction with weakness, feel faint, or pass out, go to the doctor.

Diagnosis

When cervical cancers are suspected, your physician probably begins with an initial examination of the cervix. A unique magnifying instrument (colposcope) is used to discover unusual cells.

During the colposcopic test, your physician possibly takes a part of cervical cells (biopsy) for laboratory testing. To acquire tissue, your physician may also use:

- Punch biopsy, which contains a pointy device to pinch off small samples of cervical tissue.

- Endocervical curettage uses a minor, spoon-formed instrument (Curet) or a skinny brush to scrape a part of the cervical tissue.

If one of these is problematic, your physician may also carry out one of the following tests:

- An electrical wire loop uses a skinny, low-voltage electrified wire to acquire a small tissue sample.

Generally, that is performed after local anesthesia.

- Cone biopsy (conization) is a process that permits your physician to obtain more profound layers of cervical cells for laboratory testing. A cone biopsy can be performed in a clinic under well-known anesthesia.

Treatment

Cervical cancer is treated in many ways, depending on the type and the spread through the body.

Treatments involve surgery, chemotherapy, and radiation therapy.

1. Surgery:

Doctors get rid of cancer tissue in operation, and options may include:

- Surgery to remove cancer only

- Surgery to get rid of the cervix (trachelectomy)

- Surgery to get rid of the cervix and uterus (hysterectomy)

2. Chemotherapy:

Using unique drug treatments to reduce or kill most cancers. The drugs may be pills you are taking or medicines given in your veins, or occasionally both.

Low doses of chemotherapy are sometimes mixed with radiation therapy for locally advanced cancer since chemotherapy can also enhance the radiation's outcomes. Higher doses of chemotherapy are probably recommended to assist control symptoms of very advanced cancer.

3. Radiation:

Using high-energy rays (similar to X-rays) to kill cancer and it is maybe given:

- Externally: through directing a radiation beam at the affected region of the body (external beam radiation therapy)

- Internally: through placing a device full of radioactive material inner your vagina, commonly for just a few minutes (brachytherapy)

- Both externally and internally

Differential Diagnosis

- Cervicitis/infection,

- Particularly granulomatous (which is rare)

- Pelvic Inflammatory disease

- Primary melanoma and Paget disease

- Vaginalitis

- Vaginal Cancer

References

Mayoclinic

Medscape

Web MD

Uterine Prolapse - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 20 Sep 2021 14:18:26 GMT

Prolapse Uterus

Do you have pelvic pain?

Have you ever leaked urine?

Have you held heavy things, lastly?

Or is there anyone among your family who had prolapse?

We will talk about a widespread case among women in this article.

Definition of Illness

Your uterus (or womb) is typically held in the inner pelvis area with numerous muscle tissue and ligaments. Because of pregnancy, childbirth, or challenging hard work and delivery, in a few ladies, those muscular tissues weaken. Also, as a female, a while and with a usual lack of estrogen, their uterus can drop into the vaginal canal, inflicting the circumstance called a prolapsed uterus.

Symptoms

Mild uterine prolapse typically does not reason symptoms or signs. Signs and symptoms of mild to extreme prolapse uterus include:

- A feeling of fullness or strain in your pelvis (it may sense like sitting on a small ball)

- Low back pain

- Feeling that something is popping out of your vagina

- Uterine tissue that bulges out of your vagina

- Hard sexual intercourse

- Difficulty with urination or moving your bowels

- Uncomfortable walking

Causes

Uterine prolapse is effecting by the weakening of pelvic muscle tissues and supportive tissues.

Causes of weakened pelvic muscle tissue and tissues include:

- Being pregnant and childbirth – especially in case you had a long, tough delivery, or in case you gave birth to a massive infant or more than one baby

- Ladies when they are getting older and going via menopause

- Overweight

- Hysterectomy

- Lifting heavy things

Risk Factors

- Multiple pregnancies

- Increasing age

- Obesity

- Prior pelvic surgery

- Chronic constipation

- Family history

- Being Hispanic or white

When to see a doctor?

See your medical doctor speak about your alternatives if symptoms and signs of uterine prolapse end up bothersome and disrupt your everyday activities.

Diagnosis

A prognosis of uterine prolapse usually takes place at some point in a pelvic examination.

During the pelvic examination, your physician is probably to ask you:

a. To undergo down as though having a bowel movement. Bearing down can assist your physician in investigating how some distance the uterus has slipped into the vagina.

b. To tighten your pelvic muscular tissues as though you are preventing an outflow of urine.

Differential Diagnosis

- Urethral prolapse

- Cystocele

- Enterocele

- Rectocele

- Abscess

- Mass of gynecological origin

Management

Treatment relies upon the severity of uterine prolapse. Your doctor would possibly recommend:

1. Self-care measures. If your uterine prolapse reasons few or no symptoms, easy self-care measures may also offer alleviation or save you worsening prolapse. Self-care measures consist of acting Kegel sporting activities to reinforce your pelvic muscles, dropping weight, and treating constipation.

2. Pessary: It is made of a plastic or rubber ring inserted into your vagina to assist the bulging tissue.

3. Surgery: it is minimally invasive (laparoscopic) or vaginal surgery.

Surgery can involve:

- Repair of weakened pelvic floor tissues

- Hysterectomy, which means Removal of the uterus

To sum up, try to:

a. Perform Kegel physical games to reinforce pelvic muscle tissue and assist the weakened fascia

b. Avoid constipation through consuming high-fiber ingredients and consuming lots of fluids

c. Avoid bearing down to transport your bowels

d. Avoid heavy lifting

e. Control coughing

f. Try to lose weight if you are overweight or obese

References

Mayoclinic

Web MD

NHS

NCBI

Delta Variant - Symptoms, Causes, and Treatment - Avicenna Health

Wed, 01 Sep 2021 21:28:28 GMT

5 Facts you should know about Corona Delta

1. It is more contagious.

The Delta variant is highly contagious, more than 2x as contagious as previous variants. Patients infected with the Delta variant were more likely to be hospitalized than patients infected with Alpha or the original virus that causes COVID-19.

2. You can be infected even if you are vaccinated.

Fully vaccinated people with symptomatic breakthrough infections can transmit the virus to others. Until now, we don't know if fully vaccinated people with asymptomatic breakthrough infections can transmit the virus. Fully vaccinated people will likely spread the virus for less time than unvaccinated people.

3. It's faster than Alpha and the others.

Delta was spreading 50% faster than Alpha, 50% more contagious than the original strain of SARS-CoV-2.

4. If you are not vaccinated until now, hurry up to protect yourself and your family.

The most significant risk of transmission is among unvaccinated people who are much more likely to get infected and transmit the virus. Vaccines in the US are highly effective, including against the Delta variant. Vaccination is the best way to protect yourself, your family, and your community. High vaccination coverage will reduce the spread of the virus and help prevent new variants from emerging.

5. You should wear a mask even you are vaccinated.

Many health experts across the country are wearing masks themselves even though they're fully vaccinated against COVID-19. They're also advising vaccinated people to avoid large gatherings and mask up indoors where the vaccination status of other people is unknown.

Gerd Gastroesophageal Reflux - Avicenna Health

clientservices@wehco.com (Master Account) — Thu, 26 Aug 2021 13:00:04 GMT

GERD - Gastroesophageal Reflux

Have you ever experienced a burning sensation in your chest after eating? Or while in your bed?

Do you ever get a bad sensation in your chest after eating, and you think it is a heart attack?

It is a very common disease called Gastroesophageal reflux disease, AKA GERD.

Definition of Gastroesophageal reflux?

GERD is when stomach contents flow back into the esophagus or beyond, into the oral cavity and the lungs.

It is a digestive disorder that affects the ring muscle between the esophagus and the stomach.

This muscle is called Lower Esophageal Sphincter (LES).

Symptoms

1. Heartburn – which is a burning sensation in the chest, usually after eating or at night.

2. Chest pain – and some GERD patients mistake heartburn pain for the pain of heart disease.

3. Difficulty swallowing

4. Trouble breathing

5. Nausea and vomiting

6. A feeling of fullness or a lump in the throat

7. Anemia

8. Weight loss

9. Coughing and breathing problems

Causes of GERD

Well, the cause of the disease is anything that causes the Lower esophageal sphincter to be weak or to relax when it shouldn’t.

Risk factors

- Obesity and overweight

- Hiatal hernia –which is when the stomach bulges up into the chest through an opening in the diaphragm

- Pregnancy

- Gastroparesis – which is delayed emptying of the stomach

- Diseases of connective tissue such as lupus or scleroderma

- Smoking

- Specific food and drinks (chocolate – fatty foods – fried foods – alcohol, and coffee)

- Some medications (aspirin)

- Large meals

- Eating too soon before going to bed

When to see a doctor?

- If you have severe symptoms, or having chest pain with shortness of breath, or jaw and arm pain.

- If OTC medications don’t help relieve the symptoms.

Diagnosis

The doctor can make the diagnosis with clinical history and physical examination.

But to confirm the diagnosis, the doctor can order:

- Proton-pump inhibitor trial – if the symptoms improve, then you have GERD

- Upper endoscopy – it may show esophagitis signs such as erosions and ulcerations

- Ambulatory pH monitoring

- Esophageal manometry – it may suggest other diseases that can cause the symptoms.

- X-ray of the upper digestive system

- We can do an ECG and Cardiac biomarkers to rule out heart disease.

Differential Diagnosis

- Acute coronary Syndrome

- Stable Angina

- Achalasia

- Peptic Ulcer Disease

- Eosinophilic Esophagitis

- Malignancy

- Functional Dyspepsia

Management

Lifestyle modification and over-the-counter medications.

- Medications are Antisecretory meds such as Proton Pump inhibitors (PPIs)

- Lifestyle modification:

1. Stop smoking – because smoking can decrease the lower esophageal sphincter's ability to function correctly.

2. Elevate the head of the bed

3. Not lying after a meal

4. Having a healthy weight

5. Avoid foods and drinks that trigger the disease

6. Eating food slowly and chewing it well

7. Avoid tight-fitting clothes

References

Mayo clinic

WebMD

BMJ

Healthline

PubMed

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Gastritis - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 23 Aug 2021 13:00:02 GMT

Gastritis

The body content of your post goes here. To edit this text, click on it and delete this default text and start typing your own or paste your own from a different source.

Definition of Gastritis

Gastritis is an inflammation and irritation of the protective lining of the stomach.

It can be acute gastritis, which occurs suddenly and involves severe inflammation. Or it can be chronic, which occurs slowly over time and involves long-term inflammation.

Symptoms

Symptoms of gastritis can be different from one person to another, and sometimes the disease can be asymptomatic.

The most common symptoms are:

- Abdominal pain – which is a burning pain in the abdomen that can be worse after earing.

