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 Dysthymia, sometimes referred to as mild, chronic depression, is less severe and has fewer symptoms than major depression. With dysthymia, the depression symptoms can linger for a long period of time, often two years or longer. Those who suffer from dysthymia can also experience periods of major depression--sometimes called "double depression." In modern diagnostic classification systems, dysthymia and chronic depression are now both referred to as 'persistent depressive disorders.
 

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Chest pain. The first thing you may think of is heart attack. Certainly chest pain is not something to ignore. But you should know that it has many possible causes. In fact, as much as a quarter of the U.S. population experiences chest pain that is not related to the heart. Chest pain may also be caused by problems in your lungs, esophagus, muscles, ribs, or nerves, for example. Some of these conditions are serious and life threatening. Others are not. If you have unexplained chest pain, the only way to confirm its cause is to have a doctor evaluate you.

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Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure in blood vessels the harder the heart has to work in order to pump blood. If left uncontrolled, hypertension can lead to a heart attack, an enlargement of the heart and eventually heart failure. Blood vessels may develop bulges (aneurysms) and weak spots due to high pressure, making them more likely to clog and burst. The pressure in the blood vessels can also cause blood to leak out into the brain. This can cause a stroke. Hypertension can also lead to kidney failure, blindness, rupture of blood vessels and cognitive impairment.

Blood pressure is measured in millimeters of mercury (mm Hg) and is recorded as two numbers usually written one above the other. The upper number is the systolic blood pressure - the highest pressure in blood vessels when the heart contracts, or beats. The lower number is the diastolic blood pressure - the lowest pressure in blood vessels when the heart muscle relaxes. Normal adult blood pressure is defined as a systolic blood pressure of 120 mm Hg and a diastolic blood pressure of 80 mm Hg.

Hypertension is defined as a systolic blood pressure equal to or above 140 mm Hg and/or diastolic blood pressure equal to or above 90 mm Hg.

More than 1 in 5 adults worldwide have raised blood pressure – a condition that causes around half of all deaths from stroke and heart disease. Complications from hypertension account for 9.4 million deaths worldwide every year.

In nearly all high-income countries, widespread diagnosis and treatment with low-cost medication have led to a significant drop in the proportion of people with raised blood pressure as well as the average blood pressure across populations. This has contributed to a reduction in deaths from heart disease. For example, the prevalence of raised blood pressure in the WHO region of the Americas in 2014 was 18%, as compared to 31% in 1980.

In contrast, low-income countries have the highest prevalence of raised blood pressure. In the WHO African region, more than 30% of adults in many countries are estimated to have high blood pressure. This proportion is increasing and the average blood pressure levels in this region are much higher than global averages.

Many people with high blood pressure in developing countries are not aware of their disease. Those who are diagnosed may not have access to treatment and may not be able to successfully control their illness over the long term. It contributes to the burden of heart disease, stroke and kidney failure and premature mortality and disability.

Detection, treatment and control of hypertension is an important health priority worldwide.

 

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Joints are the parts of your body where your bones meet. Joints allow the bones of your skeleton to move. Joints include:

shoulders
hips
elbows
knees
Joint pain refers to discomfort, aches, and soreness in any of the body’s joints. Joint pain is a common complaint. It doesn’t typically require a hospital visit. Sometimes, joint pain is the result of an illness or injury. Arthritis is also a common cause of joint pain. However, it can also be due to other conditions or factors.

 

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The cause of chronic kidney disease isn't always known. But any condition or disease that damages blood vessels or other structures in the kidneys can lead to kidney disease. The most common causes of chronic kidney disease are:

Diabetes . High blood sugar levels caused by diabetes damage blood vessels in the kidneys. If the blood sugar level remains high over many years, this damage gradually reduces the function of the kidneys.
High blood pressure (hypertension). Uncontrolled high blood pressure damages blood vessels, which can lead to damage in the kidneys. And blood pressure often rises with chronic kidney disease, so high blood pressure may further damage kidney function even when another medical condition initially caused the disease.

 

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Lung diseases are some of the most common medical conditions in the world. Tens of millions of people suffer from lung disease in the U.S. Smoking, infections, and genetics are responsible for most lung diseases.

The lungs are part of a complex apparatus, expanding and relaxing thousands of times each day to bring in oxygen and expel carbon dioxide. Lung disease can result from problems in any part of this system.

 

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Muscle aches, or myalgia, are extremely common. Almost everybody has experienced discomfort in their muscles at some point.

Because there is muscle tissue in nearly all parts of the body, this type of pain can be felt practically anywhere…

 

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An alkaline phosphatase (ALP) test measures the amount of ALP in your blood. ALP is an enzyme found throughout the body, but it is mostly found in the liver, bones, kidneys, and digestive system. When the liver is damaged, ALP may leak into the bloodstream. High levels of ALP can indicate liver disease or bone disorders.

Other names: ALP, ALK, PHOS, Alkp, ALK PHOS

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Alpha-fetoprotein (AFP) is a protein produced in the liver of a developing fetus. During a baby's development, some AFP passes through the placenta and into the mother's blood. An AFP test measures the level of AFP in pregnant women during the second trimester of pregnancy. Too much or too little AFP in a mother's blood may be sign of a birth defect or other condition. These include:

  • neural tube defect, a serious condition that causes abnormal development of a developing baby's brain and/or spine
  • Down syndrome, a genetic disorder that causes intellectual disabilities and developmental delays
  • Twins or multiple births, because more than one baby is producing AFP
  • Miscalculation of due date, because AFP levels change during pregnancy

Other names: AFP Maternal; Maternal Serum AFP; msAFP screen

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An epithelial cells line the surfaces of organs and tissues throughout the body, including the urinary tract. In a urine sample, the presence of epithelial cells can be an indication of various conditions that affect the urinary tract and kidneys, such as urinary tract infections, kidney disease, and bladder cancer.

An epithelial cell in urine test is a routine and non-invasive test that involves collecting a urine sample and analyzing it for the presence of epithelial cells. The interpretation of the results of epithelial cells in urine tests can be complex and requires the expertise of a healthcare professional. Depending on the results of the test, your healthcare provider may recommend further testing or follow-up to diagnose or monitor your condition.

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Hepatitis is a type of liver disease. Viruses called hepatitis Ahepatitis B, and hepatitis C are the most common causes of hepatitis. A hepatitis panel is a blood test that checks to see if you have a hepatitis infection caused by one of these viruses.

The viruses are spread in different ways and cause different symptoms:

  • Hepatitis A is most often spread by contact with contaminated feces (stool) or by eating tainted food. Though uncommon, it can also be spread through sexual contact with an infected person. Most people recover from hepatitis A without any lasting liver damage.
  • Hepatitis B is spread through contact with infected blood, semen, or other bodily fluids. Some people recover quickly from a hepatitis B infection. For others, the virus can cause long-term, chronic liver disease.
  • Hepatitis C is most often spread by contact with infected blood, usually through sharing of hypodermic needles. Though uncommon, it can also be spread through sexual contact with an infected person. Many people with hepatitis C develop chronic liver disease and cirrhosis.

A hepatitis panel includes tests for hepatitis antibodies and antigens. Antibodies are proteins that the immune system produces to help fight infections. Antigens are substances that cause an immune response. Antibodies and antigens can be detected before symptoms appear.

Other names: acute hepatitis panel, viral hepatitis panel, hepatitis screening panel

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MCV stands for mean corpuscular volume. There are three main types of corpuscles (blood cells) in your blood–red blood cells, white blood cells, and platelets. An MCV blood test measures the average size of your red blood cells, also known as erythrocytes. Red blood cells move oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. If your red blood cells are too small or too large, it could be a sign of a blood disorder such as anemia, a vitamin deficiency, or other medical condition.

Other names: CBC with differential

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MPV stands for mean platelet volume. Platelets are small blood cells that are essential for blood clotting, the process that helps you stop bleeding after an injury. An MPV blood test measures the average size of your platelets. The test can help diagnose bleeding disorders and diseases of the bone marrow.

Other names: Mean Platelet Volume

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A Pap smear is a test for women that can help find or prevent cervical cancer. During the procedure, cells are collected from the cervix, which is the lower, narrow end of the uterus that opens into the vagina. The cells are checked for cancer or for signs that they may become cancer. These are called precancerous cells. Finding and treating precancerous cells can help prevent cervical cancer. The Pap smear is a reliable way to find cancer early, when it's most treatable.

Other names for a Pap smear: Pap test, cervical cytology, Papanicolaou test, Pap smear test, vaginal smear technique

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potassium blood test measures the amount of potassium in your blood. Potassium is a type of electrolyte. Electrolytes are electrically charged minerals in your body that help control muscle and nerve activity, maintain fluid levels, and perform other important functions. Your body needs potassium to help your heart and muscles work properly. Potassium levels that are too high or too low may indicate a medical problem.

Other names: potassium serum, serum potassium, serum electrolytes, k


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A protein in urine test measures how much protein is in your urine. Proteins are substances that are essential for your body to function properly. Protein is normally found in the blood. If there is a problem with your kidneys, protein can leak into your urine. While a small amount is normal, a large amount of protein in urine may indicate kidney disease.

Other names: urine protein, 24-hour urine protein; urine total protein; ratio; reagent strip urinalysis.

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An anion gap blood test is a way to check the levels of acid in your blood. The test is based on the results of another blood test called an electrolyte panel. Electrolytes are electrically charged mineralsthat help control the balance of chemicals in your body called acids and bases. Some of these minerals have a positive electric charge. Others have a negative electric charge. The anion gap is a measurement of the difference-or gap-between the negatively charged and positively charged electrolytes. If the anion gap is either too high or too low, it may be a sign of a disorder in your lungs, kidneys, or other organ systems.

Other names: Serum anion gap

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A complete blood count or CBC is a blood test that measures many different parts and features of your blood, including:

  • Red blood cells, which carry oxygen from your lungs to the rest of your body
  • White blood cells, which fight infection. There are five major types of white blood cells. A CBC test measures the total number of white cells in your blood. A test called a CBC with differentialalso measures the number of each type of these white blood cells
  • Platelets, which help your blood to clot and stop bleeding
  • Hemoglobin, a protein in red blood cells that carries oxygen from your lungs and to the rest of your body
  • Hematocrit, a measurement of how much of your blood is made up of red blood

A complete blood count may also include measurements of chemicals and other substances in your blood. These results can give your health care provider important information about your overall health and risk for certain diseases.

Other names for a complete blood count: CBC, full blood count, blood cell count

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Hair loss, also known as alopecia or baldness, refers to a loss of hair from part of the head or body. Typically at least the head is involved. The severity of hair loss can vary from a small area to the entire body. Typically inflammation or scarring is not present.Hair loss in some people causes psychological distress.

Common types include: male-pattern hair loss, female-pattern hair loss, alopecia areata, and a thinning of hair known as telogen effluvium.The cause of male-pattern hair loss is a combination of genetics and male hormones, the cause of female pattern hair loss is unclear, the cause of alopecia areata is autoimmune, and the cause of telogen effluvium is typically a physically or psychologically stressful event.Telogen effluvium is very common following pregnancy.

Less common causes of hair loss without inflammation or scarring include the pulling out of hair, certain medications including chemotherapy, HIV/AIDS, hypothyroidism, and malnutrition including iron deficiency. Causes of hair loss that occurs with scarring or inflammation include fungal infection, lupus erythematosus, radiation therapy, and sarcoidosis.Diagnosis of hair loss is partly based on the areas affected.

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An aphrodisiac is a substance that increases libido when consumed. Aphrodisiacs are distinct from substances that address fertility issues or secondary sexual (dys)function such as erectile dysfunction (ED).

The name comes from the Greek ἀφροδισιακόν, aphrodisiakon, i.e. "sexual, aphrodisiac", from aphrodisios, i.e. "pertaining to Aphrodite", the Greek goddess of love. The opposite substance is an anaphrodisiac.

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Abdominal pain is a common symptom associated with non-serious and serious causes.

Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. In a third of cases the exact cause is unclear. About 10% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy.Determining the cause can be difficult, because many diseases can cause this symptom.
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Women's health refers to the health of women, which differs from that of men in many unique ways. Women's health is an example of population health, where health is defined by the World Health Organization as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Often treated as simply women's reproductive health, many groups argue for a broader definition pertaining to the overall health of women, better expressed as "The health of women". These differences are further exacerbated in developing countries where women, whose health includes both their risks and experiences, are further disadvantaged.

Although women in industrialised countries have narrowed the gender gap in life expectancy and now live longer than men, in many areas of health they experience earlier and more severe disease with poorer outcomes. Gender remains an important social determinant of health, since women's health is influenced not just by their biology but also by conditions such as poverty, employment, and family responsibilities. Women have long been disadvantaged in many respects such as social and economic power which restricts their access to the necessities of life including health care, and the greater the level of disadvantage, such as in developing countries, the greater adverse impact on health.

Women's reproductive and sexual health has a distinct difference compared to men's health. Even in developed countries pregnancy and childbirth are associated with substantial risks to women with maternal mortality accounting for more than a quarter of a million deaths per year, with large gaps between the developing and developed countries. Comorbidity from other non reproductive disease such as cardiovascular disease contribute to both the mortality and morbidity of pregnancy, including preeclampsia. Sexually transmitted infections have serious consequences for women and infants, with mother-to-child transmission leading to outcomes such as stillbirths and neonatal deaths, and pelvic inflammatory disease leading to infertility. In addition infertility from many other causes, birth control, unplanned pregnancy, unconsensual sexual activity and the struggle for access to abortion create other burdens for women.

While the rates of the leading causes of death, cardiovascular disease, cancer and lung disease, are similar in women and men, women have different experiences. Lung cancer has overtaken all other types of cancer as the leading cause of cancer death in women, followed by breast cancer, colorectal, ovarian, uterine and cervical cancers. While smoking is the major cause of lung cancer, amongst nonsmoking women the risk of developing cancer is three times greater than amongst nonsmoking men. Despite this, breast cancer remains the commonest cancer in women in developed countries, and is one of the more important chronic diseases of women, while cervical cancer remains one of the commonest cancers in developing countries, associated with human papilloma virus (HPV), an important sexually transmitted disease. HPV vaccine together with screening offers the promise of controlling these diseases. Other important health issues for women include cardiovascular disease, depression, dementia, osteoporosis and anemia. A major impediment to advancing women's health has been their underrepresentation in research studies, an inequity being addressed in the United States and other western nations by the establishment of centers of excellence in women's health research and large scale clinical trials such as the Women's Health Initiative
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A wisdom tooth or third molar is one of the three molars per quadrant of the human dentition. It is the most posterior of the three. Wisdom teeth generally erupt between the ages of 17 and 25. Most adults have four wisdom teeth, one in each of the four quadrants, but it is possible to have fewer or more, in which case the extras are called supernumerary teeth. Wisdom teeth commonly affect other teeth as they develop, becoming impacted. They are often extracted when or even before this occurs.
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Autism spectrum disorder (ASD) is a developmental disability  that can cause significant social, communication and behavioral challenges. There is often nothing about how people with ASD look that sets them apart from other people, but people with ASD may communicate, interact, behave, and learn in ways that are different from most other people. The learning, thinking, and problem-solving abilities of people with ASD can range from gifted to severely challenged. Some people with ASD need a lot of help in their daily lives; others need less.


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Vitiligo is a long term skin condition characterized by patches of the skin losing their pigment. The patches of skin affected become white and usually have sharp margins. The hair from the skin may also become white. Inside the mouth and nose may also be involved. Typically both sides of the body are affected. Often the patches begin on areas of skin that are exposed to the sun. It is more noticeable in people with dark skin. Vitiligo may result in psychological stress and those affected may be stigmatized.

The cause is typically unknown. It is believed to be due to genetic susceptibility that is triggered by an environmental factor such that an autoimmune disease occurs. This results in the destruction of skin pigment cells. Risk factors include a family history of the condition or other autoimmune diseases, such as hyperthyroidism, alopecia areata, and pernicious anemia. It is not contagious. Vitiligo is classified into two main types: segmental and non-segmental. Most cases are non-segmental, meaning they affect both sides; and in these cases, the affected area of the skin typically expands with time. About 10% of cases are segmental, meaning they mostly involve one side of the body; and in these cases, the affected area of the skin typically does not expand with time. Diagnosis can be confirmed by tissue biopsy.

There is no known cure for vitiligo. For those with light skin, sunscreen and makeup are all that is typically recommended. Other treatment options may include steroid creams or phototherapy to darken the light patches. Alternatively, efforts to lighten the unaffected skin, such as with hydroquinone, may be tried. A number of surgical options are available for those who do not improve with other measures. A combination of treatments generally has better outcomes. Counselling to provide emotional support may be useful.

Globally about 1% of people are affected by vitiligo. Some populations have rates as high as 2–3%. Males and females are equally affected. About half show the disorder before age 20 and most develop it before age 40. Vitiligo has been described since ancient history.
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Morning sickness, also called nausea and vomiting of pregnancy (NVP), is a symptom of pregnancy that involves nausea or vomiting. Despite the name, nausea or vomiting can occur at any time during the day. Typically these symptoms occur between the 4th and 16th week of pregnancy. About 10% of women still have symptoms after the 20th week of pregnancy. A severe form of the condition is known as hyperemesis gravidarum and results in weight loss.

The cause of morning sickness is unknown but may be related to changing levels of the hormone human chorionic gonadotrophin. Some have proposed that it may be useful from an evolutionary point of view. Diagnosis should only occur after other possible causes have been ruled out. Abdominal pain, fever, or headaches are typically not present in morning sickness.

Taking prenatal vitamins before pregnancy may decrease the risk. Specific treatment other than a bland diet may not be required for mild cases. If treatment is used the combination of doxylamine and pyridoxine is recommended initially. There is limited evidence that ginger may be useful. For severe cases that have not improved with other measures methylprednisolone may be tried. Tube feeding may be required in women who are losing weight.

Morning sickness affects about 70-80% of all pregnant women to some extent. About 60% of women have vomiting. Hyperemesis gravidarum occurs in about 1.6% of pregnancies. Morning sickness can negatively affect quality of life, result in decreased ability to work while pregnant, and result in health care expenses. Generally mild to moderate cases have no effect on the baby. Most severe cases also have normal outcomes. Some women choose to have an abortion due to the severity of symptoms. Complications such as Wernicke encephalopathy or esophageal rupture may occur but are very rare.
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Acupressure [from Latin acus "needle" (see acuity) + pressure (n.)] is an alternative medicine technique similar in principle to acupuncture. It is based on the concept of life energy which flows through "meridians" in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in these meridians. Pressure may be applied by hand, by elbow, or with various devices.

Some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, for helping lower back pain, tension headaches, stomach ache, among other things, although such studies have been found to have a high likelihood of bias. Like many alternative medicines, it may benefit from a placebo effect.

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Acupuncture is a form of alternative medicine in which thin needles are inserted into the body. It is a key component of traditional Chinese medicine. TCM theory and practice are not based upon scientific knowledge, and acupuncture is a pseudoscience. There is a diverse range of acupuncture theories based on different philosophies, and techniques vary depending on the country. The method used in TCM is likely the most widespread in the United States. It is most often used for pain relief, though it is also used for a wide range of other conditions. Acupuncture is generally used only in combination with other forms of treatment.

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A relatively new term, “adrenal fatigue” was proposed as a new condition in 1998 by Dr. James L. Wilson, a naturopath and chiropractor. His assumption was that an overstimulation of the adrenal glands (or “adrenals”) by chronic stress over time could lead to an inconsistent level of cortisol (the stress hormone) in the bloodstream, sometimes far more than normal and at other times, far too low. In addition to this overload or improper cortisol level, people with adrenal fatigue often don’t have enough DHEA, the “parent hormone” responsible for the creation of many necessary hormones in the body.

Unlike other endocrine disorders that are caused by physical damage to parts of the adrenal glands, hypoadrenia is seen by many in the natural health world as a “middle ground” syndrome with simple and easy-to-implement solutions. Currently, no official diagnosis exists for adrenal fatigue and people are either considered to have normal endocrine function or total endocrine failure, like that seen in Cushing’s syndrome or adrenal insufficiency/Addison’s disease. 

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Aplastic anemia is a rare disease in which the bone marrow and the hematopoietic stem cells that reside there are damaged. This causes a deficiency of all three blood cell types (pancytopenia): red blood cells (anemia), white blood cells (leukopenia), and platelets (thrombocytopenia). Aplastic refers to inability of the stem cells to generate mature blood cells.

It is most prevalent in people in their teens and twenties, but is also common among the elderly. It can be caused by heredity, immune disease, or exposure to chemicals, drugs, or radiation. However, in about half the cases, the cause is unknown.

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Appendicitis is inflammation of the appendix. Symptoms commonly include right lower abdominal pain, nausea, vomiting, and decreased appetite. However, approximately 40% of people do not have these typical symptoms. Severe complications of a ruptured appendix include widespread, painful inflammation of the inner lining of the abdominal wall and sepsis.

Appendicitis is caused by a blockage of the hollow portion of the appendix. This is most commonly due to a calcified "stone" made of feces. Inflamed lymphoid tissue from a viral infection, parasites, gallstone, or tumors may also cause the blockage. This blockage leads to increased pressures in the appendix, decreased blood flow to the tissues of the appendix, and bacterial growth inside the appendix causing inflammation. The combination of inflammation, reduced blood flow to the appendix and distention of the appendix causes tissue injury and tissue death.[12] If this process is left untreated, the appendix may burst, releasing bacteria into the abdominal cavity, leading to increased complications.

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Indigestion, also known as dyspepsia, is a condition of impaired digestion. Symptoms may include upper abdominal fullness, heartburn, nausea, belching, or upper abdominal pain. People may also experience feeling full earlier than expected when eating. Dyspepsia is a common problem and is frequently caused by gastroesophageal reflux disease (GERD) or gastritis. In a small minority of cases it may be the first symptom of peptic ulcer disease (an ulcer of the stomach or duodenum) and, occasionally, cancer. Hence, unexplained newly onset dyspepsia in people over 55 or the presence of other alarming symptoms may require further investigations.

Functional indigestion (previously called nonulcer dyspepsia) is indigestion "without evidence of an organic disease that is likely to explain the symptoms". Functional indigestion is estimated to affect about 15% of the general population in western countries.
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An armpit lump usually refers to the enlargement of at least one of the lymph nodes under your arm. Lymph nodes are small, oval-shaped glands that are located throughout the body. They play an important role in your body’s immune system. The lump may feel small. In other cases, it may be extremely noticeable. Armpit lumps may be caused by cysts, infection, or irritation due to shaving or antiperspirant use. However, these lumps may also indicate a serious underlying health condition. 

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Typhoid fever, also known simply as typhoid, is a bacterial infection due to Salmonella typhi that causes symptoms. Symptoms may vary from mild to severe and usually begin six to thirty days after exposure. Often there is a gradual onset of a high fever over several days. Weakness, abdominal pain, constipation, and headaches also commonly occur. Diarrhea is uncommon and vomiting is not usually severe. Some people develop a skin rash with rose colored spots. In severe cases there may be confusion. Without treatment symptoms may last weeks or months. Other people may carry the bacterium without being affected; however, they are still able to spread the disease to others. Typhoid fever is a type of enteric fever along with paratyphoid fever.

The cause is the bacterium Salmonella typhi, also known as Salmonella enterica serotype Typhi, growing in the intestines and blood. Typhoid is spread by eating or drinking food or water contaminated with the feces of an infected person. Risk factors include poor sanitation and poor hygiene. Those who travel to the developing world are also at risk and only humans can be infected. Diagnosis is by either culturing the bacteria or detecting the bacterium's DNA in the blood, stool, or bone marrow. Culturing the bacterium can be difficult. Bone marrow testing is the most accurate. Symptoms are similar to that of many other infectious diseases. Typhus is a different disease.
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Aromatherapy uses plant materials and aromatic plant oils, including essential oils, and other aroma compounds for improving psychological or physical well-being. It can be offered as a complementary therapy or, more controversially, as a form of alternative medicine. Complementary therapy can be offered alongside standard treatment, with alternative medicine offered instead of conventional, evidence-based treatments.

Aromatherapists, who specialize in the practice of aromatherapy, utilize blends of therapeutic essential oils that can be issued through topical application, massage, inhalation or water immersion to stimulate a desired response.

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A sprained ankle, also known as an twisted ankle, rolled ankle, floppy ankle, or just ankle injury, is a common injury where sprain occur on one or more ligaments of the ankle.

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Benign prostatic hyperplasia (BPH) is an enlarged prostate. The prostate goes through two main growth periods as a man ages. The first occurs early in puberty, when the prostate doubles in size. The second phase of growth begins around age 25 and continues during most of a man's life. As you age, your prostate may get larger. Benign prostatic hyperplasia often occurs with the second growth phase.


As the prostate enlarges, it can then squeeze down on your urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. The narrowing of the urethra and urinary retention--the inability to empty the bladder completely--cause many of the problems associated with benign prostatic hyperplasia. BPH is benign. This means it is not cancer. It does not cause nor lead to cancer. But BPH and cancer can happen at the same time.

BPH is common in aging men. About half of all men between the ages of 51 and 60 have BPH. Up to 90% of men over age 80 have BPH.
The Prostate


The prostate is part of the male reproductive system. It is about the size of a walnut and weighs about an ounce. The prostate is below the bladder and in front of the rectum. The prostate goes all the way around a tube called the urethra. The urethra carries urine from the bladder out through the penis. The main job of the prostate is to make fluid for semen. During ejaculation, sperm made in the testicles moves to the urethra. At the same time, fluid from the prostate and the seminal vesicles also moves into the urethra. This mixture-semen-goes through the urethra and out the penis.


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    More than 5 million people in the United States have bipolar disorder.
    People with bipolar disorder typically have mood swings that range from highs called mania, to lows called depression.
    Unless you have severe mania, bipolar disorder can be difficult to diagnose.

Bipolar disorder is a mental illness marked by extreme mood swings from high to low, and from low to high. Highs are periods of mania, while lows are periods of depression. The mood swings may even become mixed, so you might feel elated and depressed at the same time.

Bipolar disorder isn’t a rare diagnosis. A 2005 study found that 2.6 percent of the U.S. population, or more than 5 million people, are living with some form of bipolar disorder. Symptoms tend to appear in a person’s late teens or early adult years, but they can occur in children as well. Women are more likely to receive bipolar diagnoses than men, though the reason for this remains unclear.

Bipolar disorder can be hard to diagnose, but there are warning signs or symptoms that you can look for.


7 signs of mania

Mania can cause other symptoms as well, but seven of the key signs of this phase of bipolar disorder are:

    feeling overly happy or “high” for long periods of time
    having a decreased need for sleep
    talking very fast, often with racing thoughts
    feeling extremely restless or impulsive
    becoming easily distracted
    having overconfidence in your abilities
    engaging in risky behavior, such as having impulsive sex, gambling with life savings, or going on big spending sprees


    
    7 signs of depression

Like mania, depression can cause other symptoms as well, but here are seven of the key signs of depression from bipolar disorder:

    feeling sad or hopeless for long periods of time
    withdrawing from friends and family
    losing interest in activities that you once enjoyed
    having a significant change in appetite
    feeling severe fatigue or lack of energy
    having problems with memory, concentration, and decision making
    thinking about or attempting suicide, or having a preoccupation with death


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 Bipolar I disorder (pronounced "bipolar one" and also known as manic-depressive disorder or manic depression) is a form of mental illness. A person affected by bipolar I disorder has had at least one manic episode in his or her life. A manic episode is a period of abnormally elevated mood and high energy, accompanied by abnormal behavior that disrupts life.

Most people with bipolar I disorder also suffer from episodes of depression. Often, there is a pattern of cycling between mania and depression. This is where the term "manic depression" comes from. In between episodes of mania and depression, many people with bipolar I disorder can live normal lives.


Who Is at Risk for Bipolar I Disorder?

Virtually anyone can develop bipolar I disorder. About 2.5% of the U.S. population suffers from bipolar disorder -- almost 6 million people.

Most people are in their teens or early 20s when symptoms of bipolar disorder first appear. Nearly everyone with bipolar I disorder develops it before age 50. People with an immediate family member who has bipolar are at higher risk.
What Are the Symptoms of Bipolar I Disorder?

During a manic episode in someone with bipolar disorder, elevated mood can manifest itself as either euphoria (feeling "high") or as irritability.

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 Bipolar II disorder (pronounced "bipolar two") is a form of mental illness. Bipolar II is similar to bipolar I disorder, with moods cycling between high and low over time.

However, in bipolar II disorder, the "up" moods never reach full-blown mania. The less-intense elevated moods in bipolar II disorder are called hypomanic episodes, or hypomania.

A person affected by bipolar II disorder has had at least one hypomanic episode in his or her life. Most people with bipolar II disorder suffer more often from episodes of depression. This is where the term "manic depression" comes from.

In between episodes of hypomania and depression, many people with bipolar II disorder typically live normal lives.


Who Is at Risk for Bipolar II Disorder?

Virtually anyone can develop bipolar II disorder. About 2.5% of the U.S. population suffers from some form of bipolar disorder - nearly 6 million people.
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Breastfeeding difficulties refers to problems that arise from breastfeeding, the feeding of an infant or young child with milk from a woman's breasts. Although babies have a sucking reflex that enables them to suck and swallow milk, and although human breast milk is usually the best source of nourishment for human infants, there are circumstances under which breastfeeding can be problematic, or even, in rare instances, contraindicated.
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Insomnia, also known as sleeplessness, is a sleep disorder where people have trouble sleeping. They may have difficulty falling asleep, or staying asleep as long as desired. Insomnia is typically followed by daytime sleepiness, low energy, irritability, and a depressed mood. It may result in an increased risk of motor vehicle collisions, as well as problems focusing and learning. Insomnia can be short term, lasting for days or weeks, or long term, lasting more than a month.

Insomnia can occur independently or as a result of another problem. Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol. Other risk factors include working night shifts and sleep apnea. Diagnosis is based on sleep habits and an examination to look for underlying causes. A sleep study may be done to look for underlying sleep disorders. Screening may be done with two questions: "do you experience difficulty sleeping?" and "do you have difficulty falling or staying asleep?"
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Sleep apnea, also spelled sleep apnoea, is a sleep disorder characterized by pauses in breathing or periods of shallow breathing during sleep. Each pause can last for a few seconds to a few minutes and they happen many times a night. In the most common form, this follows loud snoring. There may be a choking or snorting sound as breathing resumes. As it disrupts normal sleep, those affected may experience sleepiness or feel tired during the day. In children it may cause problems in school or hyperactivity.

There are three forms of sleep apnea: obstructive (OSA), central (CSA), and a combination of the two called mixed. OSA is the most common form. Risk factors for OSA include being overweight, a family history of the condition, allergies, a small airway, and enlarged tonsils. In OSA, breathing is interrupted by a blockage of airflow, while in CSA breathing stops due to a lack of effort to breathe. People with sleep apnea may not be aware they have it. In many cases it is first observed by a family member. Sleep apnea is often diagnosed with an overnight sleep study. For a diagnosis of sleep apnea, more than five episodes an hour must occur.

Treatment may include lifestyle changes, mouthpieces, breathing devices, and surgery. Lifestyle changes may include avoiding alcohol, losing weight, stopping smoking, and sleeping on one's side. Breathing devices include the use of a CPAP machine. Without treatment sleep apnea may increase the risk of heart attack, stroke, diabetes, heart failure, irregular heartbeat, obesity, and motor vehicle collisions.
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As one of the trickiest, painful and most annoying skin issues, dealing with acne and breakouts is no easy feat. But before you go slathering on all of the spot treatments you can find, it's important to understand how your breakouts form and what can cause them.

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Have you ever felt your fingers and toes going numb? Most of us face this problem once in a while, but if this numbness becomes an everyday thing for you, you need help. Blood serves several important functions in the body. It provides oxygen and nutrients to every cell and organ in the body. It balances body temperature, providing warmth to the fingers, nose and toes.

Poor blood circulation is much more unpleasant than it sounds. It occurs when the blood flow becomes restricted to certain parts of the body like heart, legs, hands, toes, feet and fingers. In mild situations, poor blood circulation causes only discomfort. But if not handled in time, it can lead to several other serious health conditions. The health problems caused due to poor blood circulation include varicose veins, kidney issue and other blood restriction difficulties.

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Treatment. Although there is no cure for osteoporosis, there are steps you cantake to prevent, slow or stop its progress. In some cases, you may even be able to improve bone density and reverse the disorder to some degree. Getting enough calcium and vitamin D are essential to bone health.

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A bone spur (osteophyte) is a bony growth formed on normal bone. Most people think of something sharp when they think of a "spur," but a bone spur is just extra bone. It's usually smooth, but it can cause wear and tear or pain if it presses or rubs on other bones or soft tissues such as ligaments, tendons, or nerves in the body. Common places for bone spurs include the spine, shoulders, hands, hips, knees, and feet.

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Breast pain is any discomfort, tenderness, or pain in the breast or underarm region, and it may occur for a number of reasons. Generally, breast pain is not a sign of breast cancer.Breast pain is any discomfort, tenderness, or pain in the breast or underarm region, and it may occur for a number of reasons. Generally, breast pain is not a sign of breast cancer.

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Age spots are the result of an excess production of melanin, or skin pigment. Doctors don't always know why age spots develop. Skin aging, sun exposure, or other forms of ultraviolet (UV) light exposure, such as tanning beds, are all possible causes.

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The Body's Response to Sports Injury. A bruise or 'contusion' is damage to small blood vessels which causes bleeding within the tissues. A muscle strain is a small tear of muscle fibres and a ligament sprain is a small tear of ligament tissue.The Body's Response to Sports Injury. A bruise or 'contusion' is damage to small blood vessels which causes bleeding within the tissues. A muscle strain is a small tear of muscle fibres and a ligament sprain is a small tear of ligament tissue.

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Cardiomyopathy is a disease of the heart muscle. It affects any age group and is a serious lifelong condition.

Cardiomyopathy means your heart is unable to pump an adequate supply of blood around the body. 

As cardiomyopathy progresses your heart becomes weaker. 

Some types of cardiomyopathy can cause an irregular heart beat, because the heart muscle becomes stretched.

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Cervical spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones (bone spurs).

Cervical spondylosis is very common and worsens with age. More than 85 percent of people older than age 60 are affected by cervical spondylosis.

Most people experience no symptoms from these problems. When symptoms do occur, nonsurgical treatments often are effective.

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Chapped lips occur when the skin on the lips becomes very dry. The lips may hurt, crack, and even bleed in severe cases. According to the Mayo Clinic, exposure to sun, wind, and cold, dry air can cause chapped lips. Other causes include breathing with your mouth open, frequently licking your lips, sensitivity to skin-care products, and dehydration. You can heal chapped lips quickly, usually in less than a week, by moisturizing your lips and protecting them from additional dryness.

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HCA Urgent Care teams will provide prompt examination, investigation and treatment for most respiratory or chest complaints.

In our urgent care facilities, we can perform blood tests, X-rays and specialist CT scans within the hospital and have fast access to a network of senior private Consultants who specialise in Respiratory conditions or Cardiology problems to who we can refer you to be seen either on that day or within a few days depending on the urgency of the problem.

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Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.

Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Other regions within the body (such as gallbladder, liver, or heart disease, or disease of the cervical spine of the neck) also may generate pain that the brain may interpret as arising from the shoulder.
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Angina is a form of chest pain or discomfort as a result of reduced blood supply to heart muscles. This reduced blood supply results in reduced oxygen supply to heart muscles and as a result deficient waste removal from heart muscles leading to chest pain or discomfort. The most usual reason for this is some form of obstruction of coronary arteries due to medical conditions like atherosclerosis which hampers blood supply to heart muscles resulting in ischemia.

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Chickenpox, also called varicella, is characterized by itchy red blisters that appear all over the body. A virus causes this condition. It often affects children, and was so common it was considered a childhood rite of passage.

It’s very rare to have the chickenpox infection more than once. And since the chickenpox vaccine was introduced in the mid-1990s, cases have declined.

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A chiropractor is a health care professional focused on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and/or manipulation of the spine.

Most chiropractors seek to reduce pain and improve the functionality of patients as well as to educate them on how they can account for their own health via exercise, ergonomics and other therapies to treat back pain.

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Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

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The onset of pain is a symptom of illness or injury in the part of the body that is experiencing the pain. The sudden onset of pain is called acute pain. Acute pain gets a person's attention and prompts him or her to take action to prevent further worsening of the condition causing the pain. This could be a simple action such as the reflex that makes a person jerk their hand off a hot stove, or it could be more complex such as cooling, resting, or elevating an injured ankle. Moreover, the pain could prompt the person to see a doctor. Chronic pain is pain that persists over time (6 months or longer) and typically results from long-standing (chronic) medical conditions or damage to the body.

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Schizophrenia is a mental disorder characterized by abnormal social behavior and failure to understand what is real. Common symptoms include false beliefs, unclear or confused thinking, hearing voices that others do not hear, reduced social engagement and emotional expression, and a lack of motivation. People with schizophrenia often have additional mental health problems such as anxiety, depressive, or substance-use disorders. Symptoms typically come on gradually, begin in young adulthood, and last a long time.

The causes of schizophrenia include environmental and genetic factors. Possible environmental factors include being raised in a city, cannabis use during adolescence, certain infections, parental age and poor nutrition during pregnancy. Genetic factors include a variety of common and rare genetic variants. Diagnosis is based on observed behavior, the person's reported experiences and reports of others familiar with the person. During diagnosis a person's culture must also be taken into account. As of 2013 there is no objective test. Schizophrenia does not imply a "split personality" or "dissociative identity disorder" – conditions with which it is often confused in public perception.
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Chronic lymphocytic leukemia (CLL) is a cancer that affects a type of white blood cell called a "lymphocyte."

Lymphocytes help your body fight infection. They're made in the soft center of your bones, called the marrow. If you have CLL, your body makes an abnormally high number of lymphocytes that aren't working right.

More adults get CLL than any other type of leukemia. It usually grows slowly, so you may not have symptoms for years.

Some people never need treatment, but if you do, it can slow the disease and ease symptoms. People who get medical care live longer today, because doctors are diagnosing CLL earlier.

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your skin is battling sweat, pollution, and pore-clogging face makeup. If you have oily or acne-prone skin, keeping your pores spick and span is especially hard work. After all, in daily life, are so many things trying to congest your pores, including many skincare ingredients and your body’s natural oil production. See, a pore (or follicle) is “a duct in the skin that is attached to the sebaceous glands that produce sebum,” explains esthetician Renée Rouleau. Oily skin types are more prone to experience blockages in their pores, which causes bacteria to thrive, leading to whiteheads, blackheads, and papules

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Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.

Many people mistake their increased breathlessness and coughing as a normal part of aging. In the early stages of the disease, you may not notice the symptoms. COPD can develop for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease. 

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Pulmonary hypertension (PH or PHTN) is a condition of increased blood pressure within the arteries of the lungs. Symptoms include shortness of breath, syncope, tiredness, chest pain, swelling of the legs, and a fast heartbeat. The condition may make it difficult to exercise. Onset is typically gradual.

The cause is often unknown. Risk factors include a family history, prior blood clots in the lungs, HIV/AIDS, sickle cell disease, cocaine use, COPD, sleep apnea, living at high altitudes, and problems with the mitral valve. The underlying mechanism typically involves inflammation of the arteries in the lungs. Diagnosis involves first ruling out other potential causes.

There is no cure. Treatment depends on the type of disease. A number of supportive measures such as oxygen therapy, diuretics, and medications to inhibit clotting may be used. Medications specifically for the condition include epoprostenol, treprostinil, iloprost, bosentan, ambrisentan, macitentan, and sildenafil. A lung transplant may be an option in certain cases.

While the exact frequency of the condition is unknown, it is estimated that about 1,000 new cases occur a year in the United States. Females are more often affected than males. Onset is typically between 20 and 60 years of age. It was first identified by Ernst von Romberg in 1891.
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Pulmonary fibrosis (literally "scarring of the lungs") is a respiratory disease in which scars are formed in the lung tissues, leading to serious breathing problems. Scar formation, the accumulation of excess fibrous connective tissue (the process called fibrosis), leads to thickening of the walls, and causes reduced oxygen supply in the blood. As a consequence patients suffer from perpetual shortness of breath.

In some patients the specific cause of the disease can be diagnosed, but in others the probable cause cannot be determined, a condition called idiopathic pulmonary fibrosis. There is no known cure for the scars and damage in the lung due to pulmonary fibrosis.
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Periorbital puffiness, also known as "puffy eyes", or swelling around the eyes, is the appearance of swelling in the tissues around the eyes, called the orbits. It is almost exclusively caused by fluid buildup around the eyes, or periorbital edema. Minor puffiness usually detectable below the eyes only (although at times they could be present all around) is often called eye bags. Such transient puffiness is distinct from the age related and gradual increase in the size of the fat pad lying below the lower eyelids (suborbicularis oculi fat – "SOOF") which can also be colloquially referred to as eye bags.
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Posttraumatic stress disorder (PTSD) is a mental disorder that can develop after a person is exposed to a traumatic event, such as sexual assault, warfare, traffic collisions, or other threats on a person's life. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in how a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress but instead may express their memories through play. A person with PTSD is at a higher risk for suicide and intentional self-harm.

Most people who have experienced a traumatic event will not develop PTSD. People who experience interpersonal trauma (for example rape or child abuse) are more likely to develop PTSD, as compared to people who experience non-assault based trauma such as accidents and natural disasters. About half of people develop PTSD following rape. Children are less likely than adults to develop PTSD after trauma, especially if they are under ten years of age. Diagnosis is based on the presence of specific symptoms following a traumatic event.
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Psoriasis is a long-lasting autoimmune disease characterized by patches of abnormal skin. These skin patches are typically red, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.

There are five main types of psoriasis: plaque, guttate, inverse, pustular, and erythrodermic. Plaque psoriasis, also known as psoriasis vulgaris, makes up about 90 percent of cases. It typically presents as red patches with white scales on top. Areas of the body most commonly affected are the back of the forearms, shins, navel area, and scalp. Guttate psoriasis has drop-shaped lesions. Pustular psoriasis presents as small non-infectious pus-filled blisters. Inverse psoriasis forms red patches in skin folds. Erythrodermic psoriasis occurs when the rash becomes very widespread, and can develop from any of the other types Fingernails and toenails are affected in most people with psoriasis at some point in time. This may include pits in the nails or changes in nail color.
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Prostate cancer is the development of cancer in the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, some grow relatively quickly. The cancer cells may spread from the prostate to other parts of the body, particularly the bones and lymph nodes. It may initially cause no symptoms. In later stages it can lead to difficulty urinating, blood in the urine, or pain in the pelvis, back or when urinating. A disease known as benign prostatic hyperplasia may produce similar symptoms. Other late symptoms may include feeling tired due to low levels of red blood cells.

Factors that increase the risk of prostate cancer include: older age, a family history of the disease, and race. About 99% of cases occur in those over the age of 50. Having a first-degree relative with the disease increases the risk two to threefold. In the United States, it is more common in the African American population than the white American population. Other factors that may be involved include a diet high in processed meat, red meat, or milk products or low in certain vegetables. An association with gonorrhea has been found, but a reason for this relationship has not been identified. Prostate cancer is diagnosed by biopsy. Medical imaging may then be done to determine if the cancer has spread to other parts of the body.
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Premenstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period. Symptoms often vary between women and resolve around the start of bleeding. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. Often symptoms are present for around six days. A woman's pattern of symptoms may change over time. Symptoms do not occur during pregnancy or following menopause.

Diagnosis requires a consistent pattern of emotional and physical symptoms occurring after ovulation and before menstruation to a degree that interferes with normal life. Emotional symptoms must not be present during the initial part of the menstrual cycle. A daily list of symptoms over a few months may help in diagnosis. Other disorders that cause similar symptoms need to be excluded before a diagnosis is made.

The cause of PMS is unknown. Some symptoms may be worsened by a high-salt diet, alcohol, or caffeine. The underlying mechanism is believed to involve changes in hormone levels. Reducing salt, caffeine, and stress along with increasing exercise is typically all that is recommended in those with mild symptoms. Calcium and vitamin D supplementation may be useful in some. Anti-inflammatory drugs such as naproxen may help with physical symptoms. In those with more significant symptoms birth control pills or the diuretic spironolactone may be useful.

Up to 80% women report having some symptoms prior to menstruation. These symptoms qualify as PMS in 20 to 30% of pre-menopausal women. Premenstrual dysphoric disorder (PMDD) is a more severe form of PMS that has greater psychological symptoms. PMDD affects three to eight percent of pre-menopausal women. Antidepressant medication of the selective serotonin reuptake inhibitors class may be used in addition to usual measures for in PMDD.
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Nutrition and pregnancy refers to the nutrient intake, and dietary planning that is undertaken before, during and after pregnancy. Nutrition of the fetus begins at conception. For this reason, the nutrition of the mother is important from before conception (probably several months before) as well as throughout pregnancy and breast feeding. An ever-increasing number of studies have shown that the nutrition of the mother will have an effect on the child, up to and including the risk for cancer, cardiovascular disease, hypertension and diabetes throughout life.

An inadequate or excessive amount of some nutrients may cause malformations or medical problems in the fetus, and neurological disorders and handicaps are a risk that is run by mothers who are malnourished. 23.8% of babies worldwide are estimated to be born with lower than optimal weights at birth due to lack of proper nutrition. Personal habits such as smoking, alcohol, caffeine, using certain medications and street drugs can negatively and irreversibly affect the development of the baby, which happens in the early stages of pregnancy.

Caffeine is sometimes assumed to cause harm to the unborn baby but there is not enough evidence so say if this is true. A recent review showed that more research is needed to show whether caffeine intake effects birth weight, preterm births, gestational diabetes and other outcomes.
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Prediabetes is the precursor stage before diabetes mellitus in which not all of the symptoms required to diagnose diabetes are present, but blood sugar is abnormally high. This stage is often referred to as the "grey area." It is not a disease; the American Diabetes Association says, "Prediabetes should not be viewed as a clinical entity in its own right but rather as an increased risk for diabetes and cardiovascular disease (CVD). Prediabetes is associated with obesity (especially abdominal or visceral obesity), dyslipidemia with high triglycerides and/or low HDL cholesterol, and hypertension." It is thus a metabolic diathesis or syndrome, and it usually involves no symptoms and only high blood sugar as the sole sign.

Impaired fasting blood sugar and impaired glucose tolerance are two forms of prediabetes that are similar in clinical definition (glucose levels too high for their context) but are physiologically distinct. Insulin resistance, the insulin resistance syndrome (metabolic syndrome or syndrome X), and prediabetes are closely related to one another and have overlapping aspects.
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Postpartum depression (PPD), also called postnatal depression, is a type of mood disorder associated with childbirth, which can affect both sexes. Symptoms may include extreme sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns. Onset is typically between one week and one month following childbirth. PPD can also negatively affect the person's child.

While the exact cause of PPD is unclear, the cause is believed to be a combination of physical and emotional factors. These may include factors such as hormonal changes and sleep deprivation. Risk factors include prior episodes of postpartum depression, bipolar disorder, a family history of depression, psychological stress, complications of childbirth, lack of support, or a drug use disorder. Diagnosis is based on a person's symptoms. While most women experience a brief period of worry or unhappiness after delivery, postpartum depression should be suspected when symptoms are severe and last over two weeks.
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Polycystic ovary syndrome (PCOS) is a set of symptoms due to elevated androgens (male hormones) in women. Signs and symptoms of PCOS include irregular or no menstrual periods, heavy periods, excess body and facial hair, acne, pelvic pain, difficulty getting pregnant, and patches of thick, darker, velvety skin. Associated conditions include type 2 diabetes, obesity, obstructive sleep apnea, heart disease, mood disorders, and endometrial cancer.

PCOS is due to a combination of genetic and environmental factors. Risk factors include obesity, not enough physical exercise, and a family history of someone with the condition. Diagnosis is based on two of the following three findings: no ovulation, high androgen levels, and ovarian cysts. Cysts may be detectable by ultrasound. Other conditions that produce similar symptoms include adrenal hyperplasia, hypothyroidism, and hyperprolactinemia.
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Polycystic kidney disease (PKD or PCKD, also known as polycystic kidney syndrome) is a genetic disorder in which the renal tubules become structurally abnormal, resulting in the development and growth of multiple cysts within the kidney. These cysts may begin to develop before birth or in infancy, in childhood, or in adulthood. Cysts are non-functioning tubules filled with fluid pumped into them, which range in size from microscopic to enormous, crushing adjacent normal tubules and eventually rendering them non-functional also.

PKD is caused by abnormal genes which produce a specific abnormal protein which has an adverse affect on tubule development. PKD is a general term for two types, each having their own pathology and genetic cause: autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD). The abnormal gene exists in all cells in the body: as a result, cysts may occur in the liver, seminal vesicles, and pancreas. This genetic defect can also cause aortic root aneurysms, and aneurysms in the circle of Willis cerebral arteries, which if they rupture, can cause a subarachnoid hemorrhage.
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Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing. Severity is variable.

Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases. Risk factors include other lung diseases such as cystic fibrosis, COPD, and asthma, diabetes, heart failure, a history of smoking, a poor ability to cough such as following a stroke, or a weak immune system. Diagnosis is often based on the symptoms and physical examination. Chest X-ray, blood tests, and culture of the sputum may help confirm the diagnosis. The disease may be classified by where it was acquired with community, hospital, or health care associated pneumonia.
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Premenstrual syndrome (PMS) refers to physical and emotional symptoms that occur in the one to two weeks before a woman's period. Symptoms often vary between women and resolve around the start of bleeding. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. Often symptoms are present for around six days. A woman's pattern of symptoms may change over time. Symptoms do not occur during pregnancy or following menopause.

Diagnosis requires a consistent pattern of emotional and physical symptoms occurring after ovulation and before menstruation to a degree that interferes with normal life. Emotional symptoms must not be present during the initial part of the menstrual cycle. A daily list of symptoms over a few months may help in diagnosis. Other disorders that cause similar symptoms need to be excluded before a diagnosis is made.
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Plantar fasciitis is a disorder that results in pain in the heel and bottom of the foot. The pain is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin and may be worsened by a tight Achilles tendon. The condition typically comes on slowly. In about a third of people both legs are affected.

The causes of plantar fasciitis are not entirely clear. Risk factors include overuse such as from long periods of standing, an increase in exercise, and obesity. It is also associated with inward rolling of the foot and a lifestyle that involves little exercise. While heel spurs are frequently found it is unclear if they have a role in causing the condition. Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring. As inflammation plays a lesser role, many feel the condition should be renamed plantar fasciosis. The diagnosis is typically based on signs and symptoms with ultrasound sometimes used to help. Other conditions with similar symptoms include osteoarthritis, ankylosing spondylitis, heel pad syndrome, and reactive arthritis.
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A pimple, zit or spot is a kind of comedo and one of the many results of excess oil getting trapped in the pores. Some of the varieties are pustules or papules. Pimples can be treated by various acne medications prescribed by a physician, or purchased at a pharmacy with a wide variety of treatments.
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Phlegm is a liquid secreted by the mucous membranes of mammals. Its definition is limited to the mucus produced by the respiratory system, excluding that from the nasal passages, and particularly that which is expelled by coughing (sputum). Phlegm is in essence a water-based gel consisting of glycoproteins, immunoglobulins, lipids and other substances. Its composition varies depending on climate, genetics, and state of the immune system. Its color can vary from transparent to pale or dark yellow and green, from light to dark brown, and even to dark grey depending on the constituents.
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Pharyngitis is inflammation of the back of the throat, known as the pharynx. It typically results in a sore throat and fever. Other symptoms may include a runny nose, cough, headache, a hoarse voice. Symptoms usually last three to five days. Complications can include sinusitis and acute otitis media. Pharyngitis is typically a type of respiratory tract infection.