- Nausea and vomiting

- Loss of appetite

- A feeling of fullness in the abdomen, and that particularly after eating.

- Indigestion

- Abdominal bloating

- Hiccups

Causes of gastritis

- Extreme consumption of alcohol

- smoking

- NSAIDs like Ibuprofen

- Chronic Vomiting

- Infections

Risk Factors

- Infection with H. Pylori

- The regular use of pain medications such as Aspirin

- stress

- excessive alcohol consumption

- old people

- autoimmune diseases

- bile reflux – which is when the bile flows back into the stomach from the bile tract

When to see a doctor?

- If you have severe symptoms that can’t be relieved by antacids.

- If you have any of the complications like stomach ulcers which can cause bleeding. Bleeding can lead to black and tarry stools or vomiting blood.

Diagnosis

Doctors can make the diagnosis with a medical history and physical examination. But there are some tests and procedures to confirm the diagnosis and to know the exact cause;

- Tests for H. pylori (stool test or breath test) – to know if the patient has an infection with Helicobacter Pylori.

- Endoscopy – to see if there are erosions in the lining of the stomach

- FBC (blood test) – to see if the patient has anemia

- X-Ray of the upper digestive system

- Serum Vit B12 – it can be normal or low in autoimmune disease

- Fecal occult blood test (stool test) – to see if there is blood in the stool

Management

It depends on the cause of the disease.

Acute gastritis caused by NSAIDs or alcohol can be relieved by stopping these substances.

- H. Pylori infection is treated with antacids and antibiotics

- Taking Antisecretory drugs such as PPIs (Omeprazole and esomeprazole)

- Avoid irritating foods (spicy – hot – fried – fatty)

- Avoid smoking and alcohol

- Switch Pain medications (after asking the doctor)

- Eat smaller but more frequent meals

- Take Vit B12 (if the cause was an autoimmune disease such as pernicious anemia).

References

Mayo clinic

BMJ

Healthline

WebMD

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

Common Cold - Symptoms, Causes, and Treatment - Avicenna Health

Thu, 19 Aug 2021 13:00:02 GMT

Common Cold

A 19-year-old girl came to the clinic with a common cold condition said: “I have been suffering from this sore throat and runny nose for about two days. I feel a mild headache with body ache. I tried antibiotics, but I never get better even though it worked last time I took it for the same symptoms.”

Did the girl do the right thing by taking antibiotics for her condition? Go ahead and figure this out by reading this article.

Definition of Common Cold:

Common cold: A viral infection affects, chiefly, the upper respiratory system, especially the nose and the throat. A sore throat and runny nose mainly characterize it.

A common cold infects people about two to three times a year, and it considers the leading cause of missed days from school.

How much time does it last?

In most cases, the common cold is a mild condition, so people get well in about ten days, but in some exceptional circumstances, it can last longer, particularly in children.

Symptoms:

Fortunately, a common cold is a self-limited condition, even though it can impact your performance during the day with; annoying symptoms include:

- Blocked or runny nose - often with a thick yellow discharge

- Sore throat - a scratchy feeling in the throat, often worsens when you swallow.

- Fever - usually low.

In addition to:

- Cough

- Sneezing

- Tiredness

- Headache

- Drowsiness

Causes:

As we already mentioned, the common cold is a viral infection. The most common cause is rhinoviruses, which can easily be transmitted by droplets or direct contact like a handshake.

So DO NOT take any antibiotics to relieve symptoms, and remember antibiotics are only used for bacterial infections.

Risk Factors:

- Patient at a young age like children

- Female patients more than male ones

- Patient with a weak immune system

- pollutants exposure, such as cigarette smoke.

When to see a doctor?

Generally, the common cold is not a life-threatening disease, but there are some cases where you might need to get a medical consultation.

- Symptoms last for more than three weeks

- A high temperature, more than 101.3 F (38.5 C) for adults, and 100.4 F (38 C) for children.

- If you have long-term medical conditions

Other signs and symptoms that indicate a severe condition include:

- Symptoms are getting worse

- Wheezing

- Difficulty breathing

Diagnosis:

Generally, a doctor can diagnose the common cold by clinical history in addition to clinical findings like signs and symptoms.

The doctor may never ask you to do tests due to the lack of value they present.

In some cases, doctors may request a chest x-ray or lab tests to rule out other conditions like bacterial infections.

Differential Diagnosis:

- Allergic and non-allergic rhinitis

- Sinusitis

- Bronchitis or Bronchiolitis

- Influenza and parainfluenza virus infection

- Coronavirus or COVID-19

- Upper respiratory tract infection

Management:

Mainly, the common cold is not a life-threatening condition. It can be well-managed by home remedies and self-care

Even though there is no particular cure for this condition, symptoms often improve within ten days without serious complications.

Sleeping enough and getting plenty of water or juices to keep from dehydration would be beneficial to get better quickly.

Finally, if you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- WebMd.com

- Medscape.com

- Nhs.com

- Cdc.gov

- medicinenet.com

Celiac Disease - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 16 Aug 2021 13:00:02 GMT

Celiac Disease

A patient with celiac said: “When I was diagnosed at the age of 15 with Celiac Disease, I was told to adhere to a strict, gluten-free diet, and, I would be well on my way to feeling great. It’s been five years and I find myself never having found that “I feel great” moment. I am a Celiac still struggling, but have learned along the way that, unfortunately, I am not the only one.”

Definition of celiac disease

Celiac disease is an autoimmune digestive disease caused by an abnormal immune reaction to gluten. And over time, this reaction will damage the small intestine’s lining and will lead to malabsorption.

Gluten can be found in rye, wheat, barley, and related grains.

Celiac disease is also known as sprue – non-tropical sprue – gluten-sensitive enteropathy.

Symptoms

This disease usually involves the digestive system and can also affect other parts of the body.

Symptoms in adults may include:

- Abdominal pain

- Diarrhea or Constipation

- Increased gas production

- Bloating

- Weight loss

- Fatigue

- Nausea and vomiting

- Anemia

- Bone or joint pain

Causes

There is no definite cause, but there are many factors that can contribute to the disease.

It can be linked to specific genes. It can also be triggered by stressful medical events; pregnancy, surgery, viral infection.

Gastrointestinal infections and gut bacteria can also have a role in the activation of the disease.

Risk Factors

Celiac disease is more common in people who have:

- Family history with celiac disease or dermatitis herpetiformis

- Type 1 diabetes

- Down syndrome

- Turner syndrome

- Hashimoto’s thyroiditis (autoimmune thyroid disease)

- Addison’s disease (adrenal insufficiency)

- Other autoimmune diseases

When to see a doctor?

If you have digestive discomfort or diarrhea for more than a couple of weeks. And since celiac disease tends to run in families, you can ask the doctor whether you’d better be tested if one of your family members has the disease.

Diagnosis

1. Serology tests – for certain antibodies

2. FBC – to see if there is anemia

3. CRP – to see if there is inflammation

4. Vitamin D, B9, and B12 – to see if there is any vitamin deficiency

5. Iron tests – to see if there is iron deficiency anemia

6. Intestinal fatty acid-binding protein tests - to see if there is damage to the intestine

7. Genetic tests

8. Small bowel endoscopy – to view the small intestine and take a tissue sample (biopsy) to analyze for damage to the villi.

9. Capsule endoscopy

10. Skin biopsy – if the doctor suspects that the patient has dermatitis herpetiformis

Differential Diagnosis

- Crohn’s disease

- Giardiasis

- Tropical sprue

- Peptic duodenitis

- Small intestinal bacterial overgrowth

- Eosinophilic enteritis

- Post-gastroenteritis

Management

There are no drugs to treat celiac disease. All you need is a strict, lifelong gluten-free diet which is the only way to manage celiac disease.

So, it is important to know which food is safe.

Patients with celiac disease need to avoid (these always contain gluten): wheat – rye – barley – semolina – Durum – wheat berries – farro – graham – malt – spelt – bulgur.

Avoid these unless the label says gluten-free:

Beer – bread – cakes – pies – cereals – candy – cookies – noodles – pasta ... etc.

Some medications and kinds of toothpaste contain gluten, so you need to check the label before using them.

If there is anemia or nutritional deficiencies, the doctor may recommend that you take supplements, including:

• Vit B9

• Vit B12

• Vit D

• Vit K

• Iron

• Zinc

• Copper

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with Avicenna Health provider for individualized consultation.

References

Mayo clinic

Healthline

WebMD

BMJ

Monoclonal Antibodies - Symptoms and Causes - Avicenna Health

ahmadkaako@hotmail.com (Ahmad Kaako) — Sat, 14 Aug 2021 15:23:48 GMT

Monoclonal antibodies

Monoclonal antibodies that target severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to be evaluated in outpatients with mild to moderate disease.

These treatments include two kinds of medications that are given here in the US:

1. Casirivimab-imdevimab administered as a single IV dose [preferred] OR subcutaneously.

2. Sotrovimab administered as a single IV dose.

We suggest monoclonal antibody therapy for patients with early symptomatic COVID-19 who have risk factors for progression to severe illness. We recommend casirivimab-imdevimab rather than sotrovimab. Monoclonal antibody treatment should be given as soon as possible after diagnosis and within seven days of symptom onset. There is evidence suggesting that benefit is maximized with early administration. However, there are no direct data to inform the risks and benefits of monoclonal antibodies in vaccinated patients.

The FDA EUAs for casirivimab-imdevimab and sotrovimab are for non-hospitalized COVID-19 patients with mild to moderate illness and certain risk factors for severe disease. They are approved for cases not requiring supplemental oxygen or, if on chronic supplemental oxygen, without an increased oxygen requirement.

These risk factors for adults (≥18 years) include any of the following:

1. Older age (≥65 years)

2. Body mass index (BMI) ≥25 kg/m²

3. Pregnancy

4. Chronic kidney disease

5. Diabetes mellitus

6. Immunosuppression (immunosuppressive disease or treatment)

7. Cardiovascular disease (including congenital heart disease) or hypertension

8. Chronic lung disease (e.g., COPD, asthma, interstitial lung disease, cystic fibrosis, pulmonary hypertension)

9. Sickle cell disease

10. Neurodevelopmental disorders (e.g., cerebral palsy)

11. Dependence on a medical-related technology (e.g., tracheostomy, gastrostomy, or positive pressure ventilation [unrelated to COVID-19])

Furthermore, other conditions may place an individual at high risk for progression to severe COVID-19. The use of monoclonal antibody therapy is not strictly limited to those with the risk factors listed above.

If you need more information about monoclonal antibodies or a referral to get it at your local infusion center, feel free to schedule a telemedicine consultation with Avicenna Health. We are a click or a phone call away!

Bronchitis - Symptoms, Causes, and Treatment - Avicenna Health

clientservices@wehco.com (Master Account) — Fri, 13 Aug 2021 13:00:04 GMT

Bronchitis

Have you ever felt difficulty breathing?

Have you ever suffered from a productive cough that keeps you from sleeping?

Do you hear a whistling sound come off out of your chest?

If you have ever felt one of these symptoms, you may have had bronchitis.

Let us take you on a journey to learn more about this condition.

Definition of Bronchitis:

Bronchitis: An inflammation that affects the bronchial tubes, usually caused by a viral infection and sometimes bacterial ones. It can be a severe condition characterized by secreting mucus, coughing, and wheezing.

Children are the most likely to get bronchitis, especially in winter after flu or the common cold.

How much time does it last?

Mainly, there are two types:

- Acute bronchitis. The most common. It Lasts about ten days, often known as a chest cold.

- Chronic bronchitis. A More severe condition. Often constant due to some irritating substances such as smoking or recurrent that keeps coming back.

Symptoms:

Bronchitis’s symptoms can differ widely, often include:

- Cough – Keeps from sleeping, usually productive; its product can be yellow, green, or bloody.

- Wheezing – A whistling sound happens when the airways are tightened.

- Breath shortness – Medically known as dyspnea, which is the difficulty of getting enough air.

- Fever – Uncommon, usually low.

- Sore throat – A scratchy feeling in the throat often worsens when you swallow.

Other symptoms may include:

- Blocked or runny nose

- Tiredness, often accompanied by muscles aches

- Headache

Causes:

Most often, acute bronchitis is caused by viral infection. It can also be caused by bacterial infection.

A virus that causes acute bronchitis is usually the same one that causes flu or the common cold. Anyway, remember DO NOT use antibiotics in viral infections.

On the other hand, chronic bronchitis is usually an induced condition caused by irritant substances, such as smoking, grain dust, ammonia, and other chemicals.

Risk Factors:

- Patient with asthma or allergic disease

- Patient with a weak immune system

- Patient with respiratory or heart disease

- Patient with gastroesophageal reflux disease

- Infected relatives

- Female smokers more than male ones

- Elders and babies

When to see a doctor?

Acute bronchitis often improves within a week using home remedies, while prolonged symptoms often suggest chronic bronchitis or other respiratory conditions that seek medical care.

Other signs and symptoms that indicate a severe condition include:

- A high temperature of more than 100.4 F or 38 C.

- A cough lasts for more than three weeks, especially if bloody mucus discharges accompany it.

- Unexplained weight loss.

- Symptoms are getting worse even with treatment.

Diagnosis:

Patient history, in addition to his signs and symptoms, are the main steps as there is no critical test to diagnose bronchitis

A doctor may ask you to do some tests so he could exclude other conditions. Tests may include:

- Spirometry. A test that performs using a small machine called a spirometer to measure how much air you can breathe in and out and how fast. Mainly to exclude asthma and emphysema.

- Diagnostic procedures. Especially chest X-ray that can help to rules out pneumonia

- Lab tests. That includes CBC (complete blood count) and sputum tests that determine bacterial diseases.

Differential Diagnosis:

- Common cold

- Asthma

- bronchiectasis

- chronic obstructive pulmonary disease (COPD)

- sinusitis

- Cystic fibrosis

- pharyngitis

- Tonsillitis

Management:

A viral infection causes most cases of bronchitis, which is often a self-limited condition. So home remedies can help a lot in relieving the symptoms.

However, other conditions may be caused by a bacterial infection that requires prescribed antibiotics under the supervision of a doctor.

Antibiotics may also be prescribed if there is a high risk of developing severe complications.

A doctor may also prescribe:

- Mucolytic

- Bronchodilators

- Nonsteroidal anti-inflammatory drugs (NSAIDs)

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- WebMd.com

- Medscape.com

- Drugs.com

- Nhs.com

Asthma - Symptoms, Causes, and Treatment - Avicenna Health

Wed, 11 Aug 2021 13:00:02 GMT

Asthma

A patient with asthma said: "There are lots of things that trigger an attack for me. Here are just a couple. When I laugh more than just a slight chuckle, my throat tightens, and I cough a lot. I can be around dogs in the daytime, but if I fall asleep near one through the night, I wake up with a serious attack and can barely catch my breath. My lips turn blue, and my throat is so tight I can't use my rescue inhaler. I must keep a nebulizer ready at all times. It's the only thing that will stop an attack when I'm asleep, and even then, it takes a while to work."

Definition of Asthma

Asthma : An airway inflammation in which the windpipes get narrowed, producing extra mucus. this narrowing may lead to airflow obstruction, causing difficulty breathing, coughing, and wheezing.

It is considered one of the most common diseases in childhood, but it can affect people of all ages.

Asthma could be a life-threatening condition. Fortunately, a high percentage of children will have decreased symptoms as they grow up.

How much time does it last?

Most often, it is a long-term condition, mainly when it develops in adult age. Even though it is not a curable condition, you can control its symptoms with the right treatments.

Symptoms:

An asthma attack causes symptoms that can differ from one person to another; often include:

- Breath shortness - Medically known as dyspnea, which is the difficulty of getting enough air.

- Coughing - The worst at night or in the early morning.

- Chest tightness – A discomfort or heaviness feeling in your chest.

- Wheezing – A whistling sound happens when the airways are tightened.

Causes:

Triggers that induce asthma attacks may include any of the following:

- Allergens (e.g., pollen, house dust mites, pet dander, and cockroach allergens).

- Pollutants exposure, such as cigarette smoke

- Gastroesophageal reflux disease (GERD)

- Infections like common cold and sinusitis

- Emotional triggers, like stress or laughter

- Exercises, especially in children

- Drug allergies, particularly aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)

- Irritants, like strong odder or chemicals

Risk Factors:

- Patient who has relatives with asthma

- Patient with allergic diseases, for example, hay fever

- Patient with Obesity

- Smoking or secondhand smoking

- Perinatal factors, such as prematurity and smoke exposure

- Work-related-triggers exposure, like flour or wood dust

When to see a doctor?

Generally, asthma should be monitored by a doctor. So if you think you might have asthma, you need to get an appointment right away. You may also need to see a doctor if your symptoms are getting worse.

Other signs and symptoms that indicate a severe condition include:

- Symptoms are getting worse even with treatments

- Breath shortness or wheezing without any effort

- Rapid pulse with sweating

- Breathing stops even for a while

Diagnosis:

The most crucial test besides physical examination is lung function tests. Often include:

- Spirometry . A test that performs using a small machine called a spirometer to measure how much air you can breathe in and out and how fast.

- Peak flow . A test that performs by blowing as hard and as fast as you can into a device to measure how quickly you can breathe out.

Other tests may include:

- Pulse oximetry . Usually performs in acute attacks to exclude hypoxemia.

- Lab tests involving blood and saliva tests, looking for eosinophils in sputum, which is a specific white blood cell, in addition to arterial blood gas.

- Diagnostic procedures , such as chest X-rays looking for abnormalities and infection signs.

Differential Diagnosis:

- Chronic Obstructive Pulmonary Disease (COPD)

- Bronchiectasis

- Bronchiolitis

- Cystic fibrosis

- Chronic sinusitis

- Gastroesophageal reflux disease (GERD)

- Pulmonary embolism (PE)

- Foreign bodies

- Heart failure

Management:

Asthma is not a curable condition, but it can be well-controlled by medications in addition to avoiding triggers as much as you can.

Medications usually differ depending on symptoms and age. They can be classified into two main groups:

- Long-term control medication , such as:

Inhaled corticosteroids, which decrease the inflammation of the airways.

Long-acting B2 agonists, which help to relax airway muscles.

Others may include (leukotriene modifiers, mast cell stabilizers, and theophylline)

- Quick-relief medication , such as:

Short-acting B2 agonists and anticholinergic agents. In addition to some short-term corticosteroids, which can cause severe effects with long-term use.

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- Medscape.com

- Drugs.com

- Nhs.uk

- Emediciehealth.com

Peptic Ulcer - Symptoms and Treatment - Avicenna Health

Mon, 26 Jul 2021 17:36:39 GMT

PEPTIC ULCER

Do you have a stomachache daily?

Do you have pain in your stomach after eating?

Do you have untreated stress and that causes you terrible abdominal pain?

Do you overuse NSAIDs such as Ibuprofen?

Let's take a look at an interesting article about a prevalent disease called Peptic Ulcer Disease.

Definition of Peptic Ulcer

A peptic ulcer is an open sore that develops on the inside lining of the stomach and the upper portion of the small intestine.

Symptoms

- Pain – which is the most common symptom of peptic ulcers. It is an upper abdominal burning pain or discomfort.

- Indigestion - it is also called dyspepsia, which describes discomfort in the upper abdomen.

- Gastrointestinal reflux - it is when stomach content flows back into the esophagus.

- Nausea/vomiting

- Belching - it means emitting gas noisily from the stomach through the mouth.

- An important thing to add is that patients with peptic ulcer disease can be asymptomatic.

Causes of Peptic Ulcer

- The most common cause is the infection with the bacterium called Helicobacter pylori (H. pylori)

- Long-term use of NSAIDs such as Ibuprofen

Risk Factors

1. Helicobacter Pylori infection

2. Non-steroidal anti-inflammatory drugs (NSAIDs)

3. Smoking and heavy alcohol use

4. Family history of peptic ulcer disease

5. Psychological factors

6. Diet (spicy foods can make the symptoms get worse)

When to see a doctor?

When you have severe symptoms, or if you have one of the complications of the ulcer, such as;

- Internal bleeding can be a slow blood loss that leads to anemia or a severe blood loss that can require going to a hospital or a blood transfusion. Severe blood loss can cause black\bloody vomit or stools.

- Obstruction – peptic ulcers can block the passage of food through the digestive system, making the patient entirely quickly lose weight or vomit.

- Perforation – the ulcer can make a hole in the stomach or small intestine wall, which makes the patient highly susceptible to abdominal infection.

- Gastric Cancer – patients infected with Helicobacter Pylori have a higher risk of gastric cancer.

Diagnosis

- Upper Gastrointestinal Endoscopy – it is the most accurate test to diagnose peptic ulcer disease.

- Urea breath test – it is positive when patients have H.pylori

- Stool antigen test - it is also positive when patients have H.pylori

- FBC – it is ordered to see if the patient has anemia or evidence of gastrointestinal bleeding.

Differential Diagnosis

- GERD (gastroesophageal reflux disease)

- Gastric malignancy

- Gastroparesis

- Biliary disease

- chronic pancreatitis

- Irritable Bowel Syndrome

Management

Treating peptic ulcers depends on what causes them; it generally involves eradicating H.Pylori infection, reducing the use of NSAIDs, and using medication to help the ulcer to heal.