Most cases are caused by a viral infection. Strep throat is the cause in about 25% of children and 10% of adults. Uncommon causes include other bacteria such as gonorrhea, fungus, irritants such as smoke, allergies, and gastroesophageal reflux disease. Specific testing is not recommended in people who have clear symptoms of a viral infection such as a cold. Otherwise a rapid antigen detection test (RAPD) or throat swab is recommended. Other conditions that can produce similar symptoms include epiglottitis, thyroiditis, retropharyngeal abscess, and occasionally heart disease.
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Periodontitis, also known as gum disease and pyorrhea, is a set of inflammatory diseases affecting the tissues surrounding the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of teeth.

Periodontitis is caused by microorganisms that adhere to and grow on the tooth's surfaces, along with an over-aggressive immune response against these microorganisms. A diagnosis of periodontitis is established by inspecting the soft gum tissues around the teeth with a probe (i.e., a clinical examination) and by evaluating the patient's X-ray films (i.e., a radiographic examination), to determine the amount of bone loss around the teeth. Specialists in the treatment of periodontitis are periodontists; their field is known as "periodontology" or "periodontics".
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Peeling skin syndrome (also known as "Acral peeling skin syndrome," "Continual peeling skin syndrome," "Familial continual skin peeling," "Idiopathic deciduous skin," and "Keratolysis exfoliativa congenita") is an autosomal recessive disorder characterized by lifelong peeling of the stratum corneum, and may be associated with pruritus, short stature, and easily removed anagen hair.
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Panic disorder is an anxiety disorder characterized by recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something really bad is going to happen. The maximum degree of symptoms occurs within minutes. There may be ongoing worries about having further attacks and avoidance of places where attacks have occurred in the past.

The cause of panic disorder is unknown. Panic disorder often runs in families. Risk factors include smoking, psychological stress, and a history of child abuse. Diagnosis involves ruling out other potential causes of anxiety including other mental disorders, medical conditions such as heart disease or hyperthyroidism, and drug use. Screening for the condition may be done using a questionnaire.

Panic disorder is usually treated with counselling and medications. The type of counselling used is typically cognitive behavioral therapy (CBT) which is effective in more than half of people. Medications used include antidepressants and occasionally benzodiazepines or beta blockers. Following stopping treatment up to 30% of people have a recurrence.
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Panic attacks are sudden periods of intense fear that may include palpitations, sweating, shaking, shortness of breath, numbness, or a feeling that something bad is going to happen. The maximum degree of symptoms occurs within minutes. Typically they last for about 30 minutes but the duration can vary from seconds to hours. There may be a fear of losing control or chest pain. Panic attacks themselves are not dangerous physically.

Panic attacks can occur due to number of disorders including panic disorder, social anxiety disorder, post traumatic stress disorder, drug use disorder, depression, and medical problems. They can either be triggered or occur unexpectedly. Risk factors include smoking and psychological stress. Diagnosis should involve ruling out other conditions that can produce similar symptoms including hyperthyroidism, hyperparathyroidism, heart disease, lung disease, and drug use.

Treatment of panic attacks should be directed at the underlying cause. In those with frequent attacks, counselling or medications may be used. Breathing training and muscle relaxation techniques may also help. Those affected are at a higher risk of suicide.
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Pancreatitis is inflammation of the pancreas. The pancreas is a large organ behind the stomach that produces digestive enzymes and a number of hormones. There are two main types, acute pancreatitis and chronic pancreatitis. Signs and symptoms of pancreatitis include pain in the upper abdomen, nausea and vomiting. The pain often goes into the back and is usually severe. In acute pancreatitis a fever may occur and symptoms typically resolve in a few days. In chronic pancreatitis weight loss, fatty stool, and diarrhea may occur. Complications may include infection, bleeding, diabetes mellitus, or problems with other organs.

The most common causes of acute pancreatitis are gallstones and heavy alcohol use. Other causes include direct trauma, certain medications, infections such as mumps, and tumors among others. Chronic pancreatitis may develop as a result of acute pancreatitis. It is most commonly due to many years of heavy alcohol use. Other causes include high levels of blood fats, high blood calcium, some medications, and certain genetic disorders such as cystic fibrosis among others. Smoking increases the risk of both acute and chronic pancreatitis. Diagnosis of acute pancreatitis is based on a threefold increase in the blood of either amylase or lipase. In chronic pancreatitis these tests may be normal. Medical imaging such as ultrasound and CT scan may also be useful.
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Pancreatic cancer arises when cells in the pancreas, a glandular organ behind the stomach, begin to multiply out of control and form a mass. These cancerous cells have the ability to invade other parts of the body. There are a number of types of pancreatic cancer. The most common, pancreatic adenocarcinoma, accounts for about 85% of cases, and the term "pancreatic cancer" is sometimes used to refer only to that type. These adenocarcinomas start within the part of the pancreas which makes digestive enzymes. Several other types of cancer, which collectively represent the majority of the non-adenocarcinomas, can also arise from these cells. One to two percent of cases of pancreatic cancer are neuroendocrine tumors, which arise from the hormone-producing cells of the pancreas. These are generally less aggressive than pancreatic adenocarcinoma.

Signs and symptoms of the most common form of pancreatic cancer may include yellow skin, abdominal or back pain, unexplained weight loss, light-colored stools, dark urine and loss of appetite. There are usually no symptoms in the disease's early stages, and symptoms that are specific enough to suggest pancreatic cancer typically do not develop until the disease has reached an advanced stage. By the time of diagnosis, pancreatic cancer has often spread to other parts of the body.
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A pancreas transplant is an organ transplant that involves implanting a healthy pancreas (one that can produce insulin) into a person who usually has diabetes. Because the pancreas is a vital organ, performing functions necessary in the digestion process, the recipient's native pancreas is left in place, and the donated pancreas is attached in a different location. In the event of rejection of the new pancreas, which would quickly cause life-threatening diabetes, there would be a significant chance the recipient would not survive very well for long without the native pancreas, however dysfunctional, still in place. The healthy pancreas comes from a donor who has just died or it may be a partial pancreas from a living donor. At present, pancreas transplants are usually performed in persons with insulin-dependent diabetes, who can develop severe complications. Patients with the most common, and deadliest, form of pancreatic cancer (pancreatic adenomas, which are usually malignant, with a poor prognosis and high risk for metastasis, as opposed to more treatable pancreatic neuroendocrine tumors or pancreatic insulinomas) are usually not eligible for valuable pancreatic transplantations, since the condition usually has a very high mortality rate and the disease, which is usually highly malignant and detected too late to treat, could and probably would soon return.
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Palpitations are the perceived abnormality of the heartbeat characterized by awareness of cardiac muscle contractions in the chest: hard, fast and/or irregular beats. It is both a symptom reported by the patient and a medical diagnosis. Palpitation can be associated with anxiety and does not necessarily indicate a structural or functional abnormality of the heart, but it can be a symptom arising from an objectively rapid or irregular heartbeat. Palpitation can be intermittent and of variable frequency and duration, or continuous. Associated symptoms include dizziness, shortness of breath, sweating, headaches, and chest pain.

Palpitation may be associated with coronary heart disease, hyperthyroidism, diseases affecting cardiac muscle such as hypertrophic cardiomyopathy, diseases causing low blood oxygen such as asthma and emphysema; previous chest surgery; kidney disease; low levels of brain serotonin; blood loss, and pain; drugs such as antidepressants, statins, alcohol, nicotine, caffeine, cocaine, and amphetamines; electrolyte imbalances of magnesium, potassium and calcium; and deficiencies of nutrients such as taurine, arginine, and iron.
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Osteoporosis is a disease where increased bone weakness increases the risk of a broken bone. It is the most common reason for a broken bone among the elderly. Bones that commonly break include the vertebrae in the spine, the bones of the forearm, and the hip. Until a broken bone occurs there are typically no symptoms. Bones may weaken to such a degree that a break may occur with minor stress or spontaneously. Chronic pain and a decreased ability to carry out normal activities may occur following a broken bone.

Osteoporosis may be due to lower than normal bone mass and greater than normal bone loss. Bone loss increases after menopause due to lower levels of estrogen. Osteoporosis may also occur due to a number of diseases or treatments including alcoholism, anorexia, hyperthyroidism, kidney disease, and surgical removal of the ovaries. Certain medications increase the rate of bone loss including some antiseizure medications, chemotherapy, proton pump inhibitors, selective serotonin reuptake inhibitors, and glucocorticosteroids. Not enough exercise and smoking are also risk factors. Osteoporosis is defined as a bone density of 2.5 standard deviations below that of a young adult. This is typically measured by dual-energy X-ray absorptiometry at the hip.
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Diaper rash: An inflammatory reaction localized to the area of skin usually covered by the diaper. It can have many causes, including infections (yeast, bacterial, or viral), friction irritation, chemical allergies (perfumes, soaps), sweat, decomposed urine, and plugged sweat glands. Most diaper rash problems can be solved by cleansing the skin with nonperfumed, gentle products; changing diapers frequently; and exposing the affected skin area to air. Commercially available diaper rash ointments may be helpful for prevention but may actually cause further irritation if used on the inflamed areas. Also called diaper dermatitis.

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Emphysema is a chronic lung disease caused by damage to the alveoli, the tiny air sacs in the lung where the exchange of oxygen and carbon dioxide takes place. With emphysema, damage to the alveoli results in air becoming trapped, causing them to expand and rupture.

Damage to alveoli, and the resultant compromise in air exchange results in a decreased level of oxygen in the blood (hypoxemia) combined with an increased level of carbon dioxide in the blood (hypercapnia).

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Most prostatic enlargement is due to benign prostatic hyperplasia (BPH), a problem that bothers men increasingly with advancing age. The process of BPH generally begins in a man's 30s, evolves very slowly and usually causes symptoms only after he has passed the half-century mark.

In BPH the normal elements of the prostate gland grow in size and number. Their sheer bulk may compress the urethra which courses through the center of the prostate and impedes the flow of urine through the urethra from the bladder to the outside. The urethral compression leads to urine retention and the need for frequent urination. If severe enough, complete blockage can occur.
BPH is very common. Half of all men over 50 develop symptoms of PBH, but only 10% need medical or surgical intervention.
BPH is completely benign. It is not a precursor (a forerunner) to prostate cancer.
Treatment of BPH is usually reserved for men with significant symptoms. Watchful waiting with medical monitoring once a year is appropriate for most men with BPH.
The medical therapy of BPH includes medication. The prostate enlargement in BPH is directly dependent on dihydrotestosterone (DHT), the principal androgen hormone in the prostate, certain medication blocks the enzyme needed to make DHT and so lowers blood and tissue DHT levels and helps reduce the size of the prostate. Other medication belongs to a class of drugs called alpha-1 blockers which relax the smooth muscle of the prostate and the bladder neck. Relaxing these muscles helps relieve the urinary obstruction caused by the enlarged prostate
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When nerve cells in the brain fire electrical impulses at a rate of up to four times higher than normal, this causes a sort of electrical storm in the brain, known as a seizure. A pattern of repeated seizures is referred to as epilepsy. Known causes include head injuries, brain tumors, lead poisoning, maldevelopment of the brain, genetic and infectious illnesses. But in fully half of cases, no cause can be found. Medication controls seizures for the majority of patients.

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To lighten your dark lips, it is essential to know first what causes dark lips. If you can identify the reasons for your dark lips, you can easily treat your lips.

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Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel.


With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level.

More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy.


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Gas – Everyone has it, no matter how small or big we are. We eliminate it by burping or passing it on the other end.  Passing gas 14 to 23 times a day is normal for both adults and children. Even though it is entirely natural and unavoidable, it can be embarrassing.  Furthermore, when gas does not pass easily, pain often results…upset stomach, bloating and cramping.

Children are particularly susceptible to discomfort caused by gas as their delicate digestive systems develop and learn to move gas through their digestive tracts effectively.  Understanding causes, ways to reduce symptoms and treatment will help most find relief. If a child has persistently painful or extreme gassiness, it should be brought to the attention of your doctor, as it could be the sign of a more serious medical problem.


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Gastroesophageal reflux disease, commonly referred to as GERD or acid reflux, is a condition in which the liquid content of the stomach regurgitates (backs up or refluxes) into the esophagus. The liquid can inflame and damage the lining (esophagitis) although visible signs of inflammation occur in a minority of patients. The regurgitated liquid usually contains acid and pepsin that are produced by the stomach. (Pepsin is an enzyme that begins the digestion of proteins in the stomach.) The refluxed liquid also may contain bile that has backed-up into the stomach from the duodenum. The first part of the small intestine attached to the stomach. Acid is believed to be the most injurious component of the refluxed liquid. Pepsin and bile also may injure the esophagus, but their role in the production of esophageal inflammation and damage is not as clear as the role of acid.


GERD is a chronic condition. Once it begins, it usually is life-long. If there is injury to the lining of the esophagus (esophagitis), this also is a chronic condition. Moreover, after the esophagus has healed with treatment and treatment is stopped, the injury will return in most patients within a few months. Once treatment for GERD is begun it will need to be continued indefinitely although. However, some patients with intermittent symptoms and no esophagitis can be treated only during symptomatic periods.

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Cradle cap causes crusty or oily scaly patches on a baby's scalp. The condition isn't painful or itchy. But it can cause thick white or yellow scales that aren't easy to remove.


Cradle cap usually clears up on its own in a few months. Home-care measures include washing your baby's scalp daily with a mild shampoo. This can help loosen and remove the scales. Don't scratch cradle cap.


If cradle cap persists or seems severe, your doctor may suggest a medicated shampoo, lotion or other 

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As an AB blood donor, you have a unique opportunity to enhance your generous “gift of life”. People with AB Negative (.6% of the population) and AB Positive (3.4%) are potential universal plasma donors.  You may not know, but there is a special need for AB Plasma.In addition to being the most rare blood type, AB Plasma is universal and can be used for all patients regardless of their blood type. Plasma is used to treat clotting disorders, burn, and shock victims. Your plasma donation is especially important to maintaining sufficient supplies for our community, and with regular and frequent plasma donations you’ll be helping hundreds of patients in our area. Almost anyone who is a whole blood donor can donate plasma. You are eligible if you are at least 17 years old, weigh at least 110 pounds and are in generally good health.  You can donate plasma every 28 days.



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An acute (sudden, shortlived) viral illness that usually presents with inflammation of the salivary glands, particularly the parotid glands. A child with mumps often looks like a chipmunk with a full mouth due to the swelling of the parotids (the salivary glands near the ears).

Mumps can also cause inflammation of other tissues, most frequently the covering and substance of the central nervous system (meningoencephalitis), the pancreas (pancreatitis) and, after adolescence, the ovary (oophoritis) and the testis (orchitis). The testis is particularly susceptible to damage from mumps; the damage can lead to infertility.

Together with the likes of measles and chickenpox, mumps was once considered one of the inevitable infectious diseases of childhood. Since a mumps vaccine became available in 1967, the incidence of mumps has declined in the U.S., but there are still many underimmunized populations (for example, more blacks than whites have not yet been immunized).

Treatment is with rest and non-aspirin pain relievers to ease pain in swollen areas. Rarely, mumps can cause a form of meningitis, in which case hospitalization may be needed. Prevention is by immunization with the vaccine.

The origin of the word mumps is not clear. It may have to do with the English usage, now obsolete, of "mump" to mean a grimace. More probably, mumps comes from a colder climate, Iceland, where mumpa meant to fill the mouth too full.

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An involuntarily and forcibly contracted muscle that does not relax. When we use the muscles such as those of our arms and legs that can voluntarily be controlled, they alternately contract and relax as we move our limbs. Muscles that support our head, neck, and trunk contract similarly in a synchronized fashion to maintain our posture. A muscle (or even a few fibers of a muscle) that involuntarily (without consciously willing it) contracts is called a "spasm." If the spasm is forceful and sustained, it becomes a cramp. Muscle cramps can last anywhere from a few seconds to a quarter of an hour, and occasionally longer. It is not uncommon for a cramp to recur multiple times until it finally goes away. The cramp may involve a part of a muscle, the entire muscle, or several muscles that usually act together, such as those that flex adjacent fingers. Some cramps involve the simultaneous contraction of muscles that ordinarily move body parts in opposite directions. Muscle cramps are very common and become increasingly frequent with age. Any muscle under voluntary control (skeletal muscle) can cramp. The legs and feet, and particularly the calf (the classic "charley horse"), are especially subject to cramps.

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An individual’s blood type is determined by the genes inherited from his/her parents. 


Whether your blood type is common, rare, or somewhere in between, your donations are vital in maintaining a good supply of that blood type in your community. To save and improve the lives of individuals living there who are in need. 


Therefore, keep doing the noble job of blood donation regularly and register your name for a good cause.


Read Also: B Negative Blood

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One of a group of genetic diseases characterized by progressive weakness and degeneration of the skeletal or voluntary muscles which control movement. The muscles of the heart and some other involuntary muscles are also affected in some forms of muscular dystrophy, and a few forms involve other organs as well.

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As an A Positive donor you are incredibly important to maintaining the blood supply in our community. A Positive is the second most common blood type and therefore just as many patients need this blood type.

Annually, more than 120,000 units of blood, platelets and plasma are required to meet the needs of the hospitals we serve, and your blood type is crucial to maintaining an adequate supply.  We are grateful to you for so willingly giving the “gift of life”, and through your continued commitment, we are able to maintain our heritage of service to those in need. 1 in 3 people have A+ blood (approximately 35.7% of the population).


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As an O Positive donor you are incredibly important to maintaining the blood supply in our community. O Positive is the most common blood type and therefore needed by so many patients.

Annually, more than 120,000 units of blood, platelets and plasma are required to meet the needs of the hospitals we serve, and your blood type is crucial to maintaining an adequate supply. We are grateful to you for so willingly giving the “gift of life”, and through your continued commitment, we are able to maintain our heritage of service to those in need. 1 in 3 people have O+ blood (approximately 37.4% of the population).


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Psychosocial rehabilitation (also termed psychiatric rehabilitation or PSR) promotes personal recovery, successful community integration and satisfactory quality of life for persons who have a mental illness or mental health concern.  Psychosocial rehabilitation services and supports are collaborative, person directed, and individualized, and an essential element of the human services spectrum.  They focus on helping individuals develop skills and access resources needed to increase their capacity to be successful and satisfied in the living, working, learning and social environments of their choice and include a wide continuum of services and supports.  (PSR/RPS Canada, 2013)

PSR approaches are evidence-based best and promising practices in the key life domains of Employment, Education, Leisure, Wellness and Basic Living Skills as well as Family Involvement and Peer Support and Peer Delivered services. Because of their demonstrated effectiveness and recovery orientation, these approaches should be widely available to people living with long term mental illness and/or substance use problems.

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By definition, physical therapy is a unique science and art that utilizes a wide variety of procedures to restore function to the body, reduce pain and help prevent future injury. When daily life is altered due to an injury, accident, chronic medical condition or re-injury, we realize we are responsible for helping to put our patients' lives back on course and help each individual get back to life.Physical therapy utilizes a variety of evidence-based treatments, physical exercises and hands-on modalities to begin the rehabilitation process at the onset of injury or pain.


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Physical medicine and rehabilitation (PM&R), also known as physiatry or rehabilitation medicine, aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. A physician having completed training in this field is referred to as a physiatrist. Unlike other medical specialties that focus on a medical “cure,” the goals of the physiatrist are to maximize patients’ independence in activities of daily living and improve quality of life.

Physiatrists are experts in designing comprehensive, patient-centered treatment plans, and are integral members of the care team. They utilize cutting-edge as well as time-tested treatments to maximize function and quality of life for their patients, who can range in age from infants to octogenarians.

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Child development entails the biological, psychological and emotional changes that occur in human beings between birth and the end of adolescence, as the individual progresses from dependency to increasing autonomy. It is a continuous process with a predictable sequence, yet having a unique course for every child. It does not progress at the same rate and each stage is affected by the preceding developmental experiences. Because these developmental changes may be strongly influenced by genetic factors and events during prenatal life, genetics and prenatal development are usually included as part of the study of child development. Related terms include developmental psychology, referring to development throughout the lifespan, and pediatrics, the branch of medicine relating to the care of children. Developmental change may occur as a result of genetically-controlled processes known as maturation,[1] or as a result of environmental factors and learning, but most commonly involves an interaction between the two. It may also occur as a result of human nature and our ability to learn from our environment.


There are various definitions of periods in a child's development, since each period is a continuum with individual differences regarding start and ending. Some age-related development periods and examples of defined intervals are: newborn (ages 0–4 weeks); infant (ages 4 weeks – 1 year); toddler (ages 1–3 years); preschooler (ages 4–6 years); school-aged child (ages 6–12 years); adolescent (ages 13–18).[2]


Promoting child development through parental training, among other factors, promotes excellent rates of child development.[3] Parents play a large role in a child's life, socialization, and development. Having multiple parents can add stability to the child's life and therefore encourage healthy development.[4] Another influential factor in a child's development is the quality of their care. Child care programs present a critical opportunity for the promotion of child development.


The optimal development of children is considered vital to society and so it is important to understand the social, cognitive, emotional, and educational development of children. Increased research and interest in this field has resulted in new theories and strategies, with specific regard to practice that promotes development within the school system. There are also some theories that seek to describe a sequence of states that compose child developmen

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Occupational rehabilitation is the process of restoring function to injured workers so they can return to work. Rehabilitation professionals assess the needs of the person and the demands of the workplace in order to develop a plan of action to get the employee back to work that is suitable and safe for him as soon as possible. Depending on the type of injury, the individual may have to be trained in a new line of work.

A number of professionals are involved in the practice of occupational rehabilitation. Doctors, physiotherapists, occupational therapists, psychologists and massage therapists all have a different role in the rehabilitation of injured workers. Some of the problems treated by these clinicians are amputations, overuse injuries, back pain, neck pain, headaches, fractures, spinal cord injuries, and a host of other injuries.

Increased computer usage has resulted in a growing number of people seeking occupational rehabilitation because of common overuse conditions such as carpal tunnel syndrome, tendonitis, as well as problems brought on by poor sustained postures such as thoracic outlet syndrome or cervical headaches. Other common work injuries are lower back problems such as intervertebral disc bulges especially among those who work with heavy machinery. Physiotherapists and occupational therapists work together to improve the employee's posture (standing as well as sitting), the ergonomics of the work place and the way the individual performs his duties. Many problems like shoulder, back and neck pain, which were believed to be chronic, have been improved by making adjustments in workplace ergonomics and posture and through exercise programmes to restore correct muscle balance and joint alignment.

Active rehabilitation programmes in gym-based settings are a proactive way to rehabilitate injured workers. Once the initial injury has been treated by the physiotherapist in the clinic, many physiotherapists are now designing and supervising exercise programmes in local gymnasiums. These exercise programmes aim to accelerate the return of strength and function of the injured workers and prevent re-injury on their return to work, often with excellent results. Many patients finish the rehabilitation programmes stronger and fitter than before they were even injured and with a renewed passion for exercise!

By participating in active rehabilitation, injured workers can prevent loss of wages due to injuries and can enjoy a more productive working environment. Employers can preserve their bottom line by avoiding decreased man-hours and ongoing medical expenses. With a physiotherapy prescribed rehabilitation programme everyone benefits.

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Neck pain is the sensation of discomfort in the neck area. Neck pain can result from disorders of any of the structures in the neck, including the cervical vertebrae and intervertebral discs, nerves, muscles, blood vessels, esophagus, larynx, trachea, lymphatic organs, thyroid gland, or parathyroid glands. Neck pain arises from numerous different conditions and is sometimes referred to as cervical pain.

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The best way to understand the way that skin discoloration occurs is to understand how the skin gets and maintains its color. The epidermis, the outer layer of your skin, contains a bunch of cells called melanocytes. These cells have many functions, but one of their main jobs is to protect the skin. When it comes to protecting the skin from the sun, the melanocytes do so by darkening it with a pigment called melanin.


Melanin is responsible for making the skin look darker when you are exposed to the sun, but the body, for some reason, will either stop producing melanin in specific areas of the skin, or put its production into overdrive. Sometimes the skin discoloration can affect the entire body, a specific part of the body, or it can occur in just a few random places on the skin

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Non-Hodgkin's lymphoma, also called non-Hodgkin lymphoma, is cancer that originates in your lymphatic system, the disease-fighting network spread throughout your body. In non-Hodgkin's lymphoma, tumors develop from lymphocytes — a type of white blood cell.

Non-Hodgkin's lymphoma is more common than the other general type of lymphoma — Hodgkin lymphoma.

Many different subtypes of non-Hodgkin's lymphoma exist. The most common non-Hodgkin's lymphoma subtypes include diffuse large B-cell lymphoma and follicular lymphoma

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Rehabilitation of sensory and cognitive function typically involves methods for retraining neural pathways or training new neural pathways to regain or improve neurocognitive functioning that has been diminished by disease or trauma. Three common neuropsychological problems treatable with rehabilitation are attention deficit/hyperactivity disorder (ADHD), concussion, and spinal cord injury. Rehabilitation research and practices are a fertile area for clinical neuropsychologists and others.


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The pancreas is the organ responsible for the production of insulin, a crucial hormone that helps our bodies turn sugar into fuel. Additionally, the pancreas also creates enzymes that break down fat, protein and carbohydrates during digestion.

An individual without a properly functioning pancreas does not have the necessary amount of insulin being produced in their bodies, and thus, there is a surplus sugar in their blood. This can cause major problems in the body, such as kidney failure, heart disease, strokes or even death. The most common cause of pancreas disease is Type I Diabetes, formerly known as juvenile diabetes.Experimental transplant of islet cells have started to be performed as a way to treat diabetes. In these instances, the insulin-producing islet cells are isolated from the donor's pancreas and injected into the patient's liver, where they begin to produce insulin for the recipient.

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Oil pulling, also known as "kavala" or "gundusha," is an ancient Ayurvedic dental technique that involves swishing a tablespoon of oil in your mouth on an empty stomach for around 20 minutes. This action supposedly draws out toxins in your body, primarily to improve oral health but also to improve your overall health

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The pores in the skin become open when the skin is warm or when the pore is forced open by being squeezed. Opening the pores on the face is a good thing to do during the cleansing process, which should be completed daily. The pores can be opened simply by washing the face with warm water, steaming the face in the shower, or applying a warm, damp towel to the face. Once the pores are open, the face can be cleaned in order to clear out the pores and keep the skin healthy.

After the open pores have been cleaned, they can be disinfected with an astringent, which should be applied with a cotton ball or cotton pad. Astringent is especially useful for people with acne, people with oily skin, and people whose skin gets dirty or grimy on a daily basis. It can be too irritating, however, for people with dry or sensitive skin. After the astringent is applied, the face can be rinsed with cold water, which will close the pores once again.


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Painful urination (dysuria) is discomfort or burning with urination, usually felt in the tube that carries urine out of your bladder (urethra) or the area surrounding your genitals (perineum).

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Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs.

The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

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Parkinson’s disease affects the nerve cells in the brain that produce dopamine. Parkinson’s disease symptoms include muscle rigidity, tremors, and changes in speech and gait. After diagnosis, treatments can help relieve symptoms, but there is no c

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Skin peeling on fingertips is a very common problem. Skin around fingertips is sensitive and if you don't take proper care then there are many factors which can cause the skin to peel off. In the cold climate the skin looses moisture, becomes dry and begin to flak, so don't let your skin become dry. Skin conditions such as eczema and psoriasis, sunburn and skin infections can  also cause peeling of skin around fingertips. Allergies, diabetes and vitamin B deficiency, use of harsh chemical and even frequent wasting of hands can cause peeling of fingertips skin. There are a number of natural home remedies that can repair your peeling of fingertip skin. 

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Personality change refers to a shift in the way you think, act or feel. It may be noticeable only to you, or it may be evident to people close to you.


Gradual personality changes can be normal as you age. It is also normal for you to have changing behaviors or feelings based on your mood, but these changes are temporary and can usually be attributed to a specific event. A sudden, undesired or uncontrollable change in your personality may be the sign of a serious condition.

Several mental illnesses can lead to personality changes. These include anxiety disorders, borderline personality disorder, dementia, and schizophrenia. In the case of mental illness, personality changes may be the result of an interplay of factors, including heredity, environment and stress. These types of changes typically emerge before adolescence. Most mental illnesses are thought to result from imbalances in brain chemicals (neurotransmitters) and are treated with medication and psychotherapy.

Sudden changes in personality can also result from brain damage or infection. Possible causes of brain damage include injury, stroke, infection and inflammation, among others.

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Polynesia  is a subregion of Oceania, made up of more than 1,000 islands scattered over the central and southern Pacific Ocean. The indigenous people who inhabit the islands of Polynesia are termed Polynesians, who share many similar traits including language family, culture, and beliefs.[1] Historically, they had a strong tradition of sailing, using stars to navigate at night.

The term Polynesia was first used in 1756 by French writer Charles de Brosses, and originally applied to all the islands of the Pacific. In 1831, Jules Dumont d'Urville proposed a restriction on its use during a lecture to the Geographical Society of Paris. Historically, the islands of the South Seas have been known as South Sea Islands[2], and their inhabitants as South Sea Islanders, even though the Hawaiian Islands are located in the North Pacific. Another term, the Polynesian Triangle, explicitly includes the Hawaiian Islands, as they form its northern vertex.


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If you have ever experienced any pain in your neck or back, you’ve probably heard the term “pinched nerve.” In fact, if you have seen a doctor about neck or back pain that did not go away on its own after a few weeks, you’ve probably been diagnosed with a spinal pinched nerve. A pinched nerve is often the result of any type of degenerative spine condition that causes pain and other symptoms. Though this is a common occurrence for most people at some point in their lives, a pinched nerve can be difficult to treat because there are so many potential causes for nerve compression.


The best thing you can do when you start to develop pain that you believe comes from a pinched nerve is to schedule an appointment with your doctor. If diagnosed in time, you may be able to find pain relief with several weeks or months of conservative treatment. Take a moment to read below about what causes a pinched nerve and some warning signs you should be aware of to know whether or not you should see a doctor.

As part of the body’s nervous system, nerves branch out from the brain and spinal cord to carry instructions to every area of the body. Essentially, the nerves are like electrical wires that allow signals to travel from the brain to the spinal cord to the organs and extremities, and back again.

Nerves within the brain and spinal cord are part of the central nervous system, while nerves that run from the spine to other areas of the body are called peripheral nerves. The peripheral nerves originate as nerve roots that exit the spinal cord and then branch off to spread throughout the body. The nerves that travel to muscles allow the muscles to move. Nerves also pass to the skin, providing the ability to feel.


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An unreasonable sort of fear that can cause avoidance and panic. Phobias are a relatively common type of anxiety disorder. Phobias can be treated with cognitive behavioral therapy, using exposure and fear-reduction techniques. In many cases, antianxiety or antidepressant medication proves helpful, especially during the early stages of therapy.

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Also called conjunctivitis. Redness or irritation of the conjunctivae, the membranes on the inner part of the eyelids and the membranes covering the whites of the eyes. These membranes react to a wide range of bacteria, viruses, allergy-provoking agents, irritants and toxic agents. Viral and bacterial forms of conjunctivitis are common in childhood.

The leading cause of a red eye is virus infection. Viral pink eye is usually associated with more of a watery discharge, not green or yellow in color, and is frequently associated with viral cold-like symptoms. The eyelids may be swollen. Sometimes looking at bright lights is painful. While viral pink eye, may not require an antibiotic, the doctor should see the child, as occasionally this form of pink eye can be associated with infection of the cornea, (the clear portion of the front of the eyeball). This infection must be correctly detected and treated. Viral pink eye is highly contagious.

The bacteria that most commonly cause pink eye are staphylococcus, pneumococcus, and streptococcus. Symptoms include eye pain, swelling, redness, and a moderate to large amount of discharge, usually yellow or greenish in color. The discharge commonly accumulates after sleep. The eyelids may be stuck together requiring a warm wash cloth applied to the eyes to remove the discharge. This bacterial pink eye responds to repeated warm wash cloths applied to the eyes and antibiotic eye drops or ointment.

Chlamydia is a form a bacterial that is an uncommon form of pink eye in the U.S., but is very common in Africa and the Middle Eastern countries. It can cause pink eye in adults and neonates. It is a cause of pink eye in adolescents and adults that can be sexually transmitted. Chlamydia pink eye is typically treated with tetracycline (except in children less than eight years old, because of possible teeth discoloration) or erythromycin.


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Primary lateral sclerosis is a type of motor neuron disease that causes muscle nerve cells to slowly break down, causing weakness. Primary lateral sclerosis (PLS) causes weakness in your voluntary muscles, such as those you use to control your legs, arms and tongue.

Primary lateral sclerosis can happen at any age, but it usually occurs between ages 40 and 60. A subtype of primary lateral sclerosis, known as juvenile primary lateral sclerosis, begins in early childhood and is caused by an abnormal gene passed from parents to children.

Primary lateral sclerosis is often mistaken for another, more common motor neuron disease called amyotrophic lateral sclerosis (ALS). However, primary lateral sclerosis progresses more slowly than ALS, and in most cases isn't fatal.

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eastern poison ivy/Toxicodendron rydbergii -- western poison ivy) typically grows as a vine or shrub, and it can be found throughout much of North America (except in the desert, Alaska, and Hawaii). It grows in open fields, wooded areas, on the roadside, and along riverbanks. It can also be found in urban areas, such as parks or backyards. Poison ivy plants typically have leaf arrangements that are clustered in groups of three leaflets (trifoiate), though this can vary. The color and shape of the leaves may also vary depending upon the exact species, the local environment, and the time of year. The plant may have yellow or green flowers, and white to green-yellow berries, depending on the season. Eastern poison ivy typically grows as a hairy ropelike vine, whereas western poison ivy tends to grow as a low shrub.

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Polycystic liver disease (PLD or PCLD) is a rare condition that causes cysts -- fluid-filled sacs -- to grow throughout the liver. A normal liver has a smooth, uniform appearance. A polycystic liver can look like a cluster of very large grapes. Cysts also can grow independently in different parts of the liver. The cysts, if they get too numerous or large, may cause discomfort and health complications. But most people with polycystic liver disease do not have symptoms and live a normal life.

Here are the facts about polycystic liver disease you need to better understand the condition.

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The premature graying problem is largely genetic. Hair follicles contain pigment cells that produce melanin, which gives your tresses their color. When your body stops generating melanin, hair presents itself as gray, white, or silver

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The herpes simplex virus (HSV) causes cold sores. HSV-1 and HSV-2 are highly contagious viruses that can be transmitted easily as a result of close contact.After entering the body, the virus remains inactive most of the time, but, if a trigger activates the virus, a cold sore can develop.One person may have just one outbreak and no recurrence, while others may have two or three outbreaks each year.Some people may carry the virus and never have an outbreak because it remains dormantInfection with HSV-2 may result from oral sex acts with a person who has genital herpes.


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Prickly heat is the common name for the medical term "miliaria rubia." It is also known as heat rash. The rash creates an area of red skin with many tiny raised bumps. This area may also blister.

The face, neck, shoulders, and chest are the most common places for prickly heat to occur, although it may show up anywhere. While it can affect anyone, children are more likely to get prickly heat than adults.

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Probiotics are the latest health obsession thanks to their seemingly endless list of health benefits. But the hype may be warranted; these friendly bacteria are the real deal. Various probiotic strains have been shown to support the gastrointestinal (GI) tract, prevent inflammation, boost immunity and alleviate conditions ranging from allergies to diarrhea, although more research needs to be done to sort out specific strains, outcomes and dosages. “Conventionally, when people hear about probiotics, they typically think of yogurt or supplements,” says Dr. B.J. Hardick, founder of the Centre for Maximized Living in London, Ontario. “Most people are unfortunately unaware of several other incredible -- and typically better -- sources of healthy gut bacteria.” Among those sources is a wide array of cultured and fermented foods. On the next slides, we’ll describe the benefits of 13 probiotic foods – some may surprise you

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Progressive supranuclear palsy, or PSP, is a rare neurodegenerative disease that is often misdiagnosed as Parkinson's disease because its symptoms are similar. Because of its rarity, PSP is mostly unknown by the general public.

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One of the most often heard homeopathic mantras is “Homeopathy treats the person, not the disease”.

But what does this really mean?

From a medical standpoint, a disease diagnosis is key, because drugs are prescribed to target a particular disease condition – for example, Prilosec for heartburn, Fosamax for osteoporosis, and Ritalin for ADHD.

From a homeopathic standpoint, the disease name is not important. Homeopathy triggers the body’s own healing mechanism and homeopathic remedies are prescribed based on the overall symptom picture.

In an acute case – such as flu, gastroenteritis, or an injury – this picture would include such variables as:

–   Energy level – are you more or less tired than usual? Is it worse at any particular time of day?

–   Changes in emotional state – are you more weepy, restless, or angry?

–   Pace of the illness – did it come on quickly, did it progress rapidly or slowly?

– Any unusual symptoms – e.g. a fever with no thirst, hunger with no desire to eat  (These are the most important symptoms for a homeopath, as they help to individualize the case and guide to the best remedy)

An example of this is a case of the flu.

A medical doctor will elicit the common symptoms, such as aching limbs, chills, cough, sore throat, runny nose and fatigue, and the prescription will be the same for every patient.

a homeopath will take these symptoms too. but will also want to know how your flu is different from everyone else’s.

So you could have a situation where two members of the same family have contracted the same virus, but one may have felt it coming on for several days, with chilliness, irritability and fatigue, while the other experienced a rapid onset of symptoms with a high temperature, perspiration, restlessness and anxiety.  Although the medical diagnosis would be the same, the manifestation of the virus is quite different, and each person would require a different homeopathic remedy.

This is the beauty of homeopathy – that it is unique and personalized for each individual and for each case of illness – but the down side is that homeopathy is not one-size-fits-all, which makes it more complex to practice and not compatible with the double blind trials so popular in the validation of  traditional medicine.


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Healthy eating plays a very important role in a healthy pregnancy. You need to eat foods from a variety of sources to make sure you get all the vitamins, minerals and nutrients you and your developing baby need. Eating well will also help you feel better, give you more energy and help you gain a healthy amount of weight. It will also contribute to your baby's healthy growth and development.


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Naturopathic medicine is a distinct primary health care profession, emphasizing prevention, treatment, and optimal

health through the use of therapeutic methods and substances that encourage individuals’ inherent self-healing

process.  The practice of naturopathic medicine includes modern and traditional, scientific, and empirical methods.

 

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The term “massage therapy” includes many techniques, and the type of massage given usually depends on your needs and physical condition.Massage therapy dates back thousands of years. References to massage appear in ancient writings from China, Japan, India, and EgyptIn general, massage therapists work on muscle and other soft tissue to help you feel better.In Swedish massage, the therapist uses long strokes, kneading, deep circular movements, vibration, and tapping.Sports massage combines techniques of Swedish massage and deep tissue massage to release chronic muscle tension. It’s adapted to the needs of athletes.Myofascial trigger point therapy focuses on trigger points—areas that are painful when pressed and are associated with pain elsewhere in the body.Massage therapy is sometimes done using essential oils as a form of aromatherapy.

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Itching affecting the scalp, meaning the skin covering the top of the head which grows hair, can have many causes. It can be caused by parasites such as lice, irritation due to a harsh shampoo, the presence of dandruff, or a skin disease, the most common being psoriasis which causes skin lesions and itching. The treatment for an itchy scalp can be prescribed after determining the cause. The most common cause in children is head lice, the discovery of nits should lead to treatment with two applications of lotion, 8 days apart.

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Kids often come down with sore, scratchy throats. Colds and other viruses are usually to blame. Irritants such as smoke in the air can also make you feel raw.

Strep throat is different -- it’s caused by bacteria. You need to know whether you or your child has strep or another illness so you can get the right treatment.

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This swelling is caused by a build-up of fluid, or inflammation inside the lip tissue. It can have many causes, including injury, illness, certain medicines or allergies. Swollen lips can be a sign of anaphylaxis – a severe allergic reaction – which requires immediate medical attention.

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A dark spot refers to a hyper-pigmentation of the skin commonly occurring in middle aged women. Dark spots, aka pigmentations, occur when a localized patch of melanin produced accumulates on a specific area on the skin. It can be located on the forehead, face or cheek bone area. Some dark spots could mean serious skin problems and thus you should consult a dermatologist if you become suspicious. 

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A bone marrow transplant, also called a blood stem cell transplant or BMT, can treat many diseases. For some diseases, BMT is the only potential cure. There are over 70 diseases that can be treated by BMT. Some of them are listed here.  


    Acute lymphoblastic leukemia (ALL)

    Acute myeloid leukemia (AML)

    Adrenoleukodystrophy (ALD)

    Chronic lymphocytic leukemia (CLL)

    Chronic myelogenous leukemia (CML)

    Hodgkin lymphoma

    Hurler syndrome

    Krabbe disease (Globoid-Cell Leukodystrophy)

    Metachromatic Leukodystrophy (MLD)

    Multiple myeloma

    Myelodysplastic syndromes (MDS)

    Non-Hodgkin lymphoma (NHL)

    Severe aplastic anemia

    Severe Combined Immunodeficiency (SCID)

    Sickle cell disease (SCD)

    Wiskott-Aldrich syndrome (WAS)

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An itchy scalp may be irritating for anyone, especially during the hot summers. Instead of trying a host of market products and professional treatments, use these regular and popular home remedies to eliminate the itchiness from your scalp. Before opting for these home remedies, make sure you check the cause of this itchiness. Notice your scalp texture carefully. Dry skin on the scalp or infections such as dandruff and psoriasis can cause an itchy scalp. The itching and scratching can also result in excess hair fall.

Ask yourself these questions: Is your scalp dry or damaged? Are you suffering from normal dandruff or lice? Or is it any other regular reason like sweating that is giving you an itchy scalp? If your answer is yes, you can move on to the home remedies safely without further ado.


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A heart transplant is an operation in which a failing, diseased heart is replaced with a healthier, donor heart. Heart transplant is a treatment that's usually reserved for people who have tried medications or other surgeries, but their conditions haven't sufficiently improved.

While a heart transplant is a major operation, your chance of survival is good, with appropriate follow-up care.

When faced with a decision about having a heart transplant, know what to expect of the heart transplant process, the surgery itself, potential risks and follow-up care.

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Keratosis pilaris (ker-uh-TOE-sis pih-LAIR-is) is a common, harmless skin condition that causes dry, rough patches and tiny bumps, usually on the upper arms, thighs, cheeks or buttocks. The bumps generally don't hurt or itch.Keratosis pilaris is often considered a variant of normal skin. It can't be cured or prevented. But you can treat it with moisturizers and prescription creams to help improve the appearance of the skin. The condition usually disappears by age 30.


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heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). They are attributed to chronic local inflammation at the insertion of soft-tissue tendons or fascia in the area. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot.

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When you get a kidney transplant, a healthy kidney is placed inside your body to do the work your own kidneys can no longer do.  On the plus side, there are fewer limits on what you can eat and drink, but you should follow a heart-healthy diet. Your health and energy should improve.  In fact, a successful kidney transplant may allow you to live the kind of life you were living before you got kidney disease. Studies show that people with kidney transplants live longer than those who remain on dialysis.On the minus side, there are the risks of surgery.  You will also need to take anti-rejection medicines for as long as your new kidney is working, which can have side effects.  You will have a higher risk for infections and certain types of cancer.Although most transplants are successful and last for many years, how long they last can vary from one person to the next. Many people will need more than one kidney transplant during a lifetime.

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When you know the symptoms of chronic kidney disease (CKD), you can get treatment and feel your best. CKD symptoms can be subtle. Some people don’t have any symptoms — or don’t think they do. If you have one or more of the 15 symptoms below, or worry about kidney problems, see a doctor for blood and urine tests. Many of the symptoms on this list can be caused by other health problems. The only way to know the cause of YOUR symptoms is to see your doctor.




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Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury, such as a ruptured ligament or torn cartilage. Medical conditions including arthritis, gout and infections also can cause knee pain. Many types of minor knee pain respond well to self-care measures. Physical therapy and knee braces also can help relieve knee pain. In some cases, however, your knee may require surgical repair.

Our knees are constantly at work whether we are walking, standing, or sitting. The consistent stress makes them vulnerable to injury and pain. However, there are some time-tested home remedies for knee pain to prevent the pain from worsening.

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Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often continues into adulthood. ADHD includes a combination of persistent problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.

Children with ADHD also may struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.

While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcom


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Hemorrhoids (Piles) are blood vessels located in the smooth muscles of the walls of the rectum and anus. They are a normal part of the anatomy and are located at the junction where small arteries merge into veins. They are cushioned by smooth muscles and connective tissue and are classified by where they are located in relationship to the pectinate line, the dividing point between the upper 2/3 and lower 1/3 of the anus. This is an important anatomic distinction because of the type of cells that line the hemorrhoid, and the nerves that provide sensation.

Internal hemorrhoids are located above the pectinate line and are covered with cells that are the same as those that line the rest of the intestines. External hemorrhoids arise below the line and are covered with cells that resemble skin.

Hemorrhoids become an issue only when they begin to swell, causing itching, pain and/or bleeding.

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A liver transplant is an operation that replaces a patient's diseased liver with a whole or partial healthy liver from another person. This article explains the current indications for liver transplantation, types of donor livers, the operation itself, and the immunosuppression that is required after transplantation.Liver transplantation surgically replaces a failing or diseased liver with one that is normal and healthy. At this time, transplantation is the only cure for liver insufficiency or liver failure because no device or machine reliably performs all of the functions of the liver. People who require liver transplants typically have one of the following conditions


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This infection of the liver is caused by the hepatitis C virus. About 3.9 million people in the U.S. have the disease. But it causes few symptoms, so most of them don't know.


There are many forms of the hepatitis C virus. The most common in the U.S. is type 1. None is more serious than any other, but they respond differently to treatment.

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Liver

The liver is a large organ on the upper right side of your torso, opposite the stomach and behind the ribcage. One of its main functions is to make a substance called bile (composed mostly of bilirubin, bile salts, and cholesterol) that is required to digest food in the small intestine.


The liver is divided into two sections: a right lobe and a left lobe. Both lobes are made up of cells called hepatocytes. These cells produce bile and secrete it into the bile ducts, which carry bile to the gallbladder where it is stored until used by the small intestine.


Gallbladder and Bile Ducts

The gallbladder is a pear-shaped sac under the right lobe of the liver. Between meals, it stores and concentrates bile, which is produced at a constant rate by the liver. When it is not full of bile, the gallbladder is about 3 inches long and 1 inch wide at its thickest part.


After meals, the gallbladder releases bile into the duodenum to aid with digestion. The cystic duct carries bile from the gallbladder to the common bile duct, which empties into the duodenum. Entry of bile into the duodenum is regulated by layers of muscle called the sphincter of Oddi.


Between meals, the sphincter of Oddi closes and prevents bile from entering the duodenum. During and after meals, this sphincter opens and allows bile to enter the duodenum.


Pancreas

The pancreas is a long, thin gland that lies horizontally behind the bottom part of your stomach. It makes digestive enzymes that flow through the pancreatic duct to the small intestine. These enzymes, along with bile from the gallbladder, break down food for use as energy by the body. The pancreas also makes insulin and glucagon, hormones that help regulate blood glucose (sugar) levels.


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Fatigue is a constant state of tiredness, even when you’ve gotten your usual amount of sleep. This symptom develops over time and causes a drop in your physical, emotional, and psychological energy levels. You’re also more likely to feel unmotivated to participate in or do activities you normally enjoy.

Loss of appetite means you don’t have the same desire to eat as you used to. Signs of decreased appetite include not wanting to eat, unintentional weight loss, and not feeling hungry. The idea of eating food may make you feel nauseous, as if you might vomit after eating. Long-term loss of appetite is also known as anorexia, which can have a medical or psychological cause.


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Herpes is an infection caused by HSV (herpes simplex virus). This virus affects the external genitalia, anal region, mucosal surfaces, and skin in other parts of the body.


Herpes is a long-term condition. However, many people never have symptoms even though they are carrying the virus.

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The pathophysiology of lower back pain is a source of fascination, frustration, and, often, confusion by clinicians and scientists who both treat and study patients who have this problem. The statement that we do not know the origin of low back pain in the majority of cases has become a mantra to any introduction to the topic. The Agency for Health Care Policy and Research (AHCPR) Guidelines on Low Back Problems and similar guidelines in other countries have given up on attempts to define the origin of the pain in patients who have this problem and have instead resorted to differentiating between so-called Red Flag pathologic conditions and patients who have nonspecific low back pain, with or without leg symptoms.


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Hiccups are involuntary contractions of the diaphragm — the muscle that separates your chest from your abdomen and plays an important role in breathing. Each contraction is followed by a sudden closure of your vocal cords, which produces the characteristic "hic" sound.


Hiccups may result from a large meal, alcoholic or carbonated beverages or sudden excitement. In some cases, hiccups may be a sign of an underlying medical condition. For most people, a bout of hiccups usually lasts only a few minutes. Rarely, hiccups may persist for months. This can result in weight loss and exhaustion.

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Low blood pressure might seem desirable, and for some people, it causes no problems. However, for many people, abnormally low blood pressure (hypotension) can cause dizziness and fainting. In severe cases, low blood pressure can be life-threatening.

A blood pressure reading lower than 90 millimeters of mercury (mm Hg) for the top number (systolic) or 60 mm Hg for the bottom number (diastolic) is generally considered low blood pressure.

The causes of low blood pressure can range from dehydration to serious medical or surgical disorders. It's important to find out what's causing your low blood pressure so that it can be treated.


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lood is made up of several types of cells. These cells float in a liquid called plasma. The types of blood cells are:red blood cellswhite blood cellsplatelets, or thrombocytesWhen your skin is injured or broken, platelets clump together and form clots to stop the bleeding. When you don’t have enough platelets in your blood, your body cannot form clots.A low platelet count may also be called thrombocytopenia. This condition can range from mild to severe, depending on its underlying cause. For some, the symptoms can include severe bleeding and are possibly fatal if they’re not treated. Other people may not experience any symptoms.Typically, a low platelet count is the result of a medical condition, like leukemia, or certain drugs. The treatment usually addresses the condition causing the thrombocytopenia.


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Hip pain is a common complaint that can be caused by a wide variety of problems. The precise location of your hip pain can provide valuable clues about the underlying cause.

Problems within the hip joint itself tend to result in pain on the inside of your hip or your groin. Hip pain on the outside of your hip, upper thigh or outer buttock is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround your hip joint.

Hip pain can sometimes be caused by diseases and conditions in other areas of your body, such as your lower back. This type of pain is called referred pain. 

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Lung transplantation or pulmonary transplantation is a surgical procedure in which a patient's diseased lungs are partially or totally replaced by lungs which come from a donor. Donor lungs can be retrieved from a living donor or a deceased donor. A living donor can only donate one lung lobe. With some lung diseases a recipient may only need to receive a single lung. With other lung diseases such as cystic fibrosis it is imperative that a recipient receive two lungs. While lung transplants carry certain associated risks, they can also extend life expectancy and enhance the quality of life for end-stage pulmonary patients.

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For many people -- particularly women -- hips and thighs are trouble spots. Efforts to achieve slim, trim thighs can seem futile, especially since exercise and diet won't necessarily reduce fat in the places you'd like. Though you target your stomach, the excess fat may come off your bottom, or vice versa. Still, dedication to exercise combined with good nutrition will trim fat throughout your body and help you tone all over, including your thigh

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A normal mole is usually an evenly colored brown, tan, or black spot on the skin. It can be either flat or raised. It can be round or oval. Moles are generally less than 6 millimeters (about ¼ inch) across (about the width of a pencil eraser). Some moles can be present at birth, but most appear during childhood or young adulthood. New moles that appear later in life should be checked by a doctor.

Once a mole has developed, it will usually stay the same size, shape, and color for many years. Some moles may eventually fade away.Most people have moles, and almost all moles are harmless. But it’s important to recognize changes in a mole – such as in its size, shape, or color – that can suggest a melanoma may be developing.


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There is no such thing as a "bad memory", and anyone can improve their memory, as long as you are not suffering from memory loss as a medical condition. If you want to improve your memory, there are a number of things you can do, from eating blueberries to using a variety of mnemonic devices. If you're optimistic and dedicated, you'll be able to improve your memory, whether you want to win the World Memory Championships, ace your history test, or simply remember where you put your keys.

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Cholesterol is a waxy, fat-like substance found in the cell membrane and is transported in the blood plasma of all animals.

Our body needs cholesterol to a certain level to work properly, but if excess of cholesterol enters blood, it can make sticky deposits to the walls of the arteries leading to its narrowing and blockage.

High cholesterol shoots up the risk of getting various cardiovascular diseases such as Atherosclerosis, Cardiac Arrest, Stroke, Heart Attack, etc.

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Hyperpigmentation is the production of excess melanin causing dark spots on the skin. Age spots, liver spots, freckles, sun spots, pregnancy mask are all types of hyperpigmentation and there are several treatments available to reduce or remove the darker skin.

Hyperpigmentation refers to areas of skin where an excess of melanin has been produced and formed deposits, causing skin patches that appear darker than the surrounding skin.


Common skin areas that experience hyperpigmentation or dyschromia are the face, arms, and hands.  Age spots, liver spots, freckles, sun spots, melasma, and any typical dark or brown spots in the skin are examples of hyperpigmentation. 

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Hypertension is another name for high blood pressure. It can lead to severe complications and increases the risk of heart disease, stroke, and death.

Blood pressure is the force exerted by the blood against the walls of the blood vessels. The pressure depends on the work being done by the heart and the resistance of the blood vessels.

Medical guidelines define hypertension as a blood pressure higher than 130 over 80 millimeters of mercury (mmHg), according to guidelines issued by the American Heart Association (AHA) in November 2017.

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Hyperthyroidism, or overactive thyroid disease, means your thyroid gland makes and releases too much thyroid hormone. The thyroid gland is located in the front of your neck, just below your Adam’s apple. It makes hormones that control your metabolism. Metabolism is the pace of your body’s processes and includes things like your heart rate and how quickly you burn calories.


Hyperthyroidism can affect your metabolism. It can also cause nervousness, increased perspiration (sweatiness), rapid heartbeat, hand tremors, difficulty sleeping and weight loss.

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Menopause is defined as the absence of menstrual periods for 12 months. It is the time in a woman's life when the function of the ovaries ceases.The process of menopause does not occur overnight, but rather is a gradual process. This so-called perimenopausal transition period is a different experience for each woman.The average age of menopause is 51 years old, but menopause may occur as early as the 30s or as late as the 60s. There is no reliable lab test to predict when a woman will experience menopause.The age at which a woman starts having menstrual periods is not related to the age of menopause onset.

Symptoms of menopause can include abnormal vaginal bleeding, hot flashes, vaginal and urinary symptoms, and mood changes.Complications that women may develop after menopause include osteoporosis and heart disease.Treatments for menopause are customized for each woman.Treatments are directed toward alleviating uncomfortable or distressing symptoms.

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High blood pressure is also known as hypertension. Blood pressure is the amount of force exerted against the walls of the arteries as blood flows through them.


In the United States, approximately 85 million people have high blood pressure - about 1 in every 3 adults over 20, according to the American Heart Association (AHA).

The National Institutes of Health (NIH) estimate that about two-thirds of people over the age of 65 in the U.S. have high blood pressure.

If left untreated or uncontrolled, high blood pressure can cause many health problems. These conditions include heart failure, vision loss, stroke, and kidney disease.

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A normal menstrual cycle lasts 28 days, plus or minus seven days. Menstrual bleeding is considered irregular if it occurs more frequently than every 21 days or lasts longer than 8 days. Missed, early, or late periods are also considered signs of an irregular cycle.


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The chain of nerve cells that runs from the brain through the spinal cord out to the muscle is called the motor pathway. Normal muscle function requires intact connections all along this motor pathway. Damage at any point reduces the brain's ability to control the muscle's movements. This reduced efficiency causes weakness, also called paresis. Complete loss of communication prevents any willed movement at all. This lack of control is called paralysis. Certain inherited abnormalities in muscle cause periodic paralysis, in which the weakness comes and goes.

The line between weakness and paralysis is not absolute. A condition causing weakness may progress to paralysis. On the other hand, strength may be restored to a paralyzed limb. Nerve regeneration or regrowth is one way in which strength can return to a paralyzed muscle. Paralysis almost always causes a change in muscle tone. Paralyzed muscle may be flaccid, flabby, and without appreciable tone, or it may be spastic, tight, and with abnormally high tone that increases when the muscle is moved.

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Lichen planus is a chronic recurrent inflammatory disorder of the skin and mucous membranes. It is characterized by small, flat-topped, polygonal bumps that may coalesce into rough, scaly plaques on the skin. There may also be involvement of the lining tissue (mucous membranes) of the mouth and/or vagina.


Lichen planus is a poorly understood skin condition. Its name is descriptive in that to some it resembles a simple plant, a lichen, which grows on rocks and tree bark, while planus is Latin for flat.

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Staph infections are caused by staphylococcus bacteria, types of germs commonly found on the skin or in the nose of even healthy individuals. Most of the time, these bacteria cause no problems or result in relatively minor skin infections.

But staph infections can turn deadly if the bacteria invade deeper into your body, entering your bloodstream, joints, bones, lungs or heart. A growing number of otherwise healthy people are developing life-threatening staph infections.

Treatment usually involves antibiotics and drainage of the infected area. However, some staph infections no longer respond to common antibiotics.

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Prostatitis is inflammation of the prostate gland. The inflammation can be due to an infection as well as other various causes. Prostatitis accounts for nearly 2 million visits per year to outpatient urology practices in the United States.

The prostate gland is part of the male reproductive system, and it is a walnut-sized gland found in men that is located below the bladder and in front of the rectum. It surrounds the urethra, the tube through which urine and semen exit the body. Its main function is to produce seminal fluid in order to transport sperm through the urethra.

The NIH consensus definition and classification of prostatitis:

Acute bacterial prostatitis:
Caused by a bacterial infection and it typically starts suddenly and may include flu-like symptoms. It is the least common of the four types of prostatitis.
Chronic bacterial prostatitis:
Characterized by recurrent bacterial infections of the prostate gland. Between attacks the symptoms might be minor or the patient may even be symptom free, however it can be difficult to successfully treat.
Chronic prostatitis/chronic pelvic pain syndrome:
Most cases of prostatitis fall into this category, however it is the least understood. It can be further characterized as inflammatory or noninflammatory, depending upon the presence or absence of infection-fighting cells in the urine, semen, and prostatic fluid. Often no specific cause can be identified. The symptoms can come and go or remain chronically.
Asymptomatic inflammatory prostatitis:
This condition is often diagnosed incidentally during the work-up for infertility or prostate cancer. Individuals with this form of prostatitis will not complain of symptoms or discomfort, but they will have the presence of infection-fighting cells present in semen/prostatic fluid.

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Premenstrual syndrome (PMS) has a wide variety of symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.

Symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense.

Still, you don't have to let these problems control your life. Treatments and lifestyle adjustments can help you reduce or manage the signs and symptoms of premenstrual syndrome

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HRT, also known as hormone therapy (HT) or menopausal hormone therapy (MHT), is medication containing the hormones that a woman’s body stops producing after menopause. HRT is used to treat menopausal symptoms.

While HRT reduces the likelihood of some debilitating diseases such as osteoporosis, colorectal (bowel) cancer and heart disease, it may increase the chances of developing a blood clot (when given in tablet form) or breast cancer (when some types are used long-term).

‘Premature menopause’ is when the final menstrual period occurs before a woman is 40. ‘Early menopause’ is when the final menstrual period occurs before a woman is 45. For women who experience premature or early menopause, HRT is strongly recommended until the average age of menopause (around 51 years), unless there is a particular reason for a woman not to take it.

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Sleep disorders are a group of conditions that affect the ability to sleep well on a regular basis. Whether they are caused by a health problem or by too much stress, sleep disorders are becoming increasingly common in the United States. In fact, more than 75 percent of Americans between ages 20 and 59 report having sleeping difficulties fairly regularly.

Most people occasionally experience sleeping problems due to stress, hectic schedules, and other outside influences. However, when these issues begin to occur on a regular basis and interfere with daily life, they may indicate a sleeping disorder.

Depending on the type of sleep disorder, people may have a difficult time falling asleep and may feel extremely tired throughout the day. The lack of sleep can have a negative impact on energy, mood, concentration, and overall health.

In some cases, sleep disorders can be a symptom of another medical or mental health condition. These sleeping problems may eventually go away once treatment is obtained for the underlying cause. When sleep disorders aren’t caused by another condition, treatment normally involves a combination of medical treatments and lifestyle changes.

It’s important to receive a diagnosis and treatment right away if you suspect you might have a sleep disorder. When left untreated, the negative effects of sleep disorders can lead to further health consequences. They can also affect your performance at work, cause strain in relationships, and impair your ability to perform daily activities.

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Chances are we have all crossed our legs a time or two in hopes of making it to the closest restroom in time. But there's a big difference between having to go, and always feeling like you have to go. For those who live with bladder spasms, that feeling is a painful reality that can lead to embarrassing wetting accidents and an unwanted shift in lifestyle. However, there are a variety of treatment options available to manage the symptoms. Here's what you need to know about bladder spasms, from the causes to what you can do to ease the pain.


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Primary biliary cirrhosis, sometimes called PBC, is a disease in which the bile ducts in your liver are slowly destroyed. Bile, a fluid produced in your liver, plays a role in digesting food and helps rid your body of worn-out red blood cells, cholesterol and toxins.When bile ducts are damaged, as in primary biliary cirrhosis, harmful substances can build up in your liver and sometimes lead to irreversible scarring of liver tissue (cirrhosis).

Primary biliary cirrhosis is considered an autoimmune disease, in which the body turns against its own cells.Researchers think it is triggered by a combination of genetic and environmental factors. Primary biliary cirrhosis usually develops slowly and medication can slow its progression, especially if treatment begins early.


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PSC is a disease that damages and blocks bile ducts inside and outside the liver. Bile is a liquid made in the liver. Bile ducts are tubes that carry bile out of the liver to the gallbladder and small intestine. In the intestine, bile helps break down fat in food.

In PSC, inflammation of the bile ducts leads to scar formation and narrowing of the ducts over time. As scarring increases, the ducts become blocked. As a result, bile builds up in the liver and damages liver cells. Eventually, scar tissue can spread throughout the liver, causing cirrhosis and liver failure.


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Narcolepsy is a neurological disorder that affects the control of sleep and wakefulness. People with narcolepsy experience excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime. These sudden sleep attacks may occur during any type of activity at any time of the day.

In a typical sleep cycle, we initially enter the early stages of sleep followed by deeper sleep stages and ultimately (after about 90 minutes) rapid eye movement (REM) sleep. For people suffering from narcolepsy, REM sleep occurs almost immediately in the sleep cycle, as well as periodically during the waking hours. It is in REM sleep that we can experience dreams and muscle paralysis -- which explains some of the symptoms of narcolepsy.

Narcolepsy usually begins between the ages of 15 and 25, but it can become apparent at any age. In many cases, narcolepsy is undiagnosed and, therefore, untreated.

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Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of bronchiectasis. This disease is characterized by increasing breathlessness.

Many people mistake their increased breathlessness and coughing as a normal part of aging. In the early stages of the disease, you may not notice the symptoms. COPD can develop for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease. That’s why it is important that you talk to your doctor as soon as you notice any of these symptoms. Ask your doctor about taking a spirometry test.


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Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis) is inflammation of the tiny filters in your kidneys (glomeruli). Glomeruli remove excess fluid, electrolytes and waste from your bloodstream and pass them into your urine. Glomerulonephritis can come on suddenly (acute) or gradually (chronic).


Glomerulonephritis occurs on its own or as part of another disease, such as lupus or diabetes. Severe or prolonged inflammation associated with glomerulonephritis can damage your kidneys. Treatment depends on the type of glomerulonephritis you have.

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Growing pains are often described as an ache or throb in the legs — often in the front of the thighs, the calves or behind the knees. Growing pains tend to affect both legs and occur at night, and may even wake a child from sleep.


Although these pains are called growing pains, there's no evidence that growth hurts. Growing pains may be linked to a lowered pain threshold or, in some cases, to psychological issues.


There's no specific treatment for growing pains. You can make your child more comfortable by putting a warm heating pad on the sore muscles and massaging them.

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Male hypogonadism is a condition in which the body doesn't produce enough testosterone — the hormone that plays a key role in masculine growth and development during puberty — or has an impaired ability to produce sperm orboth.You may be born with male hypogonadism, or it can develop later in life, often from injury or infection. The effects — and what you can do about them — depend on the cause and at what point in your life male hypogonadism occurs. Some types of male hypogonadism can be treated with testosterone replacement therapy.


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Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. Which exams and screenings you need depends on your age, health and family history, and lifestyle choices such as what you eat, how active you are, and whether you smoke.


To make the most of your next check-up, here are some things to do before you go:

Review your family health history

Find out if you are due for any general screenings or vaccinations

Write down a list of issues and questions to take with you


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Anaphylaxis is a rapidly developing and serious allergic reaction that can affect multiple body systems at the same time. Severe anaphylactic reactions can be fatal. Anaphylaxis is often triggered by substances that are injected or ingested and thereby gain access into the bloodstream. This can result in a reaction involving the skin, lungs, nose, throat, and gastrointestinal tract.

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Malignant hyperthermia is a condition that triggers a severe reaction to certain drugs used as part of anesthesia for surgery. Without prompt treatment, the disease can be fatal.The genes that cause malignant hyperthermia are inherited. In most cases, no signs or symptoms of the condition exist until you are exposed to anesthesia.


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Ankylosing spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints. The sacroiliac joints are located at the base of the low back where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks) of the pelvis. Chronic inflammation in these areas causes pain and stiffness in and around the spine, including the neck, middle back, lower back, and buttocks. Over time, chronic inflammation of the spine (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. Ankylosis causes loss of mobility of the spine.

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Membranous nephropathy (MEM-bruh-nus nuh-FROP-uh-thee) occurs when the small blood vessels in the kidney (glomeruli), which filter wastes from the blood, become damaged and thickened. As a result, proteins leak from the damaged blood vessels into the urine (proteinuria). For many, loss of these proteins eventually causes signs and symptoms known as nephrotic syndrome.In mild cases, membranous nephropathy may get better on its own, without any treatment. As protein leakage increases, so does the risk of long-term kidney damage. In many, the disease ultimately leads to kidney failure. There's no absolute cure for membranous nephropathy, but successful treatment can lead to remission of proteinuria and a good long-term outlook.


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Palpitations make you feel like your heart is beating too hard or too fast, skipping a beat, or fluttering. You may notice heart palpitations in your chest, throat, or neck.

They can be bothersome or frightening. They usually aren't serious or harmful, though, and often go away on their own. Most of the time, they're caused by stress and anxiety, or because you’ve had too much caffeine, nicotine, or alcohol. They can also happen when you’re pregnant.

In rare cases, palpitations can be a sign of a more serious heart condition. So, if you have heart palpitations, see your doctor. Get immediate medical attention if they come with:

Shortness of breath

Dizziness

Chest pain

Fainting

After your doctor takes your medical history and looks you over, he may order tests to find the cause. If he finds one, the right treatment can reduce or get rid of the palpitations.

If there’s no underlying cause, lifestyle changes can help, including stress management.

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Colon polyps are growths that occur on the inner lining of the large intestine (colon) and usually protrude into the colon. Polyps form when the genetic material within the cells lining the colon changes and becomes abnormal (mutates). Normally, the immature cells lining the colon are programmed to divide (multiply), mature, and then die in a very consistent and timely fashion. However, the genetic changes that occur in the lining cells prevents the cells from maturing, and the cells do not die. This leads to an accumulation of immature, genetically abnormal cells, which eventually results in the formation of polyps. The mutations may occur as a sporadic event after birth or they may be present from before birth.

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Meralgia paresthetica is a condition characterized by tingling, numbness and burning pain in your outer thigh. The cause of meralgia paresthetica is compression of the nerve that supplies sensation to the skin surface of your thigh.

Tight clothing, obesity or weight gain, and pregnancy are common causes of meralgia paresthetica. However, meralgia paresthetica can also be due to local trauma or a disease, such as diabetes.

In most cases, you can relieve meralgia paresthetica with conservative measures, such as wearing looser clothing. In severe cases, treatment may include medications to relieve discomfort or, rarely, surgery.

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Hemifacial spasms happen when the muscles on only one side of your face twitch without warning. These types of spasms are caused by damage or irritation to the facial nerve, which is also known as the seventh cranial nerve. Facial spasms occur when the muscles contract involuntarily because of this nerve irritation.


Hemifacial spasms are also known as tic convulsif. At first, they may appear only as small, barely noticeable tics around your eyelid, cheek, or mouth. Over time, the tics may expand to other parts of your face.


Hemifacial spasms can happen to men or women, but they’re most common in women over 40. They also tend to occur more often on the left side of your face. 


Hemifacial spasms aren’t dangerous on their own. But a constant twitch in your face can be frustrating or uncomfortable. In severe cases, these spasms can limit function due to involuntary eye closing or the impact they have on speaking.


In some cases, these spasms may indicate that you have an underlying condition or an abnormality in your facial structure. Either of these causes can compress or damage your nerves and make your face muscles twitch.

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Hemophilia is not one disease but rather one of a group of inherited bleeding disorders that cause abnormal or exaggerated bleeding and poor blood clotting. The term is most commonly used to refer to two specific conditions known as hemophilia A and hemophilia B, which will be the main subjects of this article. Hemophilia A and B are distinguished by the specific gene that is mutated (altered to become defective) and codes for a defective clotting factor (protein) in each disease. Rarely, hemophilia C (a deficiency of Factor XI) is encountered, but its effect on clotting is far less pronounced than A or B.


Hemophilia A and B are inherited in an X-linked recessive genetic pattern and are therefore much more common in males. This pattern of inheritance means that a given gene on the X chromosome expresses itself only when there is no normal gene present. For example, a boy has only one X chromosome, so a boy with hemophilia has the defective gene on his sole X chromosome (and so is said to be hemizygous for hemophilia). Hemophilia is the most common X-linked genetic disease.


Although it is much rarer, a girl can have hemophilia, but she would have to have the defective gene on both of her X chromosomes or have one hemophilia gene plus a lost or defective copy of the second X chromosome that should be carrying the normal genes. If a girl has one copy of the defective gene on one of her X chromosomes and a normal second X chromosome, she does not have hemophilia but is said to be heterozygous for hemophilia (a carrier). Her male children have a 50% chance of inheriting the one mutated X gene and thus have a 50% chance of inheriting hemophilia from their carrier mother.


Hemophilia A occurs in about 1 out of every 5000 live male births. Hemophilia A and B occurs in all racial groups. Hemophilia A is about four times more common than B. B occurs in about 1 out of 20- 30,000 live male births.


Hemophilia has been called the Royal Disease because Queen Victoria, Queen of England from 1837 to 1901, was a carrier. Her daughters passed the mutated gene on to members of the royal families of Germany, Spain, and Russia. Alexandra, Queen Victoria's granddaughter, who became Tsarina of Russia in the early 20th century when she married Tsar Nicholas II, was a carrier. Their son, the Tsarevich Alexei, suffered from hemophilia.

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Hepatitis A is a virus, or infection, that causes liver disease and inflammation of the liver. Viruses can cause sickness. For example, the flu is caused by a virus. People can pass viruses to each other.


Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can cause organs to not work properly.

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Hepatitis B is a virus that infects the liver camera.gif. Most adults who get it have it for a short time and then get better. This is called acute hepatitis B.


Sometimes the virus causes a long-term infection, called chronic hepatitis B. Over time, it can damage your liver. Babies and young children infected with the virus are more likely to get chronic hepatitis B.


You can have hepatitis B and not know it. You may not have symptoms. If you do, they can make you feel like you have the flu. But as long as you have the virus, you can spread it to others.


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Hidradenitis suppurativa (hi-drad-uh-NIE-tis sup-yoo-ruh-TIE-vuh) is rare, long-term skin condition that features small, painful lumps under the skin. They typically develop where the skin rubs together, such as the armpits, the groin, between the buttocks and under the breasts. The lumps may break open and smell or cause tunnels under the skin.


Hidradenitis suppurativa tends to start after puberty. It can persist for many years and worsen over time, with serious effects on your daily life and emotional well-being. Early diagnosis and treatment can help manage the symptoms, keep new lumps from forming and prevent complications, such as scar

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Diabetes insipidus (die-uh-BEE-teze in-SIP-uh-dus) is an uncommon disorder that causes an imbalance of water in the body. This imbalance leads to intense thirst even after drinking fluids (polydipsia), and excretion of large amounts of urine (polyuria).


While the names diabetes insipidus and diabetes mellitus sound similar, they're not related. Diabetes mellitus — which can occur as type 1 or type 2 — is the more common form of diabetes.


There's no cure for diabetes insipidus, but treatments are available to relieve your thirst and normalize your urine output.

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Hip dysplasia is the medical term for a hip socket that doesn't fully cover the ball portion of the upper thighbone. This allows the hip joint to become partially or completely dislocated. Most people with hip dysplasia are born with the condition.


Doctors will check your baby for signs of hip dysplasia shortly after birth and during well-baby visits. If hip dysplasia is diagnosed in early infancy, a soft brace can usually correct the problem.


If hip dysplasia is diagnosed after the age of 2, surgery may be necessary to move the bones into the proper positions for smooth joint movement.


Milder cases of hip dysplasia might not start causing symptoms until a person is a teenager or young adult. Hip dysplasia can damage the cartilage lining the joint, and it can also hurt the soft cartilage (labrum) that rims the socket portion of the hip joint. This is called a hip labral tear.

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Lymphadenitis is a condition in which your lymph nodes become inflamed. When the condition affects the lymph nodes in the membrane that connects your bowel to the abdominal wall (mesentery), it's called mesenteric lymphadenitis (mez-un-TER-ik lim-fad-uh-NIE-tis).Mesenteric lymphadenitis, which is also called mesenteric adenitis, usually results from an intestinal infection. It mainly affects children and teens. This painful condition can mimic the warning signs of appendicitis. Unlike appendicitis, mesenteric lymphadenitis is seldom serious and usually clears up on its own

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Microcephaly (my-kroh-SEF-uh-lee) is a rare neurological condition in which an infant's head is significantly smaller than the heads of other children of the same age and sex. Sometimes detected at birth, microcephaly usually is the result of the brain developing abnormally in the womb or not growing as it should after birth.Microcephaly can be caused by a variety of genetic and environmental factors. Children with microcephaly often have developmental issues. Generally there's no treatment for microcephaly, but early intervention with supportive therapies, such as speech and occupational therapies, may help enhance your child's development and improve quality of life.

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MC is an inflammatory bowel condition that presents with chronic watery diarrhea but with macroscopically normal colonoscopy findings. Histological evidence of pathology is only seen through biopsies of the colonic mucosa. This is a fairly recent disease entity that was first described in the 1970s; hence, information on incidences may be underreported. Epidemiological analyses of endoscopic biopsies performed for diarrhea in North America found an incidence of 8.6 per 100,000 from 1985 to 2001.1 However, more recent studies based on the same population from 2002 to 2010 showed that incidences of MC more than doubled over that last decade with rates of 21.0 cases per 100,000 person-years.2 This probably reflects increasing awareness of the disease among both endoscopists and pathologists, leading to higher rates of detection.

Collagenous colitis (CC) and lymphocytic colitis (LC) are two subtypes of MC that have similar presentations. Histologically, however, they have distinct characteristics. It is still a controversy whether CC and LC are just really one disease under MC, or if they should be considered as two distinct diseases that share some features. A review of 226 studies on CC and LC found little to no differences in epidemiology, clinical presentation, risk factors, and response to treatment.

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Dumping syndrome is a condition that can develop after surgery to remove all or part of your stomach or after surgery to bypass your stomach to help you lose weight. Also called rapid gastric emptying, dumping syndrome occurs when food, especially sugar, moves from your stomach into your small bowel too quickly.


Most people with dumping syndrome develop signs and symptoms, such as abdominal cramps and diarrhea, 10 to 30 minutes after eating. Other people have symptoms one to three hours after eating, and still others have both early and late symptoms.


Generally, you can help prevent dumping syndrome by changing your diet after surgery. Changes might include eating smaller meals and limiting high-sugar foods. In more-serious cases of dumping syndrome, you may need medications or surgery.

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Mitral valve prolapse (MVP) occurs when the leaflets of the mitral valve bulge (prolapse) into the heart's left upper chamber (left atrium) like a parachute during the heart's contraction.Mitral (MY-trul) valve prolapse sometimes leads to blood leaking backward into the left atrium, a condition called mitral valve regurgitation.in most people, mitral valve prolapse isn't life-threatening and doesn't require treatment or changes in lifestyle. Some people with mitral valve prolapse, however, require treatment.

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  • A molar pregnancy is the result of a genetic error during the fertilization process that leads to a growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, and the growth of this material is rapid compared to normal fetal growth. It has the appearance of a large and random collection of grape-like cell clusters. There are two types of molar pregnancies, “complete,” and “partial.”
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Indigestion (dyspepsia) is a functional disease in which the gastrointestinal (GI) organs, primarily the stomach and first part of the small intestine (and occasionally the esophagus), function abnormally. It is a chronic disease in which the symptoms fluctuate in frequency and intensity usually over many months or years. It may occur every day or intermittently for days or weeks at a time followed by days or weeks of relief (a pattern referred to as periodicity).

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Morphea (mor-FEE-uh) is a rare skin condition that causes painless, discolored patches on your skin.Typically, the skin changes appear on the abdomen, chest or back. But they might also appear on your face, arms or legs. Morphea tends to affect only the outermost layers of your skin. But some forms of the condition also restrict movement in the joints.Morphea usually subsides on its own over time, though recurrences are common. In the meantime, medications and therapies are available to help treat the skin discoloration and other effects

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Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Plasma cells help you fight infections by making antibodies that recognize and attack germs.Multiple myeloma causes cancer cells to accumulate in the bone marrow, where they crowd out healthy blood cells. Rather than produce helpful antibodies, the cancer cells produce abnormal proteins that can cause complications.Treatment for multiple myeloma isn't always necessary for people who aren't experiencing any signs or symptoms. For people with multiple myeloma who require treatment, a number of treatments are available to help control the disease.

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Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.Signs and symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.There's no cure for multiple sclerosis. However, treatments can help speed recovery from attacks, modify the course of the disease and manage symptoms.

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Difficulty swallowing (dysphagia) means it takes more time and effort to move food or liquid from your mouth to your stomach. Dysphagia may also be associated with pain. In some cases, swallowing may be impossible.

Occasional difficulty swallowing, which may occur when you eat too fast or don't chew your food well enough, usually isn't cause for concern. But persistent dysphagia may indicate a serious medical condition requiring treatment.

Dysphagia can occur at any age, but it's more common in older adults. The causes of swallowing problems vary, and treatment depends on the cause.


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An ectopic pregnancy is an early pregnancy that occurs outside of the normal location (uterine lining) for a developing pregnancy. Most ectopic pregnancies occur in the Fallopian tubes. An ectopic pregnancy cannot progress normally and typically results in the death of the embryo or fetus.

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Ectropion (ek-TROH-pee-on) is a condition in which your eyelid turns outward. This leaves the inner eyelid surface exposed and prone to irritation.

Ectropion is more common in older adults, and it generally affects only the lower eyelid. In severe ectropion, the entire length of the eyelid is turned out. In less severe ectropion, only one segment of the eyelid sags away from the eye.

Artificial tears and lubricating ointments can help relieve symptoms of ectropion. But usually surgery is needed to fully correct the condition.

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Myelodysplastic syndromes are a group of disorders caused by poorly formed blood cells or ones that don't work properly. Myelodysplastic syndromes result from something amiss in the spongy material inside your bones where blood cells are made (bone marrow).Treatment for myelodysplastic syndromes usually focuses on reducing or preventing complications of the disease and its treatments. In some cases, treatment might involve chemotherapy or a bone marrow transplant.

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Myofascial pain syndrome (MPS) refers to pain and presumed inflammation in the body's soft tissues or muscles. Myofascial pain is a chronic, painful condition that affects the fascia (connective tissue that covers the muscles). Myofascial pain syndrome might involve either a single muscle or a muscle group. In some cases, the area where a person experiences the pain might not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain.

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Nasal polyps are soft, painless, noncancerous growths on the lining of your nasal passages or sinuses. They hang down like teardrops or grapes. They result from chronic inflammation due to asthma, recurring infection, allergies, drug sensitivity or certain immune disorders.Small nasal polyps may not cause symptoms. Larger growths or groups of nasal polyps can block your nasal passages or lead to breathing problems, a lost sense of smell and frequent infections.Nasal polyps can affect anyone, but they're more common in adults. Medications can often shrink or eliminate nasal polyps, but surgery is sometimes needed to remove them. Even after successful treatment, nasal polyps often return.

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Nasopharyngeal (nay-zoh-fuh-RIN-jee-ul) carcinoma is cancer that occurs in the nasopharynx, which is located behind your nose and above the back of your throat.Nasopharyngeal carcinoma is rare in the United States. In other parts of the world — specifically Southeast Asia — nasopharyngeal carcinoma occurs much more frequently.Nasopharyngeal carcinoma is difficult to detect early. That's probably because the nasopharynx isn't easy to examine and symptoms of nasopharyngeal carcinoma mimic those of other, more-common conditions.Treatment for nasopharyngeal carcinoma usually involves radiation therapy, chemotherapy or a combination of the two. You can work with your doctor to determine the exact approach depending on your particular situation

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Nephrotic syndrome is a kidney disorder that causes your body to excrete too much protein in your urine.Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood. Nephrotic syndrome causes swelling (edema), particularly in your feet and ankles, and increases the risk of other health problems.Treatment for nephrotic syndrome includes treating the underlying condition that's causing it and taking medications. Nephrotic syndrome can increase your risk of infections and blood clots. Your doctor may recommend medications and dietary changes to prevent these and other complications of nephrotic syndrome.

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Encephalitis is a rare condition that is most often caused by viruses.

It can also be caused by noninfectious diseases, such as systemic lupus erythematosus and Behçet's disease.

The leading cause of severe encephalitis is the herpes simplex virus.

Other causes include enterovirus infections or mosquito-borne viruses.

The very young and the elderly are more likely to have more severe encephalitis.

Exposure to viruses can occur through breathing in respiratory droplets from infected people, certain insect bites, and direct skin contact.


Meningitis is inflammation of the membranes (meninges) that surround the brain and spinal cord.

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Encopresis (en-ko-PREE-sis), sometimes called fecal incontinence or soiling, is the repeated passing of stool (usually involuntarily) into clothing. Typically it happens when impacted stool collects in the colon and rectum: the colon becomes too full and liquid stool leaks around the retained stool, staining underwear. Eventually, stool retention can cause swelling (distention) of the bowels and loss of control over bowel movements.


Encopresis usually occurs after age 4, when the child has already learned to use a toilet. In most cases, soiling is a symptom of chronic constipation. Far less frequently it occurs without constipation and may be the result of emotional issues.


Encopresis can be frustrating for parents — and embarrassing for the child. However, with patience and positive reinforcement, treatment for encopresis is usually successful

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Nicotine dependence ― also called tobacco dependence ― is an addiction to tobacco products caused by the drug nicotine. Nicotine dependence means you can't stop using the substance, even though it's causing you harm.Nicotine produces physical and mood-altering effects in your brain that are temporarily pleasing. These effects make you want to use tobacco and lead to dependence. At the same time, stopping tobacco use causes withdrawal symptoms, including irritability and anxiety.While it's the nicotine in tobacco that causes nicotine dependence, the toxic effects of tobacco result from other substances in tobacco. Smokers have much higher rates of heart disease, stroke and cancer than nonsmokers do.Regardless of how long you've smoked, stopping smoking can improve your health. Many effective treatments for nicotine dependence are available to help you manage withdrawal and stop smoking for good. Ask your doctor for hel

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Niemann-Pick is a rare, inherited disease that affects the body's ability to metabolize fat (cholesterol and lipids) within cells. These cells malfunction and, over time, die. Niemann-Pick disease can affect the brain, nerves, liver, spleen, bone marrow and, in severe cases, lungs.People with this condition experience symptoms related to progressive loss of function of nerves, the brain and other organs.Niemann-Pick can occur at any age but mainly affects children. The disease has no known cure and is sometimes fatal. Treatment is focused on helping people live with their symptoms.

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Entropion (en-TROH-pee-on) is a condition in which your eyelid turns inward so that your eyelashes and skin rub against the eye surface. This causes irritation and discomfort.


When you have entropion, your eyelid may be turned in all the time or only when you blink hard or squeeze your eyelids shut. Entropion is more common in older adults, and it generally affects only the lower eyelid.


Artificial tears and lubricating ointments can help relieve symptoms of entropion. But usually surgery is needed to fully correct the condition. Left untreated, entropion can cause damage to the transparent covering in the front part of your eye (cornea), eye infections and vision loss.

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Nonulcer stomach pain is a term for recurring signs and symptoms of indigestion that have no obvious cause. Nonulcer stomach pain is also called functional dyspepsia (dis-PEP-see-uh) or nonulcer dyspepsia.Nonulcer stomach pain is common and can be long lasting. The condition can cause signs and symptoms that resemble those of an ulcer, such as pain or discomfort in your upper abdomen, often accompanied by bloating, belching and nausea.

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Occupational asthma is asthma that's caused or worsened by breathing in chemical fumes, gases, dust or other substances on the job. Like other types of asthma, occupational asthma can cause chest tightness, wheezing and shortness of breath.When treated early, occupational asthma may be reversible. Long-term exposure to allergy-causing substances can cause worsening symptoms and lifelong asthma.Treatment for occupational asthma is similar to treatment for other types of asthma, and it generally includes taking medications to reduce symptoms. But the only sure way to eliminate your symptoms and prevent lung damage due to occupational asthma is to avoid whatever's triggering it.

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Optic neuritis is an inflammation that damages the optic nerve, a bundle of nerve fibers that transmits visual information from your eye to your brain. Pain and temporary vision loss in one eye are common symptoms of optic neuritis.

Optic neuritis is linked to multiple sclerosis (MS), a disease that causes inflammation and damage to nerves in your brain and spinal cord. Signs and symptoms of optic neuritis can be the first indication of multiple sclerosis, or they can occur later in the course of MS. Besides MS, optic neuritis can occur with other infections or immune diseases, such as lupus.

Most people who have a single episode of optic neuritis eventually recover their vision. Treatment with steroid medications may speed up vision recovery after optic neuritis.

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In eosinophilic esophagitis (e-o-sin-o-FILL-ik uh-sof-uh-JIE-tis), a type of white blood cell (eosinophil) builds up in the lining of the tube that connects your mouth to your stomach (esophagus). This buildup, which is a reaction to foods, allergens or acid reflux, can inflame or injure the esophageal tissue. Damaged esophageal tissue can lead to difficulty swallowing or cause food to get stuck when you swallow.


Eosinophilic esophagitis is a chronic immune system disease. It has been identified only in the past two decades, but is now considered a major cause of digestive system (gastrointestinal) illness. Research is ongoing and will likely lead to revisions in the diagnosis and treatment of eosinophilic esophagitis.

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If you learn that you or your child has a type of spine and brain cancer called an ependymoma, there's a lot to take in. You'll have lots of questions about how to treat the disease and manage the swirl of emotions you may feel.


Depending on where the cancer is, your doctor may recommend surgery, chemotherapy, or radiation. But make sure you take care of your mental health, too. Turn to family, friends, and support groups to get the emotional backing you need.

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Epidermoid (ep-ih-DUR-moid) cysts are noncancerous small bumps beneath the skin. They can appear anywhere on the skin, but are most common on the face, neck and trunk.


Epidermoid cysts are slow growing and often painless, so they rarely cause problems or need treatment. You might choose to have a cyst removed by a doctor if its appearance bothers you or if it's painful, ruptured or infected.


Many people refer to epidermoid cysts as sebaceous cysts, but they're different. True sebaceous cysts are less common. They arise from the glands that secrete oily matter that lubricates hair and skin (sebaceous glands).

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Epidermolysis bullosa (ep-ih-dur-MOL-uh-sis buhl-LOE-sah) is a group of rare diseases that cause fragile, blistering skin. The blisters may appear in response to minor injury, even from heat, rubbing, scratching or adhesive tape. In severe cases, the blisters may occur inside the body, such as the lining of the mouth or the stomach.


Most types of epidermolysis bullosa are inherited. The condition usually shows up in infancy or early childhood. Some people don't develop signs and symptoms until adolescence or early adulthood.


Epidermolysis bullosa has no cure, though mild forms may improve with age. Treatment focuses on caring for blisters and preventing new ones.

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Epididymitis (ep-ih-did-uh-MY-tis) is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Males of any age can get epididymitis.


Epididymitis is most often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia. Sometimes, a testicle also becomes inflamed — a condition called epididymo-orchitis.

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Epiglottitis is a potentially life-threatening condition that occurs when the epiglottis — a small cartilage "lid" that covers your windpipe — swells, blocking the flow of air into your lungs.


A number of factors can cause the epiglottis to swell — burns from hot liquids, direct injury to your throat and various infections. The most common cause of epiglottitis in children in the past was infection with Haemophilus influenzae type b (Hib), the same bacterium that causes pneumonia, meningitis and infections in the bloodstream. Epiglottitis can occur at any age.


Routine Hib vaccination for infants has made epiglottitis rare, but epiglottitis remains a concern. If you suspect that you or someone in your family has epiglottitis, seek emergency help immediately. Prompt treatment can prevent life-threatening complications.

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Esophageal cancer is cancer that occurs in the esophagus — a long, hollow tube that runs from your throat to your stomach. Your esophagus helps move the food you swallow from the back of your throat to your stomach to be digested.


Esophageal cancer usually begins in the cells that line the inside of the esophagus. Esophageal cancer can occur anywhere along the esophagus. More men than women get esophageal cancer.


Esophageal cancer is the sixth most common cause of cancer deaths worldwide. Incidence rates vary within different geographic locations. In some regions, higher rates of esophageal cancer cases may be attributed to tobacco and alcohol use or particular nutritional habits and obesity.


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Normally, contractions of the esophagus camera.gif (the tube that connects the mouth and the stomach) move food from the mouth to the stomach with a regular, coordinated rhythm.


Esophageal spasm means that contractions of the esophagus are irregular, uncoordinated, and sometimes powerful. This condition may be called diffuse esophageal spasm, or DES. These spasms can prevent food from reaching the stomach. When this happens, the food gets stuck in the esophagus.


Sometimes the squeezing moves down the esophagus in a coordinated way, but it is very strong. This can be called nutcracker esophagus. These contractions move food through the esophagus but can cause severe pain.

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Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases.


Esophageal varices develop when normal blood flow to the liver is blocked by a clot or scar tissue in the liver. To go around the blockages, blood flows into smaller blood vessels that aren't designed to carry large volumes of blood. The vessels can leak blood or even rupture, causing life-threatening bleeding.


A number of drugs and medical procedures can help prevent and stop bleeding from esophageal varices.

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Eustachian tubes are small tubes that run between your middle ears and the upper throat. They are responsible for equalizing ear pressure and draining fluid from the middle ear, the part of the ear behind the eardrum. The eustachian tubes are usually closed except for when you chew, swallow, or yawn.


These passageways are small in size and can get plugged for a variety of reasons. Blocked eustachian tubes can cause pain, hearing difficulties, and a feeling of fullness in the ears. Such a phenomenon is referred to as eustachian tube dysfunction (ETD).


ETD is a relatively common condition. Depending on the cause, it may resolve on its own or through simple at-home treatment measures. Severe or recurring cases may require a visit to the doctor.

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Fibromuscular dysplasia is a condition that causes narrowing (stenosis) and enlargement (aneurysm) of the medium-sized arteries in your body. Reduced blood flow from narrowed arteries to the organs can affect the function of the organs.


Fibromuscular dysplasia appears most commonly in the arteries leading to the kidneys. Fibromuscular dysplasia can also affect the arteries leading to your brain, heart, abdomen, arms and legs.


Fibromuscular dysplasia can cause a number of complications, such as high blood pressure or tears of the artery (arterial dissection), if left untreated. Arterial dissection, or spontaneous coronary artery dissection (SCAD), can limit blood flow to the organ supplied by the injured artery.

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Fibrous dysplasia is an uncommon bone disorder in which scar-like (fibrous) tissue develops in place of normal bone. This irregular tissue can weaken the affected bone and cause it to deform or fracture.


In most cases, fibrous dysplasia occurs at a single site in one bone, but can occur at multiple sites in multiple bones. Single bone involvement usually occurs in adolescents and young adults. People who have more than one affected bone typically develop symptoms before the age of 10.


Although fibrous dysplasia is a genetic disorder, it's caused by a gene mutation that's not passed from parent to child. There's no cure for the disorder. Treatment, which may include surgery, focuses on relieving pain and repairing or stabilizing bones.

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Foot drop, sometimes called "drop foot," is the inability to lift the front part of the foot. This causes the toes to drag along the ground while walking.


To avoid dragging the toes, people with foot drop may lift their knee higher than normal. Or they may swing their leg in a wide arc.


Foot drop can happen to one foot or both feet at the same time. It can strike at any age.


In general, foot drop stems from weakness or paralysis of the muscles that lift the foot. It can have many different causes. Treatments for foot drop vary according to the cause.



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Gastroparesis means weakness of the muscles of the stomach. Gastroparesis results in poor grinding of food in the stomach into small particles and slow emptying of food from the stomach into the small intestine.


The stomach is a hollow organ composed primarily of muscle. Solid food that has been swallowed is stored in the stomach while it is ground into tiny pieces by the constant churning generated by rhythmic contractions of the stomach's muscles. Smaller particles are digested better in the small intestine than larger particles, and only food that has been ground into small particles is emptied from the stomach and well digested. Liquid food does not require grinding.


The ground solid and liquid food is emptied from the stomach into the small intestine slowly in a metered fashion. The metering process allows the emptied food to be well-mixed with the digestive juices of the small intestine, pancreas, and liver (bile) and to be absorbed well from the intestine. The metering process by which solid and liquid foods are emptied from the stomach is a result of a combination of relaxation of the muscle in parts of the stomach designed to accommodate (store) food, and the pressure generated by the muscle in other parts of the stomach that pushes the food into the small intestine. (Thus, the stomach can store and empty food at the same time.) The metering also is controlled by the opening and closing of the pylorus, the muscular opening of the stomach into the small intestine.


When the contractions of the stomach's muscles are weakened, food is not thoroughly ground and does not empty into the intestine normally. Since the muscular actions whereby solid food and liquid food are emptied from the stomach are slightly different, the emptying of solids and liquids follows different time courses, and there may be slow emptying of solid food (most common), solid and liquid food (less common), or liquid food alone (least common).

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Genital herpes is a common sexually transmitted infection caused by the herpes simplex virus (HSV). Sexual contact is the primary way that the virus spreads. After the initial infection, the virus lies dormant in your body and can reactivate several times a year.


Genital herpes can cause pain, itching and sores in your genital area. But you may have no signs or symptoms of genital herpes. If infected, you can be contagious even if you have no visible sores.


There's no cure for genital herpes, but medications can ease symptoms and reduce the risk of infecting others. Condoms also can help prevent the spread of a genital herpes infection.

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Geographic tongue is the name of a condition that gets its name from its map-like appearance on the upper surface and sides of the tongue. It may occur in other areas of your mouth, as well.


You'll be relieved to know that geographic tongue is a harmless, benign condition that isn't linked to any infection or cancer. Two other names for geographic tongue are benign migratory glossitis and erythema migrans.


Affecting about 1% to 3% of people, geographic tongue can show up at any age. However, it tends to affect middle-aged or older adults more often. It appears to be more common in women than in men.

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Lichen planus is an itchy skin rash that is caused by an immune response. It can occur anywhere on your skin.oral lichen planusIn cases of oral lichen planus, the mucous membranes inside your mouth are the only area affected. Oral lichen planus presents symptoms different from other cases of lichen planus. Instead of a rash, people may experience swollen tissues, white patches, and open sores.Oral lichen planus isn’t contagious, and it can’t be spread to another person.

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Pancreatic cysts are collections (pools) of fluid that can form within the head, body, and tail of the pancreas. Some pancreatic cysts are true cysts (non-inflammatory cysts), that is, they are lined by a special layer of cells that are responsible for secreting fluid into the cysts. Other cysts are pseudocysts (inflammatory cysts) and do not contain specialized lining cells. Often these pseudocysts contain pancreatic digestive juices because they are connected to the pancreatic ducts. Pancreatic cysts can range in size from several millimeters to several centimeters. Many pancreatic cysts are small and benign and produce no symptoms, but some cysts become large and cause symptoms, and others are cancerous or precancerous. (Precancerous cysts are benign cysts that have the potential to become cancerous.)Different types of cysts contain different types of fluids. For example, pseudocysts that form after an attack of acute pancreatitis contain digestive enzymes such as amylase in high concentrations. Mucinous cysts contain mucus (a proteinaceous liquid) produced by the mucinous cells that form the inside lining of the cyst.


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A paraganglioma is a rare tumor that begins in certain nerve cells that are dispersed throughout the body. This tumor can affect people of any age but most often shows up between the ages of 30 and 50. The tumor is often slow growing and noncancerous (benign). But it can invade nearby parts of the body, become cancerous (malignant) and spread distantly (metastasize).With about half of paraganglioma tumors, the abnormal cells produce hormones known as catecholamines or adrenaline, which is the fight-or-flight hormone. This may induce high blood pressure, a rapid heartbeat, flushed skin, sweating, headache and tremors.Surgery to remove the tumor is usually the first treatment choice for a paraganglioma, if feasible. If left untreated, a paraganglioma can result in severe or life-threatening damage and progress to the point where surgical treatment isn't an option. In people with cancerous and distantly spread (metastatic) paraganglioma, medicine and other treatments can help control the disease and symptoms and even extend survival.


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A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age.


Older people are at a higher risk of hip fracture because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.


A hip fracture almost always requires surgical repair or replacement, followed by months of physical therapy. Taking steps to maintain bone density and avoid falls can help prevent hip fracture.

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Parkinson's disease is a progressive disorder of the nervous system that affects movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement.

In the early stages of Parkinson's disease, your face may show little or no expression, or your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time.

Although Parkinson's disease can't be cured, medications may markedly improve your symptoms. In occasional cases, your doctor may suggest surgery to regulate certain regions of your brain and improve your symptoms.

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Your hip is the joint where your thigh bone meets your pelvis. It is called a ball-and-socket joint, because the ball-like top of your thigh bone fits into a cup-like area within your pelvis, much like a baseball fits into a glove.


Hip


Normally, the ball glides smoothly within the socket, but a problem with the ball or socket rim can interfere with smooth motion. This problem can cause hip impingement or femoro acetabular impingement (FAI). It is believed to be a major cause of early osteoarthritis of the hip, particularly in those under age 40.

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Histoplasmosis is a type of lung infection. It is caused by inhaling Histoplasma capsulatum fungal spores. These spores are found in soil and in the droppings of bats and birds. This fungus mainly grows in the central, southeastern, and mid-Atlantic states.


Most cases of histoplasmosis don’t require treatment. However, people with weaker immune systems may experience serious problems. The disease may progress and spread to other areas of the body. Skin lesions have been reported in 10 to 15 percent of cases of histoplasmosis that has spread throughout the body.

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Both benign (non-cancerous) and cancerous salivary gland tumors may develop anywhere in the salivary glands, but the majority of them are parotid tumors. In fact, as many as 80% of salivary gland tumors begin in the parotid glands. 15% occur in the submandibular glands, and 5% form in the sublingual and minor glands. While most salivary gland tumors occur in the parotid glands, only 20% of them are cancerous. With this in mind, we want to stress that it is important that you come see us if you are find a mass in your parotid gland so we can perform a biopsy. This will allow us to determine whether a growth is cancerous or not, and in turn come up with a treatment plan that may require parotid surgery on the tumor.

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HPV infection commonly causes skin or mucous membrane growths (warts). Certain types of HPV infection cause cervical cancers. More than 100 varieties of human papillomavirus (HPV) exist.


Different types of HPV infection cause warts on different parts of your body. For example, some types of HPV infection cause plantar warts on the feet, while others cause warts that mostly appear on the face or neck.


Most HPV infections don't lead to cancer. But some types of genital HPV can cause cancer of the lower part of the uterus that connects to the vagina (cervix). Other types of cancers, including cancers of the anus, penis, vagina, vulva and back of the throat (oropharyngeal), have been linked to HPV infection.


Vaccines can help protect against the strains of genital HPV most likely to cause genital warts or cervical cancer.

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Parvovirus infection is a common and highly contagious childhood ailment — sometimes called slapped-cheek disease because of the distinctive face rash that develops. Parvovirus infection has also been known as fifth disease because, historically, it was one of five common childhood illnesses characterized by a rash.In most children, parvovirus infection is mild and requires little treatment. However, in some adults, the infection can be serious. Parvovirus infection in some pregnant women can lead to serious health problems for the fetus. Parvovirus infection is also more serious for people with some kinds of anemia or who have a compromised immune system.

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Patellar tendinitis is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run and jump.Patellar tendinitis, also known as jumper's knee, is most common in athletes whose sports involve frequent jumping — such as basketball and volleyball. However, even people who don't participate in jumping sports can get patellar tendinitis.For most people, treatment of patellar tendinitis begins with physical therapy to stretch and strengthen the muscles around the knee

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The term hydrocephalus is derived from the Greek words "hydro" meaning water and "cephalus" meaning head. As the name implies, it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Although hydrocephalus was once known as "water on the brain," the "water" is actually cerebrospinal fluid (CSF)--a clear fluid that surrounds the brain and spinal cord. The excessive accumulation of CSF results in an abnormal widening of spaces in the brain called ventricles. This widening creates potentially harmful pressure on the tissues of the brain.


The ventricular system is made up of four ventricles connected by narrow passages.. Normally, CSF flows through the ventricles, exits into cisterns (closed spaces that serve as reservoirs) at the base of the brain, bathes the surfaces of the brain and spinal cord, and then reabsorbs into the bloodstream.


CSF has three important life-sustaining functions: 1) to keep the brain tissue buoyant, acting as a cushion or "shock absorber"; 2) to act as the vehicle for delivering nutrients to the brain and removing waste; and 3) to flow between the cranium and spine and compensate for changes in intracranial blood volume (the amount of blood within the brain).


The balance between production and absorption of CSF is critically important. Because CSF is made continuously, medical conditions that block its normal flow or absorption will result in an over-accumulation of CSF. The resulting pressure of the fluid against brain tissue is what causes hydrocephalus.

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A foramen ovale is a hole in the heart. The small hole naturally exists in babies who are still in the womb for fetal circulation. It should close soon after birth. If it doesn’t close, the condition is called patent foramen ovale (PFO).PFOs are common. They occur in roughly one out of every four people. If you have no other heart conditions or complications, treatment for PFO is unnecessary.While a fetus develops in the womb, a small opening exists between the two upper chambers of the heart called the atria. This opening is called the foramen ovale. The purpose of the foramen ovale is to help circulate blood through the heart. A fetus doesn’t use their own lungs to oxygenate their blood. They rely on their mother’s circulation to provide oxygen to their blood from the placenta. The foramen ovale helps blood circulate more quickly in the absence of lung function.When your baby is born and their lungs begin to work, the pressure inside their heart usually causes the foramen ovale to close. Sometimes it may not happen for a year or two. In some people, the closure may never happen at all, resulting in PFO.

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One of the most common causes of high calcium levels (hypercalcemia), is an overproduction of parathyroid hormone, or hyperparathyroidism.