Medications may include:

1. Antibiotics to treat H. Pylori infection

2. Antisecretory therapy such as Proton Pump Inhibitors (PPIs)

Sometimes we need surgery if any complications happened, such as bleeding, perforation, obstruction, or suspected malignancy.

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References

- Mayo Clinic

- AMBOSS

- BMJ

- Up To Date

Sinusitis - Symptoms, Causes and Treatment - Avicenna Health

Mon, 26 Jul 2021 17:11:05 GMT

Sinusitis

Patient History:

A patient with sinusitis said: “I would always have pressure in my face, just constant to the point where if I ever touched it or someone else touched my face, it would be painful. I also would have just kind of constant stuffiness. I had a tough time going to sleep, falling asleep. I would always wake up kind of coughing, feeling like I couldn't breathe.”

Definition of Sinusitis:

Sinusitis: An inflammation that affects the spaces beneath your bones, next to your nose, causes mucus to gather and obstruct the drainage. This obstruction may lead to swelling in the area around your eyes and cheeks, causing a pulsing pain that worsens when bending over.

How much time does it last?

Generally, sinusitis can be divided into three types depending on the time it lasts.

· Acute sinusitis lasts about one month.

· Subacute sinusitis lasts less than three months.

· Chronic sinusitis lasts more than three months.

Symptoms:

There are a large variety of symptoms, often include:

· Facial pain - It is usually described as a pressure-like pain in the forehead and around the nose.

· Swelling – abnormal enlargement around the eyes, cheeks, or nose.

· Sore throat – A scratchy feeling in the throat. It often worsens when you swallow.

· A thick discharge - a discolored mucus, can be green or yellow when caused by infection or non-colored when it is caused by noninfectious sinusitis.

· Postnasal drip - the feeling of mucus secretions moving down the back of the throat.

· Pulsing headache .

In addition to:

· Fever

· Toothache or/and earache

· An altered sense of smell and taste

· Fatigue

· Difficulty breathing

· Blocked or runny nose

· Cough

· Sneezing

Causes:

Leading causes often include:

· A viral, bacterial, or fungal respiratory infection

· Common cold

· Allergic rhinitis

· Nasal polyp

· Irritants substances, such as cigarettes and cocaine.

· Deviated nasal septum

· Other rare conditions, like AIDS and Cystic fibrosis.

Risk Factors:

- Patient with Allergic diseases, particularly hay fever (allergic rhinitis).

- Patient with Asthma

- pollutants exposure, such as cigarette smoke.

- Anatomic abnormalities like Deviated nasal septum.

- Female sex

- Elderly and young people

When to see a doctor?

If you have symptoms for more than ten days. Or When the symptoms are worsening instead of improving. And of course, if you have recurrent sinusitis that does not respond to the treatment. Other signs and symptoms that indicate a severe condition include:

- Vision troubles

- Intense headache

- High fever

- A Stiff neck

Diagnosis:

First things first, we need to know that there is no critical test to diagnose sinusitis. Most cases are diagnosed by the clinical history and clinical findings on examination.

Diagnostic procedures such as X-Ray, CT, and MRI are rarely used due to the misleading of x-ray and the expensive cost of CT and MRI.

Lab tests can be required when the condition does not respond to the treatment. Blood tests and nasal fluid tests are the most common to be required.

Differential Diagnoses:

- Asthma

- Dental infection

- Migraine headache

- Nasal polyps

- Benign or malignant tumor, especially in the nasal and sinus cavity.

- Fever of unknown origin (FUO)

- Aspirin sensitivity

- Nasal foreign body

Management:

Most conditions can be managed from home using home remedies, such as antipyretics, painkillers, mucolytics, and sinus rinse solutions.

Some conditions require more than self-care. It depends on the type of sinusitis, as we are explaining right down:

· Viral sinusitis is usually a self-limited condition, but using home remedies is not a bad option anyway.

· Bacterial sinusitis should be treated using prescribed antibiotics.

· Usually, the first line is Augmentin , but many others can be prescribed too.

How can we differentiate between bacterial sinusitis, which requires antibiotics, and the other kinds of sinusitis?

Symptoms of bacterial sinus infection often include :

pus-like nasal mucus.
Symptoms last for longer than seven days with home remedies.

· For Fungal sinusitis, systemic antifungal treatments are critically important.

· In Allergic sinusitis, you may only need to avoid the triggers in addition to allergy medication, such as antihistamines.

· For chronic sinusitis, your doctor may prescribe steroids.

· In some cases of chronic sinusitis and recurrent sinusitis, surgery would be the best option.

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- WebMd.com

- Medicinenet.com

- Winchesterhospital.org

- Emedicinehealth.com

Irritable Bowel Syndrome (IBS) - Avicenna Health

Mon, 26 Jul 2021 16:47:54 GMT

IBS

A patient with Irritable Bowel Syndrome said: “I did a colonoscopy and two endoscopies (one with ultrasound), and my doctor only discovered mild gastritis. The doctor never once asked me about my diet and only said she didn’t know where my pain came from. She told me to take medicine for my diarrhea and stomach pain. It helped for a while, but the pain and diarrhea came back with a vengeance”.

Definition of Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome is a chronic condition characterized by abdominal pain and altered bowel habits. And since it is established, patients will need to manage long term. Some patients can control their Irritable Bowel Syndrome symptoms by managing their lifestyle and diet. However, some might have severe symptoms which need to be managed by medication.

Symptoms

The symptoms can be different from one person to another. The most common symptoms are:

- Abdominal pain – is frequently described as a cramping sensation. The severity might be mild or severe, and the location of the pain can vary a lot. The pain is usually relieved by defecation. However, some patients might have worse pain with excrement. The pain is sometimes accompanied by abdominal bloating. Some patients report increased gas production as flatulence or belching. In addition to that, stress and meals can exacerbate the pain.

- Altered bowel habits – it can be diarrhea, constipation, or alternating diarrhea and constipation.

- Mucus in the stool

- Other gastrointestinal symptoms – nausea and reflux

What triggers the disease?

This varies from one to another, but the common triggers are:

- Food – many people have severe symptoms when they eat a particular food. For example, spices, chocolate, beans, fats, milk, alcohol, and many other things.

- Stress – most Irritable Bowel Syndrome patients have worse symptoms when they are under pressure.

- Hormones – many women have worse symptoms around or during menstrual periods.

Risk Factors

- Young people less than 50 years

- Female sex

- Family history

- Mental health, depression, anxiety, sexual and physical abuse

- Previous enteric infection

- Family and job stress (weak risk factor)

When to see a doctor?

When you have severe symptoms and a persistent change in bowel habits, other signs and symptoms that indicate a severe disease and require a consult as soon as possible are rectal bleeding, weight loss, nighttime diarrhea, difficulty swallowing, unexplained vomiting, iron deficiency anemia, and continuous pain which isn't relieved by defecating or passing gas.

Diagnosis

The most important thing to know is that there is no definitive test to diagnose IBS, so lab tests and diagnostic procedures rule out the other causes of the symptoms, such as Celiac disease, Inflammatory Bowel Disease, and colon cancer.

- Lab tests may include :

1. FBC (it can be expected, or it might show that the patient has anemia)

2. Lactose intolerance test (If a person doesn't produce lactase, he may have symptoms similar to IBS)

3. fecal occult blood test (it may be expected or positive in inflammatory bowel disease or colon cancer)

4. fecal calprotectin (it is also used to differentiate IBS from inflammatory bowel disease)

5. CRP (it is considered a reasonable option to screen for inflammatory bowel disease)

6. Hydrogen breath test (it can be expected or abnormal if there is bacterial overgrowth or lactase deficiency)

7. fecal lactoferrin (elevated and it is used to differentiate IBS from IBD)

8. serologic tests for celiac disease (it should be negative in IBS)

- Diagnostic procedures may include :

1. plain abdominal X-ray (this is used to rule out the other causes of the symptoms, such as cancer)

2. CT scan (this is also used to rule out the different causes of your symptoms, such as cancer)

3. Colonoscopy (this allows the detection of IBD or a tumor)

4. Upper endoscopy (Your doctor might recommend endoscopy if celiac disease is suspected)

Differential Diagnosis

- Crohn’s Disease

- Ulcerative Colitis

- Celiac Disease

- Colon Cancer

- Bowel Infections

- Lymphocytic and collagenous Colitis

Management

- Lifestyle changes:

1. Dietary adjustments: plenty of fluids – high-fiber foods – avoidance of (gas-producing foods such as onion and beans – lactose – gluten – short-chain carbohydrates such as honey and apple)

2. Physical activity

3. Stress management

4. Psychological therapy (for patients with psychological disorders)

- Medical treatment: it is symptom-directed therapy, and it is for managing: Diarrhea – Constipation – Pain

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References

- The BMJ

- AMBOSS

- Mayo Clinic

- Up To Date

Allergic Rhinitis - Causes and Treatment - Avicenna Health

clientservices@wehco.com (Master Account) — Mon, 26 Jul 2021 16:14:54 GMT

Allergic Rhinitis

Patient History:

A patient with allergic rhinitis said: “I've been experiencing these symptoms for almost five years already, and it's not just seasonal but every day! I really don't know what to do, and I'm losing hope. I am breastfeeding now with my two-month-old boy, so I’m worried about taking medicine.”

Another said: “I had a runny nose, constant sneezing and wheezing at night. The inside of my ears itch, and I have a sluggish feeling.”

Definition of Allergic Rhinitis:

Allergic rhinitis: An inflammation that affects the nasal membrane. It is characterized by sneezing, redness in the eyes and itching.

Generally, it is caused by an allergic response to specific triggers, including pollen, dust, fur, and many others.

It is also known as hay fever, mainly When this response is caused by seasonal allergens such as pollens.

What are the main types of allergic rhinitis?

- A seasonal type, which happens during certain times of the year. For example, it might be spring allergy if you are allergic, for example, to tree pollens, or autumn allergy if you are allergic, for example, to fungus spores.

- A year-round or perennial type if you are allergic to feathers, pet dander, or dust mites.

How much time does it last?

There is no specific time, but generally, the more you are exposed to allergens, the more it lasts.

Symptoms:

Fortunately, allergic rhinitis is not a life-threatening condition, even though it can impact your performance during the day with annoying symptoms include:

- Redness in the eyes – the surface of the eye looks red due to the tiny vessels expand.

- Swollen eyes – abnormal enlargement around the eyes.

- Watery eyes – medically known as Epiphora, which is an overflow of tears.

- Itching , especially in the nose, eyes, palate, or throat.

- Postnasal drip - the feeling of mucus secretions moving down the back of the throat.

- Sore throat - a scratchy feeling in the throat, often worsens when you swallow.

In addition to:

- Blocked or runny nose

- Headache

- Earache

- Sneezing

- Cough

- Fatigue

- An altered sense of smell

- Feeling drowsy

Causes:

Many types of triggers can cause allergic rhinitis; it varies from one person to another.