Hyperparathyroidism tends to be more common in women over 50.

It can be the result of all four parathyroid glands producing too much PTH (parathyroid hyperplasia), or one gland specifically producing an excessive amount of hormone (usually the result of a parathyroid adenoma, or benign tumor).

Hypercalcemia can occur due to other medical conditions. These conditions can vary in severity and chronicity, and may be life-threatening. Malignancy is a common cause of elevated blood calcium. Up to 20% of individuals with cancer will develop hypercalcemia at some point in their disease.

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Hypereosinophilic syndrome (HES) refers to a rare group of conditions that are associated with persistent eosinophilia with evidence of organ involvement. Signs and symptoms vary significantly based on which parts of the body are affected. Although any organ system can be involved in HES, the heart, central nervous system, skin, and respiratory tract are the most commonly affected. The condition was originally thought to be "idiopathic" or of unknown cause. However, recent advances in diagnostic testing have allowed a cause to be identified in approximately a quarter of cases. Management varies based on the severity of the condition and whether or not an underlying cause has been identified but generally includes imatinib or corticosteroids as an initial treatment.

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Many schools have declared that they are “nut-free,” meaning that the onetime staple of kids’ lunchboxes — a peanut butter and jelly sandwich — is nowhere to be found on school grounds these days. That’s because peanuts can cause a life-threatening reaction in some people. Peanuts are one of the food allergens most commonly associated with anaphylaxis, a sudden and potentially deadly condition that requires immediate attention and treatment.In recent years, awareness about peanut allergy in children has risen, as has the number of peanut allergy cases reported. In May 2010, a study noted that the rate of peanut allergies in children, as reported in a telephone survey, had more than tripled between 1997 and 2008.There are several misconceptions about peanut allergies. A peanut is a legume (belonging to the same family as soybeans, peas and lentils), not a tree nut. And while it was previously believed that an allergy to peanuts was lifelong, research by the National Institutes of Health shows that about 20 percent of individuals with a peanut allergy eventually outgrow it.


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High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication.


It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart.

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Pectus carinatum, sometimes called pigeon chest, is a non-life-threatening condition. It’s marked by an abnormally outward protruding breastbone caused by rapid cartilage growth forcing the chest cavity outward. Occasionally, symptoms are present from birth or early childhood, but it’s most commonly diagnosed around 11 or 12 years of age.For most children, pectus carinatum is an aesthetic issue only. This condition frequently results in an asymmetrical chest. In more severe cases, symptoms may also include difficulty breathing during physical activities, recurring respiratory infections, and asthma.While its cause is unknown, it appears to be more common in boys, and there seems to be a hereditary component. If needed, treatment for pectus carinatum usually includes wearing a brace for children whose bones are still developing. But it can also include surgery for severe cases.

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Pectus excavatum is a condition in which a person's breastbone is sunken into his or her chest. In severe cases, pectus excavatum can look as if the center of the chest has been scooped out, leaving a deep dent.While the sunken breastbone is often noticeable shortly after birth, the severity of pectus excavatum typically worsens during the adolescent growth spurt.Also called funnel chest, pectus excavatum is more common in boys than in girls. Severe cases of pectus excavatum can eventually interfere with the function of the heart and lungs. But even mild cases of pectus excavatum can make children feel self-conscious about their appearance. Surgery can correct the deformity.

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Pediatric brain tumors are masses or growths of abnormal cells that occur in a child's brain or the tissue and structures that are near it. Many different types of pediatric brain tumors exist — some are noncancerous (benign) and some are cancerous (malignant).Treatment and chance of recovery (prognosis) depend on the type of tumor, its location within the brain, whether it has spread, and your child's age and general health. Because new treatments and technologies are continually being developed, several options may be available at different points in treatment.Treatment for brain tumors in children is typically quite different from treatment for adult brain tumors, so it's very important to enlist the expertise and experience of pediatric specialists in neurology and cancer.

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Pemphigus is a group of rare skin disorders that cause blisters and sores on the skin or mucous membranes, such as in the mouth or on the genitals.The two main types are pemphigus vulgaris and pemphigus foliaceus. Pemphigus vulgaris usually starts in your mouth. It can be painful. Pemphigus foliaceus affects the skin and tends to be more itchy than painful. Pemphigus can occur at any age, but it's most often seen in people who are middle-aged or older.Pemphigus is not to be confused with bullous pemphigoid, another blistering skin condition. Usually a chronic condition, pemphigus is best controlled by early diagnosis and treatment. Treatment may include medications and therapies similar to those used for severe burns

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Penicillin allergy is an abnormal reaction of your immune system to the antibiotic drug penicillin. Penicillin is prescribed for treating various bacterial infections.


Common signs and symptoms of penicillin allergy include hives, rash and itching. Severe reactions include anaphylaxis, a life-threatening condition that affects multiple body systems.


Research has shown that penicillin allergies may be over-reported — a problem that can result in the use of less appropriate and more expensive antibiotic treatments. Therefore, an accurate diagnosis is needed when penicillin allergy is suspected to ensure the best treatment options in the future.


Other antibiotics, particularly those with chemical properties similar to penicillin, can also result in allergic reactions.

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An “ulcer” is an open sore. The word “peptic” means that the cause of the problem is due to acid. Most of the time when a gastroenterologist is referring to an “ulcer” the doctor means a peptic ulcer.The two most common types of peptic ulcer are called “gastric ulcers” and “duodenal ulcers”. These names refer to the location where the ulcer is found. Gastric ulcers are located in the stomach (see Figure 1). Duodenal ulcers are found at the beginning of the small intestine (also called the small bowel) known as the duodenum. A person may have both gastric and duodenal ulcers at the same time.

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Pericardial effusion (per-e-KAHR-dee-ul uh-FU-zhun) is the accumulation of too much fluid in the double-layered, sac-like structure around the heart (pericardium).The space between the layers normally contains a thin layer of fluid. But if the pericardium is diseased or injured, the resulting inflammation can lead to excess fluid. Fluid can also build up around the heart without inflammation, such as from bleeding after a chest trauma.Pericardial effusion puts pressure on the heart, affecting the heart's function. If untreated, it can lead to heart failure or death

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Pericarditis is swelling and irritation of the pericardium, the thin saclike membrane surrounding your heart. Pericarditis often causes chest pain and sometimes other symptoms. The sharp chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against each other.Pericarditis usually begins suddenly but doesn't last long (acute). When symptoms develop more gradually or persist, pericarditis is considered chronic.Most cases are mild and usually improve on their own. Treatment for more-severe cases may include medications and, rarely, surgery. Early diagnosis and treatment may help to reduce the risk of long-term complications from pericarditis.

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Perimenopause means "around menopause" and refers to the time during which your body makes the natural transition to menopause, marking the end of the reproductive years. Perimenopause is also called the menopausal transition.Women start perimenopause at different ages. You may notice signs of progression toward menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.

The level of estrogen — the main female hormone — in your body rises and falls unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you may begin having menstrual cycles in which your ovaries don't release an egg (ovulate). You may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. Treatments are available to help ease these symptoms.Once you've gone through 12 consecutive months without a menstrual period, you've officially reached menopause, and the perimenopause period is over.

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Peripheral artery disease (also called peripheral arterial disease) is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs.When you develop peripheral artery disease (PAD), your extremities — usually your legs — don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking (claudication).Peripheral artery disease is also likely to be a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis). This condition may be reducing blood flow to your heart and brain, as well as your legs.You often can successfully treat peripheral artery disease by quitting tobacco, exercising and eating a healthy diet

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njuries to peripheral nerves are extremely common in many types of upper limb trauma. Injury to peripheral nerves can cause extreme dysfunction in the hand for the patient disrupting their professional and leisure activities. It is therefore vital that adequate treatment is available to repair peripheral nerves to prevent permanent financial loss for the patient as well as the healthcare economy. Galen was the first to describe the concept of the nerve but it was Paulus Aegineta in the 7th century who documented the first nerve repair and wound closure as a military surgeon. Since this time immense research has taken place to understand nerve pathology and physiology. Currently surgical repair involves either reconstruction with direct end-to-end anastomosis or by the insertion of nerve grafts. Despite the long history and major microsurgical research and improvement peripheral nerve repair remains a challenge to surgeons and still has suboptimal outcomes. This review aims to discuss the pathophysiology of nerve injuries including the limitations of surgical repair at a biological level. We will subsequently describe the current techniques, problems and advances in the surgical management of nerve injuries.


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Peripheral nerve tumors are growths in or near the strands of tissue (nerves) that transmit signals from your brain to the rest of your body. These nerves control your muscles so that you can walk, blink, swallow, pick things up and do other activities.Peripheral nerve tumors can occur anywhere in the body. Most of them aren't cancerous (malignant), but they can lead to pain, nerve damage and loss of function in the affected area.Treatment of peripheral nerve tumors usually involves surgery to remove the tumor. Sometimes the tumor can't be removed without damaging nearby healthy tissue and nerves. In these cases, other treatments may be recommended.Several types of peripheral nerve tumors occur. These tumors affect nerves by growing within them (intraneural tumors) or by pressing against them (extraneural tumors).

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Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body.

Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus.

People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. In many cases, symptoms improve, especially if caused by a treatable condition. Medications can reduce the pain of peripheral neuropathy.


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Peritonitis is inflammation of the peritoneum, the thin layer of tissue covering the inside of your abdomen and most of its organs. The inflammation is usually the result of a fungal or bacterial infection. This can be caused by an abdominal injury, an underlying medical condition, or a treatment device, such as a dialysis catheter or feeding tube.

Peritonitis is a serious condition that needs immediate medical attention. Prompt intravenous (IV) antibiotics are needed to treat the infection. Surgery is sometimes necessary to remove infected tissue. The infection can spread and become life-threatening if it isn’t treated promptly

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Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual’s personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.1There are 10 specific types of personality disorders (such as borderline personality disorder). Common to all personality disorders is a long-term pattern of behavior and inner experience that differs significantly from what is expected. The pattern of experience and behavior begins by late adolescence or early adulthood, and causes distress or problems in functioning. Without treatment, the behavior and experience is inflexible and usually long-lasting. The pattern is seen in at least two of these areas:

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If your nose runs and your eyes water or you start sneezing and wheezing after petting or playing with a cat, you likely have a cat allergy. A cat allergy can contribute to constant allergy symptoms, as exposure can occur at work, school, day care or in other indoor environments, even if a cat is not present.

Cats produce multiple allergens (proteins that can cause allergy). These allergens are found on the fur and skin and in saliva. All cats produce allergens; studies have not shown that cats can be hypoallergenic (meaning that they don’t cause allergy). Homes with more than one cat have higher levels of cat allergens. Characteristics such as the length of a cat’s hair, its sex and the amount of time a cat spends indoors are not associated with cat allergen levels.Dust and pollen in a cat’s coat can also cause allergy symptoms. In those cases, the allergy is to the dust or pollen, not to the cat.

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Peyronie's Disease is an inflammatory, benign condition that may cause a curvature, deformity or shortening of the erect penis. This process is produced by scar formation in the fibrous covering of the erectile bodies of the penis. Men may or may not feel tenderness, a lump, or an area of scarring {plaque) in the shaft of the penis. Occasionally, this condition is also associated with pain, and, in some cases, erections and stress on the penis can exacerbate the pain. Many patients with Peyronie's disease suffer psychological trauma, may experience difficulty with sexual intercourse, and may also suffer from erectile dysfunction. Those who suffer from erectile dysfunction, however, may not notice these symptoms. Peyronie's disease occurs more often in men between the ages of 50 and 70, although younger men are not immune. Its' accurate incidence is unknown, but it is not rare. Studies show that about three percent of men over the age of 40 have scar tissue in their penis labeled as Peyronie's disease. However, only a minority of these men have significant enough scarring, curvature, erectile dysfunction, or penile shortening to require medical attention.


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Phenylketonuria (commonly known as PKU) is an inherited disorder that increases the levels of a substance called phenylalanine in the blood. Phenylalanine is a building block of proteins (an amino acid) that is obtained through the diet. It is found in all proteins and in some artificial sweeteners. If PKU is not treated, phenylalanine can build up to harmful levels in the body, causing intellectual disability and other serious health problems.The signs and symptoms of PKU vary from mild to severe. The most severe form of this disorder is known as classic PKU. Infants with classic PKU appear normal until they are a few months old. Without treatment, these children develop permanent intellectual disability. Seizures, delayed development, behavioral problems, and psychiatric disorders are also common. Untreated individuals may have a musty or mouse-like odor as a side effect of excess phenylalanine in the body. Children with classic PKU tend to have lighter skin and hair than unaffected family members and are also likely to have skin disorders such as eczema.


Less severe forms of this condition, sometimes called variant PKU and non-PKU hyperphenylalaninemia, have a smaller risk of brain damage. People with very mild cases may not require treatment with a low-phenylalanine diet.Babies born to mothers who have PKU and uncontrolled phenylalanine levels (women who no longer follow a low-phenylalanine diet) have a significant risk of intellectual disability because they are exposed to very high levels of phenylalanine before birth. These infants may also have a low birth weight and grow more slowly than other children. Other characteristic medical problems include heart defects or other heart problems, an abnormally small head size (microcephaly), and behavioral problems. Women with PKU and uncontrolled phenylalanine levels also have an increased risk of pregnancy loss.


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Hyperhidrosis, or excessive sweating, is a common disorder which produces a lot of unhappiness. An estimated 2%-3% of Americans suffer from excessive sweating of the underarms (axillary hyperhidrosis) or of the palms and soles of the feet (palmoplantar hyperhidrosis). Underarm problems tend to start in late adolescence, while palm and sole sweating often begins earlier, around age 13 (on the average). Untreated, these problems may continue throughout life.


Sweating is embarrassing, it stains clothes, ruins romance, and complicates business and social interactions. Severe cases can have serious practical consequences as well, making it hard for people who suffer from it to hold a pen, grip a car steering wheel, or shake hands.

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Hyperparathyroidism is an excess of parathyroid hormone in the bloodstream due to overactivity of one or more of the body's four parathyroid glands. These glands are about the size of a grain of rice and are located in your neck.


The parathyroid glands produce parathyroid hormone, which helps maintain an appropriate balance of calcium in the bloodstream and in tissues that depend on calcium for proper functioning.


Two types of hyperparathyroidism exist. In primary hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism.


Secondary hyperparathyroidism occurs as a result of another disease that initially causes low levels of calcium in the body and over time, increased parathyroid hormone levels occur.

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Pheochromocytoma (PCC) is the term used for a rare tumor that has grown in the adrenal glands. These tumors are usually benign, meaning they are not cancerous. Most cases involve only one adrenal gland, but it is possible for both to be involved.In rare cases, PCC can be cancerous. These malignant tumors will spread like other cancers and can cause serious complications.The condition causes the adrenal glands to pump out too much adrenaline and noradrenaline. These two hormones help keep the heart rate, blood pressure, and stress response in balance. They are also responsible for the body's "fight or flight" response.When the body contains too much of these compounds at one time, it goes into a reactive state as if it were in a constant state of high stress.PCC will always form on the inside of the adrenal glands. They are often grouped together with similar tumors called paragangliomas, which are tumors that grow on the outside of the glands. The tumors are different, but both alter the production of the adrenal glands


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Hyponatremia is a condition that occurs when the level of sodium in your blood is abnormally low. Sodium is an electrolyte, and it helps regulate the amount of water that's in and around your cells.


In hyponatremia, one or more factors — ranging from an underlying medical condition to drinking too much water during endurance sports — causes the sodium in your body to become diluted. When this happens, your body's water levels rise, and your cells begin to swell. This swelling can cause many health problems, from mild to life-threatening.


Hyponatremia treatment is aimed at resolving the underlying condition. Depending on the cause of hyponatremia, you may simply need to cut back on how much you drink. In other cases of hyponatremia, you may need intravenous fluids and medications.

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Hypoparathyroidism is an uncommon condition in which your body secretes abnormally low levels of parathyroid hormone (PTH). PTH is key to regulating and maintaining a balance of your body's levels of two minerals — calcium and phosphorus.


The low production of PTH in hypoparathyroidism leads to abnormally low calcium levels in your blood and bones and to an increase of phosphorus in your blood.


Supplements to normalize your calcium and phosphorus levels treat the condition. Depending on the cause of your hypoparathyroidism, you'll likely need to take supplements for life.

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Hypopituitarism is a rare disorder in which your pituitary gland either fails to produce one or more of its hormones or doesn't produce enough of them.


The pituitary gland is a small bean-shaped gland situated at the base of your brain, behind your nose and between your ears. Despite its size, this gland secretes hormones that influence nearly every part of your body.


In hypopituitarism, you have a short supply of one or more of these pituitary hormones. This deficiency can affect any number of your body's routine functions, such as growth, blood pressure and reproduction.


You'll likely need medications for the rest of your life to treat hypopituitarism, but your symptoms can be controlled.


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A pilonidal (pie-low-NIE-dul) cyst is an abnormal pocket in the skin that usually contains hair and skin debris. A pilonidal cyst is almost always located near the tailbone at the top of the cleft of the buttocks.Pilonidal cysts usually occur when hair punctures the skin and then becomes embedded. If a pilonidal cyst becomes infected, the resulting abscess is often extremely painful. The cyst can be drained through a small incision or removed surgically.Pilonidal cysts most commonly occur in young men, and the problem has a tendency to recur. People who sit for prolonged periods of time, such as truck drivers, are at higher risk of developing a pilonidal cyst.

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Hypospadias (hi-poe-SPAY-dee-us) is a birth defect (congenital condition) in which the opening of the urethra is on the underside of the penis instead of at the tip. The urethra is the tube through which urine drains from your bladder and exits your body.


Hypospadias is common and doesn't cause difficulty in caring for your infant. Surgery usually restores the normal appearance of your child's penis. With successful treatment of hypospadias, most males can have normal urination and reproduction.

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Hypothermia is defined as a body temperature (core, or internal body temperature) of less than about 95 F (35 C). Usually, hypothermia occurs when the body's temperature regulation is overwhelmed by a cold environment. However, in the medical and lay literature there are essentially two major classifications, accidental hypothermia and intentional hypothermia.


Accidental hypothermia usually occurs from an exposure to cold that results in lowering the body temperature.


Intentional hypothermia is body temperature lowering induced usually for a medical procedure.


This article will focus on accidental hypothermia. Hypothermia is a medical emergency that, when quickly and appropriately treated, people can recover with little or no consequences.


Body temperature, when discussing hypothermia, is usually termed "core" temperature. This temperature is the temperature measured inside the body. It's a measurement that is most accurately done by a rectal thermometer, a rectal probe thermometer that has a constant temperature readout or by a bladder or esophageal temperature device. Temperatures taken by other methods may not adequately measure core temperature.

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Hypothyroidism, also called underactive thyroid disease, is a common disorder. With hypothyroidism, your thyroid gland does not make enough thyroid hormone.


The thyroid gland is located in the front lower part of your neck. Hormones released by the gland travel through your bloodstream and affect nearly every part of your body, from your heart and brain, to your muscles and skin.


Thyroid


The thyroid controls how your body's cells use energy from food, a process called metabolism. Among other things, your metabolism affects your body’s temperature, your heartbeat, and how well you burn calories. If you don't have enough thyroid hormone, your body processes slow down. That means your body makes less energy, and your metabolism becomes sluggish.

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Most adults have 32 teeth, including 4 wisdom teeth that usually emerge between the ages of 17 and 21.

This final set of molars can play a useful part in the mouth for many people.

However, for others, if they don’t come through properly or don’t emerge at all, they may need to be removed.

Having wisdom teeth out is one of the most common dental procedures in the UK.


Wisdom Teeth


Wisdom teeth present potential problems when they are misaligned as they can position themselves horizontally, be angled toward or away from the second molars or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, and nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris.


In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially break through, or erupt, through the gum.


Teeth that remain partially or completely entrapped within the soft tissue or the jawbone are called impacted. Wisdom teeth that only partially erupt allow an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

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Impetigo (im-puh-TIE-go) is a common and highly contagious skin infection that mainly affects infants and children. Impetigo usually appears as red sores on the face, especially around a child's nose and mouth, and on hands and feet. The sores burst and develop honey-colored crusts.


Treatment with antibiotics is generally recommended to help prevent the spread of impetigo to others. It's important to keep your child home from school or day care until he or she is no longer contagious — usually 24 hours after you begin antibiotic treatment.

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An incompetent cervix, also called a cervical insufficiency, is a condition that occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy.


Before pregnancy, your cervix — the lower part of the uterus that connects to the vagina — is normally closed and rigid. As pregnancy progresses and you prepare to give birth, the cervix gradually softens, decreases in length (effaces) and opens (dilates). If you have an incompetent cervix, your cervix might begin to open too soon — causing you to give birth too early.


An incompetent cervix can be difficult to diagnose and, as a result, treat. If your cervix begins to open early, your health care provider might recommend preventive medication during pregnancy, frequent ultrasounds or a procedure that closes the cervix with strong sutures (cervical cerclage).

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Intussusception (in-tuh-suh-SEP-shun) is the most common abdominal emergency affecting children under 2 years old. It happens when one portion of the bowel slides into the next, much like the pieces of a telescope.


When this "telescoping" happens, the flow of fluids and food through the bowel can become blocked, the intestine can swell and bleed, and the blood supply to the affected part of the intestine can get cut off. Eventually, this can cause part of the bowel to die.


Intussusception happens in 1 to 4 out of every 1,000 infants and is most common in babies 5 to 9 months old, though older children also can have it. Boys get intussusception more often than girls.

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A "pinched nerve" is the name given to the uncomfortable sensation, pain, or numbness caused when increased pressure leads to irritation or damage to a peripheral nerve (A peripheral nerve is one that is outside the brain and spinal cord.). Although this condition is often associated with back pain or a neck injury, almost any nerve is susceptible.

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Pineoblastoma is one of several different types of tumors that arise in the area of the pineal gland, requiring different therapies. The exact diagnosis is critical for choosing the correct therapy. Pineal tumors typically present with hydrocephalus, a buildup of fluid pressure within the brain

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Pink eye (conjunctivitis) is an inflammation or infection of the transparent membrane (conjunctiva) that lines your eyelid and covers the white part of your eyeball. When small blood vessels in the conjunctiva become inflamed, they're more visible. This is what causes the whites of your eyes to appear reddish or pink.

Pink eye is commonly caused by a bacterial or viral infection, an allergic reaction, or — in babies — an incompletely opened tear duct.Though pink eye can be irritating, it rarely affects your vision. Treatments can help ease the discomfort of pink eye. Because pink eye can be contagious, early diagnosis and treatment can help limit its spread.

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A pinworm infection is one of the most common types of human intestinal worm infections. Pinworms are tiny, narrow worms. They’re white in color and less than half an inch long. A pinworm infection, also known as enterobiasis or oxyuriasis, is the most common type of worm infection in humans in the United States, according to the Centers for Disease Control and Prevention (CDC).

Pinworm infections can spread easily. They’re most common in children between the ages of 5 and 10, people who live in institutions, and those who have regular, close contact with individuals in these groups. An effective treatment for pinworm infections is medication, though reinfection is possible. Serious complications and long-term health effects are rare.


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Pituitary tumors are abnormal growths that develop in your pituitary gland. Some pituitary tumors result in too many of the hormones that regulate important functions of your body. Some pituitary tumors can cause your pituitary gland to produce lower levels of hormones.Most pituitary tumors are noncancerous (benign) growths (adenomas). Adenomas remain in your pituitary gland or surrounding tissues and don't spread to other parts of your body.There are various options for treating pituitary tumors, including removing the tumor, controlling its growth and managing your hormone levels with medications. Your doctor may recommend observation — or a ''wait and see'' approach.



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Pityriasis rosea is a rash that usually begins as a large circular or oval spot on your chest, abdomen or back. Called a herald patch, this spot can be up to 4 inches (10 centimeters) across.The herald patch is typically followed by smaller spots that sweep out from the middle of your body in a shape that resembles drooping pine-tree branches.Pityriasis (pit-ih-RIE-uh-sis) rosea can affect any age group. It most commonly occurs between the ages of 10 and 35. It usually goes away on its own within 10 weeks. Pityriasis rosea can cause itching. Treatment may help relieve the symptoms.


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Placentaaccreta happens when the placenta attaches too firmly to the uterine wall. Normally the placenta attaches to the uterine wall during pregnancy but detaches easily during childbirth. When accreta occurs, the blood vessels andother tissue from the placenta grow more deeply into the tissue of the uterus,which can cause bleeding during the third trimester and possibly dangerous hemorrhaging (blood loss) during delivery. If the placenta penetrates even further into the uterine wall, reaching the muscle, it is called placenta increta. If it grows all the way through the uterine wall, it is called placenta percreta.


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If you have placenta previa, it means that your placenta is lying unusually low in your uterus, next to or covering your cervix. The placenta is the pancake-shaped organ – normally located near the top of the uterus – that supplies your baby with nutrients through the umbilical cord.If you're found to have placenta previa early in pregnancy, it's not usually considered a problem. But if the placenta is still close to the cervix later in pregnancy, it can cause bleeding, which can lead to other complications and may mean that you'll need to deliver early. If you have placenta previa when it's time to deliver your baby, you'll need to have a cesarean section.


If the placenta covers the cervix completely, it's called a complete or total previa. If it's right on the border of the cervix, it's called a marginal previa. (You may also hear the term "partial previa," which refers to a placenta that covers part of the cervical opening once the cervix starts to dilate.) If the edge of the placenta is within two centimeters of the cervix but not bordering it, it's called a low-lying placenta.The location of your placenta will be checked during your mid-pregnancy ultrasound exam (usually done between 16 to 20 weeks) and again later if necessary.


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A placental abruption is a serious condition in which the placenta partially or completely separates from your uterus before your baby's born.The condition can deprive your baby of oxygen and nutrients, and cause severe bleeding that can be dangerous to you both. A placental abruption also increases the risk that your baby will have growth problems (if the abruption is small and goes unnoticed), be born prematurely, or be stillborn.Placental abruption happens in about one in 150 pregnancies. It's most common in the third trimester but can happen any time after 20 weeks.


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Plague is a serious bacterial infection that's transmitted by fleas. Known as the Black Death during medieval times, today plague occurs in fewer than 5,000 people a year worldwide. It can be deadly if not treated promptly with antibiotics.The organism that causes plague, Yersinia pestis, lives in small rodents found most commonly in rural and semirural areas of Africa, Asia and the United States. The organism is transmitted to humans who are bitten by fleas that have fed on infected rodents or by humans handling infected animals.The most common form of plague results in swollen and tender lymph nodes — called buboes — in the groin, armpits or neck. The rarest and deadliest form of plague affects the lungs, and it can be spread from person to person.


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When you breathe, the thin tissues that line your lungs and chest wall, called the pleura, rub together. Typically this isn’t a problem, because the tissue is satiny and generates no friction. However, when this tissue is inflamed or infected, it becomes irritated and swollen, causing significant pain. This condition is known as pleurisy or pleuritis.This condition has a grim fame. It caused the death of a number of historical figures, including Catherine de Medici and Benjamin Franklin.Pleurisy is no longer a common condition. Over the years, antibiotics have been extremely successful in treating and preventing the bacterial infections that historically were the main causes of pleurisy. Nowadays, most cases of pleurisy are the result of a viral infection and deaths from this illness are quite rare.


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Kleptomania (klep-toe-MAY-nee-uh) is the recurrent inability to resist urges to steal items that you generally don't really need and that usually have little value. Kleptomania is a rare but serious mental health disorder that can cause much emotional pain to you and your loved ones if not treated.


Kleptomania is a type of impulse control disorder — a disorder that's characterized by problems with emotional or behavioral self-control. If you have an impulse control disorder, you have difficulty resisting the temptation or drive to perform an act that's excessive or harmful to you or someone else.


Many people with kleptomania live lives of secret shame because they're afraid to seek mental health treatment. Although there's no cure for kleptomania, treatment with medication or talk therapy (psychotherapy) may help to end the cycle of compulsive stealing.

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The spine has a series of normal curves when viewed from the side. These curves help to better absorb the loads applied to the spine from the weight of the body. The cervical spine (neck) and lumbar spine (lower back) are have a normal inward curvature that is medically referred to as lordosisor "lordotic" curvature by which the spine is bent backward. The thoracic spine (upper back) has a normal outward curvature that is medically referred to as kyphosis or the "kyphotic" curve by which the spine is bent forward. In this discussion, the term kyphosis will be used to discuss abnormal kyphosis.


The spine is normally straight when looking from the front. An abnormal curve when viewed from the front is called scoliosis. Scoliosis can occur from bony abnormalities of the spine at birth, growth abnormalities especially with adolescence, degenerative spinal changes in adulthood, or abnormal twisting of the vertebrae because of muscle spasm after an injury.


The normal curves of the spine allow the head to be balanced directly over the pelvis. If one or more of these curves is either too great or too small, the head may not be properly balanced over the pelvis. This can lead to back pain, stiffness, and an altered gait or walking pattern.

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Premenstrual syndrome (PMS) refers to the range of physical and emotional symptoms many women experience in the lead up to a period. Premenstrual dysphoric disorder (PMDD) is a more serious form of PMS. Here you will find information on PMS, PMDD symptoms, causes and treatments.


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Amblyopia, commonly known as lazy eye, is the eye condition noted by reduced vision not correctable by glasses or contact lenses and is not due to any eye disease. The brain, for some reason, does not fully acknowledge the images seen by the amblyopic eye. This almost always affects only one eye but may manifest with reduction of vision in both eyes. It is estimated that three percent of children under six have some form of amblyopia.

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Lead poisoning occurs when lead builds up in the body, often over months or years. Even small amounts of lead can cause serious health problems. Children younger than 6 years are especially vulnerable to lead poisoning, which can severely affect mental and physical development. At very high levels, lead poisoning can be fatal.


Lead-based paint and lead-contaminated dust in older buildings are the most common sources of lead poisoning in children. Other sources include contaminated air, water and soil. Adults who work with batteries, do home renovations or work in auto repair shops also might be exposed to lead.


There is treatment for lead poisoning, but taking some simple precautions can help protect you and your family from lead exposure before harm is done.

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Pneumonitis is a general term for inflammation of lung tissue. Chronic inflammation of lung tissue can lead to irreversible scarring (pulmonary fibrosis). Pneumonitis is not a specific disease but a sign of an underlying problem.Acute chemical pneumonitis causes swelling of the lung tissue, movement of fluid into the air spaces in the lung and reduced ability to absorb oxygen and remove carbon dioxide. In severe cases, death may result from hypoxia.Chronic pneumonitis may follow low levels of exposure to the irritant over long periods of time, causing inflammation which may lead to fibrosis, resulting in decreased gas exchange and stiffening of the lung, and ultimately leading to respiratory failure and death.


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A pneumothorax (noo-moe-THOR-aks) is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses.A pneumothorax can be caused by a blunt or penetrating chest injury, certain medical procedures, or damage from underlying lung disease. Or it may occur for no obvious reason. Symptoms usually include sudden chest pain and shortness of breath. On some occasions, a collapsed lung can be a life-threatening event.Treatment for a pneumothorax usually involves inserting a flexible tube or needle between the ribs to remove the excess air. However, a small pneumothorax may heal on its own.

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Lip cancers are abnormal cells that grow out of control and form lesions or tumors on the lips. They are the most common type of oral cancers. These cancers develop in thin, flat cells — called squamous cells — that line the lips, mouth, tongue, cheeks, sinuses, throat, and hard and soft palates.


Lip cancer and other kinds of oral cancers are types of head and neck cancers.


Certain lifestyle choices, such as smoking, drinking, sun exposure, and tanning, increase your risk of developing lip cancer. Dentists are typically the first to notice signs of lip cancers, often during a routine dental exam.


Lip cancers are highly curable when diagnosed early.

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POEMS syndrome is associated with a group of disorders known as monoclonal gammopathies or plasma cell dyscrasias. These disorders are characterized the uncontrolled growth of a single clone (monoclonal) of plasma cells, which results in the abnormal accumulation of M-proteins (also known as immunoglobulins) in the blood. Immunoglobulins in health fight infection. However, the specific role M-proteins play and the exact cause of POEMS syndrome is unknown. Research would suggest that a chemical called VEGF (vascular endothelial growth factor) plays an important role in this disease.

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Have you noticed a soft, rubbery bulge under your skin somewhere?


That could be a lipoma. They happen when a lump of fat starts to grow in the soft tissue of your body. Though they’re classified as tumors, they’re usually harmless.


They’re the most common tumor to form beneath your skin, with about 1 person in 1,000 getting one at some point. You usually find them in your upper body, arms, or thighs.

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A diagnosis of liposarcoma and its treatment made Mayor Rob Ford, the controversial former mayor of Toronto, decide to take his name out of the running for the election for Toronto's mayor in 2014. The disease caused his death on Tues., Mar. 22, 2016. His disease and death at age 46 has stimulated further interest in liposarcoma, especially pleomorphic liposarcoma, a relatively rare cancer that is difficult to treat because the tumors are usually found or diagnosed when the disease is advanced.

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Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function

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Some people might hear “psoriasis” and think of the skin disease that causes itchy, scaly rashes and crumbling nails. It's true, psoriasis is an autoimmune disease that primarily affects the skin. But about 30 percent of people with psoriasis also develop a form of inflammatory arthritis called psoriatic arthritis (PsA). Like psoriasis, PsA is an autoimmune disease, meaning it occurs when the body’s immune system mistakenly attacks healthy tissue, in this case the joints and skin. The faulty immune response causes inflammation that triggers joint pain, stiffness and swelling. The inflammation can affect the entire body and may lead to permanent joint and tissue damage if it is not treated early and aggressively.Most people with psoriatic arthritis have skin symptoms before joint symptoms. However, sometimes the joint pain and stiffness strikes first. In some cases, people get psoriatic arthritis without any skin changes.The disease may lay dormant in the body until triggered by some outside influence, such as a common throat infection. Another theory suggesting that bacteria on the skin triggers the immune response that leads to joint inflammation has yet to be proven.


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Answer: Low sperm count implies that the fluids (semen) you ejaculate in the course of an orgasm consist of lesser sperm when compared with normal.


A low sperm count can be referred to as oligospermia. A total lack of sperm is known as Azoospermia. Your own sperm count is regarded as less than normal when you have less than fifteen million sperm per millilitre of semen.


Having a low sperm count reduces the chances that one of your own sperm will certainly fertilize the partner’s egg, leading to pregnancy. Nevertheless, numerous males that have a low sperm count will still be in a position to father a baby.

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Lupus nephritis is inflammation of the kidney that is caused by systemic lupus erythematous (SLE). Also called lupus, SLE is an autoimmune disease. With lupus, the body's immune system targets its own body tissues. Lupus nephritis happens when lupus involves the kidneys.


Up to 60% of lupus patients will develop lupus nephritis. When the kidneys are inflamed, they can't function normally and can leak protein. If not controlled, lupus nephritis can lead to kidney failure.

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The lymphatic system is a network of specialized vessels (lymph vessels) throughout the body whose purpose is to collect excess lymph fluid with proteins, lipids, and waste products from the tissues. This fluid is then carried to the lymph nodes, which filter waste products and contain infection-fighting cells called lymphocytes. The excess fluid in the lymph vessels is eventually returned to the bloodstream. When the lymph vessels are blocked or unable to carry lymph fluid away from the tissues, localized swelling (lymphedema) is the result.

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Whiplash is a relatively common injury that occurs to a person's neck following a sudden acceleration-deceleration force that causes unrestrained, rapid forward and backward movement of the head and neck, most commonly from motor vehicle accidents. The term "whiplash" was first used in 1928. The term "railway spine" was used to describe a similar condition that was common in persons involved in train accidents prior to 1928. The term "whiplash injury" describes damage to both the bone structures and soft tissues, while "whiplash associated disorders" describes a more severe and chronic condition.Fortunately, whiplash is typically not a life threatening injury, but it can lead to a prolonged period of partial disability. There are significant economic expenses related to whiplash that can reach 30 billion dollars a year in the United States, including:medical care,disability,sick leave,lost productivity, andlitigation.While most people involved in minor motor vehicle accidents recover quickly without any chronic symptoms, some continue to experience symptoms for years after the injury. This wide variation in symptoms after relatively minor injuries has led some to suggest that, in many cases, whiplash is not so much a real physiologic injury, but that symptoms are more created as a result of potential economic gain. Many clinical studies have investigated this issue. Unfortunately, while there will always be people willing to attempt to mislead the system for personal gain, whiplash is a real condition with real symptoms.


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Whipple disease is a rare bacterial infection that most often affects your gastrointestinal system. Whipple disease interferes with normal digestion by impairing the breakdown of foods, such as fats and carbohydrates, and hampering your body's ability to absorb nutrients.Whipple disease also can infect other organs, including your brain, heart, joints and eyes.Without proper treatment, Whipple disease can be serious or fatal. However, a course of antibiotics can treat Whipple disease

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Whooping cough (pertussis) is a highly contagious respiratory tract infection. In many people, it's marked by a severe hacking cough followed by a high-pitched intake of breath that sounds like "whoop."Before the vaccine was developed, whooping cough was considered a childhood disease. Now whooping cough primarily affects children too young to have completed the full course of vaccinations and teenagers and adults whose immunity has faded.Deaths associated with whooping cough are rare but most commonly occur in infants. That's why it's so important for pregnant women — and other people who will have close contact with an infant — to be vaccinated against whooping cough.

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In Wolff-Parkinson-White (WPW) syndrome, an extra electrical pathway between your heart's upper and lower chambers causes a rapid heartbeat. The extra pathway is present at birth and fairly rare.The episodes of fast heartbeats usually aren't life-threatening, but serious heart problems can occur. Treatment can stop or prevent episodes of fast heartbeats. A catheter-based procedure (ablation) can permanently correct the heart rhythm problems.Most people with an extra electrical pathway experience no fast heartbeat. This condition, called Wolff-Parkinson-White pattern, is discovered only by chance during a heart exam. Although WPW pattern is often harmless, doctors might recommend further evaluation before children with WPW pattern participate in high-intensity sports.

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Wrist pain is often caused by sprains or fractures from sudden injuries. But wrist pain can also result from long-term problems, such as repetitive stress, arthritis and carpal tunnel syndrome.Because so many factors can lead to wrist pain, diagnosing the exact cause can be difficult, but an accurate diagnosis is essential for proper treatment and healing.

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Thrombophlebitis is inflammation of a vein caused by a blood clot. It typically occurs in the legs. A blood clot is a solid formation of blood cells that clump together. Blood clots can interfere with normal blood flow throughout your body, and are considered dangerous. Thrombophlebitis can occur in veins near the surface of your skin or deeper, down in between your muscle layers.


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Your hip is the joint where your thigh bone meets your pelvis. It is called a ball-and-socket joint, because the ball-like top of your thigh bone fits into a cup-like area within your pelvis, much like a baseball fits into a glove.


Normally, the ball glides smoothly within the socket, but a problem with the ball or socket rim can interfere with smooth motion. This problem can cause hip impingement or femoro acetabular impingement (FAI). It is believed to be a major cause of early osteoarthritis of the hip, particularly in those under age 40.

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A thunderclap headache is a severe headache that starts suddenly. This type of headache pain doesn’t gradually build in intensity. Instead, it’s an intense and very painful headache as soon as it starts. In fact, it’s frequently described as the worse headache of one’s life.A thunderclap headache may be a sign of a condition that can be life-threatening. It may be connected to some sort of bleeding in your brain. It’s important that you seek medical attention if you think you may be experiencing one. It may also have a benign cause that’s not life-threatening but should still be checked immediately to find out what’s causing it.


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Tinea capitis causes the gradual appearance of round patches of dry scale, alopecia, or both. T. tonsurans infection causes black dot ringworm, in which hair shafts break at the scalp surface; M. audouinii infection causes gray patch ringworm, in which hair shafts break above the surface, leaving short stubs. Tinea capitis less commonly manifests as diffuse scaling, like dandruff, or in a diffuse pustular pattern.


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Phantom limb pain (PLP) refers to ongoing painful sensations that seem to be coming from the part of the limb that is no longer there. The limb is gone, but the pain is real.


The onset of this pain most often occurs soon after surgery. It can feel like a variety of things, such as burning, twisting, itching or pressure. It is often felt in fingers or toes. It is believed that nearly 80 percent of the amputee population worldwide has experienced this kind of pain.


The length of time this pain lasts differs from person to person. It can last from seconds to minutes, to hours, to days. For most people, PLP diminishes in both frequency and duration during the first six months, but many continue to experience some level of these sensations for years.


People are often reluctant to tell anyone that they are experiencing PLP or phantom limb sensations, for fear that they will be considered “crazy.” However, it is important to report these pains as soon as you begin to experience them so treatment can be started.

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oison ivy rash is caused by contact with poison ivy, a plant that’s found on four continents. The sap of the poison ivy plant contains an oil called urushiol. This is the irritant that causes an allergic reaction and rash.


You don’t even have to come in direct contact with the plant to have a reaction. The oil can linger on your gardening equipment, golf clubs, or even your shoes. Brushing against the plant — or anything that’s touched it — can result in skin irritation, pain, and itching.


Here’s how to spot the danger, and what you can do if poison ivy gets too close.

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Polio is a contagious viral illness that in its most severe form causes nerve injury leading to paralysis, difficulty breathing and sometimes death.


In the U.S., the last case of naturally occurring polio was in 1979. Today, despite a worldwide effort to wipe out polio, poliovirus continues to affect children and adults in parts of Asia and Africa.


The Centers for Disease Control and Prevention (CDC) advises taking precautions to protect yourself from polio if you're traveling anywhere there's a risk of polio.


Adults who have been vaccinated who plan to travel to an area where polio is occurring should receive a booster dose of inactivated poliovirus vaccine (IPV). Immunity after a booster lasts a lifetime.

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Polycythemia vera (pol-e-sy-THEE-me-uh VEER-uh) is a slow-growing blood cancer in which your bone marrow makes too many red blood cells. These excess cells thicken your blood, slowing its flow. They also cause complications, such as blood clots, which can lead to a heart attack or stroke.


Polycythemia vera isn't common. It usually develops slowly, and you might have it for years without knowing. Often the condition is found during a blood test done for another reason.


Without treatment, polycythemia vera can be life-threatening. But proper medical care can help ease signs, symptoms and complications of this disease. Over time, in some cases there's a risk of progressing to more-serious blood cancers, such as myelofibrosis or acute leukemia.

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Tinea pedis is a common superficial fungal (dermatophyte) skin infection of the feet. It may present in several clinical varieties: intertriginous, moccasin, vesicobullous, or a combination of these. It is often referred to as “Athlete’s Foot”.  Tinea pedis may be accompanied by dermatophyte infection of other parts of the body including groin, hands or nails. It is estimated to affect about 15% of the population at large, being more common in closed communities such army barracks and boarding schools, in warm weather, among those frequenting swimming pools, and when the feet are occluded with nonporous shoes.  Tinea pedis is estimated to be present in about 40% of all patients who attend clinics for any medical concern1. Those patients with more severe symptoms seek medical help and often have concomitant fungal infection of the toenails 2, 3. There are many undiagnosed cases, many of which may be asymptomatic and unsuspecting of having tinea pedis 2  and be a possible source of infection for others. Chronic infection is common in patients with concomitant diabetes, atopy, and immunosuppression. In an increasingly aging population and with the increasing numbers of immunocompromised patients, tinea is emerging as an important and a significantly prevalent infection.


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Polyhydramnios is where there is too much amniotic fluid around the baby during pregnancy. Amniotic fluid is the fluid that surrounds your baby in the womb.


Too much amniotic fluid is normally spotted during a check-up in the later stages of pregnancy.


It isn't usually a sign of anything serious, but you'll probably have some extra check-ups and will be advised to give birth in hospital.

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Polymyalgia rheumatica (sometimes referred to as PMR) is a common cause of widespread aching and stiffness that affects adults over the age of 50, especially Caucasians. Because polymyalgia rheumatica does not often cause swollen joints, it may be hard to recognize. It may occur with another health problem, giant cell arteritis.


The average age when symptoms start is 70, so people who have PMR may be in their 80s or even older. The disease affects women somewhat more often than men. It is more frequent in whites than nonwhites, but all races can get PMR.

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Polymyositis is a disease of muscle featuring inflammation of the muscle fibers. The cause of the disease is not known. It begins when white blood cells, the immune cells of inflammation, spontaneously invade muscles. The muscles affected are typically those closest to the trunk or torso. This results in weakness that can be severe. Polymyositis is a chronic illness featuring progressive muscle weakness with periods of increased symptoms, called flares or relapses, and minimal or no symptoms, known as remissions.


Polymyositis is slightly more common in females. It affects all age groups, although its onset is most common in middle childhood and in the 20s. Polymyositis occurs throughout the world. Polymyositis can be associated with a characteristic skin rash and is then referred to as "dermatomyositis." Dermatomyositis in children is referred to as juvenile dermatomyositis. "Amyopathic dermatomyositis" is the term used to describe people who have skin changes compatible with dermatomyositis but do not have diseased muscle involvement.


Polymyositis can also affect other areas of the body and is, therefore, referred to as a systemic illness. Occasionally, it is associated with cancer or with other diseases of connective tissue (such as systemic lupus erythematosus, scleroderma, and rheumatoid arthritis). Depending on which other diseases it is associated with, it may be referred to as an "overlap syndrome" or "mixed connective tissue disease."

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Poor or deficient color vision is an inability to see the difference between certain colors, but color is still seen. Many people commonly use the term "colorblind" for this condition. But true colorblindness — in which everything is seen in shades of black and white — is rare.


Poor color vision is usually inherited. Men are more likely to be born with poor color vision. Most people with poor color vision can't distinguish between certain shades of red and green. Less commonly, people with poor color vision can't distinguish between shades of blue and yellow.


Certain eye diseases and some medications also can cause poor color vision.


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Porphyria is a group of disorders that can cause nerve or skin problems.


A porphyria that affects the skin is called cutaneous porphyria. A porphyria that affects the nervous system is called acute porphyria.


The most common type of porphyria is porphyria cutanea tarda (PCT), which affects the skin. PCT is also the most treatable.


No known cure exists for any type of porphyria.

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Postherpetic neuralgia (also termed PHN) is a condition of recurring or persistent pain in an area of the body that has undergone an outbreak of herpes zoster virus (HZ), also known as the varicella zoster virus, commonly termed shingles. It usually begins after shingles lesions (blisters) begin to crust over and heal but may occur in some patients who do not produce lesions. Some investigators suggest the pain has to be present for three months to be termed PHN.


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Postpartum preeclampsia is a rare condition that can develop soon after birth (usually within the first 48 to 72 hours after delivery) and is marked by high blood pressure and excess protein in the urine. In rare cases, preeclampsia onset can be delayed up to about one month postpartum; it is usually called late postpartum preeclampsia if the onset is more than 48 hours postpartum. "It takes time for the uterus to shed its lining after birth, so this process may be behind the delay that's sometimes seen in late onset preeclampsia after delivery," says James N. Martin, M.D., past president of the American College of Obstetricians and Gynecologists. It's also possible this condition begins during pregnancy but doesn't show signs or symptoms until after the baby has arrived.


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Postpartum thyroiditis is an exacerbation of an underlying autoimmune thyroiditis, aggravated by the immunological rebound that follows the partial immunosuppression of pregnancy (1–3). Women who express human leukocyte antigen haplotypes DR-3, DR-4, and DR-5 have an increased risk for postpartum thyroiditis. In women who develop postpartum thyroiditis, CD4+/CD8+ and CD4 + 2H4+ ratios are elevated throughout pregnancy and the postpartum (4). Histologically, thyroid aspirates reveal either a lymphocytic infiltrate or diffuse destruction, changes similar to those seen in both Hashimoto’s thyroiditis (2, 3, 5) and painless sporadic silent thyroiditis (6). In essence, the immunological rebound that follows the end of pregnancy precipitates the clinical expression of Hashimoto’s disease, which before pregnancy was clinically silent

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The literature lacks consensus regarding the nomenclature applicable to the development of new health problems in persons who previously had acute paralytic poliomyelitis, with frequently used terms including "late effects of polio" (LEoP), "postpolio syndrome" (PPS) and "postpolio muscular atrophy." PPS is typically characterized as a sub-category of LEoP. [1]


PPS is a neurologic disorder characterized by new and progressive muscular weakness, pain, and fatigue many years after the acute paralytic polio. Halstead introduced the term "post-polio syndrome" in 1986, and he published revised criteria for diagnosing PPS in 1991, in which new muscle weakness was introduced as an obligatory criterion.

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After a patient has had a total proctocolectomy (removal by surgery of the large intestine and rectum), a procedure called ileal pouch-anal anastomosis (IPAA) is performed. In an IPAA, the ileum, or lowest part of the small intestine, is connected to the anus to create a structure (pouch) that can store and eliminate stools.


The surgeon creates a J-pouch (which resembles the letter J) to provide for the storage area. Other pouch shapes (S and K) are also possible. The pouch helps improve the patient’s quality of life and reduces the risk of growths that could develop into cancer. However, after this surgery, some patients may get pouchitis.


Pouchitis is an inflammation (swelling) of the pouch that occurs when the pouch becomes irritated and inflamed. The inflammation can cause increased bowel frequency (having to go to the bathroom more often), abdominal cramping or bloating, lower abdominal pain, or sometimes blood in the stool. This condition should be evaluated and managed by an experienced gastroenterologist.

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People with Prader-Willi syndrome typically have mild to moderate intellectual impairment and learning disabilities. Behavioral problems are common, including temper outbursts, stubbornness, and compulsive behavior such as picking at the skin. Sleep abnormalities can also occur. Additional features of this condition include distinctive facial features such as a narrow forehead, almond-shaped eyes, and a triangular mouth; short stature; and small hands and feet. Some people with Prader-Willi syndrome have unusually fair skin and light-colored hair. Both affected males and affected females have underdeveloped genitals. Puberty is delayed or incomplete, and most affected individuals are unable to have children (infertile).

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Precocious puberty is when a child's body begins changing into that of an adult (puberty) too soon. Puberty that begins before age 8 in girls and before age 9 in boys is considered precocious puberty.


Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the body's ability to reproduce.


The cause of precocious puberty often can't be found. Rarely, certain conditions, such as infections, hormone disorders, tumors, brain abnormalities or injuries, may cause precocious puberty. Treatment for precocious puberty typically includes medication to delay further development.

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Slightly elevated blood pressure is known as prehypertension. Prehypertension will likely turn into high blood pressure (hypertension) unless you make lifestyle changes, such as getting more exercise and eating healthier foods. Both prehypertension and high blood pressure increase your risk of heart attack, stroke and heart failure.


A blood pressure reading has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure). Prehypertension is a systolic pressure from 120 to 139 millimeters of mercury (mm Hg) or a diastolic pressure from 80 to 89 mm Hg.


Weight loss, exercise and other healthy lifestyle changes can often control prehypertension, and set the stage for a lifetime of better health.

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A premature baby is one who is born too early, before 37 weeks. Premature babies may have more health problems and may need to stay in the hospital longer than babies born later. 


They also may have long-term health problems that can affect their whole lives. About 1 in 10 babies is born prematurely each year in the United States. 


The earlier in pregnancy a baby is born, the more likely he is to have health problems. Some premature babies have to spend time in a hospital’s neonatal intensive care unit (also called NICU). This is the part of a hospital that takes care of sick newborns. But thanks to advances in medical care, even babies born very prematurely are more likely to survive today than ever before.

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Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction. It has probably affected every man at some point in his life.


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A sacral dimple is a small, usually shallow indentation in the small of the back, just above or within the crease of the buttocks.


About 3 to 8 percent of the population has a sacral dimple. A very small percentage of people with a sacral dimple can have spinal abnormalities.


In most cases, a sacral dimple causes no problems and isn’t associated with any health risks.

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Premature ovarian failure — also known as primary ovarian insufficiency — is a loss of normal function of your ovaries before age 40. If your ovaries fail, they don't produce normal amounts of the hormone estrogen or release eggs regularly. Infertility is a common result.


Premature ovarian failure is sometimes referred to as premature menopause, but the two conditions aren't the same. Women with premature ovarian failure can have irregular or occasional periods for years and might even become pregnant. Women with premature menopause stop having periods and can't become pregnant.


Restoring estrogen levels in women with premature ovarian failure helps prevent some complications, such as osteoporosis, that occur as a result of low estrogen.

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Presbyopia is when your eyes gradually lose the ability to see things clearly up close. It is a normal part of aging. In fact, the word “presbyopia” means “old eye” in Greek. You may start to notice presbyopia shortly after age 40. You will probably find that you hold reading materials farther away in order to see them clearly.

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Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants.


Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who abuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines.

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    Toxic Hepatitis defines inflammatory liver disease.  The effect of irritant to liver cells causes inflammation of the liver tissue Irritant toxics to liver cells are alcohol, chemicals, street drugs and some nutritional supplements.  There have bene cases where Toxic Hepatitis has developed in a matter of hours or days since exposure to toxins whereas there have been other instances where it has taken months of regular exposure to the toxin before any symptom of Toxic Hepatitis is observed. Generally, symptoms produced by Toxic Hepatitis are self limiting and tend to go away when the exposure to the toxin is eliminated but there have been cases where Toxic Hepatitis has permanently damaged the liver resulting in cirrhosis and in some instances liver failure


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Transposition of the great arteries is a serious but rare heart defect present at birth (congenital), in which the two main arteries leaving the heart are reversed (transposed). The condition is also called dextro-transposition of the great arteries. A rarer type of this condition is called levo-transposition of the great arteries.Transposition of the great arteries changes the way blood circulates through the body, leaving a shortage of oxygen in blood flowing from the heart to the rest of the body. Without an adequate supply of oxygen-rich blood, the body can't function properly and your child faces serious complications or death without treatment.Transposition of the great arteries is usually detected either prenatally or within the first hours to weeks of life.Corrective surgery soon after birth is the usual treatment for transposition of the great arteries. Having a baby with transposition of the great arteries can be alarming, but with proper treatment, the outlook is promising

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Premature labor is also called preterm labor. It’s when your body starts getting ready for birth too early in your pregnancy. Labor is premature if it starts more than three weeks before your due date.

Premature labor can lead to an early birth. But the good news is that doctors can do a lot to delay an early delivery. The longer your baby gets to grow inside you -- right up to your due date -- the less likely he or she is to have problems after birth.


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Priapism is a prolonged erection of the penis. The persistent erection continues hours beyond or isn't caused by sexual stimulation. Priapism is usually painful.

Although priapism is an uncommon condition overall, it occurs commonly in certain groups, such as people who have sickle cell anemia. Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction).

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When your child has a primary immunodeficiency disease (PIDD), his body has a harder time fighting germs that make people sick. He may get a lot of infections in his ears, lungs, skin, or other areas that take a long time to go away.

Most cases happen in babies or young children, but sometimes it doesn't show up until adulthood. There are many different types -- more than 200 -- and they affect different parts of the immune system. All make it more likely that he'll get sick from infections.

Everyone with a PIDD has a different experience. If your child has it, in most cases he'll be able to go to school and make friends like other kids. As an adult with a PIDD, he'll be able to work and have an active, normal life.

If your child's PIDD is mild, he may need to take medicines to treat the infections he gets.

Doctors treat some of the more serious types of PIDD with doses of antibodies to fight infections. He'll get these antibodies through an IV in his veins. The treatment takes several hours, and he'll need one every few weeks.

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Proctitis is an inflammation of the lining of the rectum. The rectum is a muscular tube that's connected to the end of your colon. Stool passes through the rectum on its way out of the body.

Proctitis can cause rectal pain and the continuous sensation that you need to have a bowel movement. Proctitis symptoms can be short-lived, or they can become chronic.

Proctitis is common in people who have inflammatory bowel diseases. Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation therapy for certain cancers.

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A prolactinoma is a benign tumor (called an adenoma) of the pituitary gland. A prolactinoma produces an excessive amount of the hormone prolactin. Prolactin is a natural hormone which supports a woman's normal lactation, which is the secretion of milk by the mammary glands of the breast. Prolactinomas are the most common type of pituitary tumor. Symptoms of prolactinoma are caused by pressure of the tumor on surrounding tissues or by excessive release of prolactin from the tumor into the blood (causing a condition known as hyperprolactinemia).

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Pseudobulbar affect (PBA) is a condition that’s characterized by episodes of sudden uncontrollable and inappropriate laughing or crying. Pseudobulbar affect typically occurs in people with certain neurological conditions or injuries, which might affect the way the brain controls emotion.

If you have pseudobulbar affect you'll experience emotions normally, but you'll sometimes express them in an exaggerated or inappropriate way. As a result, the condition can be embarrassing and disruptive to your daily life.

Pseudobulbar affect often goes undiagnosed or is mistaken for mood disorders. Once diagnosed, however, pseudobulbar affect can be managed with medication.

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Pseudogout is a type of inflammation of joints (arthritis) that is caused by deposits of crystals, called calcium pyrophosphate, in and around the joints. Pseudogout literally means "false gout." It derives its name from its similarity to gout.

Pseudogout has many similarities to true gout, which also can cause arthritis. However, the crystal that incites the inflammation of gout is monosodium urate. The crystals that cause pseudogout and gout each have distinct appearances when joint fluid containing them is viewed under a microscope. This makes it possible to precisely identify the cause of the joint inflammation when joint fluid is available.

Pseudogout has been reported to occasionally coexist with gout. This means that the two types of crystals can sometimes be found in the same joint fluid. Researchers have also noted that the cartilage of patients who had both forms of crystals in their joint fluid was often visibly calcified, as seen on X-ray images.

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Pseudomembranous colitis (PMC) is inflammation in your colon that happens when there's too much of certain bacteria in your system. The most common bacterium that causes PMC isClostridium difficile, or C. diff.

PMC is also called antibiotic-associated colitis or C. difficilecolitis. Most of the time, it's a side effect of taking antibiotics.

People in hospitals or nursing homes also can get PMC, especially if they've just had surgery or are receiving treatment for cancer.

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Pseudotumor cerebri is a condition in which the pressure around your brain increases, causing headaches and vision problems. The name means “false brain tumor” because its symptoms are similar to those caused by brain tumors. It’s also known as idiopathic intracranial hypertension. This condition is treatable, but it can return in some cases.

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Schizoid personality disorder is an uncommon condition in which people avoid social activities and consistently shy away from interaction with others. They also have a limited range of emotional expression.


If you have schizoid personality disorder, you may be seen as a loner or dismissive of others, and you may lack the desire or skill to form close personal relationships. Because you don't tend to show emotion, you may appear as though you don't care about others or what's going on around you.


The cause of schizoid personality disorder is unknown. Talk therapy, and in some cases medications, can help.

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People with schizotypal personality disorder are often described as odd or eccentric and usually have few, if any, close relationships. They generally don't understand how relationships form or the impact of their behavior on others. They may also misinterpret others' motivations and behaviors and develop significant distrust of others.


These problems may lead to severe anxiety and a tendency to turn inward in social situations, as the person with schizotypal personality disorder responds inappropriately to social cues and holds peculiar beliefs.


Schizotypal personality disorder typically is diagnosed in early adulthood and is likely to endure, though treatment, such as medications and therapy, can improve symptoms.

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Trichotillomania (trik-o-til-o-MAY-nee-uh), also called hair-pulling disorder, is a mental disorder that involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows or other areas of your body, despite trying to stop.Hair pulling from the scalp often leaves patchy bald spots, which causes significant distress and can interfere with social or work functioning. People with trichotillomania may go to great lengths to disguise the loss of hair.For some people, trichotillomania may be mild and generally manageable. For others, the compulsive urge to pull hair is overwhelming. Some treatment options have helped many people reduce their hair pulling or stop entirely.

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Tricuspid atresia is a condition seen in newborns in which they’re born without an important part of the heart called “the tricuspid valve.” This valve plays a part in the heart’s essential function, which is to pump blood between the lungs and body.In some newborns, the tricuspid valve is missing or hasn’t properly developed. Tricuspid atresia is a rare heart disorder that’s congenital, or present at birth. It’s a serious condition, and it can be life-threatening.

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Tricuspid valve disease affects the valve that connects the upper and lower chambers (atrium and ventricle) on the right side of your heart.Aurora Health Care’s teams are the region’s leaders in diagnosing and treating heart valve diseases. We offer customized treatment using the most advanced, minimally invasive procedures, whether the condition is congenital (a birth defect) or develops later in life.

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Puffiness under the eyes can be bothersome, but it’s usually just a cosmetic concern. While rare, undereye puffiness can be a symptom of some kidney and thyroid conditions. If you occasionally wake up with puffiness under the eyes, consider what you did the day before to look for lifestyle causes such as staying up late or eating too much salt. Consider talking to your doctor about possible treatments for chronic undereye puffiness.

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Uterine polyps are soft red outgrowths from the lining of the womb (the endometrium), usually less than 1 cm in diameter, which often flatten to fit the cavity of the uterus.The stalk of the polyp (or pedicle) is usually short, but sometimes it grows long enough for the polyp to project from the cervix (the lower opening of the womb). Polyps are prone to bleeding, and a uterine polyp that develops near the fallopian tubes may obstruct the opening of the tubes, possibly leading to difficulty with becoming pregnant. Uterine polyps can develop in pre- or post-menopausal women. Very rarely, polyps can be cancerous.


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The uterus (the womb, in which a fetus develops) is normally held in place inside the pelvis with various muscles and ligaments. Sometimes, because of childbirth or difficult labor and vaginal delivery, these tissues are weakened. As a woman ages and with age-related decrease in the concentration of the hormone estrogen, her uterus can move downward into the vaginal canal, causing the condition known as a prolapsed uterus.Muscle weakness or relaxation may allow the uterus to sag or come completely out of the body. Prolapsed uterus can be described in the following stages

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There are six basic types of nutrients that are considered essential to life: proteins, carbohydrates, fats, vitamins, minerals, and water. These nutrients are needed for your body to function properly, and your diet is the source of them. Vitamins and minerals are considered micronutrients because they are needed in smaller quantities than the macronutrients (protein, carbohydrates, and fat). Micronutrients do not provide calories. When your body does not absorb an adequate amount of any of the micronutrients, diseases can occur. It's important to understand what your nutritional needs are and how to achieve them.Vitamins are broken down into two categories: water-soluble and fat-soluble. Water-soluble vitamins dissolve in water. Leftover amounts are not stored and will leave your body through your urine. For this reason, you must consume them on a continuous basis. The water-soluble vitamins are the B vitamins and vitamin C. Fat-soluble vitamins dissolve in fat, not water. These vitamins need dietary fat in order to be better absorbed in the small intestines. They are then stored in the liver and fatty tissues (adipose tissues) and can accumulate to toxic levels when consumed in excess quantities. The fat-soluble vitamins are vitamins A, D, E, and K.Recommendations for essential nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Institute of Medicine of the National Academies. Dietary Reference Intakes is the general term for a set of reference values used for planning and assessing nutrient intake for healthy people. There are three important types of DRI reference values; Recommended Dietary Allowances (RDA), Adequate Intakes (AI), and Tolerable Upper Intake Levels (UL). The RDA is set to meet the nutrient requirements for the average daily intake of nearly all healthy individuals in each age and gender group. When there is insufficient data to set an RDA for a nutrient, an AI is set. AIs meet or exceed the amount needed to maintain an adequate nutritional state in nearly everyone of a specific age and gender group. Some nutrients can cause health problems when consumed in excessive quantities. The UL was set to provide the maximum daily intake that is unlikely to result in adverse health effects. Numerous health conditions, however, can impact your nutritional needs. A registered dietitian or physician can help you better determine your needs based upon your overall health and condition.


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The palate is commonly called the roof of the mouth. It is divided into two parts: the bony hard palate in the front, and the fleshy soft palate (called the velum) in the back of the mouth. The hard palate is part of the oral cavity and the soft palate is part of the oropharynx.The hard palate creates a barrier between the mouth and the nasal cavity. A natural opening in the palate for nerves and blood vessels (near the third molar) can create a passageway for a tumor to spread into the nasal cavity.The soft palate closes the nasal passage during swallowing so food does not enter the nose. It also helps create speech sounds. If the palate does not function correctly during speech, air escapes through the nose, and the speech has a nasal sound. During a sneeze, the soft palate closes the nasal passage to protect it. Substances in the sneeze are thrown out into mouth.


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Concern or fear about certain situations, activities, animals or objects is not uncommon. Many people feel anxious when faced with a snake or spider, heights, or travelling by plane. Fear is a rational response to situations that can pose a threat to our safety.However, some people react to objects, activities or situations (the phobic stimulus) by imagining or irrationally exaggerating the danger. Their feelings of panic, fear or terror are completely out of proportion to the actual threat. Sometimes the mere thought of the phobic stimulus, or the sight of it on TV, is enough to cause a reaction. These types of excessive reactions may be indicative of a specific phobia.People with specific phobias are often well aware that their fears are exaggerated or irrational, but feel that their anxious reaction is automatic or uncontrollable. Specific phobias are often associated with panic attacks, during which the person experiences overwhelming physical sensations that may include a pounding heart, choking, nausea, faintness, dizziness, chest pain, hot or cold flushes and perspiration.

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A spermatocele is an often pain-free benign cyst that occurs close to a testicle. It may also be known as a spermatic or epididymal cyst.The cyst forms in the epididymis. The epididymis is a coiled tube behind each testicle. The cyst is filled with fluid and may contain dead sperm. Read on to learn more about identifying and treating this condition

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Spider bites are quite rare. Spiders are not bloodsucking creatures and do not feed on humans.In fact, many species' fangs cannot pierce human skin.The only reason a spider would bite a human is defense. Spiders will bite when they are surprised or feel trapped.Quickly putting a hand or foot into a place where a spider lives, like a shoe or box, may surprise the spider and cause it to attack.A spider may also attack if it is trapped, such as in a jacket that has been hanging in the closet for some time.

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Spina bifida means open spine. The spine (backbone) protects the spinal cord, a bundle of nerves that runs down the middle of your back. The spinal cord carries signals back and forth between your body and your brain. Spina bifida happens when the bones in the spine don’t form correctly, or when the spinal cord doesn’t form correctly, leaving a gap or opening. Spina bifida can happen anywhere along the spine.Spina bifida is the most common kind of neural tube defect (also called NTD). NTDs are birth defects of the brain and spinal cord. Birth defects are health conditions that are present at birth. Birth defects change the shape or function of one or more parts of the body. They can cause problems in overall health, in how the body develops or in how the body works.A baby’s neural tube normally develops into the brain and spinal cord. It starts out as a tiny, flat ribbon that turns into a tube by the end of the first month of pregnancy. NTDs happen if the tube doesn’t close completely. About 1,500 to 2,000 babies are born with spina bifida each year in the United States.

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A spinal cord injury is damage to the spinal cord. It’s an extremely serious type of physical trauma that’s likely to have a lasting and significant impact on most aspects of daily life.The spinal cord is a bundle of nerves and other tissue that the vertebrae of the spine contains and protects. The vertebrae are the bones stacked on top of each other that make up the spine. The spine contains many nerves, and extends from the brain’s base down the back, ending close to the buttocks.The spinal cord is responsible for sending messages from the brain to all parts of the body. It also sends messages from the body to the brain. We’re able to perceive pain and move our limbs because of messages sent through the spinal cord.If the spinal cord sustains an injury, some or all of these impulses may not be able to “get through.” The result is a complete or total loss of sensation and mobility below the injury. A spinal cord injury closer to the neck will typically cause paralysis throughout a larger part of the body than one in the lower back area.

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A spinal tumor is a growth that develops within your spinal canal or within the bones of your spine. A spinal cord tumor, also called an intradural tumor, is a spinal tumor that that begins within the spinal cord or the covering of the spinal cord (dura). A tumor that affects the bones of the spine (vertebrae) is called a vertebral tumor.Spinal cord tumors may be classified as one of three different types depending on where they occur relative to the protective membranes of the spinal cord.

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A spinal headache, also known as a postdural puncture headache, is a complication of needle insertion into the subarachnoid space through the dural sac. The dural sac encases the spinal cord and cerebrospinal fluid.This is a pressurized system that extends from the intracranial cavity down to the sacrum. Fluctuation in pressure can result in headache. This commonly occurs after diagnostic lumbar puncture. It is a less common complication of spinal anesthesia and spinal interventional pain injections.

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In the medical field, stenosis means the abnormal narrowing of a body channel. When combined with the word spinal, it defines a narrowing of the bone channel occupied by the spinal nerves or the spinal cord.Some people are born with a congenital form, but most develop spinal stenosis as part of the degenerative cascade. A few do not feel any effects of the narrowing, but as part of the aging process, most people will eventually notice radiating pain, weakness, and/or numbness secondary to the compression of the nerves or spinal cord.While the narrowing may occur at different parts of the spine, the symptoms of nerve compression are often similar. That is why specialists often will perform testing to determine the cause and location of the narrowing.

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A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. Falling, twisting, or getting hit can all cause a sprain. Ankle and wrist sprains are common. Symptoms include pain, swelling, bruising, and being unable to move your joint. You might feel a pop or tear when the injury happens.A strain is a stretched or torn muscle or tendon. Tendons are tissues that connect muscle to bone. Twisting or pulling these tissues can cause a strain. Strains can happen suddenly or develop over time. Back and hamstring muscle strains are common. Many people get strains playing sports. Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle.At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. Later treatment might include exercise and physical therapy.

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Staphylococcus bacteria (also termed staph) are responsible for a number of common infections. Staphylococcus is a genus of bacteria that is characterized by a round shape (coccus or spheroid shaped), Gram-stain positive, and found as either single cells, in pairs, or more frequently, in clusters that resemble a bunch of grapes. The genus name Staphylococcus is derived from Greek terms (staphyle and kokkos) that mean "a bunch of grapes," which is how the bacteria often appear microscopically after Gram-staining. In 1884, Rosenbach first described and named the bacteria. Two major divisions of the genus Staphylococcus are separated by the ability to produce coagulase, an enzyme that can clot blood. Most, but not all, human bacterial infections are caused by coagulase-positive Staphylococcus aureus strains. Staphylococcus epidermidis strains and other Staphylococcus species that are coagulase-negative produce slime that interferes with immune defenses. S. epidermidis are often associated with implanted devices (for example, catheters or prosthetic devices).

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Stomach polyps — also called gastric polyps — are masses of cells that form on the lining inside your stomach. These polyps are rare and usually don't cause any signs or symptoms. Stomach polyps are most often discovered when your doctor is examining you for some other reason.Most stomach polyps don't become cancerous. But certain types can increase your risk of stomach cancer in the future. Depending on the type of stomach polyp you have, treatment might involve removing the polyp or monitoring it for changes.

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An arrhythmia is an abnormality in the timing or pattern of the heartbeat. Arrhythmias may cause the heart to beat too rapidly, too slowly, or irregularly. They are common and may cause a wide variety of symptoms, such as a racing, skipping or fluttering sensation (called palpitations) in your chest.Cardiac arrhythmias also may cause light-headedness, fainting, chest pain, shortness of breath, fatigue or no symptoms at all. Many types of arrhythmia are merely nuisances, other types may be serious problems because they cause the patient to develop heart failure, pass out or even die suddenly when the heart beats too slowly or too rapidly to pump blood to the body.Supraventricular tachycardia is a series of rapid heartbeats that begin in or involve the upper chambers (atria) of the heart. SVT can cause the heart to beat very rapidly or erratically. As a result, the heart may beat inefficiently, and the body may receive an inadequate blood supply. There are three major types of SVT including:

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Swollen lymph nodes usually occur as a result of exposure to bacteria or viruses. When swollen lymph nodes are caused by an infection, this is known as lymphadenitis (lim-fad-uh-NIE-tis). Rarely, swollen lymph nodes are caused by cancer.Your lymph nodes, also called lymph glands, play a vital role in your body's ability to fight off infections. They function as filters, trapping viruses, bacteria and other causes of illnesses before they can infect other parts of your body. Common areas where you might notice swollen lymph nodes include your neck, under your chin, in your armpits and in your groin.In some cases, the passage of time and warm compresses may be all you need to treat swollen lymph nodes. Treatment of lymphadenitis depends on the cause.

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Syphilis is a sexually transmitted infection (STI) caused by a type of bacteria known as Treponema pallidum. In 2016, more than 88,000 cases of syphilis were reported in the United States, according to the Centers for Disease Control and Prevention. The rate of women with syphilis has been declining in the United States, but the rate among men, particularly men who have sex with men, has been rising. The first sign of syphilis is a small, painless sore. It can appear on the sexual organs, rectum, or inside the mouth. This sore is called a chancre. People often fail to notice it right away.Syphilis can be challenging to diagnose. Someone can have it without showing any symptoms for years. However, the earlier syphilis is discovered, the better. Syphilis that remains untreated for a long time can cause major damage to important organs, like the heart and brain.Syphilis is only spread through direct contact with syphilitic chancres. It can’t be transmitted by sharing a toilet with another person, wearing another person’s clothing, or using another person’s eating utensils

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Takotsubo cardiomyopathy is a weakening of the left ventricle, the heart's main pumping chamber, usually as the result of severe emotional or physical stress, such as a sudden illness, the loss of a loved one, a serious accident, or a natural disaster such as an earthquake. (For additional examples, see "Stressors associated with takotsubo cardiomyopathy.") That's why the condition is also called stress-induced cardiomyopathy, or broken-heart syndrome. The main symptoms are chest pain and shortness of breath.

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Tapeworms are long, segmented worms of the class Cestoda, which comprise 1 of 3 classes of parasitic worms (worms that require a host within which to mature). The other classes are Nematoda and Trematoda. These worms lack an intestinal tract and instead can absorb nutrients through their integument.The adult consists of a head (scolex), where the worms attach to the mucosa of the intestine; a neck; and a segmented body that contains both male gonads and female gonads (proglottids).

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The pulmonary veins are the four blood vessels (two on each side) that return oxygen-rich blood from the lungs to the left atrium (left upper chamber) of the heart. Total anomalous pulmonary venous return (TAPVR) is a rare congenital malformation in which all four pulmonary veins do not connect normally to the left atrium. Instead the four pulmonary veins drain abnormally to the right atrium (right upper chamber) by way of an abnormal (anomalous) connection.

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The features of seizures beginning in the temporal lobe can be extremely varied, but certain patterns are common. There may be a mixture of different feelings, emotions, thoughts, and experiences, which may be familiar or completely foreign. In some cases, a series of old memories resurfaces. In others, the person may feel as if everything – including home and family – appears strange. Hallucinations of voices, music, people, smells, or tastes may occur. These features are called “auras” or “warnings.” They may last for just a few seconds or may continue as long as a minute or two.Experiences during temporal lobe seizures vary in intensity and quality. Sometimes the seizures are so mild that the person barely notices. In other cases, the person may be consumed with fright, intellectual fascination, or even pleasure.The experiences and sensations that accompany these seizures are often impossible to describe, even for the most eloquent adult. And of course it is even more difficult to get an accurate picture of what people are feeling.

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The temporomandibular joint (TMJ) is the joint that connects your mandible (lower jaw) to your skull. The joint can be found on both sides of your head in front of your ears. It allows your jaw to open and close, enabling you to speak and eat.This abbreviation is also used to refer to a group of health problems related to your jaw. These disorders can cause tenderness at the joint, facial pain, and difficulty moving the joint. According to the National Institute of Dental and Craniofacial Research, as many as 10 million Americans suffer from TMJ. TMJ is more common among women than men. These disorders are treatable, but there are many different possible causes. This can make diagnosis difficult.Keep reading to learn more about TMJ. You should discuss any concerns with your doctor.

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The term tetraplegia refers to a condition that causes total or partial paralysis in all four limbs, including the whole of the body. Tetraplegia can be caused by injury or illness, both  of which can damage the spinal cord permanently between the levels of  C1 - 7. The term tetraplegic refers to an individual who suffers from tetraplegia. Quadriplegic is the American terminology for tetraplegic.

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Thrombocytopenia is a condition in which you have a low blood platelet count. Platelets (thrombocytes) are colorless blood cells that help blood clot. Platelets stop bleeding by clumping and forming plugs in blood vessel injuries.Thrombocytopenia often occurs as a result of a separate disorder, such as leukemia or an immune system problem. Or it can be a side effect of taking certain medications. It affects both children and adults.Thrombocytopenia may be mild and cause few signs or symptoms. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

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Pilates aims to strengthen the body in an even way, with particular emphasis on core strength to improve general fitness and wellbeing. Pilates exercises are done on a mat or using special equipment, such as the Reformer, the Cadillac and Wunda Chair. With its system of pulleys and springs, handles and straps, the apparatus can provide either resistance or support, depending on your needs.Pilates was developed by German-born Joseph Pilates, who believed mental and physical health were closely connected. His method was influenced by western forms of exercise, including gymnastics, boxing and Greco-Roman wrestling. Pilates immigrated to the US in the 1920s and opened a studio in New York, where he taught his method – which he called contrology – for several decades.


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Those who are looking to feel the burn, baby! Looking to strengthen and tone your legs and glutes? Step right up.We combine the awesome toning and strengthening power of Step aerobics, with the fun fitness-party that only Zumba® brings to the dance-floor.Zumba® Step increase cardio and calorie burning, while adding moves that define and sculpt your core and legs.


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Step aerobics is a classic cardio workout. It's lasted for decades for a simple reason: It delivers results.The "step" is a 4-inch to 12-inch raised platform. You step up, around, and down from the platform in different patterns to boost your heart rate and breathing, and strengthen your muscles.Step aerobics moves range from simple to advanced. The most basic is a step-up, step-down. Once you get more experienced, you do moves that take you over the top and around the step forwards, sideways, and backwards.Most people take step aerobics classes at a gym, with an instructor showing you each move. The instructor and the upbeat music motivate you to keep going.Your class will start with a warm-up, followed by choreographed routines on the step, and a cooldown at the end. In some classes, you'll use hand weights for strength-training moves off the step.


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This beginner level workout features basic choreography. Gin Miller, the inventor of step aerobics, leads this video. In an article appearing on the IDEA Health and Fitness Association website, Miller says "Everbody Steps" is a top seller. It's a solid, complete introduction to step workouts. You burn fat while learning the step basics from Miller, an IDEA Instructor of the Year with 12 years of step experience. Miller makes the moves understandable and explains common step-aerobic terminology in laymen's terms. The video has six distinct segments that allow you to advance at your own pace and stop when you want. The workout begins with the simplest steps and the easiest patterns and progresses into classic step-aerobic combinations, such as straddles, turns and transitions.


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A nine-to-five job shackled to your cubicle leaves you with hardly any stamina to hit the gym in the evenings. Add to that, lack of motivation and it can only spell doom for your waistline. In such a scenario, can a party workout be that much-needed boost The party workout is redefining the concept of the workout, which brings the dance club into the gym. Fitness clubs host disco-lit classes of boot-camp style routines set to pumping music played by DJs. It's the latest fitness fad hitting New York gyms, and is generally wrapped up with post-workout 'pretend'tinis made from vitamin water! While it sounds like the perfect fix for those who want a club experience minus the calories of cocktails, can it really work for you? We get experts to comment.


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Copper is an essential mineral that the body incorporates into enzymes. These enzymes play a role in the regulation of iron metabolism, formation of connective tissue, energy production at the cellular level, the production of melanin (the pigment that produces skin color), and the function of the nervous system. This test measures the amount of copper in the blood, urine, or liver (hepatic).


Copper is found in many foods including nuts, chocolate, mushrooms, shellfish, whole grains, dried fruits, and liver. Drinking water may acquire copper as it flows through copper pipes, and food may acquire it when people cook or serve food in copper dishes. Normally, the body absorbs copper from food or liquids in the intestines, converts it to a non-toxic form by binding it to a protein, and transports it to the liver. The liver stores some of the copper and binds most of the rest to another protein called apoceruloplasmin to produce the enzyme ceruloplasmin. About 95% of the copper in the blood is bound to ceruloplasmin, and most of the rest is bound to other proteins such as albumin. Only a small amount is normally present in the blood in a free (unbound) state. The liver eliminates excess copper into the bile and it is removed from the body in the stool. Some copper is also eliminated in the urine.


Both excess and deficiency of copper are rare. Wilson disease, a rare inherited disorder, can lead to excess storage of copper in the liver, brain, and other organs. Copper excess (toxicity) can also occur when a person is exposed to and absorbs large amounts over a short period of time (acute exposure) or various amounts over a long period (chronic exposure).


Copper deficiency may occasionally occur in people who have conditions associated with severe malabsorption, such as cystic fibrosis and celiac disease, and in infants exclusively fed cow-milk formulas.


A rare X-linked genetic condition called Menkes kinky hair syndrome leads to copper deficiency in the brain and liver of affected infants. The disease, which affects primarily males, is associated with seizures, delayed development, abnormal artery development in the brain, and unusual gray brittle kinky hair.

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This assay is useful for diagnosis of Acute Hepatitis B infection. It identifies Acute HBV infection in the core window period when HBsAg and Anti HBs are negative. It also differentiates between acute and chronic HBV infection in the presence of positive Anti HBc

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Blood typing is a screening test to determine blood groups and Rh antigen for blood transfusion and pregnancy. The four blood groups A, B, O, and AB are determined by the presence of antigens A and B or their absence (O) on a patient's red blood cells. In addition to ABO grouping, most immunohematology testing includes evaluation of Rh typing tests for Rh(D) antigen. Blood cells that express Rh(D) antigen are Rh positive. Red blood cells found lacking Rh(D) are considered Rh negative. Rh typing is also important during pregnancy because of the potential for mother and fetus Rh incompatiblity. If the mother is Rh negative but the father is Rh positive, the fetus may be positive for the Rh antigen. As a result, the mother’s body could develop antibodies against the Rh antigen. These antibodies may cross the placenta and cause destruction of the baby’s red blood cells, resulting in a condition known as hemolytic disease of the fetus and newborn.


Blood typing is performed by agglutination testing. The patient's red cells are tested with anti-A and anti-B antibodies for the presence or absence of agglutination (forward type, aka cell type), and patient's serum or plasma is tested against known A and B cells (reverse type, aka serum type, aka back type). Rh typing is done by testing patient red blood cells with anti-D antibody.


Transfusion of blood components of the correct blood type is necessary in order to prevent an adverse immunologic reaction. These reactions can range from very mild and sub-clinical to very severe or fatal, depending upon the components involved and condition of the recipient. Therefore, accurate assessment of both blood component and recipient ABO and Rh status is mandatory. The results of this testing will determine what blood group types a recipient may receive safely. For plasma components such as fresh frozen plasma (FFP) and platelets, it is important that the plasma be compatible with the recipient's red blood cells. This is always true for FFP which must be transfused in adequate volume to replace essential components in the recipient. For platelets, they can be concentrated if the ABO types are incompatible such that the amount of plasma given to the recipient is reduced to a minimum and the resulting hemolysis, if any, is reduced accordingly.

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C-peptide is a substance, a short chain of amino acids, that is released into the blood as a byproduct of the formation of insulin by the pancreas. This test measures the amount of C-peptide in a blood or urine sample.


In the pancreas, within specialized cells called beta cells, proinsulin, a biologically inactive molecule, splits apart to form one molecule of C-peptide and one molecule of insulin. Insulin is vital for the transport of glucose into the body's cells and is required on a daily basis. When insulin is required and released from the beta cells into the blood in response to increased levels of glucose, equal amounts of C-peptide are also released. Since C-peptide is produced at the same rate as insulin, it is useful as a marker of insulin production.


In particular, C-peptide testing can be used to help evaluate the production of insulin made by the body (endogenous) and to help differentiate it from insulin that is not produced by the body but is taken in as diabetic medication (exogenous) and so does not generate C-peptide. This test may be done in conjunction with an insulin test.





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Herpes simplex virus or HSV (family Herpesviridae) is a transmittable and infectous virus usually triggered by two strains of the herpes simplex virus, type 1 (HSV-1) and type 2 (HSV-2). HSV-1 normally affects the mouth and lips in the form of cold sores, whereas HSV-2 is more common and usually perceptible in the genital and anal area. HSV is very easily transmittable and infectous and is transmitted through contact with an infected person who produces it and sheds the virus. It could spread by direct contact with sores or occassionally by contact with the oral and genital areas of people with chronic HSV infection, who are between episodes of sores.Contamination with the herpes virus is classified by clearly distinguished disorders based on where the infection is like infection of the face, throat, and mouth, hands, eye, the central nervous system, brain, buttocks or anal area and the genitals. Ressurection of a latent oral or genital HSV contamination could set off by a fever, menstruation, emotional stress, or suppression of the immune system (for example, by a drug taken to prevent rejection of an organ transplant). An episode of the HSV infection could break out after physical trauma, like a dental procedure or overexposure of the lips to sunlight. Often, the set off is unknown. Once infected, the virus remains in the body for life and can keep recurring.


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Creatine kinase-MB (CK-MB) is a form of an enzyme found primarily in heart muscle cells. This test measures CK-MB in the blood.


CK-MB is one of three forms (isoenzymes) of the enzyme creatine kinase (CK). These isoenzymes include:


CK-MM (found in skeletal muscles and the heart)

CK-MB (found mostly in the heart, but small amounts found in skeletal muscles)

CK-BB (found mostly in the brain and smooth muscle, such as the intestines and uterus)

CK is released from muscle cells and is detectable in the blood whenever there is muscle damage. The small amount of CK that is normally in the blood is primarily CK-MM. CK-BB almost never gets into the blood, and CK-MB will typically only be present in significant amounts when the heart is damaged. A CK test measures the total level but does not distinguish between the three isoenzymes. When there is an increased amount of CK present in the blood, the CK-MB test can be used to determine whether it is due to heart damage or is more likely to be related to skeletal muscle injury.

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Creatine Kinase Total test is performed on a sample of blood to measure level of Creatine Kinase in blood.It is performed to confirm Myocardial Infraction, Myocardial Injury and Skeletal Muscle Injury and also during treatment and after treatment of Myocardial Infraction, Myocardial Injury and Skeletal Muscle Injury.

Also known as

CK - Total Spectrophotometric method Blood, CPK - Total, Creatine Phosphokinase Total Spectrophotometric method Blood, Serum CPK Test, CK - Total, Creatine Kinase Total, Creatine Phosphokinase Total, Serum CPK.

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C-reactive protein (CRP) is an acute phase reactant, a protein made by the liver and released into the blood within a few hours after tissue injury, the start of an infection, or other cause of inflammation. Markedly increased levels are observed, for example, after trauma or a heart attack, with active or uncontrolled autoimmune disorders, and with serious bacterial infections like sepsis. The level of CRP can jump as much as a thousand-fold in response to inflammatory conditions, and its rise in the blood can precede pain, fever, or other clinical indicators. The test measures the amount of CRP in the blood and can be valuable in detecting inflammation due to acute conditions or in monitoring disease activity in chronic conditions.


The CRP test is not diagnostic, but it provides information to a health practitioner as to whether inflammation is present. This information can be used in conjunction with other factors such as signs and symptoms, physical exam, and other tests to determine if someone has an acute inflammatory condition or is experiencing a flare-up of a chronic inflammatory disease. The health practitioner may then follow up with further testing and treatment.


This standard CRP test is not to be confused with an hs-CRP test. These are two different tests that measure CRP and each test measures a different range of CRP level in the blood for different purposes:


The standard CRP test measures markedly high levels of the protein to detect diseases that cause significant inflammation. It measures CRP in the range from 10 to 1000 mg/L.

The hs-CRP test accurately detects lower levels of the protein than the standard CRP test and is used to evaluate individuals for risk of cardiovascular disease. It measures CRP in the range from 0.5 to 10 mg/L.

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Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.


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Cryptococcosis is an invasive fungal infection caused by Cryptococcus neoformans or Cryptococcus gattii. C. neoformans has been isolated from several sites in nature, particularly weathered pigeon droppings. C. gatti was previously only associated with tropical and subtropical regions; however, more recently this organism has also been found to be endemic in British Columbia and among the pacific northwest United States, and is associated with several different trees species.


Infection is usually acquired via the pulmonary route. Patients are often unaware of any exposure history. Approximately half of the patients with symptomatic disease have a predisposing immunosuppressive condition such as AIDS, steroid therapy, lymphoma, or sarcoidosis. Symptoms may include fever, headache, dizziness, ataxia, somnolence, and cough. While the majority of C. neoformans infections occur in immunocompromised patient populations, C.gattii is has a higher predilection for infection of healthy hosts.(1,2)


In addition to the lungs, cryptococcal infections frequently involve the central nervous system (CNS), particularly in patients infected with HIV. Mortality among patients with CNS cryptococcosis may approach 25% despite antibiotic therapy. Untreated CNS cryptococcosis is invariably fatal. Disseminated disease may affect any organ system and usually occurs in immunosuppressed individuals.

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Cerebrospinal fluid (CSF) analysis is a set of laboratory tests that examine a sample of the fluid surrounding the brain and spinal cord. This fluid is an ultrafiltrate of plasma. It is clear and colorless. It contains glucose, electrolytes, amino acids, and other small molecules found in plasma, but has very little protein and few cells. CSF protects the central nervous system from injury, cushions it from the surrounding bone structure, provides it with nutrients, and removes waste products by returning them to the blood. CSF is withdrawn from the subarachnoid space through a needle by a procedure called a lumbar puncture or spinal tap. CSF analysis includes tests in clinical chemistry, hematology, immunology, and microbiology. Usually three or four tubes are collected. The first tube is used for chemical and/or serological analysis and the last two tubes are used for hematology and microbiology tests. This reduces the chances of a falsely elevated white cell count caused by a traumatic tap (bleeding into the subarachnoid space at the puncture site), and contamination of the bacterial culture by skin germs or flora.




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You will lie on a narrow table that slides into the center of the CT scanner. Most often, you will lie on your back with your arms raised above your head.

Once you are inside the scanner, the machine's x-ray beam rotates around you. Modern "spiral" scanners can perform the exam without stopping.

A computer creates separate images of the belly area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the belly area can be made by stacking the slices together.

You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.

The scan should take less than 30 minutes.

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An angiogram of the head and neck is an X-ray test that uses a special dye and camera (fluoroscopy) to take pictures of the blood flow in the blood vessels of the head and neck camera.gif. An angiogram of the neck (carotid angiogram) can be used to look at the large arteries in the neck that lead to the brain. An angiogram of the head (cerebral angiogram) can be used to look at the veins or the four arteries (four-vessel study) carrying blood to the brain.


During an angiogram, a thin, soft tube called a catheter is placed camera.gif into a blood vessel in the groin (femoral artery or vein) or just above the elbow (brachial artery or vein). The catheter is guided to the head and neck area. Then an iodine dye (contrast material) is injected into the vessel to make the area show clearly on the X-ray pictures. The angiogram pictures can be made into regular X-ray films or stored as digital pictures in a computer.


An angiogram can find a bulge in a blood vessel (aneurysm). It can also show narrowing or a blockage in a blood vessel that slows or stops blood flow. An abnormal pattern of blood vessels (arteriovenous [AV] malformation) or abnormal vessels near a tumor can be seen.


A magnetic resonance angiogram (MRA) or computed tomography angiogram (CTA) may be an option instead of a standard angiogram. Each of these tests is less invasive than an angiogram. Some MRA tests and all CTA tests require an injection of dye. A CTA also involves radiation exposure.


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This is a procedure used to evaluate the blood flow of the arteries in the arms or legs. Using image-guidance, doctors can determine if there is damage to or a blockage of blood flow in an artery. This is helpful in diagnosing certain conditions such as atherosclerosis (hardening of the blood vessel) or damage caused by trauma. This helps doctors in planning for future interventions, including vascular procedures (such as stent placement) or surgery.

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Hysterosalpingography is a procedure where x rays are taken of a woman's reproductive tract after a dye is injected.Hystero means uterus and salpingo means tubes, so hysterosalpingography literally means to take pictures of the uterusand fallopian tubes. This procedure may also be called hysterography (or HSG).As with other types of pelvic examinations, the woman will lie on her back on an examination table with her legssometimes raised in stirrups. The x-ray equipment is placed above the abdomen.A speculum is inserted into the vagina and a catheter (a thin tube) is inserted into the uterus through the cervix (theopening to the uterus). A small balloon in the catheter is inflated to hold it in place. A liquid water-based or oil-based dyeis then injected through the catheter into the uterus. This process can cause cramping, pain, and uterine spasms.As the dye spreads through the reproductive tract, the doctor may watch for blockages or abnormalities on an x-raymonitor. Several x rays will also be taken. The procedure takes approximately 15-30 minutes. The x rays will bedeveloped while the patient waits, but the final reading and interpretation of the x rays by a radiologist (a doctor whospecializes in x rays) may not be available for a few days.Interestingly, sometimes the hysterosalpingography procedure itself can be considered a treatment. The dye used cansometimes open up small blockages in the fallopian tubes. The need for additional test procedures or surgical treatmentsto deal with infertility should be discussed with the doctor.


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You will be asked to lie on a narrow table that slides into the center of the CT scanner.


While inside the scanner, the machine's x-ray beam rotates around you.


A computer creates many separate images of the body area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the head and neck area can be created by stacking the slices together.


You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.


Complete scans usually take only a few seconds. The newest scanners can image your entire body, head to toe, in less than 30 seconds.

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A computerized tomography (CT) coronary angiogram is an imaging test that looks at the arteries that supply blood to your heart. It might be used to diagnose the cause of chest pain or other symptoms.


A CT coronary angiogram relies on a powerful X-ray machine to produce images of your heart and its blood vessels. These tests are noninvasive and don't require recovery time. Coronary CT angiograms are increasingly an option for people with a variety of heart conditions.


A traditional (not CT-based) coronary angiogram requires that a flexible tube (catheter) be threaded through your groin or arm to your heart or coronary arteries. If you have known coronary artery disease, your doctor might recommend a traditional coronary angiogram because you can also receive treatment during that procedure.

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Despite the morbidity associated with anogenital condylomas and the mortality associated with anal, penile, and cervical carcinoma as a direct consequence of human papillomavirus (HPV), the US Centers for Disease Control and Prevention currently does not recommend routine screening for HPV in immuno competent men. However, findings of emerging research focusing on the high-risk populations of men who have sex with men and men who test positive for human immunodeficiency virus, in whom HPV infection is pervasive and persistent, suggest that these populations may benefit from screening. Therefore, HPV screening, including anal cytology, should be considered for these men in settings where appropriate follow-up, including high-resolution anoscopy, is available.

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Bronchoscopy is a procedure that looks inside the lung airways. It involves inserting a bronchoscope tube, with its light and small camera, through your nose or mouth, down your throat into your trachea, or windpipe, and to the bronchi and bronchioles of your lungs. This procedure is used to find the cause of a lung problem. It can detect tumors, signs of infection, excess mucus in the airways, bleeding, or blockages in the lungs. It also can allow your doctor to take samples of mucus or tissue for other laboratory tests, as well as to insert airway stents, or small tubes, to keep your airway open to treat some lung problems.


The procedure is performed using a flexible bronchoscope or a rigid bronchoscope. Flexible bronchoscopy is more common than rigid bronchoscopy, and flexible bronchoscopy usually does not require general anesthesia. Before the procedure, you will be given medicine to relax you. A liquid medicine also will be given to numb your nose and throat. If you have low blood oxygen levels during the procedure, you will be treated with oxygen therapy. If you have a lot of bleeding in your lungs or a large object is stuck in your airway, you may require rigid bronchoscopy in a hospital operating room under general anesthesia.


After the procedure, you will be monitored to make sure you don’t have complications. You may experience a sore throat, cough, or hoarseness that will go away with time. If you had the procedure as an outpatient, you likely will be able to go home after a few hours, but you will need a ride home because of the medicines or anesthesia you received. You will need to follow up with your doctor after the procedure to get your results.


Bronchoscopy is usually safe, but there is a small risk for fever, minor bleeding, or pneumonia. Pneumothorax, or collapsed lung, is a rare but serious side effect that can be treated. Your doctor may do a chest x ray after the procedure to check for lung problems.

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Visual Evoked Potential/ Response (VEP/VER) measures the electrical signal generated at visual cortex in response to visual stimulation. The visual cortex is primarily activated by the central visual field and there is a large presentation of the macula at occipital cortex. VEP depends on integrity of visual pathway including eye, optic nerve, chiasma, optic tract, optic radiation and cerebral cortex. Standard International Society for Clinical Electrophysiology of Vision (ISCEV) protocols[1] assess the anterior visual pathway (eye, optic nerve anterior to the optic chiasma). For dysfunctions of posterior visual pathway extended multi-channel protocols are needed.


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The inhibin A test is done to measure the amount of this hormone in a pregnant woman's blood to see if the baby may have Down syndrome. Inhibin A is made by the placenta during pregnancy. The level of inhibin A in the blood is used in a maternal serum quadruple screening test. Generally done between 15 and 20 weeks, this test checks the levels of four substances in a pregnant woman's blood. The quad screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), a type of estrogen (unconjugated estriol, or uE3), and the hormone inhibin A. The levels of these substances-along with a woman's age and other factors-help the doctor estimate the chance that the baby may have certain problems or birth defects.


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Virtual colonoscopy is a minimally invasive exam to screen for cancer of the large intestine (colon cancer). Virtual colonoscopy is also known as a screening CT colonography.


Unlike traditional colonoscopy, which requires a scope to be inserted into your rectum and advanced through your colon, virtual colonoscopy uses a CT scan to produce hundreds of cross-sectional images of your abdominal organs. The images are combined and digitally manipulated to provide a detailed view of the inside of the colon and rectum.


Virtual colonoscopy is one option used to screen for colon cancer. Discuss your colon cancer screening options with your doctor to determine whether virtual colonoscopy is the right option for you.

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The spinal cord is made up of three bones: lumbar, dorsal, and cervical. The dorsal spine, the middle portion of the cord, comprises 12 vertebrae and forms the largest portion. A CT scan with a Virtualscopy test of the dorsal spine gives a 3D scanned image of the spine. It is useful in getting a clear picture of the condition of the bones and helps in detecting any abnormalities in the same. Back pain and multiple sclerosis are the most common symptoms that call for a CT scan test of the dorsal spine. It is a relatively painless procedure.

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The advent of high-resolution computed tomography (CT) scanning in the 1980s has revolutionized diagnostic imaging of the temporal bone. CT scanning offers the greatest structural definition of any currently available imaging modality. [1, 2] The purpose of this article is to familiarize the reader with the normal anatomy of the temporal bone depicted by CT scanning. The article reviews the anatomy of the middle ear space and surrounding bone and presents radiographic imaging in both axial and coronal views, with labeled salient features and relevant text.


An axial view through the superior portion of the temporal bone can be seen below.


A study by Visvanathan and Morrissey used high-resolution CT scanning to determine that temporal bone variations are not uncommon. Evaluating 339 temporal bones, the investigators found that the incidences of deep sinus tympani, anteriorly located sigmoid sinus, high dehiscent jugular bulb, enlarged internal auditory meatus, and enlarged cochlear aqueduct were 5.01%, 2.94%, 2.76%, 1.76%, and 0.58%, respectively.

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A doctor or physician may order a CT scan of the leg to make detailed pictures and analyze the internal structure. Computerized tomography (CT) scanning is useful to get a very detailed 3D image of certain parts of legs.


The process begins by taking many different X-ray views at various different angles, which are then combined with the use of computer processing to create cross-sectional images of the bones and soft tissue inside of your body, including tissues inside of solid organ. Ordinary X-ray testing does not show clear images of soft tissue, so doctors often request CT scanning to get a good image of soft tissue including organs, muscles, blood vessels, nerves, and the brain. Sometimes a contrast dye is used as it shows up clearer on the screen.


A quality CT scan of the leg will use multiple x-rays to make cross sectional pictures of the leg.

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Computed tomography (CT) of the abdomen and pelvis is a diagnostic imaging test used to help detect diseases of the small bowel, colon and other internal organs and is often used to determine the cause of unexplained pain. CT scanning is fast, painless, noninvasive and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.


Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking, and allergies. You will be instructed not to eat or drink anything for a few hours beforehand. If you have a known allergy to contrast material, your doctor may prescribe medications to reduce the risk of an allergic reaction. These medications must be taken 12 hours prior to your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A CT scan, commonly referred to as a CAT scan, is a type of X-ray that produces cross-sectional images of a specific part of the body. In the case of a lumbar spine CT scan, your doctor can see a cross-section of your lower back. The scanning machine circles the body and sends images to a computer monitor, where they are reviewed by a technician.


The lumbar portion of the spine is a common area where back problems occur. The lumbar spine is the lowest portion of your spine. It’s made up of five vertebral bones. Below the lumbar spine is the sacrum and below the sacrum is the coccyx (tailbone). Large blood vessels, nerves, tendons, ligaments, and cartilage are also part of the lumbar spine.

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As an ancillary test for congenital adrenal hyperplasia (CAH), particularly in situations in which a diagnosis of 21-hydroxylase and 11-hydroxylase deficiency have been ruled out


Confirming a diagnosis of 3-beta-hydroxy dehydrogenase (3-beta-HSD) deficiency


Analysis for 17-hydroxypregnenolone is also useful as part of a battery of tests to evaluate females with hirsutism or infertility; both can result from adult-onset CAH

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The hormone 17-hydroxyprogesterone is a building block for producing the hormone cortisol. Cortisol is produced mainly by the adrenal cortex (the outer part of the two adrenal glands, located above the kidneys). Cortisol is called the "stress hormone" because it's secreted in larger amounts as part of the body's response to physical or emotional stress.


Cortisol levels normally vary throughout the day. They're highest in the morning, just before waking up, and lowest at night.


Some people, however, can't make enough cortisol because they lack an enzyme in the adrenal glands that's needed to make it. They'll have a buildup of 17-hydroxyprogesterone in the blood because it's not being converted to cortisol.


In kids, the most common cause of cortisol deficiency, and consequently high levels of 17-hydroxyprogesterone, is one of the forms of the genetic disorder congenital adrenal hyperplasia (CAH).


CAH can affect both boys and girls. It causes the adrenal glands to make excess androgens (male steroid hormones) and, in some cases, not enough of the hormones that regulate the body's salt balance.


Though treatable, undetected CAH can sometimes lead to more serious symptoms such as dehydration and shock in infants.

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Testosterone plays a central role in male development and health. Likewise, androgen deficiency, or hypogonadism, is associated with a variety of symptoms including decreased energy, diminished libido and erectile dysfunction, among others. Male androgen levels steadily decline with age, and, in a subset of symptomatic older men, can result in late-onset hypogonadism (LOH). Over the last decade, increased awareness of hypogonadism among patients and providers has led to a significant rise in the use of testosterone replacement therapy (TRT) for hypogonadism, and especially in LOH. Accompanying the rise in TRT are concerns of potential adverse effects, including cardiovascular risks and the promotion of prostate cancer. The ‘androgen hypothesis’ asserts that prostate cancer development and progression is driven by androgens, and thus TRT has the theoretical potential to drive prostate cancer development and progression. In this review, we examine existing data surrounding testosterone and prostate cancer. There is significant evidence that androgens promote prostate cancer in experimental systems. However, there is no clear evidence that elevations in endogenous testosterone levels promote the development of prostate cancer in humans. As a result of experimental and historical data on the progression of prostate cancer following TRT, there has been widespread belief that TRT will promote disease progression in prostate cancer patients. Despite these fears, there are a growing number of studies demonstrating no increase in prostate cancer incidence among men on TRT. Furthermore, in studies involving a small number of patients, there has been no discernable increase in disease progression in prostate cancer patients on TRT. While data from large, prospective, randomized, controlled trials are absent, TRT in select prostate cancer patients is likely safe. In the end, the use of TRT in prostate cancer patients is still considered experimental and should only be offered after well-informed shared decision making and with close monitoring.