The most common triggers include:

- House dust mites , which are microscopic insect-like creatures.

- Pollens , which are tiny grains produced by flowers to fertilize other ones.

- Mold or fungal spores

- Animal’s tiny flecks of skin

- Animal’s saliva and urine

- Fur and feathers

- Work-related triggers, such as wood or flour dust

Risk Factors:

- Patients with allergic diseases, such as allergic asthma or atopic dermatitis.

- A patient who has relatives with allergies

- Working in an environment full of allergens

- Cigarette smoke exposure, at a young age, especially during the first year of life.

When to see a doctor?

As we already mentioned, allergic rhinitis is not a life-threatening disease, but there are some cases where you might need to get a medical consultation.

- If your symptoms are getting worse and affecting your daily life.

- Home remedies cannot relieve your symptoms or cause side effects.

- When you already have another related problem such as sinusitis, asthma, or allergic disease.

Other signs and symptoms that indicate a severe condition include:

- Worsening asthma

- Anaphylaxis symptoms, such as difficulty breathing or wheezing, rapid pulse, confusion, and faintness.

Diagnosis:

Clinical history and physical exams are the most important to diagnose allergic rhinitis. And like many other diseases, allergic rhinitis has no critical test. Anyway, your doctor may request some helpful tests, include:

Lab tests involving blood tests: especially total serum IgE, an antibody produced by the immune system in response to a suspected allergen.

Diagnostic procedures , such as CT scan, X-ray, and nasal endoscopy, are rarely used. But it can be significant to check for complications—for example, nasal polyps.

Allergy tests are like skin prick tests. By exposing the skin to an allergen, then pricked the spot with needles. They are causing an itchy welt if you are allergic to this particular allergen.

Differential Diagnoses:

- Common cold

- Non-allergic rhinitis, Like anatomic rhinitis, vasomotor rhinitis, hormonal rhinitis, and many others.

- Csf leak, which is a fluid surrounding the brain and spinal cord.

- Nasal polyps.

- Chronic or acute sinusitis.

Management:

The most essential and significant management is to avoid the triggers. You can use masks and sunglasses to prevent the pollens from getting inside your nose or mouth. Keep windows closed. Avoid gardens and pets as much as possible.

Mild symptoms can be treated by the one itself using antihistamines and other home remedies. However, your doctor may suggest different kinds of medications, such as Decongestants and corticosteroids.

Immunotherapy also can be used if the symptoms are severe.

If you have any concerns about non-emergent health conditions, you may schedule a telemedicine consult with the Avicenna Health provider for an individualized consultation.

References:

- Mayoclinic.org

- WebMd.com

- Drugs.com

- Medscape.com

- NHS.uk

- Emediciehealth.com

Sunburn - Causes and Treatment - Avicenna Health

Mon, 12 Apr 2021 14:22:39 GMT

TREATING A SUNBURN

Your skin can burn if it gets too much sun without proper protection from sunscreen and clothes. It is essential to begin treating sunburn as soon as you notice it to help heal and soothe stinging skin. The first thing you should do is to get out of the sun—and preferably indoors.

Once indoors, these dermatologists’ tips can help relieve the discomfort:

1. Take frequent cool baths or showers to help relieve the pain. As soon as you get out of the bathtub or shower, gently pat yourself dry, but leave a little water on your skin. Then, apply a moisturizer to help trap the water in your skin. This can help ease the dryness.

2. Apply a moisturizer that contains aloe vera or soy to help soothe sunburned skin. If a particular area feels incredibly uncomfortable, you may apply over-the-counter hydrocortisone cream. Do not treat sunburn with “-caine” products (such as benzocaine), as these may irritate the skin or cause an allergic reaction.

3. Consider taking aspirin or ibuprofen to help reduce any swelling, redness, and discomfort.

4. Drink extra water. A sunburn draws fluid to the skin’s surface and away from the rest of the body. Drinking more water when you are sunburned helps prevent dehydration.

5. If your skin blisters, allow the blisters to heal. Blistering skin means you have a second-degree sunburn. It would be best if you did not pop the blisters, as blisters form to help your skin heal and protect you from infection.

6. Take extra care to protect sunburned skin while it heals. Wear clothing that covers your skin when outdoors. Tightly woven fabrics work best. When you hold the material up to bright light, you shouldn’t see any light coming through.

Although it may seem like a temporary condition, sunburn—a result of skin receiving too much exposure from the sun’s ultraviolet (UV) rays—can cause long-lasting damage to the skin. This damage increases a person’s risk of getting skin cancer, making it critical to protect the skin from the sun.

Source: American Academy of Dermatology Association

Rheumatoid Arthritis and Osteoarthritis - Avicenna Health

ahmadkaako@hotmail.com (Ahmad Kaako) — Mon, 15 Mar 2021 21:09:12 GMT

Do you have Rheumatoid Arthritis or Osteoarthritis?

Rheumatoid arthritis is an autoimmune disease that affects multiple joints in the body, mainly the hands and feet' small joints. The body's immune system attacks the joints, causing joints pain, swelling, and stiffness. See More

Some of the characteristics of Rheumatoid arthritis include:

• Morning stiffness lasting more than an hour

• Seven classic signs of symmetric joint pain in the hand (three different areas), wrist, elbow, knee, and ankles

• Inflammation of the soft tissue surrounding the joints

• Nodules under the skin.

Your doctor may order some lab test to evaluate your rheumatoid arthritis:

• Rheumatoid factor had a sensitivity of 80% with a specificity of 87%

• Elevated inflammatory markers such as ESR or CRP level

• Anemia

• Positive anti-CCP antibody assay (It is highly specific 96%, but not very sensitive 76%).

Osteoarthritis is usually caused by the "wear and tear" of the joint and the breakdown of the cartilage (the thick tissue that cushions the joints), leading to pain, stiffness, swelling, and different joints, including the spine, fingers, hips, and knees. Age is the most critical risk factor for developing primary osteoarthritis in women and men. See More

Characteristics of osteoarthritis include:

Short term morning stiffness (less than 30 minutes)
Gelling, a brief stiffness of the joint after inactivity
Crepitus (the popping sounds with joint movement)
Tenderness along the joint line
Reduced range of motion of the joint.

Your doctor may order lab tests to rule out inflammation related to other inflammatory arthritis. In osteoarthritis, the inflammatory markers are usually negative.

X-rays usually show a narrowing of the joint space and possibly bone spurs.

Early recognition and treatment for rheumatoid arthritis is essential to avoid disability. Over time, untreated rheumatoid arthritis can cause joint damage and deformities. Sometimes it is hard to differentiate osteoarthritis from other similar clinical presentations such as septic arthritis, bursitis, tenosynovitis, gout or CPPD (Calcium pyrophosphate dihydrate crystal deposition disease). If you are in doubt, consult with your physician or call Avicenna Health!

This material is written by Ahmad Kaako, MD, MBA, FACP.

What is Insomnia? - Symptoms and Causes - Avicenna Health

Tue, 15 Sep 2020 13:19:53 GMT

What is Insomnia?

Insomnia is a sleep disorder that makes it hard for the individual to fall asleep or stay asleep. This sleep condition can be acute (lasting from one night to a few weeks) or chronic (occurs three nights a week for three months or more). Suppose you have trouble with sleep initiation, maintenance, consolidation, or lack of adequate sleep quality despite the time and opportunity for sleep. In that case, you might be experiencing insomnia. Insomnia can be a primary problem, but it can also be related to other medical conditions or medications.

Symptoms

While not every single individual experience the exact set of symptoms as another individual suffering from insomnia, here are some basic symptoms seen in patients suffering from this particular sleeping disorder.

-difficulty falling asleep at night

-easily being woken in the nigh t

-frequently waking up too early

-tiredness or sleepiness during the daytime

-irritability

-anxiety or depression

- poor concentration and trouble with recollection -an increased amount of errors relating to accidents

-constant worry about sleep

Causes

As mentioned above, insomnia can be a primary condition or associated with other medical conditions or occur because of certain medications. A few common causes of insomnia include:

-Stress: concerns about work, school, family, health, or finances can result in an individual's mind staying active throughout the night and making it hard to fall asleep. Stressful life events such as the death of a loved one can also lead to insomnia.

-Poor sleep habits: this can occur due to irregularities in an individual's bedtime, taking frequent naps, or doing physical and strenuous activities closer to bedtime. Computers, TVs, video games, and any other technological device can also interfere with a person's sleep schedule.

-Eating too much too close to bedtime: Having a small snack closer to bedtime can be alright but heavy meals before bed can cause an individual to feel physically uncomfortable while lying down or resting. Some individuals may experience heartburn or acid reflux, which may cause them to have a tough time sleeping.

Additional common causes for experiencing insomnia may include:

-Caffeine, nicotine, and alcohol: recreational use of these products late in the afternoon can cause problems sleeping during the night. While alcohol may help an individual fall asleep, it prevents deeper sleep stages from occurring, causing insufficient sleep. It can also result in frequent waking up during the night time.

-Medical conditions: some conditions that are linked to insomnia are diabetes, heart disease, asthma, gastroesophageal reflux disease, overactive thyroid, Parkinson's disease, Alzheimer's diseases, and chronic pain.

-Medications: Certain prescription drugs that can alter an individual's sleep patterns and schedule. Medications for asthma, blood pressure, or certain antidepressants can disrupt sleep. Over the counter medications such as pain medication, allergy or cold medications and weight loss products can also have similar effects.

What to avoid

• Do not have caffeinated drinks for 8 hours before bed.

• Do not smoke or use tobacco near bedtime.

• Avoid drinking alcohol late in the evening.

• Do not eat a big meal close to bedtime. If you are hungry, eat a light snack.

• Do not drink a lot of fluid close to bedtime, as may trigger the need to urinate frequently at night.

• Do not take your "water pill" close to bedtime, as may trigger the need to urinate frequently at night.

• Do not read or watch TV in bed.

What to try

• Go to bed at the same time every night, and wake up at the same time every morning. Long naps during the day are discouraged.

• Keep your bedroom quiet, dark, and cool.

• Sleep on a comfortable pillow and mattress.

• If watching the clock makes you anxious, turn it facing away from you.

• If you worry when you lie down, start a worry book. Well before bedtime, write down your worries and then set the book and your concerns aside.

• Try meditation or other relaxation techniques before you go to bed.

• If you cannot fall asleep, get up and go to another room until you feel sleepy. Do something relaxing. Repeat your bedtime routine before you go to bed again.

• Make your house quiet and calm about an hour before bedtime. Turn down the lights, turn off the TV, log off the computer, and turn down the music volume.

When should you see a doctor?

When insomnia affects your daily functions, seek a doctor to identify the cause of the sleeping problem and possible treatment options. Your doctor will assess and determine to refer an individual to a special testing sleep center if needed.