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White blood cells are an important part of your body’s immune system. They’re vital to protecting you from invading bacteria, viruses, and parasites. Your bone marrow produces all five of the different kinds of white blood cells in the body.


Each white blood cell lives anywhere from several hours to several days in the blood stream. An eosinophil is a type of white blood cell. Eosinophils are stored in tissues throughout the body, surviving for up to several weeks. The bone marrow continually replenishes the body’s white blood cell supply.


The number and type of each white blood cell in your body can give doctors a better understanding of your health. Elevated levels of white blood cells in your blood can be an indicator that you have an illness or infection. Elevated levels often mean your body is sending more and more white blood cells to fight off infections.


An eosinophil count is a blood test that measures the quantity of eosinophils in your body. Abnormal eosinophil levels are often discovered as part of a routine complete blood count (CBC) test.


Ongoing research continues to uncover an expanding list of roles performed by eosinophils. It appears now that nearly every system of the body relies on eosinophils in some way. Two important functions are within your immune system. Eosinophils destroy invading germs like viruses, bacteria, or parasites such as hookworms. They also have a role in the inflammatory response, especially if an allergy is involved.


Inflammation is neither good nor bad. It helps isolate and control the immune response at the site of an infection, but a side effect is tissue damage around it. Allergies are immune responses that often involve chronic inflammation. Eosinophils play a significant role in the inflammation related to allergies, eczema, and asthma.

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Most of the time blood is drawn from a vein on the inside of the elbow or the back of the hand. The site is cleaned with an antiseptic. The health care provider wraps an elastic band around your upper arm to make the vein swell with blood.


Next, the provider gently inserts a needle into the vein. The blood collects into an airtight tube attached to the needle. The elastic band is removed from your arm. The needle is then removed and the site is covered to stop bleeding.


In infants or young children, a sharp tool called a lancet may be used to prick the skin. The blood collects in a small glass tube, or onto a slide or test strip. A bandage is put on the spot to stop bleeding.


In the lab, the blood is placed on a microscope slide. A stain is added to the sample. This causes eosinophils to show up as orange-red granules. The technician then counts how many eosinophils are present per 100 cells. The percentage of eosinophils is multiplied by the white blood cell count to give the absolute eosinophil count.

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Prostatic acid phosphatase (PAP) is an enzyme that is found in the prostate gland and semen of men. If the prostate isn’t working properly, then PAP is released into the blood. PAP determination in conjunction with PSA measurements is useful in assessing the prognosis of prostate cancer.1,2 Measurement of two markers allows identification of prostate cancer patients who have an elevation of PAP but not of PSA, and thus help monitoring the course of disease and response to treatment.

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Protein C, a part of the natural anticoagulant system, is a vitamin K-dependent protein zymogen (molecular weight=62,000 da) that is synthesized in the liver and circulates at a plasma concentration of approximately 5 mcg/mL. Protein C is activated to activated protein C (APC) via proteolytic cleavage by thrombin bound to thrombomodulin, an endothelial cell surface membrane protein. APC downregulates the procoagulant system by proteolytically inactivating procoagulant factors Va and VIIIa. Protein S, another vitamin K-dependent coagulation protein, catalyzes APC inactivation of factors Va and VIIIa. APC interacts with and proteolyses factors V/Va and VIII/VIIIa at specific APC binding and cleavage sites, respectively. Resistance to activated protein C (APC resistance) is a term used to describe abnormal resistance of human plasma to the anticoagulant effects of human APC. APC resistance is characterized by a reduced anticoagulant response of patient plasma after adding a standard amount of APC. For this assay, the activated partial thromboplastin time clotting test fails to prolong significantly after the addition of APC.

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Alpha-fetoprotein (AFP) is a single polypeptide chain glycoprotein with a molecular weight of approximately 70,000 daltons. Synthesis of AFP occurs primarily in the liver and yolk sac of the fetus. It is secreted in fetal serum, reaching a peak at approximately 13 weeks gestation, after which it rapidly declines until about 22 weeks gestation and then gradually declines until term. Transfer of AFP into maternal circulation is accomplished primarily through diffusion across the placenta. Maternal serum AFP levels rise from the normal nonpregnancy level of 0.20 ng/mL to about 250 ng/mL at 32 weeks gestation.


If the fetus has an open neural tube defect, AFP is thought to leak directly into the amniotic fluid causing unexpectedly high concentrations of AFP. Other fetal abnormalities such as omphalocele, gastroschisis, congenital renal disease, and esophageal atresia; and other fetal distress situations such as threatened abortion, prematurity, and fetal demise, may also show AFP elevations. Decreased amniotic fluid AFP values may be seen when gestational age has been overestimated.

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Alpha-fetoprotein (AFP) is a protein produced in the liver of a developing fetus. During a baby's development, some AFP passes through the placenta and into the mother's blood. An AFP test measures the level of AFP in pregnant women during the second trimester of pregnancy. Too much or too little AFP in a mother's blood may be sign of a birth defect or other condition. These include:


A neural tube defect, a serious condition that causes abnormal development of a developing baby's brain and/or spine

Down syndrome, a genetic disorder that causes intellectual disabilities and developmental delays

Twins or multiple births, because more than one baby is producing AFP

Miscalculation of due date, because AFP levels change during pregnancy

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PNS is the full form of Para Nasal Sinuses. A Computed Tomography (CT) Scan of the PNS is an imaging test of sinuses which uses X-Rays to bring out in-depth images of air-filled spaces within the bones of the face, surrounding the nasal cavity. It usually includes the upper area of the throat, behind the nose. Some doctors refer to CT Scan PNS as Sinus CT Scan also. 

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Alpha-fetoprotein (AFP) is a glycoprotein that is produced in early fetal life by the liver and by a variety of tumors including hepatocellular carcinoma, hepatoblastoma, and nonseminomatous germ cell tumors of the ovary and testis (eg, yolk sac and embryonal carcinoma). Most studies report elevated AFP concentrations in approximately 70% of patients with hepatocellular carcinoma. Elevated AFP concentrations are found in 50% to 70% of patients with nonseminomatous testicular tumors.(1)


AFP is elevated during pregnancy. Persistence of AFP in the mother following birth is a rare hereditary condition.(2) Neonates have markedly elevated AFP levels (>100,000 ng/mL) that rapidly fall to below 100 ng/mL by 150 days and gradually return to normal over their first year.(2)


Concentrations of AFP above the reference range also have been found in serum of patients with benign liver disease (eg, viral hepatitis, cirrhosis), gastrointestinal tract tumors and, along with carcinoembryonic antigen in ataxia telangiectasia.

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A CT scan uses X-rays to make detailed pictures camera.gif of the spine and vertebrae camera.gif.


During the test, you will lie on a table that is attached to the CT scanner, which is a large doughnut-shaped machine. The CT scanner sends X-rays through the body. Each rotation of the scanner takes a second and provides a picture of a thin slice of the organ or area being studied. One part of the scanning machine can tilt to follow the curve of your spine. All of the pictures are saved as a group on a computer. They also can be printed.


In some cases, a dye called contrast material may be put in a vein (IV) in your arm or into the spinal canal. The dye makes structures and organs easier to see on the CT pictures. The dye may be used to check blood flow and look for tumors, areas of inflammation, or nerve damage.

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Abdominal and Pelvic CT scan shows the abdominal and pelvic organs of our body (such as the pancreas, liver, kidneys, spleen, and adrenal glands) and the gastrointestinal tract. A doctor usually orders this test to check for a cause of abnormal pain and sometimes to follow-up on an abnormality seen on another test such as an ultrasound.

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An alpha-fetoprotein (AFP) blood test checks the level of AFP in a pregnant woman's blood. AFP is a substance made in the liver of an unborn baby (fetus). The amount of AFP in the blood of a pregnant woman can help see whether the baby may have such problems as spina bifida and anencephaly. An AFP test can also be done as part of a screening test to find other chromosomal problems, such as Down syndrome (trisomy 21) or Edwards syndrome (trisomy 18). An AFP test can help find an omphalocele, a congenital problem in which some of the baby's intestines stick out through the belly wall.


Normally, low levels of AFP can be found in the blood of a pregnant woman. No AFP (or only a very low level) is generally found in the blood of healthy men or healthy, nonpregnant women.


The level of AFP in the blood is used in a maternal serum triple or quadruple screening test. Generally done between 15 and 20 weeks, these tests check the levels of three or four substances in a pregnant woman's blood. The triple screen checks alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and a type of estrogen (unconjugated estriol, or uE3). The quad screen checks these substances and the level of the hormone inhibin A. The levels of these substances-along with a woman's age and other factors-help the doctor estimate the chance that the baby may have certain problems or birth defects.

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To determine whether the presence of circulating desialylated glycoproteins reflect the existence and/or the severity of liver disease, 73 patients were evaluated with liver biopsies, conventional liver function tests, and the measurement of the degree of desialylation of two glycoproteins alpha 1-acid glycoprotein (alpha 1-AGP) and alpha 1-antitrypsin (alpha 1-AT). A combination of two immunological methods, available as routine laboratory tests, was used for the determination of the desialylation of alpha 1-AGP and alpha 1-AT. The severity of liver disease was assessed by a clinical classification depending upon the presence or absence of four complications (jaundice, ascites, hepatic encephalopathy, and weight loss). The presence of serum desialylated alpha 1-AGP did not allow detection of mild liver disease, but asialo alpha 1-AGP (and to a lesser extent of asialo-alpha 1-(AT) correlated with the severity of liver disease. The sensitivity of desialylated alpha 1-AGP in detection of severe liver disease was 65%, and its specificity was 80%.

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Blood typing is a screening test to determine blood groups and Rh antigen for blood transfusion and pregnancy. The four blood groups A, B, O, and AB are determined by the presence of antigens A and B or their absence (O) on a patient's red blood cells. In addition to ABO grouping, most immunohematology testing includes evaluation of Rh typing tests for Rh(D) antigen. Blood cells that express Rh(D) antigen are Rh positive. Red blood cells found lacking Rh(D) are considered Rh negative. Rh typing is also important during pregnancy because of the potential for mother and fetus Rh incompatiblity. If the mother is Rh negative but the father is Rh positive, the fetus may be positive for the Rh antigen. As a result, the mother’s body could develop antibodies against the Rh antigen. These antibodies may cross the placenta and cause destruction of the baby’s red blood cells, resulting in a condition known as hemolytic disease of the fetus and newborn.


Blood typing is performed by agglutination testing. The patient's red cells are tested with anti-A and anti-B antibodies for the presence or absence of agglutination (forward type, aka cell type), and patient's serum or plasma is tested against known A and B cells (reverse type, aka serum type, aka back type). Rh typing is done by testing patient red blood cells with anti-D antibody.


Transfusion of blood components of the correct blood type is necessary in order to prevent an adverse immunologic reaction. These reactions can range from very mild and sub-clinical to very severe or fatal, depending upon the components involved and condition of the recipient. Therefore, accurate assessment of both blood component and recipient ABO and Rh status is mandatory. The results of this testing will determine what blood group types a recipient may receive safely. For plasma components such as fresh frozen plasma (FFP) and platelets, it is important that the plasma be compatible with the recipient's red blood cells. This is always true for FFP which must be transfused in adequate volume to replace essential components in the recipient. For platelets, they can be concentrated if the ABO types are incompatible such that the amount of plasma given to the recipient is reduced to a minimum and the resulting hemolysis, if any, is reduced accordingly.

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Alpha-1-antitrypsin (A1A) is the most abundant serum protease inhibitor and inhibits trypsin and elastin, as well as several other proteases. The release of proteolytic enzymes from plasma onto organ surfaces and into tissue spaces results in tissue damage unless inhibitors are present. Congenital deficiency of A1A is associated with the development of emphysema at an unusually early age and with an increased incidence of neonatal hepatitis, usually progressing to cirrhosis.

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Alpha-2-macroglobulin is a protease inhibitor and is 1 of the largest plasma proteins. It transports hormones and enzymes, exhibits effector and inhibitor functions in the development of the lymphatic system, and inhibits components of the complement system and hemostasis system.


Increased levels of alpha-2-macroglobulin are found in nephrotic syndrome when other lower molecular weight proteins are lost and alpha-2-macroglobulin is retained because of its large size. In patients with liver cirrhosis and diabetes, the levels are found to be elevated.


Patients with acute pancreatitis exhibit low serum concentrations which correlate with the severity of the disease. In hyperfibrinolytic states, after major surgery, in septicemia and severe hepatic insufficiency, the measured levels of alpha-2-macroglobulin are often low. Acute myocardial infarction patients with low alpha-2-macroglobulin have been reported to have a significantly better prognosis with regard to the >1 year survival time.

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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels





 

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A dexamethasone suppression test is primarily used to help diagnose Cushing syndrome. Cushing syndrome indicates that you have an abnormally high level of cortisol. Cortisol is a steroid hormone produced by the body during high levels of stress. (Abnormally low cortisol levels can be a sign of Addison’s disease, which is not diagnosed by this test.)

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Cardiolipin antibodies (CA) are seen in a subgroup of patients with autoimmune disorders, particularly systemic lupus erythematosus (SLE), who are at risk for vascular thrombosis, thrombocytopenia, cerebral infarct and/or recurrent spontaneous abortion. Elevations of CA associated with increased risk have also been seen in idiopathic thrombocytopenic purpura, rheumatoid and psoriatic arthritis, and primary Sjögren's syndrome.

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Antineutrophil cytoplasmic antibodies (ANCA) can occur in patients with autoimmune vasculitis including Wegener's granulomatosis (WG), microscopic polyangiitis (MPA), or organ-limited variants thereof such as pauci-immune necrotizing glomerulonephritis.(1) Detection of ANCA is a well-established diagnostic test for the evaluation of patients suspected of having autoimmune vasculitis. ANCA react with enzymes in the cytoplasmic granules of human neutrophils including proteinase 3 (PR3), myeloperoxidase (MPO), elastase, and cathepsin G. Antibodies to PR3 occur in patients with WG (both classical WG and WG with limited end-organ involvement) and produce a characteristic pattern of granular cytoplasmic fluorescence on ethanol-fixed neutrophils called the cANCA pattern. Antibodies to MPO occur predominately in patients with MPA and produce a pattern of perinuclear cytoplasmic fluorescence on ethanol-fixed neutrophils called the pANCA pattern.

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An antisperm antibody test looks for special proteins (antibodies) that fight against a man's sperm in blood, vaginal fluids, or semen. The test uses a sample of sperm and adds a substance that binds only to affected sperm.


Semen can cause an immune system response in either the man's or woman's body. The antibodies can damage or kill sperm. If a high number of sperm antibodies come into contact with a man's sperm, it may be hard for the sperm to fertilize an egg. The couple has a hard time becoming pregnant. This is also called immunologic infertility.

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Apolipoprotein A1 (ApoA1) is the primary protein associated with high-density lipoprotein (HDL) particles, and plays a central role in reverse cholesterol transport.(1) HDL cholesterol (HDL-C) and ApoA1 concentrations are inversely related to the risk for coronary artery disease (CAD).(2) There are a variable number of ApoA1 proteins per HDL particle. Therefore, ApoA1 is not a 1:1 surrogate marker for HDL particles. Similarly, the number of ApoA1 proteins and the amount of cholesterol contained in HDL particles is highly variable. This heterogeneity has led to unique clinical findings related to ApoA1 compared with HDL-C.


Increased ApoA1 concentrations are more strongly associated with a reduction in risk of a first myocardial infarction than HDL-C concentrations.(3) Low concentrations of ApoA1, but not HDL-C, are predictive of preclinical atherosclerosis as assed by computed tomography estimated coronary artery calcium (CAC) scoring.(4) Increased ApoA1, but not HDL-C concentrations, are associated with reduced cardiovascular events among statin-treated patients, even when LDL-C <50 mg/dL.(5) In statin-treated patients, patients whose ApoA1 increased while on treatment were at lower risk than those whose ApoA1 did not increase.


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The activated partial thromboplastin time (APTT) assay is used as a screening test to evaluate the overall integrity of the intrinsic/common coagulation pathway and to monitor patients on heparin therapy.


This test reflects the activities of most of the coagulation factors in the intrinsic and common procoagulant pathway, but not the extrinsic procoagulant pathway, which includes factor VII and tissue factor, nor the activity of factor XIII (fibrin stabilizing factor).


Effective November 2016, APTT will no longer be used as the primary method for therapeutic heparin monitoring, for that purpose, order the heparin anti-Xa assay HEPTP / Heparin Anti-Xa Assay, Plasma.

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An echocardiogram (echo) is a graphic outline of the heart's movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart's valves and chambers and helps the sonographer evaluate the pumping action of the heart. Echo is often combined with Doppler ultrasound and color Doppler to evaluate blood flow across the heart's valves.

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Arginine vasopressin (AVP), or antidiuretic hormone (ADH), is a nonapeptide produced by the hypothalamus and released from the posterior pituitary in response to extracellular fluid hyperosmolarity and hypovolemia. AVP promotes concentration of the urine by increasing water reabsorption in the kidney tubules. Inadequate AVP action causes diabetes insipidus (DI), a syndrome characterized by nonglycosuric polyuria, polydipsia, and dehydration. Central DI refers to insufficient AVP release due to diseases of the hypothalamus, pituitary stalk, and pituitary gland. Nephrogenic DI is the result of impaired renal responsiveness to AVP and may be congenital or due to renal disease, hypokalemia, hypercalcemia, systemic disorders (eg, multiple myeloma and amyloidosis), or drugs (eg, lithium or demeclocycline and ethanol).


DI diagnosis is based on the presence of hyperosmolar serum with inappropriately dilute urine. Central and nephrogenic DI can be differentiated by measuring the plasma AVP level and interpreting it in light of the simultaneous plasma osmolality.


The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is manifested by hyponatremia and inappropriately concentrated urine. The diagnosis is confirmed by plasma or urine AVP levels inappropriate for serum osmolality.

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Fetal echocardiography is a test similar to an ultrasound. This exam allows your doctor to better see the structure and function of your unborn child’s heart. It’s typically done in the second trimester, between weeks 18 to 24.


The exam uses sound waves that “echo” off of the structures of the fetus’ heart. A machine analyzes these sound waves and creates a picture, or echocardiogram, of their heart’s interior. This image provides information on how your baby’s heart has formed and whether it’s working properly.


It also allows your doctor to see the blood flow through their heart. This in-depth look allows your doctor to find any defects or abnormalities in the baby’s blood flow or heartbeat.

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Aspergillus precipitin is a laboratory test performed on your blood. It’s ordered when a doctor suspects that you have an infection caused by the fungus Aspergillus.


The test may also be called:


aspergillus fumigatus 1 precipitin level test

aspergillus antibody test

aspergillus immunodiffusion test

test for precipitating antibodies


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The child will lie down tilted slightly on his / her side on a hospital bed in our child-friendly examination room, not an operating room. Many exam rooms are equipped with a television to keep a child entertained and alleviate boredom. The child must be undressed from the waist up and can choose to wear a short gown.


To improve the quality of the pictures, a colorless, warm gel is applied to the skin on the area of the chest where the heart is located. A transducer, a small microphone-like device, is placed on top of the gel and against the skin. The transducer uses sound waves, which bounce off the different parts of a child's heart, creating a picture.


The transducer is moved over the chest, abdominal area, and neck in order to obtain the images.


The sounds you may hear from the echo machine are the sounds of the blood flowing from one chamber to another and the valves opening or closing as the blood moves through the heart.


The colors you see on the screen are not the colors of the blood. The colors tell us what direction the blood is flowing. The red color shows the blood is flowing towards the transducer and the blue color shows blood is flowing away. A child may feel some discomfort from the pressure of the transducer. Pediatric echosonographers are trained to complete scans in as pain-free and patient-sensitive manner as possible. 


A computer interprets the information from the transducer to make an image of the heart appear on the screen. This image is recorded into a digital storage system for the cardiologist to measure and review. 

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A stress echocardiography, also called an echocardiography stress test or stress echo, is a procedure that determines how well your heart and blood vessels are working.


During a stress echocardiography, you’ll exercise on a treadmill or stationary bike while your doctor monitors your blood pressure and heart rhythm. When your heart rate reaches peak levels, your doctor will take ultrasound images of your heart to determine whether your heart muscles are getting enough blood and oxygen while you exercise.


Your doctor may order a stress echocardiography test if you have chest pain that they think is due to coronary artery disease or a myocardial infarction, which is a heart attack. This test also determines how much exercise you can safely tolerate if you’re in cardiac rehabilitation. The test can also tell your doctor how well treatments such as bypass grafting, angioplasty, and anti-anginal or antiarrhythmic medications are working.

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A brainstem auditory evoked response (BAER) test measures how your brain processes the sounds you hear. The BAER test records your brainwaves in response to clicks or other audio tones that are played for you. The test is also called a brainstem auditory evoked potentials (BAEP) or auditory brainstem response (ABR) test.


A BAER test can help to diagnose hearing loss and nervous system disorders, especially in newborns, young children, and others who may not be able to participate in a standard hearing test.


BAER tests are often administered to canines and are the only scientifically reliable way to test a dog’s ability to hear with one or both ears.

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The Bence-Jones protein (BJP) test measures the level of BJP in your urine. Bence-Jones proteins are named for Henry Bence-Jones, a physician and chemist who first isolated them in 1847. These proteins are not present in healthy urine samples and are usually a sign of multiple myeloma. Multiple myeloma is a type of bone marrow cancer that is most common in people who are older than 60 years.


Your bone marrow is found in the center of your larger bones. It makes red and white blood cells as well as platelets. Multiple myeloma is a condition where your bone marrow makes too much of a type of white blood cell.


Normally, white blood cells make many different types of antibodies. They play an important role in your immune system. However, when you have multiple myeloma, one white blood cell line grows out of control. It produces only one type of antibody. These cells then crowd out the normal cells. Your body is then vulnerable to illness.

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Electrolytes are minerals that are found in body tissues and blood in the form of dissolved salts. As electrically charged particles, electrolytes help move nutrients into and wastes out of the body's cells, maintain a healthy water balance, and help stabilize the body's acid/base (pH) level.


The electrolyte panel measures the blood levels of the main electrolytes in the body: sodium (Na+), potassium (K+), chloride (Cl-), and bicarbonate (HCO3-; sometimes reported as total CO2).


A person's diet provides sodium, potassium, and chloride. The kidneys help maintain proper levels by reabsorption or by elimination into the urine. The lungs provide oxygen and regulate CO2. The CO2 is produced by the body and is in balance with bicarbonate. The overall balance of these chemicals is an indication of the functional well-being of several basic body functions. They are important in maintaining a wide range of body functions, including cardiac and skeletal muscle contraction and nerve impulse conduction.


Any disease or condition that affects the amount of fluid in the body, such as dehydration, or affects the lungs, kidneys, metabolism, or breathing has the potential to cause a fluid, electrolyte, or pH imbalance (acidosis or alkalosis). Normal pH must be maintained within a narrow range of 7.35-7.45 and electrolytes must be in balance to ensure the proper functioning of metabolic processes and the delivery of the right amount of oxygen to tissues. (For more on this, see the condition article on Acidosis and Alkalosis and also on Dehydration.)

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You can do a lot to take care of yourself and give your body what it needs. Still, as you get older, your body changes in ways you can’t always control. For most men, one of those changes is that the prostate gets bigger.


It’s a natural part of aging, but at some point, it can lead to a condition called BPH, or benign prostatic hyperplasia.


Your prostate surrounds part of your urethra, the tube that carries urine and semen out of your penis. When you have BPH, your prostate is larger than usual, which squeezes the urethra. This can cause a weak stream when you pee and cause you to wake up a lot at night to go to the bathroom.


BPH isn’t prostate cancer and doesn’t make you more likely to get it.


It’s a common condition, especially in older men, and there are a lot of treatments for it, from lifestyle changes to surgery. Your doctor can help you choose the best care based on your age, health, and how the condition affects you.

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We reviewed the records of 52 amyotrophic lateral sclerosis (ALS) patients examined between 1995 and 2000 who had needle electromyography (EMG) of their respiratory muscles, including the diaphragm, at or near the time of their diagnosis. With respiratory function testing, patients with abnormal diaphragmatic EMG at diagnosis (Group 1, n=23) had significantly lower forced vital capacity (FVC), lower daytime arterial PO(2) and higher PCO(2) measurements (p<0.05) than patients with normal diaphragmatic EMG (Group 2, n=29). Twenty-eight percent of the patients without symptoms or signs of respiratory insufficiency at the time they were examined had an abnormal diaphragm EMG. Mean survival of Groups 1 and 2 were similar. However, sub-analysis of patients within each group, comparing those treated with non-invasive positive pressure ventilation (NIPPV) with those not treated, showed that treated patients in Group 1 (abnormal diaphragm EMG) survived significantly longer (p<0.05) than untreated patients. They also started NIPPV earlier than treated patients in Group 2. We conclude that respiratory muscle EMG was simply and safely performed on ALS patients at or around the time of diagnosis. The procedure can detect sub-clinical respiratory muscle dysfunction. The technique used for EMG of the respiratory muscles, its pitfalls and contraindications are also reviewed.

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Intravenous pyelogram (IVP) is an x-ray exam that uses an injection of contrast material to evaluate your kidneys, ureters and bladder and help diagnose blood in the urine or pain in your side or lower back. An IVP may provide enough information to allow your doctor to treat you with medication and avoid surgery.Inform your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to iodine-based contrast materials. Your doctor may instruct you to take a mild laxative the evening before the exam and to not eat or drink anything after midnight. Wear loose, comfortable clothing and leave jewelry at home. You may be asked to wear a gown.


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Hypoperfusion is the most common cause of lactic acidosis and hyperlactacidemia may be the only marker of tissue hypoperfusion.1 Suspect lactic acidosis when unexplained anion gap metabolic acidosis is encountered, especially if azotemia or ketoacidosis are not present. Evaluate metabolic acidosis, regional or diffuse tissue hypoperfusion, hypoxia, shock,2 congestive heart failure, dehydration, complicated postoperative state, ketoacidosis or nonketotic acidosis in diabetes mellitus, patients with infections, inflammatory states, postictal state, certain myopathies, acute leukemia and other neoplasia, enzyme defects, glycogen storage disease (type I), thiamine deficiency, and hepatic failure. A spontaneous form of lactic acidosis occurs. It is a prognostic index in particular clinical settings, especially in critically ill patients in shock.3 A relationship to renal disease also exists. With skin rash, seizures, alopecia, ataxia, keratoconjunctivitis, and lactic acidosis in children, consider defective biotin metabolism.4 Phenformin, ethanol, methanol, and salicylate poisoning and ethylene glycol may cause lactic acidosis. Acetaminophen toxicity causes lactic acidosis, sometimes with hypoglycemia. Cyanide, isoniazid, and propylene glycol are among the causes of lactic acidosis.1 Lactic acidosis may be due to inborn errors of metabolism.

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This course shows you videos of the commonly studied muscles in the upper extremity, insertional activity and muscle activation and motor unit analysis techniques to help you gain a working understanding of the technical skills you need to perform needle EMG examinations. The video will focus on muscle localization and needle insertion techniques, what results you should expect, how to study the shape, amplitude and duration of motor unit waveforms, pitfalls and common errors you should watch for. Muscles studied include the First Dorsal Interosseous (FDI), the Abductor Pollicis Brevis (APB), the Flexor Carpi Radialis (FCR) the Brachio-Radialis (BR), the Triceps (TRI), the Deltoid (DEL) and the Cervical Paraspinals.

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Lupus erythematosus (LE) cell testing was once performed to diagnose systemic lupus erythematous but has been replaced for this purpose by antinuclear antibody testing.

Negative findings on LE cell testing exclude a diagnosis of systemic lupus erythematosus (SLE).

The presence of LE cells indicates lupus.

A smear is considered positive when 10 or more characteristic LE cells are seen during a 15-minute search, associated with the presence of extracellular, amorphous, nuclear masses.

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The pemphigus   Pemphigus foliaceus  and pemphigoid   Skin: bullous pemphigoid  autoimmune skin diseases   Immune-mediated disease: overview   are mediated by autoantibodies that target antigens within the interkeratinocyte desmosomes (pemphigus) or the basement membrane zone hemidesmosomes (pemphigoid).

A range of laboratory methods may be used to demonstrate the presence of these autoantibodies. These tests have not been used widely in equine pemphigus or pemphigoid diseases and, in those report available, have shown variable sensitivity and specifity.

Autoantibodies may be detected either in situ(within lesional skin biopsies), or circulating with the serum of affected animals.

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Leptin is a hormone produced by fat cells in the body. It is the gatekeeper of fat metabolism, monitoring how much energy a person takes in. Leptin acts to maintain energy balance in the body by regulating metabolism and hunger. The level of leptin circulating in your body is directly proportional to the total amount of fat you have. That means the more fat you have, the greater the amount of leptin you have. When present in high levels, it signals our brain that we’re full and can stop eating. When low, we feel hungry and crave food. Most people don't have a leptin deficiency, rather they have lost sensitivity to their leptin. Much like insulin resistance, it's possible to have enough leptin in your blood, but because your body doesn't use it effectively, you still feel hungry. In these cases, the leptin is not getting into the brain effectively and it is important to take measures to improve your body’s leptin sensitivity. This improvement can help you maintain a stable body weight.

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Leptospirosis is a zoonotic disease transmitted through soil, food or water contaminated by urine of infected animal. Illness may be self limiting or cause Hepatorenal failure (Weil syndrome. IgM antibodies appear within 1-2 weeks after onset of illness and peak at 2-4 weeks.Leptospirosis is a zoonotic disease transmitted through soil, food or water contaminated by urine of infected animal. Illness may be self limiting or cause Hepatorenal failure (Weil syndrome. IgM antibodies appear within 1-2 weeks after onset of illness and peak at 2-4 weeks.

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Epstein-Barr virus (EBV) is a virus that typically causes a mild to moderate illness. Blood tests for Epstein-Barr virus detect antibodies to EBV in the blood and help establish a diagnosis of EBV infection.


Epstein-Barr virus causes an infection that is very common. According to the Centers for Disease Control and Prevention (CDC), most people in the United States are infected by EBV at some point in their lives. The virus is very contagious and easily passed from person to person. It is present in the saliva of infected individuals and can be spread through close contact such as kissing and through sharing utensils or cups.


After initial exposure to EBV, there is a period of several weeks before associated symptoms may appear, called the incubation period. During the acute primary infection, the virus multiplies in number. This is followed by a decrease in viral numbers and resolution of symptoms, but the virus never completely goes away. Latent EBV remains in the person's body for the rest of that person's life and may reactivate but usually causes few problems unless the person's immune system is significantly weakened.


Most people are infected by EBV in childhood and experience few or no symptoms. However, when the initial infection occurs in adolescence, it can cause infectious mononucleosis, commonly called mono, a condition associated with fatigue, fever, sore throat, swollen lymph nodes, an enlarged spleen, and sometimes an enlarged liver. These symptoms occur in about 25% of infected teens and young adults and usually resolve within a month or two.


People with mono are typically diagnosed by their symptoms and the findings from a complete blood count (CBC) and a mono test (which tests for a heterophile antibody). About 25% of those with mono do not produce heterophile antibodies and will have a negative mono test; this is especially true with children. Tests for EBV antibodies can be used to determine whether or not the symptoms these people are experiencing are due to a current infection with the EBV virus.


EBV is the most common cause of mono. According to the CDC, examples of other causes of mono include cytomegalovirus (CMV), hepatitis A, hepatitis B or hepatitis C, rubella, and toxoplasmosis. Sometimes, it can be important to distinguish EBV from these other illnesses. For instance, it may be important to diagnose the cause of symptoms of a viral illness in a pregnant woman. Testing can help to distinguish a primary EBV infection, which has not been shown to affect a developing baby, from a CMV, herpes simplex virus, or toxoplasmosis infection, as these illnesses can cause complications during the pregnancy and may harm the fetus.


It can also be important to rule out EBV infection and to look for other causes of the symptoms. Those with strep throat, an infection caused by group A streptococcus, for instance, need to be identified and treated with antibiotics. A person may have strep throat instead of mono or may have both conditions at the same time.


Several tests for different types and classes of EBV antibodies are available. The antibodies are proteins produced by the body in an immune response to several different Epstein-Barr virus antigens. During a primary EBV infection, the level of each of these EBV antibodies rises and falls at various times as the infection progresses. Measurement of these antibodies in the blood can aid in diagnosis and typically provides the healthcare practitioner with information about the stage of infection and whether it is a current, recent, or past infection.

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A leukocyte alkaline phosphatase (LAP) test is a laboratory test that can be conducted on a sample of your blood. Your doctor can order it to measure the amount of alkaline phosphatase, a group of enzymes, in certain white blood cells. Before the advent of more advanced tests, the LAP test was commonly use to diagnose chronic myeloid leukemia (CML). This is a type of cancer than affects white blood cells. If you have CML, the level of alkaline phosphatase in your white blood cells will be lower than normal. Some doctors still order the LAP test to check for signs of CML. It can also help them rule out other disorders. But it’s now generally accepted that a cytogenetic test (a test of your cells and chromosomes) is needed to confirm a CML diagnosis. As a result, the LAP test is used less often now than in the past.


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Receptors are specialized proteins on the surface of or within cells that recognize and bind to other substances. The binding typically has a specific effect on the cells. Many, but not all, breast cancer cells have receptors that bind to the hormones estrogen and progesterone. Breast cancer tumors with estrogen receptors (ER) and progesterone receptors (PR) depend on the hormones to grow and divide. ER and PR testing of breast tumor tissue determines if one or both types of receptors are present.


Knowing if a tumor depends on hormones to grow helps a health practitioner determine a person's risk of breast cancer recurrence and whether it can be treated with hormone therapy to block estrogen and progesterone. About two-thirds of breast cancer tissues are positive for both ER and PR.


In 2010, the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) jointly published guidelines that recommend that all tumors from individuals with newly diagnosed invasive breast cancer be evaluated for estrogen and progesterone receptors. The guidelines also state that all recurrent breast cancers should be tested and that the option of testing should be provided for patients who have non-invasive breast cancer.

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Erythropoietin (EPO) is a hormone produced primarily by the kidneys. It plays a key role in the production of red blood cells (RBCs), which carry oxygen from the lungs to the rest of the body. This test measures the amount of erythropoietin in the blood.


Erythropoietin is produced and released into the blood by the kidneys in response to low blood oxygen levels (hypoxemia). EPO is carried to the bone marrow, where it stimulates production of red blood cells. The hormone is active for a short period of time and then eliminated from the body in the urine.


The amount of erythropoietin released depends upon how low the oxygen level is and the ability of the kidneys to produce erythropoietin. Increased production and release of erythropoietin continues to occur until oxygen levels in the blood rise to normal or near normal concentrations, then production falls. The body uses this dynamic feedback system to help maintain sufficient oxygen levels and a relatively stable number of RBCs in the blood.


However, if a person's kidneys are damaged and do not produce sufficient erythropoietin, then too few RBCs are produced and the person typically becomes anemic. Similarly, if a person's bone marrow is unable to respond to the stimulation from EPO, then the person may become anemic. This can occur with some bone marrow disorders or with chronic diseases, such as rheumatoid arthritis. (Read Anemia of Chronic Diseases to learn more.)


Individuals who have conditions that affect the amount of oxygen they breathe in, such as lung diseases, may produce more EPO to try to compensate for the low oxygen level. People who live at high altitudes may also have higher levels of EPO and so do chronic tobacco smokers.


If too much erythropoietin is produced, as occurs with some benign or malignant kidney tumors and with a variety of other cancers, too many RBCs may be produced (polycythemia or erythrocytosis). This can lead to an increase in the blood's thickness (viscosity) and sometimes to high blood pressure (hypertension), blood clots (thrombosis), heart attack, or stroke. Rarely, polycythemia is caused by a bone marrow disorder called polycythemia vera, not by increased erythropoietin.

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Your pancreas makes an enzyme called lipase. When you eat, lipase is released into your digestive tract to help your intestines break down the fats in the food you’re eating. Lipase also allows cell nutrients and cell waste to move through the walls of the cells in your body. Certain levels of lipase are needed to maintain normal digestive and cell function. Abnormally high levels of the enzyme in your blood can be a sign of a health problem.The serum lipase test is used to measure the amount of lipase in the body. The lipase test is often ordered at the same time as the amylase test. An amylase test is used to diagnose diseases of the pancreas. The results from these tests are typically used to diagnose and monitor specific health conditions, including:


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This group of tests measures the amount of cholesterol and other fats in your blood. Cholesterol and triglycerides are lipids, or fats. These fats are important for cell health, but they can be harmful when they build up in the blood. Sometimes they can lead to clogged, inflamed arteries, a condition call atherosclerosis. This may keep your heart from working normally if the arteries of your heart muscle are affected. This panel of tests helps predict your risk for heart disease and stroke.


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Reference ranges of lipoprotein (a) (Lp[a]) vary and depend on assay and reporting laboratories. They also differ by population and may differ regionally worldwide. Nonetheless, many US lipidologists generally consider an Lp(a) level of less than 10 mg/dL to indicate a lower cardiovascular risk. levels higher than 10 mg/dL are associated with an increase in cardiovascular risk (see Interpretation). The apolipoproteins have a primary responsibility for the transport of lipids and cholesterol. Apolipoprotein B (apoB) is a nonexchangeable lipoprotein that exists in two forms in humans, apoB-100 and apoB-48.


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Lipids are a group of fats and fat-like substances that are important constituents of cells and sources of energy. A lipid profile measures the level of specific lipids in the blood.


Two important lipids, cholesterol and triglycerides, are transported in the blood by lipoprotein particles. Each particle contains a combination of protein, cholesterol, triglyceride, and phospholipid molecules. The particles measured with a lipid profile are classified by their density into high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL).


Monitoring and maintaining healthy levels of these lipids is important in staying healthy. While the body produces the cholesterol needed to function properly, the source for some cholesterol is the diet. Eating too much of foods that are high in saturated fats and trans unsaturated fats (trans fats) or having an inherited predisposition can result in a high level of cholesterol in the blood. The extra cholesterol may be deposited in plaques on the walls of blood vessels. Plaques can narrow or eventually block the opening of blood vessels, leading to hardening of the arteries (atherosclerosis) and increasing the risk of numerous health problems, including heart disease and stroke. A high level of triglycerides in the blood is also associated with an increased risk of developing cardiovascular disease (CVD), although the reason for this is not well understood.

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Histopathology (or histology) involves the examination of sampled whole tissues under the microscope. Three main types of specimen are received by the pathology laboratory.


Specimens received by the pathology laboratory require tissue preparation then are treated and analysed using techniques appropriate to the type of tissue and the investigation required. For immediate diagnosis during a surgical procedure a frozen section is performed


Larger specimens include whole organs or parts thereof, which are removed during surgical operations. Examples include a uterus after a hysterectomy, the large bowel after a colectomy or tonsils after a tonsillectomy.


Pieces of tissue rather than whole organs are removed as biopsies, which often require smaller surgical procedures that can be performed whilst the patient is still awake but sedated. Biopsies include excision biopsies, in which tissue is removed with a scalpel (e.g. a skin excision for a suspicious mole) or a core biopsy, in which a needle is inserted into a suspicious mass to remove a slither or core of tissue that can be examined under the microscope (e.g. to investigate a breast lump).


Fluid and very small pieces of tissue (individual cells rather than groups of cells, e.g. within fluid from around the lung) can be obtained via a fine needle aspiration (FNA). This is performed using a thinner needle than that used in a core biopsy, but with a similar technique. This type of material is usually liquid rather than solid, and is submitted for cytology rather than histology (see Cytopathology).

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Lupus anticoagulant (LAC) testing is important for evaluating patients with antiphospholipid syndromes and hypercoagulable states. We reviewed results of proficiency testing challenges (n = 5) distributed by the North American Specialized Coagulation Laboratory Association to examine LAC testing performed by participating laboratories. The activated partial thromboplastin time (APTT) and dilute Russell viper venom time (dRVVT) constituted major testing methods. In screening studies, LAC-sensitive APTT methods were more sensitive to weak LAC than dRVVT-based methods but less specific. In confirmatory testing, dRVVT methods performed better, but performance was LAC-dependent. The highest false-negative confirmatory test results were obtained for the platelet neutralization procedure. Noncompliance with recommendations for LAC testing by the International Society on Thrombosis and Haemostasis was high (8%–38%), with the majority of noncompliant laboratories failing to report results of mixing studies. These data provide new insights into LAC testing in North America and identify opportunities for standardization.


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Malaria antigen detection tests are a group of commercially available rapid diagnostic tests of the rapid antigen test type that allow quick diagnosis of malaria by people who are not otherwise skilled in traditional laboratory techniques for diagnosing malaria or in situations where such equipment is not available. There are currently over 20 such tests commercially available (WHO product testing 2008). The first malaria antigen suitable as target for such a test was a soluble glycolytic enzyme Glutamate dehydrogenase.[1][2][3] None of the rapid tests are currently as sensitive as a thick blood film, nor as cheap. A major drawback in the use of all current dipstick methods is that the result is essentially qualitative. In many endemic areas of tropical Africa, however, the quantitative assessment of parasitaemia is important, as a large percentage of the population will test positive in any qualitative assay.

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Mammography is a specific type of breast imaging that uses low-dose x-rays to detect cancer early – before women experience symptoms – when it is most treatable. Tell your doctor about any breast symptoms or problems, prior surgeries, hormone use, whether you have a family or personal history of breast cancer, and if there’s a possibility you are pregnant. If possible, obtain copies of your prior mammograms and make them available to your radiologist on the day of your exam. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. Don’t wear deodorant, talcum powder or lotion under your arms or on your breasts as these may appear on the mammogram and interfere with correct diagnosis.

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Fibrin degradation products (FDP) are substances that remain in your bloodstream after your body dissolves a blood clot. Your fibrinolytic (clot-busting) system manages and regulates clot dissolving.


When you cut yourself, the injured blood vessel constricts to stop bleeding and promote healing. This process is called hemostasis. Platelets in your blood gather together and stick to the injury site to form a plug or clot. The formation of the plug or clot is called the clotting cascade.


Fibrin is a protein that aids in clotting. Clotting, also called coagulation, at the wound site produces a mass of fibrin threads called a net. The net remains in place until the cut is healed. As the cut heals, the clotting slows down. Eventually the clot breaks down and dissolves.


When the clot and fibrin net dissolve, fragments of protein are released into the body. These fragments are fibrin degradation products (FDPs). If your body is unable to dissolve a clot, you may have abnormal levels of FDPs.


Blood tests can measure your level of FDPs to see if you have a clotting disorder. The fibrin degradation products test is a specific test that determines the amount of FDPs in your blood. The test is also known as the fibrin split products (FSPs) test, or the fibrin breakdown products test.

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For a palpable breast lump, a fine needle is inserted through the skin and directed towards the suspicious area. When this needle reaches the mass, the doctor suctions out a sample with the help of syringe, which is then sent to the laboratory for further analysis.

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The fluorescent treponemal antibody absorption (FTA-ABS) test is a blood test that checks for the presence of antibodies to Treponema pallidum bacteria. These bacteria cause syphilis.


Syphilis s a sexually transmitted infection (STI) that’s spread through direct contact with syphilitic sores. Sores are most often present on the penis, vagina, or rectum. These sores aren’t always noticeable. You may not even know that you’re infected.


The FTA-ABS test doesn’t actually check for the syphilis infection itself. However, it can determine whether you have antibodies to the bacteria that cause it. Antibodies are special proteins produced by the immune system when harmful substances are detected. These harmful substances, known as antigens, include viruses, fungi, and bacteria. This means that people who are infected with syphilis will have the corresponding antibodies.

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Fluoroscopy is a study of moving body structures. It’s much like an X-ray "movie" and is often done while a contrast dye moves through the part of the body being examined. A continuous X-ray beam is passed through the body part and sent to a video monitor so that the body part and its motion can be seen in detail. Fluoroscopy, as an imaging tool, allows healthcare providers to look at many body systems, including the skeletal, digestive, urinary, cardiovascular, respiratory, and reproductive systems.


Fluoroscopy may be used to evaluate specific areas of the body. These include the bones, bowel, muscles, heart vessels, and joints.

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Prostate specific antigen (PSA) is a protein produced primarily by cells in the prostate, a small gland that encircles the urethra in males and produces a fluid that makes up part of semen. Most of the PSA that the prostate produces is released into this fluid, but small amounts of it are also released into the bloodstream. This test measures the amount of PSA in the blood.


The PSA test is used as a tumor marker to screen for and to monitor prostate cancer. It is a good tool but not a perfect one, and most experts agree that screening should be done on asymptomatic men only after thorough discussions with their healthcare providers on the benefits and risks and after informed decisions are made to undergo screening. Elevated levels of PSA are associated with prostate cancer, but they may also be seen with prostatitis and benign prostatic hyperplasia (BPH). PSA levels tend to increase in all men as they age, and men of African American heritage may have levels that are higher than other men, even at earlier ages.


PSA is not diagnostic of cancer. The gold standard for identifying prostate cancer is the prostate biopsy, collecting small samples of prostate tissue and identifying abnormal cells under the microscope. (Read the article on Anatomic Pathology for more information on biopsies.) The total PSA test and digital rectal exam (DRE) are used together to help determine the need for a prostate biopsy.


The goal of screening is to detect prostate cancer while it is still confined to the prostate. Once the presence of prostate cancer is confirmed by biopsy, another decision must be made with regard to treatment. Prostate cancer is relatively common in men as they age and many, if not most, of the tumors are very slow-growing. While prostate cancer is the number two cause of death in men, the slow-growing type is an uncommon cause of death. A pathologist may be able to help differentiate between slow-growing cases and cancers that are likely to grow aggressively and spread to other parts of the body (metastasize).

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Blood typing is a test that determines a person’s blood type. The test is essential if you need a blood transfusion or are planning to donate blood. Not all blood types are compatible, so it’s important to know your blood group. Receiving blood that’s incompatible with your blood type could trigger a dangerous immune response.

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B-type natriuretic peptide (BNP) is a hormone produced by your heart. N-terminal (NT)-pro hormone BNP (NT-proBNP) is a non-active prohormone that is released from the same molecule that produces BNP. Both BNP and NT-proBNP are released in response to changes in pressure inside the heart. These changes can be related to heart failure and other cardiac problems. Levels goes up when heart failure develops or gets worse, and levels goes down when heart failure is stable. In most cases, BNP and NT-proBNP levels are higher in patients with heart failure than people who have normal heart function.

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Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.


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Red blood cell (RBC) indices are individual components of a routine blood test called the complete blood count (CBC). The CBC is used to measure the quantity and physical characteristics of different types of cells found in your blood.

Blood consists of RBCs, white blood cells (WBCs), and platelets that are suspended in your plasma. Platelets are cells that enable clot formation. RBCs contain hemoglobin, which carries oxygen throughout your body to all of your tissues and organs. An RBC is pale red and gets its color from hemoglobin. It’s shaped like a doughnut, but it has a thinner area in the middle instead of a hole. Your RBCs are normally all the same color, size, and shape. However, certain conditions can cause variations that impair their ability to function properly.  The RBC indices measure the size, shape, and physical characteristics of the RBCs. Your doctor can use RBC indices to help diagnose the cause of anemia. Anemia is a common blood disorder in which you have too few, misshapen, or poorly functional RBCs.





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MCH stands for Mean Corpuscular Hemoglobin, and is a calculation of the average amount of hemoglobin contained within each of a person's red blood cells. Hemoglobin is the substance that carries oxygen from the lungs to the cells of the body through the bloodstream. Abnormally high or low levels of MCH, as determined by blood testing, can be an indication of a number of problems within the body, ranging from nutrient deficiencies to chronic diseases.The MCH blood test is done as a component of a blood test called a Complete Blood Count (CBC), which evaluates the composition of the blood, checking hematocrit, white blood cells (WBC) and platelets as well as hemoglobin and red blood cells (RBC). It is usually ordered to get an overview of general health. MCH is not measured directly, but calculated based on the hemoglobin value (Hgb), which is the total measure of hemoglobin in the blood, and the RBC, which is the number of red blood cells in the blood. To calculate MCH, the Hgb is divided by RCB, yielding an average amount of hemoglobin per red blood cell. Normal levels of MCH are between 26 and 33 picograms (pg) of hemoglobin per RBC.


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Medullary thyroid cancer can be highly aggressive, especially if the diagnosis is done in advanced stages. Early diagnosis is based on RET genetic testing, for familial forms, and on the routine measurement of calcitonin (Ct). Nevertheless, since false-positive results can be obtained with the basal measurement of Ct, a provocative test to evaluate stimulated Ct is often needed. Pentagastrin which has been widely used to stimulate basal Ct, especially in European countries, is now hardly available. Thus, the stimulation with calcium (Ca), used in the 1970s-1980s and then abandoned for around 30 years, has recently elicited more interest. In the past 3 years, studies in patients and normal controls have demonstrated that the stimulation with Ca (2.3-2.5 mg/kg of elemental Ca, corresponding to 25 mg/kg of Ca gluconate) is highly potent and accurate. Novel gender-related cut-offs have been proposed for the Ca test, though the analysis of additional large series is predicted to modify these preliminary data. Finally, Ca seems to be the test of choice to stimulate Ct for the diagnosis and follow-up of medullary thyroid cancer, also because it is widely available, has a low cost and it is associated with a low number and intensity of side effects. In the present review the different methods to stimulate Ct and the cut-offs for the identification of the hyperplastic/neoplastic transformation of the C cells will be reported and discussed.

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The mean corpuscular hemoglobin concentration (MCHC) is the average concentration of hemoglobin in your red blood cells. Hemoglobin is the protein molecule that allows red blood cells to carry oxygen to tissues within your body. Your MCHC can fall into low, normal, and high ranges even if your red blood cell count is normal.


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MCV stands for mean corpuscular volume. There are three main types of corpuscles (blood cells) in your blood–red blood cells, white blood cells, and platelets. An MCV blood test measures the average size of your red blood cells, also known as erythrocytes. Red blood cells move oxygen from your lungs to every cell in your body. Your cells need oxygen to grow, reproduce, and stay healthy. If your red blood cells are too small or too large, it could be a sign of a blood disorder such as anemia, a vitamin deficiency, or other medical condition.


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A test for catecholamines measures the amount of the hormones epinephrine, norepinephrine, and dopamine in the blood. These catecholamines are made by nerve tissue camera.gif, the brain, and the adrenal glands. Catecholamines help the body respond to stress or fright and prepare the body for "fight-or-flight" reactions.


The adrenal glands make large amounts of catecholamines as a reaction to stress. The main catecholamines are epinephrine (adrenaline), norepinephrine (noradrenaline), and dopamine. They break down into vanillylmandelic acid (VMA), metanephrine, and normetanephrine. Metanephrine and normetanephrine also may be measured during a catecholamine test.


Catecholamines increase heart rate, blood pressure, breathing rate, muscle strength, and mental alertness. They also lower the amount of blood going to the skin and intestines and increase blood going to the major organs, such as the brain, heart, and kidneys.


Certain rare tumors (such as a pheochromocytoma) can increase the amount of catecholamines in the blood. This causes high blood pressure, excessive sweating, headaches, fast heartbeats (palpitations), and tremors.


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Ceruloplasmin, a glycoprotein produced in the liver, carries or transports more than 95 percent of the copper in blood plasma.


Copper plays an important role in the body by aiding crucial bodily processes. These include producing energy, forming connective tissue, and helping your central nervous system function.


A ceruloplasmin test can determine the levels of ceruloplasmin in your body. It’s most often used in the diagnosis of Wilson’s disease, a genetic disorder.