References:

https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167

https://www.medicinenet.com/what_are_the_three_types_of_insomnia/article.htm

https://www.healthwise.org

Hypothyroidism - Symptoms and Treatment - Avicenna Health

Thu, 27 Aug 2020 16:02:28 GMT

What is Hypothyroidism?

Hypothyroidism can be seen across all age forms. This condition occurs when an individual's thyroid gland located at the front of the neck right longer produces enough of certain essential hormones, especially the thyroid hormone. A person needs a proper amount of these hormones to be functioning healthily.

What causes hypothyroidism?

While there are many different reasons an individual can develop hypothyroidism, according to the American Thyroid Association here are some common reasons:

Autoimmune disease: In certain people, the immune system, which helps protects the body from different microscopic invaders, mistakes the thyroid gland as a foreign body and attacks the gland. This autoimmune dysfunction can cause the gland to stop functioning properly.
Surgical removal of part or all of the gland: In some cases, individuals undergo surgery to have their thyroid gland removed for other medical reasons. However, this can cause insufficiency of the hormones that are typically released by the thyroid.
Radiation treatment: Some individuals get treated by radiation for other medical conditions. The radiation can destroy the thyroid gland and decreases the hormones typically released by the gland to decrease.
Congenital hypothyroidism: some babies are born without a thyroid gland present or have their gland located in the wrong place. Some babies have their thyroid cells or enzymes not function properly.
Thyroiditis: Can occur when the thyroid gland gets inflamed. The inflammation can occur for a variety of different reasons. Still, the outcome results in the gland releasing the stored amount of thyroid hormones into the blood all at once, causing the thyroid to be overactive for a while and then dormant.
Medicine: Certain medicines such as lithium, amiodarone, and interleukin-2 prevent the thyroid gland from making proper amounts of the thyroid hormone, resulting in too little thyroid hormone in the blood.

What are some of the signs and symptoms?

There are many symptoms present for an individual suffering from hypothyroidism. Symptoms can include but are not limited to:

• Fatigue

• Higher than usual sensitivity to cold.

• Constipation

• Dry skin

• Muscle weakness

• Thinning hair

• High cholesterol level

• Enlarged thyroid gland

When should you see a doctor?

It might be time to consult with a physician if you feel tired for no reason or seem to be displaying the symptoms mentioned above. If you are currently receiving hormone therapy for hypothyroidism, continuously schedule follow-up visits with a doctor for the best care and health results.

Learn More

Resources: Information adapted from The American Thyroid Association and Mayo Clinic

https://www.thyroid.org/hypothyroidism /

https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284

The Facts on Ginseng - Benefits and Risks - Avicenna Health

Mon, 24 Aug 2020 19:03:33 GMT

Ginseng is a quintessential Chinese herb, having been in use for over 4,500 years. Although most of us associate ginseng with China, there are several types of ginseng grown throughout the world, and several herbs marketed as ginseng are not true ginseng. True ginseng is in the Panax family. All types of ginseng are found naturally in the wild. However, today most oriental ginseng is cultivated.

Over 80,000 tons of ginseng are produced worldwide annually, and distributed to 35 countries around the world. Although Ginseng is an herb that is native to several continents, the herbs often have very different properties from one another. In other words, ginseng is often a catchall term for several species with varying properties.

Ginseng has been an important component of traditional Chinese medicine for centuries, used to treat a wide variety of conditions and ills. It was also highly valued by Native Americans.

Species of ginseng

Asian ginseng: Asian ginseng (Panax ginseng) is native to China and Korea, where it is an important medicinal herb used for many medical conditions. According to Chinese medicine practitioners, Asian ginseng, called Ren Shen , falls into the category of Herbs that Tonify the Qi (qi or chi is the vital force that guides a person’s physical and mental processes) used when the functional aspects of the body or an organ are weak. It is considered to be “hot” so care must be taken for those who are hot natured, but can be beneficial for those who are cold natured. Ren Shen has been widely harvested over the years and is nearly extinct in the wild. Although Oriental ginseng is available commercially, it is very expensive. It is also known as red ginseng, true ginseng or Asian ginseng.

American ginseng: A cousin to Asian ginseng, American ginseng (Panax quinquefolius) is referred to as Xi Yang Shen in China, and is native to North America, particularly the Appalachian mountain region of the United States. American ginseng grows wild in forested areas and is also cultivated in Canada and the U.S. Traditional practitioners of Chinese medicine consider American ginseng to be mild and “cool.” It nourishes the Qi and Yin (the cooling system in the human body). Therefore, it is indicated for those who are warm natured or have hot flashes. Used by women during menopause, it has many functions and is often used as a calming tonic, and also will remove heat from the Lungs to treat cough.

Where Ren Shen is warm and nourishes and warms the Lung Qi, Spleen Qi, Kidney and Heart Qi, Xi Yang Shen can clear heat from the Lungs, nourishes the Yin of the Lung and Kidney, cooling it down to relieve hot flashes and anxiety.

Note: Any time you want to nourish or tonify the Qi, it is important to include medicinals that move or invigorate the qi. If Qi is stagnant, nourishing Qi may exacerbate uncomfortable symptoms – like putting more water in the reservoir without opening the dam. This is why most Chinese herbs are used in formulas, including several herbs that work together for balance and best effect.

Indian ginseng: Although Indian ginseng (Withania somnifera) is labeled and marketed as ginseng, it isn’t a member of the Panax family and, thus, isn’t a true ginseng. However, it is thought to have powerful anti-inflammatory and antioxidant properties. Indian ginseng is also known as winter cherry or poison gooseberry.

Brazilian ginseng: Like Indian ginseng, Brazilian ginseng (Pfaffia paniculata) isn’t a true ginseng. However, some herbal medicine practitioners believe it may have anti-cancer properties. It is marketed as suma , thought to restore sexual health and relieve stress.

Siberian ginseng: Eleuthero ginseng, this is another herb often marketed and used as ginseng, although it isn’t a member of the Panax family. It is considered to be a stress reliever and has mild stimulant properties. Siberian ginseng is acrid, bitter and warm, and tonifies the Spleen and Kidney qi. It is used for weak and sore low back and knees, fatigue and insomnia.

San Qi , the Chinese name for what is called in English pseudoginseng or notoginseng root. This is not a true ginseng and falls into the category of “Herbs that Stop Bleeding” in Chinese medicine. Used for internal and external bleeding, it can stop bleeding without causing blood stasis. Therefore, it also stops pain, especially for traumatic injuries, swelling and pain due to falls and fractures, contusions and sprains.

Why is there white and red ginseng?

The difference in colour comes down to how ginseng is treated. ‘White’ ginseng is naturally dried in the sun. ‘Red’ ginseng is steam heated between 100–110° for 2–3 hours. This treatment kills any potential pathogens on the plant’s roots. The downside is that it degrades some of the active components which are found in the outer layers of bark.

What are the Possible Health Benefits of Ginseng?

• Improves Mood and Reduces Stress

• Improves Brain Function • Anti-Inflammatory Properties

• Helps with Weight Loss

• Improves Lung Function

• Lowers Blood Sugar Levels

• Boosts Immune System

Heatstroke in Cars and How To Prevent It

Mon, 10 Aug 2020 17:13:57 GMT

On average, over thirty children have died after being left in a hot vehicle every year since 1998 and these deaths were entirely preventable. What is most alarming is that the majority of parents who left their children in the car did so unintentionally. Over half of the children who died were in the vehicle because the person looking after them forgot to take them out of the car before leaving them in the vehicle. Preventing these tragedies from occurring is everyone’s responsibility— from parents and caregivers to those who happen to notice a child in a vehicle alone on a hot day.

Toddlers Represent Majority of Deaths Due to Vehicular Heatstroke

There have been 717 deaths from 1998 to present day due to children being trapped in hot vehicles. An overwhelming number of these fatalities have involved children under six years old. Infants represent the largest share, with 225 of the deaths under a year old and another 382 between the age of one and three. The reason for these accidents can include the assumption that cloud cover or more moderate temperatures make for less dangerous conditions and the forgetfulness of the caregiver.

Contrary to what some believe, vehicles can heat up rapidly even on cloudy or temperate days. Some children have died from heat stroke inside vehicles while the temperature was as low as 57 degrees. The reason for this is that a closed vehicle can trap UV rays and the heat from the sun, heating up rapidly in a matter of minutes.

Studies have shown that it can take only ten minutes for the inside of an SUV to reach a temperature of 100 on a 73 degree day. If the temperature is 90 degrees, the interior can warm to over 160 degrees in less than ten minutes.

How to Prevent Vehicular Heatstroke

Children of all ages are at risk if they remain inside of a warm vehicle, so it is important that you don’t leave your child unattended for any period of time, even if you intend to make a quick trip in and out of a store. 54% of heatstroke related deaths occurred when parents forgot their child, but another 28% were the result of a child entering the vehicle without supervision.

The following are ways that you can prevent these accidents or to respond when a child is in danger.

Make it a habit to lock your vehicle so that children are unable to get inside while unsupervised.

Also make it a habit to look inside your vehicle before you lock it so that you do not forget your child.

Never leave a child alone in a car for any reason. There are too many things that can go wrong, regardless of how soon you will return.
If you see a child inside of a vehicle on a hot day, give the driver no more than two or three minutes to return before taking action.
If the child is unresponsive, remove him or her from the vehicle. Call 9-11 immediately and use cool water to bring his or her temperature down.

If the child is responsive, remain at the vehicle until a guardian arrives. Find someone to search for the driver.

Taking a proactive approach to vehicular heatstroke may save a life, so do not hesitate to do what is necessary to remove a child from danger.

Finally, make sure that any babysitter or caregiver you trust to care for your child understands that he or she may never leave your child unattended in a vehicle. Many vehicular heatstroke deaths involved caregivers who were not the parent or guardian.

This article written by [Jonathan Rosenfled] https://www.rosenfeldinjurylawyers.com/jonathan-rosenfeld.html ) from Rosenfeld Injury Lawyers and being published on the Health Tip of the Week page in collaboration with Avicenna Health.

Carpal Tunnel Syndrome - Symptoms and Causes - Avicenna Health

Wed, 22 Jul 2020 15:38:09 GMT

• Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm, becomes pressed or squeezed at the wrist .
• Symptoms usually start gradually, with frequent numbness or tingling in the fingers, especially the thumb and the index and middle fingers. The dominant hand is commonly affected first and produces the most severe symptoms, especially with activities such as talking on the phone, reading a book or newspaper, or driving.

• Women are three times more likely than men to develop carpal tunnel syndrome. Diabetes or other metabolic disorders can affect the body’s nerves and make them more susceptible to compression are also at high risk. CTS usually occurs only in adults.

• Carpal tunnel syndrome is more reported in those performing assembly line work—such as manufacturing, sewing, finishing, cleaning, and meatpacking—than it is among data-entry personnel.

How can you care for yourself at home?

You may apply cold compresses on the area for 15 minutes to help with the swelling and pain.

Your doctor may prescribe over-the-counter medication such as Tylenol or NSAIDs. Please take it as prescribed.

Few exercises could help your condition, such as prayer stretch, wrist flexor stretch, and wrist extensor stretch. Many Resources and demonstration videos are available for this kind of exercise. Here is just one example: https://youtu.be/HrErY47ryho

Your doctor may recommend a splint or brace for you to wear it at night. Adherence to splint wearing may help to alleviate the symptoms.

Your doctor may prescribe a steroid course. Take it as prescribed.

Your doctor may refer you for additional nerve studies or surgical evaluation.

Where can you learn more?

References and additional resources:

National Institute of Neurological Disorders and Stroke

American College of rheumatology

Uptodate.com

MedlinePlus

Tension Headache - Causes and Treatment - Avicenna Health

Fri, 26 Jun 2020 14:13:53 GMT

Most headaches are tension headaches. These headaches tend to happen again, especially if you are under stress. A tension headache may cause pain or a feeling of pressure all over your head. You probably can't pinpoint the center of the pain. If you keep getting tension headaches, the best thing you can do to limit them is to find out what is causing them and then make changes in those areas.

How can you for yourself at home?

• Rest in a quiet, dark room with a cool cloth on your forehead until your headache is gone. Close your eyes and try to relax or go to sleep. Don't watch TV or read. Avoid using the computer.

• Use a warm, moist towel or a heating pad set on low to relax tight shoulder and neck muscles.

• Have someone gently massage your neck and shoulders.

• Take pain medicines exactly as directed.

• If the doctor gave you a prescription medicine for pain, take it as prescribed.

• If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

• Be careful not to take pain medicine more often than the instructions allow, because you may get worse or more frequent headaches when the medicine wears off.

• If you get another tension headache, stop what you are doing and sit quietly for a moment. Close your eyes and breathe slowly. Try to relax your head and neck muscles.

• Do not ignore new symptoms that occur with a headache, such as fever, weakness or numbness, vision changes, or confusion. These may be signs of a more serious problem.

To help prevent headaches

• Keep a headache diary so you can figure out what triggers your headaches. Avoiding triggers may help you prevent headaches. Record when each headache began, how long it lasted, and what the pain was like (throbbing, aching, stabbing, or dull). List anything that may have triggered the headache, such as being physically or emotionally stressed or being anxious or depressed. Other possible triggers are hunger, anger, fatigue, poor posture, and muscle strain.

• Find healthy ways to deal with stress. Headaches are most common during or right after stressful times. Take time to relax before and after you do something that has caused a headache in the past. • Exercise daily to relieve stress. Relaxation exercises may help reduce tension.

• Get plenty of sleep.

• Eat regularly and well. Long periods without food can trigger a headache.

• Treat yourself to a massage. Some people find that massages are very helpful in relieving tension.

• Try to keep your muscles relaxed by keeping good posture. Check your jaw, face, neck, and shoulder muscles for tension, and try to relax them. When sitting at a desk, change positions often, and stretch for 30 seconds each hour.

• Reduce eyestrain from computers by blinking frequently and looking away from the computer screen every so often. Make sure you have proper eyewear and that your monitor is set up properly, about an arm's length away.

• Call 911 anytime you think you may need emergency care. For example, call if:

• You have signs of a stroke. These may include:

• Sudden numbness, paralysis, or weakness in your face, arm, or leg, especially on only one side of your body.

• Sudden vision changes.

• Sudden trouble speaking.

• Sudden confusion or trouble understanding simple statements.

• Sudden problems with walking or balance.

• A sudden, severe headache that is different from past headaches. Call your doctor now or seek immediate medical care if:

• You have new or worse nausea and vomiting.

• You have a new or higher fever.

• Your headache gets much worse.

Information source: https://www.healthwise.net/patientEd

Heat Exhaustion and Heatstroke - Avicenna Health

Mon, 08 Jun 2020 20:59:58 GMT

Heat exhaustion occurs when you are hot, sweat a lot, and do not drink enough to replace the lost fluids or loss of electrolytes.

Symptoms of heat exhaustion include fatigue, weakness, headache, dizziness, and nausea. Also, the skin is pale, cool, and moist.

Mild heat exhaustion may sometimes cause fainting. But it doesn't cause a change in your mental alertness and usually can be treated at home. Moderate to severe heat exhaustion can sometimes lead to heatstroke, which requires emergency treatment.

Classic heatstroke can develop without exertion when a person is exposed to a hot environment and the body is unable to cool itself effectively. In this type of heatstroke, the body's ability to sweat and transfer the heat to the environment is reduced. A person with heatstroke may stop sweating. Classic heatstroke may develop over several days. Babies, older adults, and people with chronic health problems have the greatest risk of this type of heatstroke.

Exertional heatstroke may develop when a person is working or exercising in a hot environment. A person with heatstroke from exertion may sweat profusely, but the body still produces more heat than it can lose. This causes the body's temperature to rise to high levels.

Heatstroke occurs when the body fails to regulate its own temperature, and body temperature continues to rise. Heatstroke can lead to problems with many different organs and can be life-threatening. Symptoms of heatstroke include:

• Unconsciousness for longer than a few seconds.

• Confusion, severe restlessness, or anxiety.

• Convulsion (seizure).

• Symptoms of moderate to severe difficulty breathing.

• Fast heart rate.

• Sweating that may be heavy or may have stopped.

• Skin that may be red, hot, and dry, even in the armpits.

• Nausea and vomiting.

To prevent heat exhaustion

• Drink plenty of fluids, enough so that your urine is light yellow or clear like water. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

• Drink plenty of water before, during, and after you are active. This is very important when it is hot out and when you do intense exercise.

• During hot weather, wear light-colored clothing that fits loosely and a hat with a brim to reflect the sun.

• Limit or avoid strenuous activity during hot or humid weather, especially during the hottest part of the day (10 a.m. to 4 p.m.). Heat exhaustion and heatstroke usually develop when you are working or exercising in hot weather. Humidity makes hot weather even more dangerous.

• Cars can get very hot inside. Open the windows or turn on the air conditioning before you get in and close the doors.

• Try to stay cool during hot weather. If your home is not air-conditioned, seek an air-conditioned place. That could be in the library, a neighborhood café, or a friend's home. Spray yourself with a cool mist. Take a cool shower, bath, or sponge bath.

How can you care for yourself at home?

• Reduce your activities and get plenty of rest. Your doctor will give you instructions on when you can resume your normal schedule.

• Stay in a cool room for at least the next 24 hours.

• Drink rehydration drinks, juices, and water to replace fluids. Drinks such as sports drinks that contain electrolytes work best, because they have salt and minerals. You need salt and minerals as well as water. You are drinking enough fluids when your urine is normal in color (light yellow or clear), and you are urinating every 2 to 4 hours. If you have kidney, heart, or liver disease and have to limit fluids or salt, talk with your doctor before you increase your fluid or salt intake.

• Avoid drinks that have caffeine or alcohol.

Information source: https://www.healthwise.net/patientEd

Gastroesophageal Reflux Disease (GERD) - Avicenna Health

Fri, 29 May 2020 16:32:15 GMT

Gastroesophageal reflux disease (GERD) is the backward flow of stomach acid into the esophagus. The esophagus is the tube that leads from your throat to your stomach. A one-way valve prevents the stomach acid from backing up into this tube. When you have GERD, this valve does not close tightly enough. This can also cause pain and swelling in your esophagus (esophagitis).

If you have mild GERD symptoms including heartburn, you may be able to control the problem with antacids or over-the-counter medicine. Changing your diet and eating habits, such as not eating late at night, losing weight, and making other lifestyle changes can also help reduce symptoms.

How can you care for yourself at home?

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.

• Your doctor may recommend over-the-counter medicine. For mild or occasional indigestion, antacids, such as Tums, Gaviscon, Mylanta, or Maalox, may help. Your doctor also may recommend over-the-counter acid reducers, such as Pepcid AC (famotidine) or Prilosec (omeprazole). Read and follow all instructions on the label. If you use these medicines often, talk with your doctor.

• Change your eating habits.

•• It's best to eat several small meals instead of two or three large meals.

•• After you eat, wait 2 to 3 hours before you lie down.

•• Chocolate, mint, and alcohol can make GERD worse.

•• Spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make GERD symptoms worse in some people. If your symptoms are worse after you eat a certain food, you may want to stop eating that food to see if your symptoms get better.

• Do not smoke or chew tobacco. Smoking can make GERD worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

• If you have GERD symptoms at night, raise the head of your bed 6 to 8 inches by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)

• Do not wear tight clothing around your middle.

• Lose weight if you need to. Losing just 5 to 10 pounds can help.

Call your doctor if:

• Your stools are black and tarlike or have streaks of blood.

• Food seems to catch in your throat or chest .

Information source: https://www.healthwise.net/patientEd

Migraine Headaches - Symptoms and Causes - Avicenna Health

Wed, 20 May 2020 18:37:52 GMT

Migraines are painful, throbbing headaches that often start on one side of the head. They may cause nausea and vomiting and make you sensitive to light, sound, or smell. Without treatment, migraines can last from 4 hours to a few days. Medicines can help prevent migraines or stop them after they have started. Your doctor can help you find which ones work best for you.

Without treatment, migraines can last from 4 hours to a few days. Medicines can help prevent migraines or stop them after they have started. Your doctor can help you find which ones work best for you.

How can you care for yourself at home?

Do not drive if you have taken a prescription pain medicine.
Rest in a quiet, dark room until your headache is gone. Close your eyes, and try to relax or go to sleep. Don't watch TV or read.
Put a cold, moist cloth or cold pack on the painful area for 10 to 20 minutes at a time. Put a thin cloth between the cold pack and your skin.
Use a warm, moist towel or a heating pad set on low to relax tight shoulder and neck muscles.
Have someone gently massage your neck and shoulders.
Take your medicines exactly as prescribed. Don't take medicine for headache pain too often. Talk to your doctor if you are taking medicine more than 2 days a week to stop a headache. Taking too much pain medicine can lead to more headaches. These are called medicine-overuse headaches.
Your doctor may prescribe a medicine that you take only when you get a migraine. Take it at the first sign of a migraine, unless your doctor has given you other instructions.