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Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme involved in energy production. It is found in all cells, including red blood cells (RBCs) and helps protect them from certain toxic by-products of cellular metabolism. A deficiency in G6PD causes RBCs to become more vulnerable to breaking apart (hemolysis) under certain conditions. This test measures the amount of G6PD in RBCs to help diagnose a deficiency.


G6PD deficiency is a genetic disorder. When individuals who have inherited this condition are exposed to a trigger such as stress, an infection, certain drugs or other substance(s), significant changes occur in the structure of the outer layer (cell membrane) of their red blood cells. Hemoglobin, the life-sustaining, oxygen-transporting protein within RBCs, forms deposits (precipitates) called Heinz bodies. Some individuals may experience these reactions when exposed to fava beans, a condition called "favism." With these changes, RBCs can break apart more readily, causing a decrease in the number of RBCs. When the body cannot produce sufficient RBCs to replace those destroyed, hemolytic anemia results and the individual may develop jaundice, weakness, fatigue, and/or shortness of breath.


G6PD deficiency is the most common enzyme deficiency in the world, affecting more than 400 million people. It may be seen in up to 10% of African-American males and 20% of African males. It is also commonly found in people from the Mediterranean and Southeast Asia.


G6PD deficiency is inherited, passed from parent to child, due to mutations or changes in the G6PD gene that cause decreased enzyme activity. There are over 440 variants of G6PD deficiency. The G6PD gene is located on the sex-linked X chromosome. Since men have one X and one Y sex chromosome, their single X chromosome carries the G6PD gene. This may result in a G6PD deficiency if a male inherits the single X chromosome with an altered gene.


Since women have two X sex chromosomes, they inherit two copies of the G6PD gene. Women with only one mutated gene (heterozygous) produce enough G6PD that they usually do not experience any symptoms (i.e., asymptomatic), but under situations of stress, they may demonstrate a mild form of the deficiency. In addition, a mother may pass the single mutated gene to any male children. Rarely do women have two mutated gene copies (homozygous), which could result in G6PD deficiency.

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MR angiography (MRA) uses a powerful magnetic field, radio waves and a computer to evaluate blood vessels and help identify abnormalities or diagnose atherosclerotic (plaque) disease. This exam does not use ionizing radiation and may require an injection of a contrast material called gadolinium, which is less likely to cause an allergic reaction than iodinated contrast material. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. In some instances, your doctor will provide you with a card that includes information about your implant to give to the technologist. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam.


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Constipation has a high prevalence in the general population and is a cause for significant morbidity. It has been estimated that approximately 10% of the Indian population suffers from constipation. [1] Chronic constipation leads to approximately 2.5 million visits to the physicians in the United States annually. [2] Various definitions have been used for chronic constipation. However, recently, the Rome II criteria were developed to promote consistency in the diagnosis. [3] Constipation may be primary or secondary. Primary constipation may be due to slow transit disorder or anorectal expulsion disorder (obstructive defecation) or a combination of these. According to the National Institute for health and Clinical Excellence (NICE) guidelines issued in 2010, obstructed defecation syndrome (ODS) is characterized by the urge to defecate but an impaired ability to expel the fecal bolus. Symptoms include unsuccessful fecal evacuation attempts, excessive straining, pain, bleeding after defecation, and a sense of incomplete fecal evacuation. [4] Patients may also resort to digital rectal evacuation. Evaluation and treatment of these patients has been difficult. Magnetic resonance defecography (MRD) has been shown to demonstrate the structural abnormalities associated with ODS, and patients with significant structural abnormalities may benefit from surgical interventions like stapled transanal resection of rectum (STARR). Patients who do not demonstrate significant structural abnormalities can be referred for biofeedback techniques. We present our experience in a large series of patients with suspected ODS who underwent MRD at our tertiary care center.


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You can have peace of mind that we place you first with a focus on giving you comprehensive benefits, value for money and services to improve the quality of care available to you. As a Discovery Health Medical Scheme member you have access to the broadest and best level of healthcare cover in the market based on your medical condition needs. Depending on your medical aid plan, we cover for in- and out-hospital tests and screening, including investigations, radiology and blood tests, vaccinations for adults and children and blood tests


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Mammography is a screening tool for breast cancer. At NM Medical we employ advanced digital imaging technology for the dual benefits of optimum diagnostic quality and maximum patient comfort. Mammography is important because in its earliest stages breast cancer may not be palpable; it may be too small to feel as a lump or tissue change. Mammography can help detect these changes two years or more before you would feel them. Physical examination is also important because pre-menopausal breast tissue is often dense and fibrous, which may decrease the reliability of mammography for young women.

  

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MR spectroscopy (MRS) allows tissue to be interrogated for the presence and concentration of various metabolites. Grossman and Yousem said "If you need this to help you, go back to page 1; everything except Canavan has low NAA, high Choline". This is perhaps a little harsh, however it is fair to say that MRS often does not add a great deal to an overall MR study but does increase specificity, and may help in improving our ability to predict histological grade.


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Diffusion tensor imaging tractography, or DTI tractography, is an MRI (magnetic resonance imaging) technique that measures the rate of water diffusion between cells to understand and create a map of the body’s internal structures; it is most commonly used to provide imaging of the brain. This advanced imaging technique, which provides much more detailed images of the brain than a conventional MRI, may also be used in the diagnosis of stroke, acute ischemia, brain tumors and multiple sclerosis, as well as pre-operative planning.  Using MRI technology, DTI tractography is non-invasive and uses radio waves and a magnetic field to produce images of the brain, tissues and skull. MRI technology provides detailed images showing small changes in body tissue and blood flow, which makes it an extremely reliable tool for the detection of disease, injury, bleeding and swelling.  Loyola offers state-of-the-art imaging and diagnostic techniques in order to provide timely and accurate diagnosis for our patients. Our expert radiologists are recognized nationally for clinical excellence, innovative diagnostic and therapeutic methods and skilled use of the latest technology. Our experienced technologists provide testing in a caring and compassionate environment where we want you to feel comfortable asking any questions you may have about your test or procedure. 


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Magnetic resonance cholangiopancreatography or MRCP uses a powerful magnetic field, radio waves and a computer to evaluate the liver, gallbladder, bile ducts, pancreas and pancreatic duct for disease. It is noninvasive and does not use ionizing radiation. Tell your doctor about any health problems, recent surgeries or allergies and whether there’s a possibility you are pregnant. The magnetic field is not harmful, but it may cause some medical devices to malfunction. Most orthopedic implants pose no risk, but you should always tell the technologist if you have any devices or metal in your body. Guidelines about eating and drinking before your exam vary between facilities. Unless you are told otherwise, take your regular medications as usual. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown. If you have claustrophobia or anxiety, you may want to ask your doctor for a mild sedative prior to the exam


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A magnetic resonance angiogram (MRA) is a type of magnetic resonance imaging (MRI) scan that uses a magnetic field and pulses of radio wave energy to provide pictures of blood vessels inside the body. In many cases MRA can provide information that can't be obtained from an X-ray, ultrasound, or computed tomography (CT) scan. MRA can find problems with the blood vessels that may be causing reduced blood flow. With MRA, both the blood flow and the condition of the blood vessel walls can be seen. The test is often used to look at the blood vessels that go to the brain, kidneys, and legs. Information from an MRA can be saved and stored on a computer for further study. Photographs of selected views can also be made.During MRA, the area of the body being studied is placed inside an MRI machine. Contrast material is often used during MRA to make blood vessels show up more clearly.


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Gamma-glutamyl transferase (GGT) is an enzyme that is found in many organs throughout the body, with the highest concentrations found in the liver. GGT is elevated in the blood in most diseases that cause damage to the liver or bile ducts. This test measures the level of GGT in a blood sample.


Normally, GGT is present in low levels, but when the liver is injured, the GGT level can rise. GGT is usually the first liver enzyme to rise in the blood when any of the bile ducts that carry bile from the liver to the intestines become obstructed, for example, by tumors or stones. This makes it the most sensitive liver enzyme test for detecting bile duct problems.


However, the GGT test is not very specific and is not useful in differentiating between various causes of liver damage because it can be elevated with many types of liver diseases, such as liver cancer and viral hepatitis, as well as other non-hepatic conditions, such as acute coronary syndrome. For this reason, the GGT test is not recommended for routine use by itself. However, it can be useful in conjunction with other tests and in determining the cause of a high alkaline phosphatase (ALP) level, another enzyme found in the liver.


Both GGT and ALP are increased in liver diseases, but only ALP will be increased with diseases affecting bone tissue. Therefore, GGT can be used as a follow up to an elevated ALP to help determine if the high ALP result is due to liver or bone disease.


GGT levels are sometimes increased with consumption of even small amounts of alcohol. Higher levels are found more commonly in chronic heavy drinkers than in people who consume less than 2 to 3 drinks per day or who only drink heavily on occasion (binge drinkers). The GGT test may be used in evaluating someone for acute or chronic alcohol abuse.

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C-peptide is a substance, a short chain of amino acids, that is released into the blood as a byproduct of the formation of insulin by the pancreas. This test measures the amount of C-peptide in a blood or urine sample.


In the pancreas, within specialized cells called beta cells, proinsulin, a biologically inactive molecule, splits apart to form one molecule of C-peptide and one molecule of insulin. Insulin is vital for the transport of glucose into the body's cells and is required on a daily basis. When insulin is required and released from the beta cells into the blood in response to increased levels of glucose, equal amounts of C-peptide are also released. Since C-peptide is produced at the same rate as insulin, it is useful as a marker of insulin production.


In particular, C-peptide testing can be used to help evaluate the production of insulin made by the body (endogenous) and to help differentiate it from insulin that is not produced by the body but is taken in as diabetic medication (exogenous) and so does not generate C-peptide. This test may be done in conjunction with an insulin test.

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This is a blood test to check for diabetes. If you have diabetes, your body doesn't make enough insulin to keep your blood sugar in check. This means your blood sugar levels are too high, and over time this can lead to serious health problems including nerve and eye damage.


This test is done to see how your body responds to sugar and starch after you eat a meal. As you digest the food in your stomach, blood glucose, or blood sugar, levels rise sharply. In response, your pancreas releases insulin to help move these sugars from the blood into the cells of muscles and other tissues to be used for fuel. Within two hours of eating, your insulin and blood glucose levels should return to normal. If your blood glucose levels remain high, you may have diabetes.

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Gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard to identify central precocious puberty (CPP). This test requires multiple blood samples at different time points to measure gonadotropin levels, and is therefore expensive, time-consuming, and uncomfortable for patients. We aimed to simplify the GnRH stimulation test to require fewer blood samples.

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When pregnancy screening tests are abnormal; whenever signs of a chromosomal abnormality-associated disorder are present; as indicated to detect chromosomal abnormalities in a person and/or detect a specific abnormality in family members; sometimes when a person has leukemia, lymphoma, myeloma, myelodysplasia or another cancer and an acquired chromosome abnormality is suspected

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Cytogenetics of hematologic disorders attempts to define and interpret chromosomal aberrations that occur in neoplastic cells associated with leukemia, lymphoma and other hematologic malignancies. Chromosome abnormalities in cancer cells of patients with malignant hematologic disorders including acute and chronic myeloid and lymphoid leukemias, myelodysplastic and myeloproliferative disorders, lymphomas and unexplained anemias may correlate with the diagnosis, prognosis, treatment and etiology of disease.

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The diagnosis of pheochromocytoma/paraganglioma (PPGL) involves detection of elevated levels of plasma and/or 24-h urine catecholamines and/or their metabolites, including metanephrines. Although these tests are reasonably sensitive, false-positive results are often encountered. Follow-up tests can provide additional information to correctly diagnose PPGL. In this regard, the utility of the urinary clonidine suppression test (UCST) remains unknown.

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A carotid Doppler test is generally an outpatient procedure, states Johns Hopkins Medicine. During the test, the patient must lie on his back with his neck bent back slightly. A technician applies a gel to the skin, presses a device called a transducer against the neck, and moves it around the area of the carotid artery. The technician then repeats the process on the other side of the neck. Carotid Doppler tests do not expose patients to radiation, and they usually do not cause any discomfort.


Patients who have carotid artery blockage or narrowing sometimes experience symptoms such as dizziness, confusion, drowsiness or headache that prompt a doctor to perform a carotid Doppler test, states Johns Hopkins Medicine. Other symptoms that may indicate problems with blood flow in the carotid arteries include momentary blindness in one eye or temporary problems speaking or moving. Carotid Doppler is sometimes performed as part of an evaluation prior to major cardiac surgery.

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A Doppler ultrasound is a noninvasive test that can be used to estimate the blood flow through your blood vessels by bouncing high-frequency sound waves (ultrasound) off circulating red blood cells. A regular ultrasound uses sound waves to produce images, but can't show blood flow.


A Doppler ultrasound may help diagnose many conditions, including:


Blood clots

Poorly functioning valves in your leg veins, which can cause blood or other fluids to pool in your legs (venous insufficiency)

Heart valve defects and congenital heart disease

A blocked artery (arterial occlusion)

Decreased blood circulation into your legs (peripheral artery disease)

Bulging arteries (aneurysms)

Narrowing of an artery, such as in your neck (carotid artery stenosis)

A Doppler ultrasound can estimate how fast blood flows by measuring the rate of change in its pitch (frequency). During a Doppler ultrasound, a technician trained in ultrasound imaging (sonographer) presses a small hand-held device (transducer), about the size of a bar of soap, against your skin over the area of your body being examined, moving from one area to another as necessary.


This test may be done as an alternative to more-invasive procedures, such as angiography, which involves injecting dye into the blood vessels so that they show up clearly on X-ray images.


A Doppler ultrasound test may also help your doctor check for injuries to your arteries or to monitor certain treatments to your veins and arteries.

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Magnetic Resonance Imaging is a highly advanced imaging modality. Epilepsy Protocol MRI involves obtaining images of brain slices through MRI scanning in epileptic patients. This scanning enables the doctor in obtaining evidences of abnormalities or injuries in brain. Underlying pathologies inside of brain like infections or tumors cannot be seen externally. Such occurrences can be investigated through an MRI Epilepsy Protocol. As a result, MRI becomes the most accurate mode for planning line of treatment.


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At least 3 blood samples are taken.


The test is done in the following way:


The first blood sample is collected between 6 a.m. and 8 a.m before you eat or drink anything.

You then drink a solution containing glucose (sugar). You may be told to drink slowly to avoid becoming nauseated. But you must drink the solution within 5 minutes to ensure the test result is accurate.

The next blood samples are usually collected for 1 to 2 hours after you finish drinking the glucose solution. Sometimes they are taken every 30 or 60 minutes.

Each sample is sent to the laboratory right away. The lab measures the glucose and growth hormone (GH) levels in each sample.

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Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations.

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HE  MRI technician should be informed if you have any inner ear implants, artificial joints, a defibrillator or pacemaker, particular types of heart valves, vascular stents, brain aneurysm clips.

The staff will ask you to remove anything that contains metal, including jewelry, sunglasses or any electronic gadgets. All these interferes with the MRI machine’s ability to produce a clear image. Braces and dental fillings will typically not pose a problem, but pens, pins, and certain dental appliances can interfere. 

In the case of implants and pacemakers, those items can stop working properly due to an MRI’s magnetic field.

You will be asked to wear a hospital gown or clothing that doesn’t contain metal fasteners. 

Lastly if you’re pregnant , kindly inform the staff, the doctor may postponed the test if required.

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This study aimed to evaluate the vascular pattern of solid breast lesions using power Doppler ultrasonography (PDUS) and assess whether the presence of intratumoural penetrating vessels can predict breast cancer malignancy.

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Helicobacter pylori is a type of bacteria that is known to be a major cause of peptic ulcer disease. H. pylori testing detects an infection of the gastrointestinal (GI) tract caused by the bacteria.


H. pylori is very common, especially in developing countries. The bacteria are present in (colonize) the stomachs and intestines of as many as 50% of the world's population. Most of those affected will never have any symptoms, but the presence of H. pylori increases the risk of developing ulcers (peptic ulcer disease), chronic gastritis, and gastric (stomach) cancer. The bacteria decrease the stomach's ability to produce mucus, making the stomach prone to acid damage and peptic ulcers.


There are several different types of H. pylori testing that can be performed. Some are less invasive than others.


Noninvasive


Stool antigen test – detection of H. pylori in a stool sample

Urea breath test – detection of labeled carbon dioxide in the breath after drinking a solution 


An antibody test using a blood sample is not recommended for routine diagnosis or for evaluation of treatment effectiveness. This test detects antibodies to the bacteria and will not distinguish between a present and previous infection. If the antibody test is negative, then it is unlikely that a person has had an H. pylori infection. If ordered and positive, results should be confirmed using a stool antigen or breath test.


Invasive


Invasive tests using an endoscopy procedure are less frequently performed than noninvasive tests because they require a tissue biopsy collection. Tests include:


Histology – examination of tissue under a microscope

Rapid urease testing – detects urease, an enzyme produced by H. pylori

Culture – growing H. pylori in/on a nutrient solution

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A hemoglobin electrophoresis test is a blood test used to measure and identify the different types of hemoglobin in your bloodstream. Hemoglobin is the protein inside red blood cells responsible for transporting oxygen to your tissues and organs.


Genetic mutations can cause your body to produce hemoglobin that is formed incorrectly. This abnormal hemoglobin can cause too little oxygen to reach your tissues and organs.


There are hundreds of different types of hemoglobin. They include:


Hemoglobin F: This is also known as fetal hemoglobin. It’s the type found in growing fetuses and newborns. It’s replaced with hemoglobin A soon after birth.

Hemoglobin A: This is also known as adult hemoglobin. It’s the most common type of hemoglobin. It’s found in healthy children and adults.

Hemoglobin C, D, E, M, and S: These are rare types of abnormal hemoglobin caused by genetic mutations.

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 Magnetic Resonance Imaging (MRI) of the dorsal spine is a non invasive process used to scan the dorsal section of your spinal cord. It uses radio waves and high intensity magnetic fields to learn about the internal tissue structures of the dorsal spine. This scanning technique is used for various diagnostic as well as treatment purposes


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Magnetic Resonance Imaging (MRI) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. MR imaging uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. The images can then be examined on a computer monitor, transmitted electronically, printed or copied to a CD. MRI does not use ionizing radiation (X-rays). Detailed MR images allow physicians to better evaluate various parts of the body and determine the presence of certain diseases that may not be assessed adequately with other imaging methods such as x-ray, ultrasound or computed tomography (also called CT or CAT scanning)


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Haptoglobin is a protein produced by the liver that the body uses to clear free hemoglobin (found outside of red blood cells) from circulation. This test measures the amount of haptoglobin in the blood.


Hemoglobin is the iron-containing protein complex that transports oxygen throughout the body. It is normally found within red blood cells (RBCs) and very little is found free circulating in the blood. Haptoglobin binds to free hemoglobin in the blood. This forms a haptoglobin-hemoglobin complex that is rapidly cleared out of circulation for degradation and iron recycling.


However, when an increased number of RBCs are damaged and/or break apart (hemolysis), they release their hemoglobin into the blood, increasing the amount of free hemoglobin in circulation. When large numbers of RBCs are destroyed, haptoglobin concentrations in the blood will temporarily decrease as the haptoglobin is used up faster than the liver can produce it. A decrease in the amount of haptoglobin may be a sign that a person has a condition that is causing red blood cells to be destroyed or break apart. When the binding capacity of haptoglobin is exceeded, free hemoglobin level in circulation goes up and may cause tissue damage and organ dysfunction.


Increased RBC destruction may be due to inherited or acquired conditions. Some examples include transfusion reactions, certain drugs, and mechanical breakage, such as may be seen with some prosthetic heart valves. The destruction may be mild or severe, occurring suddenly (acute) or developing and lasting over a long period of time (chronic), and it can lead to hemolytic anemia. People with hemolytic anemia may experience symptoms such as fatigue, weakness, and shortness of breath and their skin may be pale or jaundiced. (For additional details, read the article on Hemolytic Anemia.)


Liver disease may also result in decreased haptoglobin concentrations as liver damage may inhibit both the production of haptoglobin and the clearing of the haptoglobin-free hemoglobin complexes.



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The right hip pain diagnosis is essential to obtaining the right care. Specialization and unmatched experience are the hallmarks of the Center for Hip Preservation’s medical staff. The advanced hip pain tests available at our center assist our specialists in making the right diagnosis and pursuing the right treatment. Both a physical examination and radiological examinations are conducted to diagnose hip joint pain. Without an official reading by an experienced radiologist, subtle X-ray findings (e.g., tears, infections, systematic diseases, tumors, etc.) may remain undetected until such time as an abnormality has progressed to the point where a non-imaging specialist may identify it. Delays in diagnosis add to medical cost and may considerably effect treatment and ultimate patient outcome. The skilled staff members at the Center for Hip Preservation help patients and families understand their hip pain and all of the treatment options available.


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Hip pain is a common and disabling condition that affects patients of all ages. The differential diagnosis of hip pain is broad, presenting a diagnostic challenge. Patients often express that their hip pain is localized to one of three anatomic regions: the anterior hip and groin, the posterior hip and buttock, or the lateral hip. Anterior hip and groin pain is commonly associated with intra-articular pathology, such as osteoarthritis and hip labral tears. Posterior hip pain is associated with piriformis syndrome, sacroiliac joint dysfunction, lumbar radiculopathy, and less commonly ischiofemoral impingement and vascular claudication. Lateral hip pain occurs with greater trochanteric pain syndrome. Clinical examination tests, although helpful, are not highly sensitive or specific for most diagnoses; however, a rational approach to the hip examination can be used. Radiography should be performed if acute fracture, dislocations, or stress fractures are suspected. Initial plain radiography of the hip should include an anteroposterior view of the pelvis and frog-leg lateral view of the symptomatic hip. Magnetic resonance imaging should be performed if the history and plain radiograph results are not diagnostic. Magnetic resonance imaging is valuable for the detection of occult traumatic fractures, stress fractures, and osteonecrosis of the femoral head. Magnetic resonance arthrography is the diagnostic test of choice for labral tears.


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 An MRI scan uses magnets and radio waves to capture images inside your body without making a surgical incision. The scan allows your doctor to see the soft tissue of your body, like muscles and organs, in addition to your bones. An MRI can be performed on any part of your body. A lumbar MRI specifically examines the lumbar section of your spine — the region where back problems commonly originate.The lumbosacral spine is made up of the five lumbar vertebral bones (L1 thru L5), the sacrum (the bony “shield” at the bottom of your spine), and the coccyx (tailbone). The lumbosacral spine also consists of large blood vessels, nerves, tendons, ligaments, and cartilage.


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Myelography uses a real-time form of x-ray called fluoroscopy and an injection of contrast material to evaluate the spinal cord, nerve roots and spinal lining (meninges). It is particularly useful for assessing the spine following surgery and for assessing disc abnormalities in patients who cannot undergo MRI. You will be instructed on how to prepare. Tell your doctor if there’s a possibility you are pregnant and discuss any recent illnesses, medical conditions, medications you’re taking and allergies, especially to iodinated contrast materials. You may be advised to stop taking blood thinners or other medications several days prior to your exam. You also may be told to avoid solid food and increase your fluid intake beforehand. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.


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Neoplastic disease of the nose, paranasal sinuses, the nasopharynx and the parapharyngeal space requires thorough assessment of location and extent in order to plan appropriate treatment. CT allows the deep soft tissue planes to be evaluated and provides a complement to the physical examination. It is especially helpful in regions involving thin bony structures (paranasal sinuses, orbita); here CT performs better than MRI. MRI possesses many advantages over other imaging modalities caused by its excellent tissue contrast. In evaluating regions involving predominantly soft tissue structures (ec nasopharynx and parapharyngeal space) MRI is superior to CT. The possibility to obtain strictly consecutive volume data sets with spiral CT or 3D MRI offer excellent perspectives to visualize the data via 2D or 3D postprocessing. Because head and neck tumors reside in a complex area, having a 3D model of the anatomical features may assist in the delineation of pathology. Data sets may be transferred directly into computer systems and thus be used in computer assisted surgery.


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A pelvis MRI (magnetic resonance imaging) scan is an imaging test that uses a machine with powerful magnets and radio waves to create pictures of the area between the hip bones. This part of the body is called the pelvic area. Structures inside and near the pelvis include the bladder, prostate and other male reproductive organs, female reproductive organs, lymph nodes, large bowel, small bowel, and pelvic bones. An MRI does not use radiation. Single MRI images are called slices. The images are stored on a computer or printed on film. One exam produces dozens or sometimes hundreds of images.


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Pituitary gland plays a central role in body growth, metabolism, and reproductive function. A number of diseases that affect the pituitary-hypothalamic axis can have profound clinical, endocrinological as well as neurological consequences. These conditions can be classified as neoplastic, infectious, inflammatory, posttraumatic, congenital/developmental, and physiological. Various neoplastic conditions include pituitary adenoma/apoplexy, hypothalamic glioma, craniopharyngioma, rathke cleft cyst, germinoma, teratoma, metastasis, leukemic infiltration, lymphoma, and Langerhans cell histiocytosis. Infectious and inflammatory causes include tubercular/lymphocytic hypophysitis, sarcoidosis, and Wegener's granulomatosis. Traumatic causes include postoperative sella or transection of the pituitary stalk. Accurate diagnostic differentiation of these lesions is essential for both safe and effective disease management. Recent advances in neuroimaging helps the radiologists and endocrinologists to study the pituitary region in greater detail. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluating hypothalamic-pituitary-related endocrine diseases.

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Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers, so that other findings may be required to help make the diagnosis. These findings include thickening of an attachment of the lateral pterygoid muscle, rupture of retrodiskal layers, and joint effusion and can serve as indirect early signs of TMJ dysfunction. It is important for the radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its final stage, an advanced and irreversible phase that is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further studies conducted with the latest MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms.


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The purpose of this study was to correlate disc position and the type of disc displacement, intra-capsular effusion and degenerative changes of the condyle as demonstrated in MRI studies. In this study, 126 temporomandibular joints (TMJs) of 63 patients with TMJ disorders were investigated using clinical examination and MRI. One hundred and twelve TMJs were found to have internal derangement as disc displacement. The angle between the posterior margin of the disc and the vertical line drawn through the centre of the condyle was measured on MRI for each TMJ. The positions of the discs were normal, 0 degrees-10 degrees, in 11.11%; slightly displaced, 11 degrees-30 degrees, in 37.30%; mildly displaced 31 degrees-50 degrees, in 15.08%; moderately displaced, 51 degrees-80 degrees, in 7.14% of the TMJs with anterior displacement with reduction (ADDR). The disc position was severely displaced anteriorly, as over 80 degrees, in all TMJs with anterior disc displacement without reduction (ADD), constituting 27.78% of all cases. We found that the smaller the degree of disc displacement the milder the internal derangement and that the intra-capsular effusion was more frequently associated with TMJ with ADDR. The degenerative condylar changes were more severe with an increased degree of anterior disc displacement.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.

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Carotid ultrasound uses sound waves to produce pictures of the carotid arteries in the neck which carry blood from the heart to the brain. A Doppler ultrasound study – a technique that evaluates blood flow through a blood vessel – is usually part of this exam. It’s most frequently used to screen patients for blockage or narrowing of the carotid arteries, a condition called stenosis which may increase the risk of stroke.


Little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. A loose-fitting, open necked shirt or blouse is ideal.

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The use of Doppler ultrasound to assess both the changing haemodynamics of the neonatal circulation and the perfusion of the brain is reviewed. The brain is particularly susceptible to both ischaemic and haemorrhagic injury in preterm and asphyxiated infants. However, the unique characteristics of the transitional neonatal circulation, and of the cerebral vasculature, pose considerable problems in the interpretation of Doppler signals from intracranial arteries. A volumetric Doppler method which eliminates some of those problems is discussed. The same method allows full assessment of the cardiovascular status of the newborn infant, including estimation of ductal shunting and left ventricular output. Doppler ultrasound, if used with a full understanding of the inherant assumptions and limitations of the particular methodology, is likely to prove invaluable in investigating pathological cerebral and cardiac vascular events in the newborn.

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With the most advanced Echo-cardiography ultrasound and color Doppler system from Philips which uses a X- Matrix Probe (>9000 piezoelectric crystals) and break-through pure wave single crystal technology deliver high wualty images.


This is the only diagnostic centre in city doing ultrasound contrast study. 

Some of the features are unique in the machine and not available elsewhere. The machine gives extreme resolution for excellent 2D and LIVE 3D (4D) images. It has extreme color sensitivity. 3D images in cross sectional view (all three planes). VOCAL ( Volumetric organ calculation), Multislice CT like images. PANORAMIC images to include a wide area in single image. Dynamic MR to give maximum resolution, Broad band frequency compounding, harmonic imaging etc.

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A recent estimate of the number of men in the United States suffering with complete erectile dysfunction is 10 to 20 million. When partial erectile dysfunction is included, the estimate jumps to 30 million.1 Age-specific prevalence is estimated to be 5% at age 40, increasing to 15% to 25% by age 65. In clinical series, the ratio of organic to psychologic male sexual dysfunction also varies with age: 70% of patients under 35 years of age have a psychogenic cause, and 85% of patients over 50 years of age have organic impotence.2 Patient accounts of coital frequency similarly vary with age: 75% of men in their seventh decade report having coitus once monthly, and 37% of patients 60 to 69 years old describe having weekly coitus.

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Doppler ultrasonography of the lower extremity arteries is a valuable technique, although it is less frequently indicated for peripheral arterial disease than for deep vein thrombosis or varicose veins. Ultrasonography can diagnose stenosis through the direct visualization of plaques and through the analysis of the Doppler waveforms in stenotic and poststenotic arteries. To perform Doppler ultrasonography of the lower extremity arteries, the operator should be familiar with the arterial anatomy of the lower extremities, basic scanning techniques, and the parameters used in color and pulsed-wave Doppler ultrasonography.

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A Doppler ultrasound is a test that uses high-frequency sound waves to measure the amount of blood flow through your arteries and veins, usually those that supply blood to your arms and legs.


Vascular flow studies, also known as blood flow studies, can detect abnormal flow within an artery or blood vessel. This can help to diagnose and treat a variety of conditions, including blood clots and poor circulation. A Doppler ultrasound can be used as part of a blood flow study.


A Doppler ultrasound is a risk-free and pain-free procedure that requires little preparation. The test provides your doctor with important information about the flow of blood through your major arteries and veins. It can also reveal blocked or reduced blood flow through narrowed areas in the arteries, which could eventually lead to a stroke.

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A prospective study comparing colour Doppler ultrasound (US) with the 'gold standard' of intra-arterial digital subtraction angiography in the evaluation of renal transplant artery stenosis was performed. Both the intrarenal vessels and the transplant renal artery were examined by Doppler US. Diagnostic arteriography was performed only if, on Doppler, the peak systolic velocity in the transplant renal artery exceeded 1.5 ms-1. Of 109 patients, the transplant artery could not be visualized using colour Doppler US in three, and these were omitted from statistical analysis. Of the remaining 106 patients, 31 had a peak systolic velocity greater than 1.5 ms-1 in the transplant renal artery and were referred for DSA. Of the multiple renal Doppler indices recorded, the peak systolic velocity in the transplant artery was the best discriminating measurement for the detection of renal artery stenosis. A peak systolic velocity of > or = 2.5 ms-1 in the transplant renal artery had a sensitivity of 100% and a specificity of 95% for the detection of renal artery stenosis ( > 50% diameter reduction). Although a significant difference in Pulsatility Index, Resistive Index, Acceleration Index and Acceleration Time was recorded from the intrarenal vessels in the angiographically normal and stenosed groups with Doppler, these measurements were less useful as discriminating diagnostic tests. In conclusion, the peak systolic velocity in the transplant renal artery is the most sensitive Doppler criterion for renal artery stenosis and is sensitive and specific enough to be used as a screening test. The intrarenal acceleration time and index should not be used in isolation.

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Magnetic resonance cholangiopancreatography (MRCP) is a special type of magnetic resonance imaging (MRI) exam that produces detailed images of the hepatobiliary and pancreatic systems, including the liver, gallbladder, bile ducts, pancreas and pancreatic duct. Magnetic resonance imaging (MRI) is a non-invasive medical test that physicians use to diagnose and treat medical conditions.MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI does not use ionizing radiation (x-rays). Detailed MR images allow physicians to evaluate various parts of the body and determine the presence of certain diseases.

Doctors use MRCP to examine diseases of the liver, gallbladder, bile ducts, pancreas and pancreatic duct. These may include tumours, stones, inflammation or infection evaluate patients with pancreatitis to detect the underlying cause. In patients with pancreatitis, an MRCP may be performed using a medication called Secretin to assess for long term scarring and to determine the amount of healthy pancreatic function and secretions help to diagnose unexplained abdominal pain and provide a less invasive alternative to endoscopic retrograde cholangiopancreatography (ERCP). ERCP is a diagnostic procedure that combines endoscopy, which uses an illuminated optical instrument to examine inside the body, with iodinated contrast injection and x-ray images. You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary. Usually, you will be instructed not to eat or drink anything for several hours before your procedure.Jewellery and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. In general, metal objects used in orthopaedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect and identify any metal objects.


You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centres allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment.  A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you.


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A device called a transducer is passed over the scrotum, directing high-frequency sound waves (ultrasound) at the structures within, including the testicle, epididymis (the tube that transports sperm from the testicle), and blood vessels. The sound waves are reflected back to the transducer and electronically converted into real-time images displayed on a viewing monitor. These images are then saved on film or video and reviewed for abnormalities.

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Color Doppler ultrasound is a medical imaging technique which is used to provide visualization of the bloodflow, using color processing to add color to the image so that a doctor or care provider can clearly see what is happening inside the body. This technique requires the use of an ultrasound machine which is capable of color Doppler ultrasound, and can be performed in a hospital or clinic as an outpatient procedure. Having this imaging study performed is not usually painful, and the patient does not require sedatives. 

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Venous ultrasound uses sound waves to produce images of the veins in the body. It is commonly used to search for blood clots, especially in the veins of the leg – a condition often referred to as deep vein thrombosis. Ultrasound does not use ionizing radiation and has no known harmful effects.


On occasion, you may be asked not to eat or drink anything but water for six to eight hours beforehand. Otherwise, little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. You may be asked to wear a gown.

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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus.

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Complement C3 is a blood test that measures the activity of a certain protein. This protein is part of the complement system. The complement system is a group of proteins that move freely through your bloodstream. The proteins work with your immune system and play a role in the development of inflammation.


The complement system protects the body from infections, dead cells and from foreign material. Rarely, people may inherit deficiency of some complement proteins. These people are prone to certain infections or autoimmune disorders.


There are nine major complement proteins. They are labeled C1 through C9. This test measures C3.

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This test measures the amount of C4 proteins in your blood. These proteins are part of your complement system, an important part of your immune system that helps kill disease-causing bacteria and viruses.


By measuring complement C4 levels, especially in how they compare with other parts of the complement system, your healthcare provider can diagnose and monitor treatment of certain diseases. One of the diseases that commonly involves abnormal C4 is systemic lupus erythematosus, or lupus, an autoimmune disorder.

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A Whole Spine MRI Scan is an imaging test done to access the spinal anatomy and investigate the causes of a patient's back pain. The MRI can find changes in the spine and other tissues. MRI scans are needed when other imaging tests like X-ray, and CT scan fails to obtain any critical information and conservative treatment has stopped working or responding well. A Whole Spine MRI Scan is recommended to better diagnose the problems with your spine and provide an alternative treatment. The MRI Scan can also find problems such as infection or a tumour.


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A complement test is a blood test that measures the activity of a group of proteins in the part of the blood called the serum. These proteins make up the complement system, which is part of the immune system.


The complement system helps antibodies fight off infections and destroy substances that are foreign to the body, such as viruses, bacteria, and other germs. It’s also activated when the body makes antibodies against its own tissues that it views as foreign. This happens in autoimmune diseases.


A complement test can monitor the progress of people undergoing treatment for autoimmune diseases, such as lupus and rheumatoid arthritis (RA). The test can measure how advanced these diseases are based on the activity of the complement protein in the blood. It can also gauge the effectiveness of ongoing treatments for autoimmune disorders and diagnose some cancers and infectious diseases.


There are nine major complement proteins. They’re labeled C1 through C9. A total complement measurement checks the function of your complement system by gauging the total amount of complement protein in your blood.


The complement test involves a simple blood draw. It requires no preparation and carries few risks. Your doctor will send the blood sample to a laboratory for analysis. Your doctor will receive the results.

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Pulmonary atresia is a form of heart disease in which the pulmonary valve does not form properly. It is present from birth (congenital heart disease). The pulmonary valve is an opening on the right side of the heart that regulates blood flow from the right ventricle (right side pumping chamber) to the lungs.


In pulmonary atresia, a solid sheet of tissue forms where the valve opening should be, and the valve stays closed. Because of this defect, blood from the right side of the heart cannot go to the lungs to pick up oxygen.

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Edema, in general, means swelling. This typically occurs when fluid from inside blood vessels seeps outside the blood vessel into the surrounding tissues, causing swelling. This can happen either because of too much pressure in the blood vessels or not enough proteins in the bloodstream to hold on to the fluid in the plasma (the part of the blood that does not contain any blood cells).


Pulmonary edema is the term used when edema happens in the lungs. The immediate area outside of the small blood vessels in the lungs is occupied by very tiny air sacs called the alveoli. This is where oxygen from the air is picked up by the blood passing by, and carbon dioxide in the blood is passed into the alveoli to be exhaled out. Alveoli normally have a thin wall that allows for this air exchange, and fluids are usually kept out of the alveoli unless these walls lose their integrity.

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Pulmonary embolism is a blockage in one of the pulmonary arteries in your lungs. In most cases, pulmonary embolism is caused by blood clots that travel to the lungs from the legs or, rarely, other parts of the body (deep vein thrombosis).


Because the clots block blood flow to the lungs, pulmonary embolism can be life-threatening. However, prompt treatment greatly reduces the risk of death. Taking measures to prevent blood clots in your legs will help protect you against pulmonary embolism.


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The mumps virus is a member of the Paramyxoviridae family of viruses, which include parainfluenza virus serotypes 1-4, measles, respiratory syncytial virus, and metapneumovirus. Mumps is highly infectious among unvaccinated individuals and is typically transmitted through inhalation of infected respiratory droplets or secretions. Following an approximately 2-week incubation period, symptom onset is typically acute with a prodrome of low-grade fever, headache, and malaise.(1,2) Painful enlargement of the salivary glands, the hallmark of mumps, occurs in approximately 60% to 70% of infections and in 95% of patients with symptoms. Testicular pain (orchitis) occurs in approximately 15% to 30% of postpubertal men and abdominal pain (oophoritis) is found in 5% of postpubertal women.(1) Other complications include mumps-associated pancreatitis (<5% of cases) and central nervous system disease (meningitis <10% and encephalitis <1%).

Widespread routine immunization of infants with attenuated mumps virus has dramatically decreased the number of reported mumps cases in the United States. However, outbreaks continue to occur, indicating persistence of the virus in the general population. Laboratory diagnosis of mumps is typically accomplished by detection of IgM- and IgG-class antibodies to the mumps virus. However, due to the widespread mumps vaccination program, in clinically suspected cases of acute mumps infection, serologic testing should be supplemented with virus isolation in culture or detection of viral nucleic acid by PCR in throat, saliva, or urine specimens.


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The pulmonic valve is one of two valves that allow blood to leave the heart via the arteries. It is a one-way valve, meaning that blood cannot flow back into the heart through it. The valve is opened by the increased blood pressure of the ventricular systole (contraction of the muscular tissue), pushing blood out of the heart and into the artery. It closes when the pressure drops inside the heart. It is located in the right ventricle of the heart. The pulmonic valve opens into the pulmonary artery. The frequency of this cycle depends upon the heart rate. Pulmonary stenosis is a condition where the blood flow out of the heart is obstructed at the pulmonic valve. The most common cause of this is congenital heart disease, although rheumatic heart disease and a malignant carcinoid tumor can also initiate the problem. The condition is treated by surgical repair or replacement of the pulmonic valve.

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Pulmonary valve stenosis is a condition in which a deformity on or near your pulmonary valve narrows the pulmonary valve opening and slows the blood flow. The pulmonary valve is located between the lower right heart chamber (right ventricle) and the pulmonary arteries. Adults occasionally have pulmonary valve stenosis as a complication of another illness, but mostly, pulmonary valve stenosis develops before birth as a congenital heart defect.


Pulmonary valve stenosis ranges from mild and without symptoms to severe. Mild pulmonary stenosis doesn't usually worsen over time, but moderate and severe cases may worsen and require surgery. Fortunately, treatment is generally highly successful, and most people with pulmonary valve stenosis can expect to lead normal lives.

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Proximal conduction studies by F-wave technique, with conventional distal motor and sensory conduction were performed along the ulnar nerves of 20 patients each with cervical spondylotic radiculopathy and/or myelopathy and with classical motor neurone disease (MND). Such F-wave parameters as shortest F-latency, F-conduction velocity, conduction time and F-ratio were calculated. Twenty-five age- and sex-matched healthy volunteers acted as controls. Proximal slowing associated with sensory conduction abnormalities and normal distal motor conduction favored cervical spondylosis (CS). Distal slowing with a normal proximal motor and sensory conduction was associated with motor neurone disease.


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Ophthalmology is a branch of medicine dealing with the diagnosis, treatment and prevention of diseases of the eye and visual system. The eye, its surrounding structures and the visual system can be affected by a number of clinical conditions. Ophthalmology involves diagnosis and therapy of such conditions, along with microsurgery. Eye health services are becoming more and more important as the UK population ages. An ageing population means there are more and more incidences of age-related diseases of the eye, such as age-related macular degeneration. These eye diseases can be successfully treated if caught early, and can be managed effectively with existing treatments and medicines. Cataracts are the main cause of impaired vision worldwide, and in England and Wales it is estimated that around 2.5 million people aged 65 or older have some degree of visual impairment caused by cataracts. Cataract surgery is the second most common operation performed in the NHS in England – over 300,000 procedures are performed each year. Patients and members of the general public can view more information about eye conditions and treatments in our ‘For Patients‘ section.


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Hepatitis A is a highly contagious liver infection caused by the hepatitis A (HAV). It is one of several various causes of hepatitis, a condition characterized by inflammation and enlargement of the liver. This test detects antibodies in the blood that are produced by the immune system in response to a hepatitis A infection.


Hepatitis A is one of five "hepatitis viruses" identified so far, including B, C, D, and E, that are known to cause the disease. While hepatitis A can cause a severe, acute disease that typically lasts 1 to 2 months, it does not cause a chronic infection as do some of the other hepatitis viruses.


Hepatitis A is spread, most commonly, from person-to person through stool (fecal) contamination or by ingesting food or water contaminated by the stool of an infected person (a foodborne illness). Recognized risk factors for hepatitis A include close contact with an infected person, international travel, household or personal contact with a child who attends a child care center, household or personal contact with a newly arriving international adoptee, a recognized foodborne outbreak, men who have sex with men, and use of illegal drugs.


Although there are many causes of hepatitis, the symptoms remain the same. In hepatitis, the liver is damaged and unable to function normally. It cannot process toxins or waste products such as bilirubin for their removal from the body. During the course of the disease, bilirubin and liver enzyme levels in the blood can increase. While tests such as bilirubin or a liver panel can tell a health practitioner that someone has hepatitis, they do not identify the cause. Antibody tests for hepatitis viruses may help determine the cause.

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n addition to a complete blood cell count, the principal studies used to establish the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) are flow cytometry of peripheral blood and bone marrow analysis. Flow cytometry measures the percentage of cells that are deficient in the glycosyl phosphatidylinositol–anchored proteins (GPI-APs) and identifies discrete populations with different degrees of deficiency. Because of the missing GPI-APs, red blood cells (RBCs) and other cells in patients with PNH lack DAF (CD55) and MIRL (CD59), which regulate complement. Hemosiderin is nearly always present in the urine sediment and can accumulate in the kidneys; this is visible on magnetic resonance images (MRI) or computed tomography (CT) scans. An elevated reticulocyte count and serum lactate dehydrogenase (LDH) level with a low serum haptoglobin level in the absence of hepatosplenomegaly are the hallmarks of intravascular hemolysis.Bone marrow examination will differentiate classic PNH from PNH that develops in the setting of other bone marrow disorders. In addition, bone marrow examination will identify an erythroid and hyperplastic bone marrow during the hemolytic phase or a hypoplastic bone marrow in the aplastic phase.


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Pulmonary function tests are a broad range of tests that measure how well the lungs take in and exhale air and how efficiently they transfer oxygen into the blood. Spirometry measures how well the lungs exhale. The information gathered during this test is useful in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases (especially asthma and chronic obstructive pulmonary disease, COPD). Lung volume measurement detects restrictive lung diseases. In this set of diseases, a person cannot inhale a normal volume of air. Restrictive lung diseases may be caused by inflammation or scarring of the lung tissue (interstitial lung disease) or by abnormalities of the muscles or skeleton of the chest wall. Testing the diffusion capacity (also called the DLCO) permits an estimate of how efficiently the lungs transfer oxygen from the air into the bloodstream.


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Pyoderma gangrenosum is an uncommon, ulcerative cutaneous condition of uncertain etiology. It is associated with systemic diseases in at least 50% of patients who are affected. [1, 2] The diagnosis is made by excluding other causes of similar-appearing cutaneous ulcerations, including infection, malignancy, vasculitis, collagen vascular diseases, diabetes, and trauma. In a process termed pathergy, new ulcerations may occur after trauma or injury to the skin in 30% of patients who already have pyoderma gangrenosum. (See Presentation, DDx, and Workup.)Patients with pyoderma gangrenosum may have involvement of other organ systems that manifests as sterile neutrophilic infiltrates. Culture-negative pulmonary infiltrates are the most common extracutaneous manifestation. [3] Other organs systems that may be involved include the heart, the central nervous system, the gastrointestinal (GI) tract, the eyes, [4, 5] the liver, the spleen, the bones, and the lymph nodes. (See Presentation and Workup.)n Therapy for pyoderma gangrenosum involves the use of anti-inflammatory agents, including antibiotics, corticosteroids, immunosuppressive agents, and biologic agents. The prognosis is generally good; however, the disease can recur and residual scarring is common. (See Prognosis, Treatment, and Medication.)


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Pyloric stenosis is an uncommon condition in infants that blocks food from entering the small intestine.Normally, a muscular valve (pylorus) between the stomach and small intestine holds food in the stomach until it is ready for the next stage in the digestive process. In pyloric stenosis, the pylorus muscles thicken and become abnormally large, blocking food from reaching the small intestine.Pyloric stenosis can lead to forceful vomiting, dehydration and weight loss. Babies with pyloric stenosis may seem to be hungry all the time.


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Hepatitis B core antibodies (anti-HBc Ab) appear shortly after the onset of symptoms of hepatitis B infection and soon after the appearance of hepatitis B surface antigen (HBsAg). Initially, anti-HBc Ab consist almost entirely of the IgM class, followed by appearance of anti-HBc IgG, for which there is no commercial diagnostic assay.


The anti-HBc total antibodies test, which detects both IgM and IgG antibodies, and the test for anti-HBc IgM antibodies may be the only markers of a recent hepatitis B infection detectable in the "window period." The window period begins with the clearance of HBsAg and ends with the appearance of antibodies to hepatitis B surface antigen (anti-HBs Ab). Anti-HBc total Ab may be the only serologic marker remaining years after exposure to hepatitis B.

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Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). It is one of several various causes of hepatitis, a condition characteriszed by inflammation and enlargement of the liver. Other causes of hepatitis include, for example, certain drugs, inherited disorders, and autoimmune diseases. HBV is one of five "hepatitis viruses" identified so far. The other four are A, C, D, and E. 


The course of HBV infections can vary from a mild form (acute) that lasts only a few weeks to a more serious, chronic, form lasting years. Sometimes chronic HBV leads to serious complications such as cirrhosis or liver cancer. 


HBV is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for IV drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Mothers can pass the infection to their babies, usually during or after birth. The virus, however, is not spread through food or water, casual contact such as holding hands, or coughing or sneezing.

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This test measures the actual amount of hepatitis B in a blood sample, which helps determine whether HBV is reproducing in the liver. In a person with detectable HBeAg, an HBV viral load greater than 20,000 international units per milliliter (IU/mL) of blood indicates that the virus is active and has the greatest potential to cause damage to the liver. Similarly, in a person with an HBeAg-negative chronic hepatitis B, an HBV viral load of greater than 2,000 IU/mL indicates that the virus is active and has the potential to cause damage to the liver. Generally speaking, if the HBV viral load is above these numbers, treatment is considered necessary. However, HBV treatment decisions are based on multiple factors, and your medical provider may make recommendations based on other input.

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HBeAg is the hepatitis B envelope antigen, and anti-HBe are the antibodies produced against this antigen. If HBeAg is detectable in a blood sample, this means that the virus is still active in the liver (and can be transmitted to others). If HBeAg is negative and anti-HBe is positive, this generally means that the virus is inactive. However, this is not always the case. Some people with chronic hepatitis—especially those who have been infected with HBV for many years—may have what is known as a precore or core variant mutated form of HBV. This can cause HBeAg to be negative and anti-HBe to be positive, even though the virus is still active in the liver.

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Often used as a marker of ability to spread the virus to other people (infectivity); it may also be used to monitor the effectiveness of treatment. However, there are some types (strains) of HBV that do not make e-antigen; these are especially common in the Middle East and Asia. In areas where these strains of HBV are common, testing for HBeAg is not very useful to determine whether the virus can be spread to others.

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An HCV antibody test is typically reported as "positive" or "negative."


Results of HCV viral load testing are reported as a number if virus is present. If no virus is present or if the amount of virus is too low to detect, the result is often reported as "negative" or "not detected."


Interpretation of the HCV screening and follow-up tests is shown in the table below. In general, if the HCV antibody test is positive, then the individual tested is infected or has likely been infected at some time with hepatitis C. If the HCV RNA test is positive, then the person has a current infection. If no HCV viral RNA is detected, then the person either does not have an active infection or the virus is present in very low numbers.


For monitoring purposes, an HCV viral load (HCV RNA quantitative) can indicate whether or not treatment is effective. A high or increasing viral load may be a sign that treatment is not successful whereas a low, decreasing, or undetectable viral load may imply that the treatment is working.


Successful treatment causes a decrease of 99% or more in viral load soon after starting treatment (as early as 2-4 weeks) and usually leads to undetectable viral load after treatment is completed. According to guidelines from the American Association for the Study of Liver Diseases and the Infectious Disease Society of America, an undetectable viral load in a treated person's blood 12 weeks after the end of the treatment means that the HCV infection has responded to therapy.

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The qualitative HCV RNA tests use either a process called polymerase chain reaction (PCR) or a process called transcription-mediated amplification (TMA). Either type of qualitative test will report whether the hepatitis C virus is present in the bloodstream or not. The result is reported as either "detected" or "not detected."

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Hepatitis E virus (HEV) causes an acute, usually self-limited infection. This small, non-enveloped RNA virus is from animal reservoir (eg, hogs) to humans via the fecal-oral route. HEV is endemic in Southeast and Central Asia, with several outbreaks observed in the Middle East, northern and western parts of Africa, and Mexico. In developed countries, HEV infection occurs mainly in persons who have traveled to disease-endemic areas. Transmission of HEV may also occur parenterally, and direct person-to-person transmission is rare. Clinically severe cases occur in young to middle-aged adults. Unusually high mortality (approximately 20%) occurs in patients infected during the third trimester of pregnancy. Although there is no carrier state associated with HEV, immunocompromised patients may have prolonged periods (eg, months) of viremia and virus shedding in the stool.


In immunocompetent patients, viremia and virus shedding in the stool occur in the preicteric phase, lasting up to 10 days into the clinical phase. After an incubation period ranging from 15 to 60 days, HEV-infected patients develop symptoms of hepatitis with appearance of anti-HEV IgM antibody in serum, followed by detectable anti-HEV IgG within a few days. Anti-HEV IgM may remain detectable up to 6 months after onset of symptoms, while anti-HEV IgG usually persists for many years after infection. Anti-HEV IgM is the serologic marker of choice for diagnosis of acute HEV infection.