To prevent migraines

Keep a headache diary so you can figure out what triggers your headaches. Avoiding triggers may help you prevent headaches. Record when each headache began, how long it lasted, and what the pain was like. Write down any other symptoms you had with the headache, such as nausea, flashing lights or dark spots, or sensitivity to bright light or loud noise. Note if the headache occurred near your period. Triggers may include certain foods (chocolate, cheese, wine) or odors, smoke, bright light, stress, or lack of sleep
Your doctor may prescribe a medicine that you take regularly to help prevent migraines. Take it exactly as prescribed.
Migraines are most common during or right after stressful times. Try finding healthy ways to deal with stress like practicing mindfulness or deep breathing exercises.
Get plenty of sleep and exercise. But be careful to not push yourself too hard during exercise. It may trigger a headache.
Eat meals on a regular schedule. Avoid foods and drinks that often trigger migraines. These include chocolate, alcohol (especially red wine and port), aspartame, monosodium glutamate (MSG), and some additives found in foods (such as hot dogs, bacon, cold cuts, aged cheeses, and pickled foods).
Limit caffeine. Don't drink too much coffee, tea, or soda. But don't quit caffeine suddenly. That can also give you migraines.
If you are taking birth control pills or hormone therapy, talk to your doctor about whether they are triggering your migraines.
Do not smoke or allow others to smoke around you.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You have signs of a stroke. These may include:

Sudden numbness, paralysis, or weakness in your face, arm, or leg, especially on only one side of your body.
Sudden vision changes.
Sudden trouble speaking.
Sudden confusion or trouble understanding simple statements.
Sudden problems with walking or balance.
A sudden, severe headache that is different from past headaches.

Information Source: https://www.healthwise.net/patientEd

Mastitis - Symptoms, Causes, and Treatment - Avicenna Health

Mon, 11 May 2020 18:21:15 GMT

Mastitis

Mastitis is an inflammation of the breast. It occurs most often in breastfeeding women, but it can affect any woman. Mastitis can be caused by poor milk flow from the breast. When milk builds up in a breast, it leaks into the nearby breast tissue. Infection can also develop when the nipples become cracked or irritated. The tissue can then become infected with bacteria.

Antibiotics can usually cure mastitis. For women who are nursing, continued breastfeeding (or pumping) can help. If mastitis is not treated, a pocket of pus may form in the breast and need to be drained.

How can you care for yourself at home?

If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better.
If you are breastfeeding, continue breastfeeding or pumping breast milk every 2 to 3 hours while you are awake.
These tips may help:

Before breastfeeding, place a warm, wet washcloth over your breast for about 15 minutes. Massaging the affected breast may also increase milk flow.
Breastfeed on both sides starting with your healthy breast first. Then, after your milk is flowing, breastfeed from the affected breast until it feels soft. You should empty this breast completely.
Pump or express milk from the affected breast if it hurts too much to breastfeed.

Take an over-the-counter pain medicine, such as acetaminophen or ibuprofen to relieve pain and fever.
Rest as much as possible.
Drink extra fluids.
If pus is draining from your infected breast, wash the nipple gently and let it air-dry before you put your bra back on. A disposable breast pad placed in the bra cup may absorb the pus.
Sometimes, a blocked nipple pore, called a milk blister (or bleb) causes milk to back up in the breast. It is often a white dot on your nipple that can be painful. It can cause mastitis, so it's important to treat this if it happens. You may place a warm, wet washcloth over the blister before breastfeeding or pumping. If this doesn't clear the blockage, your doctor can open the blister using a sterile needle.

Information Source: https://www.healthwise.net/patientEd

Stress and Heart Attack - Avicenna Health

Wed, 11 Mar 2020 15:24:55 GMT

This is a subtitle for your new post

Nine risk factors have been identified to account for more than 90% of the risk for heart attack.

These are the risk factors in descending order:

Dyslipidemia (abnormal cholesterol levels)
Smoking
Psychosocial stressors
Diabetes mellitus
Hypertension
Obesity
Alcohol consumption
Physical inactivity, and
Diet low in fruits and vegetables.

All of the above risk factors could be modified by lifestyle modification, including diet, exercise, weight loss, smoking cessation, seeking social support, and alcohol abstinence.

Basic Protective Measures Against the Novel Coronavirus

Wed, 12 Feb 2020 20:07:34 GMT

Wash your hands frequently with hand and soap or with alcohol-based hand rub.
Practice general respiratory hygiene by covering your mouth and nose with a tissue or your flexed elbow.
Maintain social distancing by staying at least 3 feet away from people, especially those who are sick.
Avoid touching eyes, nose, and mouth. It may transfer the virus from your hands to these organs.
If you have a fever, cough, and difficulty breathing, seek medical care early.
If you have mild respiratory symptoms and no travel history to or within China, carefully practice basic respiratory and hand hygiene and stay home until you are recovered, if possible.
Practice general hygiene measures when visiting live animal markets, wet markets, or animal product markets.
Avoid consumption of raw or undercooked animal products and apply good food practices.

Adopted from the World Health Organization Website

Heartburn Hurts - Know these Steps

clientservices@wehco.com (Master Account) — Mon, 06 Jan 2020 15:24:05 GMT

Acid reflux (heartburn) occurs when the stomach contents back up into the esophagus and/or mouth. People with gastroesophageal reflux disease (GERD) experience bothersome symptoms or damage to the esophagus as a result of acid reflux. Symptoms of GERD can include heartburn, regurgitation, and difficulty or pain with swallowing.

Here are important lifestyle changes for GERD patients to consider to relieve their symptoms:

Losing weight (if you are overweight)
Raising the head of your bed 6-8 inches, by simply putting blocks of wood under the legs or a foam wedge under the mattress or using commercial products for this purpose.
Avoiding foods that trigger symptoms – Such as caffeine, chocolate, alcohol, peppermint, and fatty foods may cause bothersome acid reflux in some people.
Quitting smoking.
Avoiding late meals – plan your meals for at least two to three hours before bedtime.
Wearing loose, comfortable clothing.

Essential Tips for the Holidays

clientservices@wehco.com (Master Account) — Thu, 26 Dec 2019 16:22:23 GMT

During the Holiday season excitement, it is easy to skip some good habits to which we are accustomed.

Here are some essential tips for the Holiday:

Keep your medications in a daily organizer and carry them wherever you go and do your best to take them on time.

Holiday food variety is always tempting, so pick wisely (less packed food and more fruit and vegetables) and try to keep a distance from the food area!

Drink plenty of water (unless you have a medical condition that requires fluid restriction.)

Diet for patient with chronic kidney disease - Avicenna Health

Tue, 17 Dec 2019 16:27:31 GMT

If you are a patient with chronic kidney disease (CKD) or caring for a patient with CKD, learning about important dietary recommendations could be beneficial to reduce the risk of some complications. High protein diet from plant source, high calcium diet, mild to moderate restriction of sodium, potassium and phosphorus (based on the stage of CKD) are all helpful dietary recommendations for patients with CKD.

Limit or avoid, chicken and beef liver and drinks high in phosphorus such as cocoa, beer, dark sodas (always check the label!) and enjoy phosphorus lower alternatives such as: apples, berries, grapes, carrot sticks, cucumber, rice cakes.

Limit or avoid high potassium food and drinks such as banana, dried fruit, kiwi, prune, orange, grapefruit, Papaya, raisins, beets, lentils, and enjoy lower potassium alternatives such as apple, pineapple, berries, pears, lettuce, eggplant, Cauliflower, corn, rice, noodles.

For more helpful tips, visit: https://www.kidney.org/nutrition/Kidney-Disease-Stages-1-4

Photos Source: National Kidney Foundation

Know the Signs of the Flu - Avicenna Health

Tue, 10 Dec 2019 22:25:04 GMT

Influenza (the flu) is a highly contagious illness that happens more often in the winter months when people spend more time in close contact with one another.

Symptoms include fever, headache, fatigue, muscle pain, cough, and possibly sore throat. Fever in the flu is usually more prolonged (2-5 days) than the temperature with the upper respiratory infection (1-2 days).

People with the flu are encouraged to seek rest, take a large amount of fluid to avoid dehydration, treat the symptoms with over the counter medications such as acetaminophen and decongestants.

Antiviral treatment is a prescription medication that can reduce the severity and duration of symptoms by about one day. Antiviral medication is most useful for influenza when it is taken within the first 48 hours of flu symptoms. When your doctor prescribes this medication, then fill it, and use it as soon as possible to achieve the maximum benefit.

Know your Tylenol limits

Wed, 04 Dec 2019 21:32:23 GMT

Some people take acetaminophen in different forms and combinations without realizing it. Acetaminophen is a common ingredient in many over the counter cold and congestion medicines as well as some prescription narcotics. To avoid liver damage, you need to check the amount of acetaminophen, so it does not exceed 4 grams daily. If you have already liver disease, the amount should not exceed 2 grams daily.

You can take up to 4 grams (8 of the 500 mg tab) of Acetaminophen (Tylenol) daily if you have no liver disease, and only up to 2 grams (4 of the 500 mg tab) if you have liver disease.

Watch your water pill

Wed, 04 Dec 2019 21:27:22 GMT

Did you know?

If you are a patient who takes a water pill and you start to have diarrhea, vomiting, or other reason for dehydration, you may hold your water pill for the days when dehydration occurs and then resume it once the dehydration issue is resolved.

Some people believe that they should follow the doctor's orders and recommendations literally with no deviation. Well, there is room for flexibility and common sense when it comes to doctor orders, prescriptions and recommendations. If you are in doubt, always ask!

Too much water can be bad for you

Wed, 27 Nov 2019 14:33:26 GMT

Did you know?

Some people believe that drinking copious amounts of water is beneficial, regardless of their medical problems. Well, if you have congestive heart failure or chronic kidney disease, you are advised to be on the fluid restriction of no more than 1800 ml/day (60 Oz/day) or even 1500 ml/day (50 Oz/day) in advanced cases. Be mindful that the measured fluid should include not only water; but also milk, juice, coffee, tea, soda, etc.

Do Not Drink large amount of water if you have congestive heart failure or chronic kidney disease!

Setting Goals The Smart Way | Weekly Health Tip | Avicenna

Wed, 20 Nov 2019 06:00:00 GMT

Whether you are trying to lose weight or cut down on your smoking toward quitting, it is vital to do it the SMART way:

Setting goals the SMART way!

S pecific about what you will set out to do

M easurable so you can determine whether your goal has been met

A ttainable/Action-oriented rather than passive

R elevant and Realistic for your condition

T ime-based, so the goal is being measured within a particular time

Examples of setting the goals, the SMART approach:

For someone with obesity and sub optimal exercise level, SMART goal could be walking around the block every day for the next two weeks. For this person, the goal is specific (particular exercise performance). It is Action-oriented (the person has to do it, rather than depending on someone else to do it passively). It is realistic (not to expect to run a marathon in the first few phases), and It could be measured by marking if the task is done daily and how many days in the time frame period (2 weeks).
For someone with alcohol dependence, SMART goal could be lowering the number of daily drinks by one drink (or beer) every week over the next month.

Follow Avicenna Health for more tips on staying healthy and happy!