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This patient education piece is designed to help improve patients’ understanding regarding rectal prolapse, specifically its presentation, evaluation and treatment. This information may also be useful to the friends, families, and caregivers of patients dealing with rectal prolapse. Treatment of this condition may often require surgery, and this patient education material is intended for patients with rectal prolapse who are considering or have been recommended surgery. It will address why surgery may have been recommended, what the various treatment options are, what it involves and how it may help patients.


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Ringworm is a common skin disorder otherwise known as “tinea” or “dermatophytosis.” It is caused by a fungus that can live on skin, surfaces like locker room floors, and household items like towels, bedding, and clothes. While there are multiple forms of ringworm, the most common forms affect:


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The spleen is an organ of the lymphatic system located on the left side of your stomach (abdomen) under the rib cage and diaphragm in a region that is referred to as the left upper quadrant. In humans the spleen is about the size of a fist and its primary roles are filtering the body’s blood and helps to fight infection. It also serves a role in storing and releasing certain types of immune cells that mediate tissue inflammation. [1]Rupturing a spleen describes an emergency situation in which your spleen has developed a disruption in its surface or blood supply. This is serious condition that can occur during a direct blow or trauma and without emergency treatment a ruptured spleen can cause life threatening internal bleeding. [2]


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Do you have an itch? Some scratch their heads while giving something some serious thought in a “hmm, let me think about that” sort of moment. But for many others, a serious scratching is desired because there is a genuine and persistent itch on the head, specifically an itchy scalp.


Often, we assume it must be dandruff, a common problem, but there are many conditions that can cause a dry, itchy scalp in addition to dandruff, such as ringworm or even a bacterial infection caused by an autoimmune condition.


With itching being the most common symptom, skin infections, swelling, redness, balding and damaged hair may also result from an itchy scalp. Common treatments are usually in some form of antimicrobial or keratolytic therapy, steroids, and special diets. However, there is no doubt that one of the most effective treatments for itchy scalp is a good old shampoo scrub to help remove loose and scaly skin. And to really stop the itch long term, you need to find out what’s causing it. Let’s look at some of the best natural treatments for an itchy scalp and the most common causes


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Scorpions use their sting to capture prey and to defend themselves. They hunt at night and will not sting unless provoked or they feel threatened. All scorpions use their stings as a defense mechanism or a weapon to incapacitate prey. But the potency to humans of stings varies, depending on the scorpion species. One thing that all scorpions have in common is that the sting possesses venom, which usually is neurotoxic in nature.






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A separated shoulder is an injury to the ligaments that hold your collarbone (clavicle) to your shoulder blade. In a mild separated shoulder, the ligaments might just be stretched. In severe injuries, ligaments might be torn. In most people, a separated shoulder doesn't usually require surgery. Instead, conservative treatment — such as rest, ice and pain relievers — is often enough to relieve the pain. Most people regain full shoulder function within a few weeks after having a separated shoulder.


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Sepsis is a life-threatening illness caused by your body’s response to an infection. Your immune system protects you from many illnesses and infections, but it’s also possible for it to go into overdrive in response to an infection. Sepsis develops when the chemicals the immune system releases into the bloodstream to fight an infection cause inflammation throughout the entire body instead. Severe cases of sepsis can lead to septic shock, which is a medical emergency.


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Septic arthritis is also known as infectious arthritis, and is usually caused by bacteria. It can also be caused by a virus or fungus. The condition is an inflammation of a joint that's caused by infection. Typically, septic arthritis affects one large joint in the body, such as the knee or hip. Less frequently, septic arthritis can affect multiple joints.



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Severe acute respiratory syndrome (SARS) is a serious form of pneumonia. It is caused by a virus that was first identified in 2003. Infection with the SARS virus causes acute respiratory distress (severe breathing difficulty) and sometimes death.


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Shin splints (medial tibial stress syndrome) is an inflammation of the muscles, tendons, and bone tissue around your tibia. Pain typically occurs along the inner border of the tibia, where muscles attach to the bone.


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Central sleep apnea is a disorder in which your breathing repeatedly stops and starts during sleep.Central sleep apnea occurs because your brain doesn't send proper signals to the muscles that control your breathing. This condition is different from obstructive sleep apnea, in which you can't breathe normally because of upper airway obstruction. Central sleep apnea is less common than obstructive sleep apnea. Central sleep apnea may occur as a result of other conditions, such as heart failure and stroke. Sleeping at a high altitude also may cause central sleep apnea. Treatments for central sleep apnea may involve treating existing conditions, using a device to assist breathing or using supplemental oxygen.


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Obstructive sleep apnea is a potentially serious sleep disorder. It causes breathing to repeatedly stop and start during sleep.There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring. Treatments for obstructive sleep apnea are available. One treatment involves using a device that keep your airway open while you sleep. Another option is a mouthpiece to thrust your jaw forward during sleep. In more severe cases, surgery may be an option too


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Sleep terrors are episodes of screaming, intense fear and flailing while still asleep. Also known as night terrors, sleep terrors often are paired with sleepwalking. Like sleepwalking, sleep terrors are considered a parasomnia — an undesired occurrence during sleep. A sleep terror episode usually lasts from seconds to a few minutes, but episodes may last longer. Sleep terrors affect almost 40 percent of children and a much smaller percentage of adults. However frightening, sleep terrors aren't usually a cause for concern. Most children outgrow sleep terrors by their teenage yearsSleep terrors may require treatment if they cause problems getting enough sleep or they pose a safety risk.

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Sleepwalking, formally known as somnambulism, is a behavior disorder that originates during deep sleep and results in walking or performing other complex behaviors while asleep. It is much more common in children than adults and is more likely to occur if a person is sleep deprived. Because a sleepwalker typically remains in deep sleep throughout the episode, he or she may be difficult to awaken and will probably not remember the sleepwalking incident.

Sleepwalking usually involves more than just walking during sleep; it is a series of complex behaviors that are carried out while sleeping, the most obvious of which is walking. Symptoms of sleepwalking disorder range from simply sitting up in bed and looking around, to walking around the room or house, to leaving the house and even driving long distances. It is a common misconception that a sleepwalker should not be awakened. In fact, it can be quite dangerous not to wake a sleepwalker.

The prevalence of sleepwalking in the general population is estimated to be between 1% and 15%. The onset or persistence of sleepwalking in adulthood is common, and is usually not associated with any significant underlying psychiatric or psychological problems. Common triggers for sleepwalking include sleep deprivation, sedative agents (including alcohol), febrile illnesses, and certain medications.

The prevalence of sleepwalking is much higher for children, especially those between the ages of three and seven, and occurs more often in children with sleep apnea. There is also a higher instance of sleepwalking among children who experience bedwetting. Sleep terrors are a related disorder and both tend to run in families.


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Before smallpox was eradicated, it was a serious infectious disease caused by the variola virus. It was contagious—meaning, it spread from one person to another. People who had smallpox had a fever and a distinctive, progressive skin rash.Most people with smallpox recovered, but about 3 out of every 10 people with the disease died. Many smallpox survivors have permanent scars over large areas of their body, especially their faces. Some are left blind. Thanks to the success of vaccination, smallpox was eradicated, and no cases of naturally occurring smallpox have happened since 1977. The last natural outbreak of smallpox in the United States occurred in 1949.


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You probably know that smoking tobacco isn’t great for your health. A recent report by the U.S. surgeon general attributes nearly half a million deaths annually to smoking. Your lungs are one of the organs that’s most impacted by tobacco. Here’s how smoking affects your lungs and your overall health.


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A somatosensory evoked potential (SSEP) is an evoked potential caused by a physical stimulus (usually a small electric pulse). Electrodes positioned over particular areas of the body record responses of the SSEP, these are then observed as a reading on an electroencephalogram (EEG).  A SSEP can most commonly involve stimulation of the median nerve at the wrist, or the posterior tibial nerve at the ankle. This investigation therefore tests the pathway of the sensory nerves to the sensory areas of the brain, even though the stimuli are non-physiological.


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Somatosensory Evoked Potentials (SSEPs) are electric signals recorded from the scalp or spine following stimulation to the peripheral nerves. They are time-locked responses, representing the function of the ascending sensory pathways. Early in the 1960s Larson et al introduced the use of somatosensory evoked potentials to monitor neural structure during neurosurgical procedures. It was utilized as a supplement to the wake-up test during correctional spinal surgeries for spinal deformities such as scoliosis to provide warning of compromised spinal cord function to the spine surgeons, as reported by McCallum et al and Nash et al in the 1970s. Since then SSEP has become one of the earliest and primary tools for intraoperative neurophysiological monitoring.


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Somatosensory Evoked Potentials (SSEPs) are electrical responses recorded from the nervous system following electrical stimulation of a peripheral nerve.  For example, stimulation of the median nerve at the wrist produces electrical activity that travels along the sensory pathway on its way to the brain. This activity can be recorded with electrodes positioned along that pathway.


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Tachycardia is a common type of heart rhythm disorder (arrhythmia) in which the heart beats faster than normal while at rest.It's normal for your heart rate to rise during exercise or as a physiological response to stress, trauma or illness (sinus tachycardia). But in tachycardia (tak-ih-KAHR-dee-uh), the heart beats faster than normal in the upper or lower chambers of the heart or both while at rest.Your heart rate is controlled by electrical signals sent across heart tissues. Tachycardia occurs when an abnormality in the heart produces rapid electrical signals that quicken the heart rate, which is normally about 60 to 100 beats a minute at rest.In some cases, tachycardia may cause no symptoms or complications. But if left untreated, tachycardia can disrupt normal heart function and lead to serious complications, including:


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Your doctor has requested an ultrasound-guided biopsy. The goal of a biopsy is to remove a sample of tissue for testing in a laboratory. A biopsy can help diagnose abnormalities such as infection, inflammation or malignancy. During your biopsy, an imaging physician will use an ultrasound scanner to accurately guide a needle to the site of the biopsy. The needle will then be used to remove a tissue sample. At the S. Mark Taper Foundation Imaging Center, a highly trained medical team will oversee your procedure. This team will include an imaging physician, a diagnostic medical sonographer and a registered nurse.


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A biophysical profile (BPP) test measures the health of your baby (fetus) during pregnancy. A BPP test may include a non stress test with electronic fetal heart monitoring and a fetal ultrasound. The BPP measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby. A BPP is commonly done in the last trimester of pregnancy. If there is a chance that your baby may have problems during your pregnancy (high-risk pregnancy), a BPP may be done by 32 to 34 weeks or earlier. Some women with high-risk pregnancies may have a BPP test every week or twice a week in the third trimester. It is usually done to keep track of your baby’s health. 

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A nerve conduction study (NCS) involves activating nerves electrically with small safe pulses over several points on the skin, usually on the limbs, and measuring the responses obtained. Usually, the response or signal is measured from the nerve itself or from a muscle supplied by the nerve being activated. This gives information about the state of health of the nerve, muscle and neuromuscular junction (the portion responsible for communication between the nerve and muscle). A commercial device is normally employed to measure the signals.

Electromyography (also known as needle EMG) involves the measuring of electrical activity within muscles by way of a needle electrode. It is rather similar to having an electrical microphone at the tip of the needle. Muscles are electrically active organs, and the signals and patterns of signals can lend additional information regarding the state of the muscle as well as the nerve supplying it.

In Australia, the person responsible for these tests is a neurologist, who frequently has had further training in the subspecialty of clinical neurophysiology.
A doctor may recommend that you undergo this test. There are a wide variety of conditions that are assessed with this technique. Quite frequently, the examination is requested because the patient is experiencing symptoms that suggest some problem with the nerves (numbness, tingling, weakness or pain) or muscles (weakness or pain), even though the physical examination is normal. Indeed, in many cases, there is no abnormality seen and the test can then be reassuring, but it cannot detect all conditions. In general terms, the test is useful for detecting if there is a significant abnormality, but this is also often easier when there is a definite clinical abnormality. In such cases, the test can help clarify what the problem is, although usually, unless the nerve problem is a common entrapment (site of compression), other tests may be required to ascertain the exact nature of the problem.
There are several types of nerves but generally speaking, the two major types are motor and sensory nerves. Motor nerves carry signals from the brain to the muscle to enable contraction and movement, and sensory nerves relay information to the brain. When the nerve is stimulated with metal electrodes (metallic patch/es that can conduct signals), a response can be measured by surface (on the skin) electrodes some distance away in sensory nerves overlying the nerve itself. For the motor nerves, the response is usually detected over the muscle that is activated by that nerve. In this fashion, results can reveal information about the size and speed of the electrically conducted impulse. The size usually reveals the number of nerve fibres present and the speed, the integrity of the myelin (insulating membrane around the nerve ‘axon’ or cable). This is why the word ‘conduction’ is used.
You will be given instructions on how to prepare for the test. You should not use creams or emollients on your hands and feet (the most common sites of your nerve tests) on the day of the test, and preferably since your last shower or bath. Generally speaking, there are no other preparations of note.

Please advise the neurologist performing the test if you have a pacemaker or other similar devices. If you are taking warfarin, heparin or some other medication to thin your blood, and if you are having a needle EMG test, you should advise both your GP and the neurologist. A measurement of how thin your blood is may be important before that test can be performed.
The NCS procedure is usually very safe and is non-invasive. Firstly, you will be told how to position yourself and the skin area will be prepared. Then some electrodes will be attached to your skin and you will be forewarned when to expect the stimulation. Many people are understandably anxious about the intensities of the small safe electrical pulses that are passed via the skin, but usually relax quickly when they know what to expect. It is faily important that you remain relaxed for the recordings to minimise the ‘noise’ (interference) in the recordings from excessive muscular activity.
Here, a small needle is inserted through the skin into a muscle belly. Sterilisation of the skin and a local anaesthetic is not generally required. Usually the consultation and procedure takes about 30-45 minutes in all. More complicated assessments may demand more time.
Following the test, you will be allowed to put on your garments and shoes. It should be noted that the final interpretation of the clinical meaning of the test rests with the clinician who ordered the test. This is because they can put together the whole picture. For this reason, the neurologist performing the test can only give you limited information about the meaning of the results, and may not even be able to provide any information on the next step or any possible treatments because they are unaware of all the other clinical information.


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A Doppler ultrasound, also called a Color Doppler test is a non-invasive test that can be used to estimate your blood flow through blood vessels. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (foetus) to check the health of the foetus. 

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Color Doppler is an ultrasound-based diagnostic imaging technique used to visualize subcutaneous body structures including tendons, muscles, joints, vessels and internal organs for possible Pathology or Lesions. Colour Doppler is also used for the following applications:-

Carotid Colour Doppler to detect risk of stroke and paralysis by   evaluating the vessels   in the neck that supply blood to the brain.  Peripherial Arterial Colour Doppler.

Peripherial Venous Colour Doppler for detection of Deep Vein Thrombosis (DVT).

Renal Doppler (especially for hypertensive patients and diabetics).

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Triphasic spiral liver Computed Tomography (CT) is a standardized procedure for the detection and characterization of a large variety of benign and malignant liver lesions. This helps in the decline of mortality and morbidity rates among patients with liver disease. Spiral computed tomography has gained acceptance as the preferred computed tomography technique for routine liver evaluation because it provides image acquisition at peak enhancement of liver parenchyma during a single breath hold. In addition fast data acquisition allows successive scanning of the entire liver at different intervals after injection of the iodinated contrast material, thus creating the possibility of multiphase liver computed tomography.

Triphasic CT scan is a good non-invasive tool and can be used as first line imaging modality for differentiating benign and malignant focal liver lesions. Benign lesions like haemangioma can be reliably differentiated from malignant liver lesion; therefore unnecessary biopsies can be avoided. It is also particularly useful for hypervascular lesions which can be easily missed on routine CT scanning.



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Computed tomography (CT) perfusion of the head uses special x-ray equipment to show which areas of the brain are adequately supplied with blood (perfused) and provides detailed information about blood flow to the brain. CT perfusion is fast, painless, noninvasive and accurate. It’s a useful technique for measuring blood flow to the brain, which may be important for treating stroke, brain blood vessel disease and brain tumors.

Computed tomography (CT) perfusion imaging shows which areas of the brain are adequately supplied or perfused with blood and provides detailed information on delivery of blood or blood flow to the brain.

CT perfusion scanning is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

CT scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. These cross-sectional images of the area being studied can then be examined on a computer monitor, printed or transferred to a CD.

CT scans of internal organs, bones, soft tissue and blood vessels provide greater clarity and reveal more details than regular x-ray exams.

In many ways CT scanning works very much like other x-ray examinations. Different body parts absorb the x-rays in varying degrees. It is this crucial difference in absorption that allows the body parts to be distinguished from one another on an x-ray film or CT electronic image.

In a conventional x-ray exam, a small amount of radiation is aimed at and passes through the part of the body being examined, recording an image on a special electronic image recording plate. Bones appear white on the x-ray; soft tissue, such as organs like the heart or liver, shows up in shades of gray, and air appears black.With CT scanning, numerous x-ray beams and a set of electronic x-ray detectors rotate around you, measuring the amount of radiation being absorbed throughout your body. Sometimes, the examination table will move during the scan, so that the x-ray beam follows a spiral path. A special computer program processes this large volume of data to create two-dimensional cross-sectional images of your body, which are then displayed on a monitor. CT imaging is sometimes compared to looking into a loaf of bread by cutting the loaf into thin slices. When the image slices are reassembled by computer software, the result is a very detailed multidimensional view of the body's interior.

Refinements in detector technology allow nearly all CT scanners to obtain multiple slices in a single rotation. These scanners, called multislice CT or multidetector CT, allow thinner slices to be obtained in a shorter period of time, resulting in more detail and additional view capabilities.


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An ultrasound / SONOGRAPHY is a procedure that uses high-frequency sound waves to scan a the internal organs of the body woman’s abdomen and pelvic cavity, the reproductive system and the fetus of a pregnant woman creating a picture (sonogram) of the baby and placenta. Although the terms ultrasound and sonogram are technically different, they are used interchangeably and reference the same exam. They can show the structure and movement of the body's internal organs, including the abdomen, the fetus of pregnant women as well as blood flowing through blood vessels.


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The number of neutrophils in the blood is expressed as absolute neutrophil count (ANC) and it measures the percentage of neutrophils in the differential WBC count. The ANC of a healthy individual falls in the range of 2,500 to 6,000 per microliter.

A total blood count gives the levels of the three types of blood cells - white blood cells, red blood cells, and platelets. Neutrophils are present in two forms – polys and bands. Polys are also known as segmented neutrophils and are the most abundant of the WBCs. Bands are also called stabs and are immature polys. Both polys and bands destroy invaders (i.e. microbes) in the body.

The ANC is calculated by multiplying the number of WBCs in blood by the percentage of total neutrophils.  For example, for a WBC count of 7000 per microliter, if neutrophils constitute 40% of the WBCs, the ANC in this case will be 7000 × 0.40 = 2800 per microliter.

An ANC below 1,000 per microliter is called neutropenia. ANCs less than 500 per microliter significantly increase the risk of infection. In cancer patients, frequent blood tests are performed to assess WBC count and ANC to monitor the body’s response to cancer treatment.

Neutrophils constitute nearly 55 to 70% of the total WBC count. Acute infections or trauma are the main triggers for production of neutrophils leading to elevated WBC count also known as neutrophilia or neutrophil leukocytosis.

In cancer patients, ANC is a reflection of the immunologic status of the patient in response to chemotherapy. This therapy suppresses production of WBC and hence neutrophils, thus increasing infection risks. Hence, a low ANC or neutropenia can be an indication of the need for reducing chemotherapy dosage or delaying the next sessions of chemotherapy. ANC also allows prediction of neutropenia-related events including fever after chemo­therapy sessions. It thus offers a clear picture of the patient’s immunologic status.

ANC helps determine the need for antibiotics or other measures along with therapy to decrease complications related to neutro­penia. While for an in-patient, a low ANC may be an indicator of the need to isolate the patient so as to protect him or her from exposure to infectious agents, in case of an out-patient, it can highlight the need to keep away from crowds or people having flu or colds. ANC is thus a powerful monitoring tool in cancer patients who are prone to bone marrow suppression due to radiation, chemotherapy, or bone marrow transplant.



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Acetylcholine receptor (AChR) antibodies are autoantibodies produced by the immune system that mistakenly target proteins called acetylcholine receptors that are located on skeletal muscle fibers. This test detects and measures AChR antibodies in the blood.

Acetylcholine receptors function as "docking stations" for acetylcholine, a chemical substance (neurotransmitter) that transmits messages between nerve cells. Muscle movement starts when an impulse is sent down a nerve to the nerve ending, where it stimulates the release of acetylcholine. Acetylcholine travels across a microscopic gap between the nerve ending and a muscle fiber at the "neuromuscular junction." When it reaches the muscle fiber, it binds to one of many acetylcholine receptors and activates it, initiating muscle contraction.

AChR antibodies impede communication between nerves and skeletal muscles, inhibit muscle contraction, and cause rapid muscle fatigue by preventing activation of the acetylcholine receptors. They do this in three major ways:


1.Binding antibodies attach to the receptors on nerve cells and may initiate an inflammatory reaction that destroys the receptors.

2.Blocking antibodies may sit on the receptors, preventing acetylcholine from binding.

3.Modulating antibodies may cross-link the receptors, causing them to be taken up into the muscle cell and removed from the neuromuscular junction.


The end result of this interference is the development of myasthenia gravis (MG), a chronic autoimmune disorder associated with the presence of these antibodies and with their effects on muscle control.

AChR antibodies may be detected in different ways to determine which mechanism may be the problem in a particular individual, and the antibodies may be referred to as "binding," "blocking," or "modulating." However, the technique that measures "binding" is the most commonly performed and, generally speaking, it is rare for the other two tests to be positive without the "binding" test being positive as well. These other approaches may be useful when a healthcare practitioner strongly suspects myasthenia gravis and the "binding" test is negative.

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Approximately 90% of patients with myasthenia gravis MG) express antibodies to the acetylcholine receptor (aChR), which can be divided into binding, blocking, and modulating antibody. Binding antibody can activate complement and lead to loss of aChR. Blocking antibody may impair aChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of aChR expression, which correlates most closely with clinical severity of disease. Approximately 10% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibody. Myasthenia gravis (MG) is an autoimmune disease in which an acetylcholine receptor (AChR) is the antibody target. The AChR in the motor end-plate of skeletal muscle is an integral membrane protein consisting of five subunits (a pentamer). The alpha chain carries both the binding site for cholinergic ligands (binding site for acetylcholine and bungarotoxin) and the main immunogenic region, a region against which a majority of the antibodies of MG patients are directed. In MG, acetylcholine-dependent neuromuscular transmission is impaired by a loss of signal transduction. The final result is that threshold potential in the cell is never reached and the muscle cannot contract. The patient experiences voluntary muscle weakness and fatigue characteristic of the disease, as well as difficulty in swallowing, diplopia, ptosis (in ocular MG), and, in severe cases, death. Individuals who manifest AChR antibodies generally do not express a single, monoclonal antibody population. The antibody population is divided into three classes: • Binding • Blocking • Modulating Binding antibodies are those that are epitopically directed toward the large hydrophilic domain of the receptor. This class of antibodies can activate the complement cascade, resulting in tissue damage and receptor loss. The AChR binding antibody radioimmunoassay detects a wide population of autoantibodies. The use of soluble receptor measures not only antibody directed against the extracellular region of the receptor, presumably the portion involved in the pathophysiology of the disease, but intracellular determinants of the receptor not normally exposed to immunoglobulins. The assay is incapable of differentiating general binding antibodies from the more specific modulating population. Moreover, the binding assay does not easily measure a blocking population. Blocking autoantibodies prevent the binding of acetylcholine to the receptor. They may act by direct steric interference or by an allosteric mechanism. The pathology associated with this type of antibody will result in the most rapid loss of receptor function. Modulating antibodies as a class accelerate endocytosis, resulting in loss of receptors. It is largely this class of antibodies to which clinical severity has been most closely associated. In fifty-three percent of samples with any measurable autoantibody, all three antibody populations were present. Addition of blocking and modulating antibody assays to the binding assay increased the number of samples that tested positive by approximately 10 percent. Studies show that the presence of modulating antibody generally compares more closely to disease severity than either binding or blocking classes. Drachman et al showed that the blocking population has a disease severity correlation nearly as high as that of modulating antibodies (88% vs. 91%). Approximately 90 percent of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibody. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10 percent of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibody.


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Approximately 85-90% of patients with myasthenia gravis (MG) express antibodies to the acetylcholine receptor (AChR), which can be divided into binding, blocking, and modulating antibodies. Binding antibody can activate complement and lead to loss of AChR. Blocking antibody may impair AChR binding to the receptor, leading to poor muscle contraction. Modulating antibody causes receptor endocytosis resulting in loss of AChR expression, which correlates most closely with clinical severity of disease. Approximately 10-15% of individuals with confirmed myasthenia gravis have no measurable binding, blocking, or modulating antibodies. This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.


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For several decades, nonspecific methods, which depend upon raised globulin levels, have been used in the diagnosis of VL. Some of the tests used for detecting these nonspecific immunoglobulins are Napier's formol gel or aldehyde test and the Chopra antimony test. Since these tests depend upon raised globulin levels, results can be positive in a host of conditions (13, 14). Lack of specificity, as well as varying sensitivities, renders them highly unreliable.


Several immunodiagnostic methods which are more sensitive and specific have been developed. They are useful in identifying specific cases and can be used for community surveillance. The human body makes an attempt to fight against VL by producing some of the highest levels of antibodies found in response to any disease, all to no avail. This is due to polyclonal activation of the B cells, resulting in marked elevation of levels (in serum) of immunoglobulin G (IgG) and IgM against various nonspecific proteins and haptens (23). The consistent presence of high levels of antibodies against parasite antigens can simplify diagnosis of VL. Several serological techniques are based on detection of these antibodies. The specificity of the antibody depends upon the antigen or epitope used in the test, as the parasite stimulates production of a wide array of antibodies, including group-, genus-, and species-specific antibodies. Therefore, the sensitivity may depend upon the test and its methodology, but the specificity will depend on the antigen rather than the serological procedure used. In most serological tests, the sensitivity and specificity data are compared against demonstration of parasites in various tissues.


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Bone Specific Alkaline Phosphatase is one of the isoenzymes of Alkaline Phosphatase.

Bone Specific Alkaline Phosphataseit is associated with osteoblast cell function and thought to have a role in bone mineralization.

The measurement of Bone Specific Alkaline Phosphatase provides information useful in the evaluation and treatment of people with Paget’s disease, osteoporosis, and metastases to bone.

Bone alkaline phosphatase (BAP) is the bone-specific isoform of alkaline phosphatase. A glycoprotein that is found on the surface of osteoblasts, BAP reflects the biosynthetic activity of these bone-forming cells. BAP has been shown to be a sensitive and reliable indicator of bone metabolism.(1)

Normal bone is constantly undergoing remodeling in which bone degradation or resorption is balanced by bone formation. This process is necessary for maintaining bone health. If the process becomes uncoupled and the rate of resorption exceeds the rate of formation, the resulting bone loss can lead to osteoporosis and, consequently, a higher susceptibility to fractures.

Osteoporosis is a metabolic bone disease characterized by low bone mass and abnormal bone microarchitecture. It can result from a number of clinical conditions including states of high bone turnover, endocrine disorders (primary and secondary hyperparathyroidism and thyrotoxicosis), osteomalacia, renal failure, gastrointestinal diseases, long-term corticosteroid therapy, multiple myeloma, and cancer metastatic to the bones.

Paget disease is another common metabolic bone disease caused by excessive rates of bone remodeling resulting in local lesions of abnormal bone matrix. These lesions can result in fractures or neurological involvement. Antiresorptive therapies are used to restore the normal bone structure.



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Cryptococcosis is an invasive fungal infection caused by Cryptococcus neoformans or C gattii. C neoformans has been isolated from several sites in nature, particularly weathered pigeon droppings. C gatti was previously only associated with tropical and subtropical regions; however, more recently this organism has also been found to be endemic in British Columbia and among the Pacific Northwest United States, and is associated with several different trees species.

Infection is usually acquired via the pulmonary route. Patients are often unaware of any exposure history. Approximately half of the patients with symptomatic disease have a predisposing immunosuppressive condition such as AIDS, steroid therapy, lymphoma, or sarcoidosis. Symptoms may include fever, headache, dizziness, ataxia, somnolence, and cough. While the majority of C neoformans infections occur in immunocompromised patient populations, C gattii is has a higher predilection for infection of healthy hosts.(1,2)

In addition to the lungs, cryptococcal infections frequently involve the central nervous system (CNS), particularly in patients infected with HIV. Mortality among patients with CNS cryptococcosis may approach 25% despite antibiotic therapy. Untreated CNS cryptococcosis is invariably fatal. Disseminated disease may affect any organ system and usually occurs in immunosuppressed individuals.

The presence of cryptococcal antigen in any body fluid (serum or cerebrospinal fluid) is indicative of cryptococcosis. Specimens that are positive by the lateral flow assay screen are automatically repeated with the same method utilizing dilutions in order to generate a titer value.

Disseminated infection is usually accompanied by a positive serum test.

Higher Cryptococcus antigen titers appear to correlate with more severe infections. Declining titers may indicate regression of infection. However, monitoring titers to cryptococcal antigen should not be used as a test of cure or to guide treatment decisions, as low level titers may persist for extended periods of time following appropriate therapy and the resolution of infection.(3)

A negative result does not preclude diagnosis of cryptococcosis, particularly if only a single specimen has been tested and the patient shows symptoms consistent with cryptococcosis. 

A positive result is indicative of cryptococcosis, however all test results should be reviewed in light of other clinical findings.

Testing should not be performed as a screening procedure for the general populations and should only be performed when clinical evidence suggests the diagnosis of cryptococcal disease.

Testing hemolyzed serum specimens may lead to false-negative results due to the high background color on the lateral flow assay strip.

Although rare, extremely high concentrations of cryptococcal antigen can result in weak test lines and in extreme instances, yield negative test results.



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Fungal Smear test is performed on a sample of skin to measure the level of Fungal Smear (Skin) in the skin.It is performed to confirm Fungal Infection of Skin and also during the treatment and after the treatment of Fungal Infection of Skin and Immunosuppressive Condition.

No special preparation is needed for Fungal Smear Koh Test Skin. Inform your doctor if you are on any medications or have any underlying medical conditions or allergies before undergoing Fungal Smear Koh Test Skin. Your doctor depending on your condition will give specific instructions.

The normal result for Fungal Smear Koh Test Skin for Fungal Smear (Skin) is A normal KOH test result shows no Fungi. A stained slide fluoresce is observed if positive for fungus. A positive test indicates Fungal infection but it cannot identify the organism. If KOH test is positive then, specimen is inoculated into culture media. for Unisex gender and for All age groups.


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Hepatitis A is a highly contagious liver infection caused by the hepatitis A (HAV). It is one of several various causes of hepatitis, a condition characterized by inflammation and enlargement of the liver. This test detects antibodies in the blood that are produced by the immune system in response to a hepatitis A infection.

Hepatitis A is one of five "hepatitis viruses" identified so far, including B, C, D, and E, that are known to cause the disease. While hepatitis A can cause a severe, acute disease that typically lasts 1 to 2 months, it does not cause a chronic infection as do some of the other hepatitis viruses.

Hepatitis A is spread, most commonly, from person-to person through stool (fecal) contamination or by ingesting food or water contaminated by the stool of an infected person (a foodborne illness). Recognized risk factors for hepatitis A include close contact with an infected person, international travel, household or personal contact with a child who attends a child care center, household or personal contact with a newly arriving international adoptee, a recognized foodborne outbreak, men who have sex with men, and use of illegal drugs.

Although there are many causes of hepatitis, the symptoms remain the same. In hepatitis, the liver is damaged and unable to function normally. It cannot process toxins or waste products such as bilirubin for their removal from the body. During the course of the disease, bilirubin and liver enzyme levels in the blood can increase. While tests such as bilirubin or a liver panel can tell a health practitioner that someone has hepatitis, they do not identify the cause. Antibody tests for hepatitis viruses may help determine the cause.

There are two different classes of hepatitis A antibody that may be tested, IgM and IgG. When a person is exposed to hepatitis A, the body first produces hepatitis A IgM antibodies. These antibodies typically develop 2 to 3 weeks after first being infected (and are detectable before the onset of symptoms) and persist for about 3 to 6 months. Hepatitis A IgG antibodies are produced within 1 to 2 weeks of the IgM antibodies and usually persist for life.

1.Because hepatitis A IgM antibodies develop early in the course of infection, a positive hepatitis A IgM test is usually considered diagnostic for a current or recent infection of hepatitis A. This test may be done as part of an acute viral hepatitis panel used to determine which virus is causing symptoms when viral hepatitis is suspected.

2.An HAV IgG test may be used to help determine if a person has been infected in the past and has some immunity to the disease.

3.A total hepatitis A antibody test detects the presence of both the IgM and IgG antibodies, thus can identify current and past infections.

A vaccine that prevents hepatitis A has been available since 1995. Historically, infection rates varied cyclically, with nationwide increases every 10-15 years. However, rates have declined in general since the vaccine was introduced. In 2010, the number of acute hepatitis A cases reported nationwide declined by approximately 53% from about 3,600 in 2006.



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Hepatitis B tests detect substances that reflect a current or previous infection with hepatitis B virus (HBV). Some tests detect viral proteins (antigens) or the antibodies that are produced in response to an infection, while other types of tests detect or evaluate the genetic material (DNA) of the virus. The pattern of test results can identify a person who has a current active infection or one who has immunity as a result of previous exposure.

For details on the various tests, see the table under "How is it used?"

Hepatitis is a condition characterized by inflammation and enlargement of the liver. It has several various causes, one of which is infection by a virus. HBV is one of five "hepatitis viruses" identified so far that are known to mainly infect the liver. The other four are hepatitis A, hepatitis C, hepatitis D, and hepatitis E.

HBV is spread through contact with blood or other body fluids from an infected person. Exposure can occur, for example, through sharing of needles for IV drug use or through unprotected sex. People who live in or travel to areas of the world where hepatitis B is prevalent are at a greater risk. Rarely, mothers can pass the infection to their babies, usually during or after birth. The virus is not spread through casual contact such as holding hands, coughing or sneezing. However, the virus can survive outside the body for up to seven days, including in dried blood, and can be passed by sharing items such as razors or toothbrushes with an infected person.

Effective hepatitis B vaccines have been available in the U.S. since 1981, and beginning in 1991, health care providers in the U.S. began vaccinating infants at birth. Still, the Centers for Disease Control and Prevention (CDC) estimates that between 804,000 and 1.4 million people in the U.S. are infected with the virus, most of whom are not aware that they are infected.

The course of HBV infections can vary from a mild form that lasts only a few weeks to a more serious chronic form lasting years. Sometimes chronic HBV leads to serious complications such as cirrhosis or liver cancer. Some of the various stages or forms of hepatitis B include:

  • Acute infection — presence of typical signs and symptoms with a positive screening test
  • Chronic infection — persistent infection with the virus detected by laboratory tests accompanied by inflammation of the liver
  • Carrier (inactive) state — persistent infection but no liver inflammation (a carrier is someone who may appear to be in good health but harbors the virus and can potentially infect others)
  • "Cleared" infection — no longer has any evidence of infection; viral antigen and DNA tests are negative and no signs or symptoms of liver inflammation (although, in many cases, the virus is present in an inactive state in the liver)
  • Reactivation — return of HBV infection with liver damage in a person who was a carrier or who had "cleared" infection; this most commonly occurs in persons treated with chemotherapy for cancer or with drugs that suppress the immune system used to treat autoimmune diseasesor following an organ transplant.

Though a potentially serious infection, acute HBV infection usually resolves on its own in most adults. Infants and children tend to develop a chronic infection more often than adults. Approximately 90% of infants infected with HBV will develop a chronic condition. For children between the ages of one and five, the risk of developing chronic hepatitis drops to between 25% and 50%. Over the age of five, only 6% to 10% of HBV infections become chronic.

The vast majority of those with chronic infections will have no symptoms. For acute infections, the symptoms are very similar to those of other types of acute hepatitis. Symptoms include fever, fatigue, nausea, vomiting, and jaundice. With acute hepatitis, the liver is damaged and is not able to function normally. It may not process toxins or waste products such as bilirubin for their removal from the body. During the course of disease, bilirubin and liver enzyme levels in the blood may increase. While tests such as bilirubin or a liver panel can tell a health practitioner that someone has hepatitis, they will not indicate what is causing it. Tests that detect infection with a hepatitis virus may help determine the cause.

Hepatitis B testing can be used to screen for infection in the absence of symptoms, to determine whether infection is acute or chronic, or to monitor a chronic infection and the effectiveness of treatment. Initial testing may include the following, often performed together as a panel of tests:

  • Hepatitis B surface antigen
  • Hepatitis B surface antibody
  • Total hepatitis B core antibody (IgM and IgG)

Additional or follow-up testing may include:

  • IgM antibody to hepatitis B core antigen
  • Hepatitis B e-antigen
  • Anti-hepatitis B e antibody
  • Hepatitis B viral DNA
  • Hepatitis B genotyping

Two tests, hepatitis B surface Ag and hepatitis B core antibody, IgM, may be performed as part of an acute viral hepatitis panel.



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There are two types of pregnancy tests; one uses a urine sample, the other a sample of blood. Both tests detect the presence of a hormone called human chorionic gonadotropin (hCG). This hormone is produced by the placenta shortly after the embryo attaches to the uterine lining and builds up rapidly in your body in the first few days of pregnancy. It is this rapid shift in hormones that triggers most of your pregnancy symptoms.

URINE TEST  :-Urine tests can be performed in two different ways and these can be performed at home or in a clinic. One way involves collecting your urine in a cup and dipping a stick into the urine or putting urine into a special container with an eyedropper. Another option involves placing a stick into your urine stream and catching your urine in midstream.

Tests vary in how long you have to wait to get a result. You will be looking for a change in color, a line, or a symbol (like a plus or minus). The newer digital pregnancy test offered by Clearblue Easy makes reading your results simple: the window will either show the words “not pregnant” or “pregnant”.


BLOOD TEST:- There are two types of blood tests. A quantitative blood test measures the exact amount of hCG in the blood, and a qualitative hCG blood test gives a simple yes or no answer to whether you are pregnant or not.


Advantages of having a blood test done:

1.Can detect a pregnancy earlier than a urine test at about 7-12 days from possible conception (but if a negative result is received, a test should be repeated if a period is missed.)

2.Can measure the concentration of hCG hormone in your blood (this is useful information for your healthcare provider in tracking certain problems in pregnancy)


Disadvantages to having a blood test done:

1.More expensive than a urine test (price depends on cost of doctor’s visit and lab fees)

2.Takes longer to get result

3.Must be done in a doctor’s office.


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This test provides a measure of myelin fragments released into the spinal fluid as a result of the breakdown of myelin during acute phases in the course of demyelinating disease of the CNS (most common example of which is multiple sclerosis). MBP is a 169 amino acid peptide that comprises 30% of the protein of the myelin sheath. While MBP is a useful test in the diagnosis of active MS, some patients with this disorder will have normal limits, especially during remissions, and elevations may be seen in other disorders as well. Therefore, tests such as CSF oligoclonal bands and IgG index, which are positive in 90% of MS patients during active disease or remission, are preferred for the initial diagnosis. However, MBP is useful for providing objective evidence of disease activity.

CSF MBP levels were found to decrease to the level of controls in a group of 11 cases of chronic progressive multiple sclerosis patients receiving immunosuppressive therapy (cyclophosphamide and prednisone). These findings suggest that MBP might be used to monitor the hoped for beneficial effect of such therapy in some cases of MS.

It has been suggested that MBP levels in the CSF might be used in the assessment of radiation-induced myelopathy. MS patients in relapse have been shown to have increased interleukin 1 and interleukin 2 production as the result of MBP stimulated peripheral blood mononuclear cells.



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Enolase is a glycolytic enzyme that catalyzes the conversion of 2-phosphoglycerate to phosphoenolpyruvate. Enolase exists in the form of several tissue-specific isoenzymes, consisting of homo or heterodimers of 3 different monomer-isoforms (alpha, beta, and gamma). Neuron specific enolase (NSE) is a 78 kD gamma-homodimer and represents the dominant enolase-isoenzyme found in neuronal and neuroendocrine tissues. Its levels in other tissues, except erythrocytes, are negligible. The biological half-life of NSE in body fluids is approximately 24 hours.

Due to this organ-specificity, concentrations of NSE in serum or, more commonly, cerebrospinal fluid (CSF), are often elevated in diseases which result in relative rapid (hours/days to weeks, rather than months to years) neuronal destruction. Measurement of NSE in serum of CSF can therefore assist in the differential diagnosis of a variety of neuron-destructive and neurodegenerative disorders. The most common application is in the differential diagnosis of dementias, where elevated CSF concentrations support the diagnosis of rapidly progressive dementias, such as Creutzfeldt-Jacob Disease. NSE might also have utility as a prognostic marker in neuronal injury. There is, for example, increasing evidence that elevated serum NSE levels correlate with a poor outcome in coma, in particular when caused by hypoxic insult.

NSE is also frequently overexpressed by neural crest-derived tumors. Up to 70% of patients with small cell lung carcinoma (SCLC) have elevated serum NSE concentrations at diagnosis, and approximately 90% of patients with advanced SCLC will have serum levels above the healthy reference range. Other neuroendocrine tumors with frequent expression of NSE include carcinoids (up to 66% of cases), islet cell tumors (typically <40% of cases), and neuroblastoma (exact frequency of NSE expression unknown). NSE levels in NSE-secreting neoplasms correlate with tumor mass and tumor metabolic activity. High levels have therefore some negative prognostic value. Falling or rising levels are often correlated with tumor shrinkage or recurrence, respectively.

Serum neuron-specific enolase (NSE) measurement has its greatest utility in the follow-up of patients with tumors of any type that have been shown to secrete NSE. With successful treatment, serum concentrations should fall with a half-life of approximately 24 hours. Persistent NSE elevations in the absence of other possible causes (see Cautions) suggest persistent tumor. Rising levels indicate tumor spread, or in patients who had previously become NSE negative, recurrence.

In the context of a patient with a lung mass, disseminated malignancy of unknown origin or symptoms suggestive of paraneoplastic disease without identifiable tumor, elevated NSE suggests an underlying small cell lung carcinoma (SCLC).


In patients with suspected carcinoid, islet cell tumor, or neuroblastoma, who have no clear elevations in the primary tumor markers used to diagnose these conditions, an elevated serum NSE level supports the clinical suspicion.

1.Carcinoid: chromogranin A, urinary 5-hydroxyindoleacetic acid, serum/blood 5-hydroxytryptamine

2.Islet cell tumors: variety of peptide and amine-derived hormones, chromogranin A

3.Neuroblastoma: vanillylmandelic acid and homovanillic acid


When considered alongside established outcome predictors of coma, such as Glasgow coma scale and other clinical predictors (papillary light responses, corneal reflexes, motor responses to pain, myoclonus, status epilepticus), electroencephalogram, sensory evoked potentials, measurement of serum NSE concentrations provides additional information. Elevated levels are indicative of a poor outcome. Currently, no established algorithms exist to combine serum NSE concentrations and the various other predictors into a composite score that gives clear predictive outcome information. The NSE measurement therefore needs to be considered in a qualitative or semi-quantitative fashion and carefully weighed against other predictors by a physician experienced in examining and managing coma patients.

All neuron-specific enolase (NSE) test results must be considered in the clinical context, and interferences or artifactual elevations should be suspected if the clinical NSE test results are at odds with the clinical picture or other tests. The laboratory should be contacted for assistance in these situations.

Hemolysis can lead to significant artifactual NSE elevations, since erythrocytes contain NSE.

Hemoglobin concentrations as low as 20 mg/dL were found to have an adverse effect on NSE testing.

Proton pump inhibitor treatment, hemolytic anemia, hepatic failure, and end stage renal failure can also result in artifactual NSE elevations.

Other false positives depend on the treating context. When performing NSE testing for tumor diagnosis or follow-up, epileptic seizure, brain injury, encephalitis, stroke, and rapidly progressive dementia might result in false-positive results. On the other hand, when NSE testing is performed to assist in neurological diagnosis, NSE-secreting tumors can represent a source of false-positive results.

NSE values can vary significantly between methods/assays. Serial follow-up should be performed with the same assay. If assays are changed, patients should be re-baselined. This assay is an immunometric assay, and can therefore in rare situations be affected by false low results in the presence of extremely high NSE concentrations ("hooking") or autoantibodies to NSE, as well as by false results in the presence of heterophile antibodies.


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Diagnosis of Niemann-Pick disease begins with a thorough physical exam, which can show an early warning sign such as an enlarged liver or spleen. Your doctor will also take a detailed medical history and discuss symptoms and family health history. Niemann-Pick disease is rare, and its symptoms can be confused with other diseases. Diagnostic techniques depend on the type of Niemann-Pick disease.

1.Type A or B. Using a blood or skin sample (biopsy), experts measure how much sphingomyelinase is in white blood cells to confirm the diagnosis.

2.Type C. Experts take a small sample of skin to test for Niemann-Pick to assess how the cells move and store cholesterol.


Other tests also may be done, such as:

1.Magnetic resonance imaging (MRI). An MRI of the brain may show loss of brain cells. But in the early stages of Niemann-Pick, an MRI may be normal because symptoms typically occur before the loss of brain cells.

2.Eye exam. An eye exam can show signs that may be an indication of Niemann-Pick disease, such as eye movement difficulties.

3.Genetic testing. DNA testing of a blood sample may show the specific abnormal genes that cause Niemann-Pick types A, B and C. DNA tests can show who the carriers are for all types of Niemann-Pick disease if the mutations have been described in the first person identified in a family (the index case).

4.Prenatal testing. Ultrasound can detect the enlarged liver and spleen that's caused by type C. And amniocentesis or chorionic villus sampling may be used to confirm a diagnosis of Niemann-Pick.


No cure exists for Niemann-Pick disease. No effective treatment is available to people with type A or B. For people with mild to moderate type C, a drug called miglustat (Zavesca) may be an option. An international study of 92 people with type C Niemann-Pick showed improved neurological symptoms after taking miglustat regularly for an average of two years.

Physical therapy is an important part of treatment to help maintain mobility as long as possible. People with Niemann-Pick disease need to see their doctors regularly, because the disease progresses and symptoms worsen.


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Nipple discharge is the most common complaint of patients seeking medical attention for breast disease, accounting for about 5% of all breast symptoms. Nipple discharge can be either pathologic or physiologic. Pathologic nipple discharge typically is unilateral, involves a single duct, is spontaneous, and may be serous or bloody/ bloodstained. Physiologic nipple discharge is usually bilateral, involves multiple ducts, and is white or green. Although ominous to patients, most pathologic nipple discharge is due to benign breast disease. Most of the women presenting with pathologic nipple discharge have been reported to have an underlying malignancy.
Detection and differentiation of benign and malignant lesions Reduce mortality by early detection of diseases Breast cancer can be detected at early stage The test results are useful in surgical planning Diagnosis of recurrent or metastatic breast cancer Confirmation of locally advanced cancer Breast cytology has gradually established itself as an individual risk assessment tool for women at risk of developing breast cancer Unfolding and distinguishing benign and malignant breast lesions.



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In biology, the nuclear matrix is the network of fibres found throughout the inside of a cell nucleus and is somewhat analogous to the cell cytoskeleton. However, in contrast to the cytoskeleton, the nuclear matrix has been proposed to be a highly dynamic structure, perhaps more like a dynamic sponge with open compartments for free diffusion of molecules in the nucleus.The nuclear matrix, along with the nuclear lamina aid in organizing the genetic information within the cell.

The exact function of this matrix is still disputed, and its very existence has recently been called into question.Evidence for such a structure was recognised as long ago as 1948 (Zbarskii and Debov), and consequently many proteins associated with the matrix have been discovered. The presence of intra-cellular proteins is largely indisputable, and it is well recognized that proteins such as the Scaffold, or Matrix Associated Proteins (SAR or MAR) have some role in the organisation of chromatins. There is evidence that the nuclear matrix is involved in regulation of gene expression in Arabidopsis thaliana.

For a long time the question whether a polymer meshwork, a “nuclear matrix” or “nuclear-scaffold” or "NuMat"is an essential component of the in vivo nuclear architecture has remained a matter of debate. While there are arguments that the relative position of chromosome territories (CTs), the equivalent of condensed metaphase chromosomes at interphase, may be maintained due to steric hindrance or electrostatic repulsion forces between the apparently highly structured CT surfaces, this concept has to be reconciled with observations according to which cells treated with the classical matrix-extraction procedures maintain defined territories up to the point where a minor subset of acidic nuclear matrix proteins is released – very likely those proteins that governed their association with the nuclear skeleton.The nuclear matrix proteome consists of structural proteins, chaperones, DNA/RNA-binding proteins, chromatin remodeling and transcription factors. The complexity of NuMat is an indicator of its diverse structural and functional significance.
S/MARs (scaffold/matrix attachment elements), the DNA regions that are thought to attach genomic DNA to the nuclear skeleton, show an ever increasing spectrum of established biological activities. All these activities are in agreement with (or most easily explained by) the nuclear matrix hypothesis. This is one justification for maintaining this concept before equally plausible alternative models emerge.

S/MARs find increasing use for the rational design of vectors with widespread use in gene therapy and biotechnology. Nowadays S/MAR functions can be modulated, improved and custom-tailored to the specific needs of novel vector systems
The nuclear matrix composition on human cells has been proven to be cell type and tumor specific. It has been clearly demonstrated that the nuclear matrix composition in a tumor is different from its normal counterparts.This fact could be useful to characterize cancer markers and to predict the disease even earlier. These markers have been found in urine and blood and could potentially be used in early detection and prognosis of human cancers.

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Osteocalcin, or bone Gla protein (BGP), is the major noncollagenous protein of bone matrix. It has a molecular weight of approximately 5.8 kilodaltons and consists of 49 amino acids, including three residues of γ-carboxyglutamic acid. Osteocalcin is synthesized in bone by osteoblasts. After production, it is partly incorporated into the bone matrix and partly delivered to the circulatory system. The precise physiological function of osteocalcin is still unclear. A large number of studies have shown that the circulating level of osteocalcin reflects the rate of bone formation.
Determination of serum osteocalcin has proven to be valuable as an aid in identifying women at risk of developing osteoporosis, for monitoring bone metabolism during perimenopause and postmenopause, and during antiresorptive therapy.



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The packed cell volume (PCV) is a measurement of the proportion of blood that is made up of cells. The value is expressed as a percentage or fraction of cells in blood. For example, a PCV of 40% means that there are 40 millilitres of cells in 100 millilitres of blood. 
Red blood cells account for nearly all the cells in the blood. The PCV rises when the number of red blood cells increases or when the total blood volume is reduced, as in dehydration. The PCV falls to less than normal, indicating anaemia, when your body decreases its production of red blood cells or increases its destruction of red blood cells.

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A Pap smear, also called a Pap test, is a procedure to test for cervical cancer in women.
A Pap smear involves collecting cells from your cervix — the lower, narrow end of your uterus that's at the top of your vagina.
Detecting cervical cancer early with a Pap smear gives you a greater chance at a cure. A Pap smear can also detect changes in your cervical cells that suggest cancer may develop in the future. Detecting these abnormal cells early with a Pap smear is your first step in halting the possible development of cervical cancer.
The Pap smear is usually done in conjunction with a pelvic exam. In women older than age 30, the Pap test may be combined with a test for human papillomavirus (HPV) — a common sexually transmitted infection that can cause cervical cancer in some women.
Doctors generally recommend repeating Pap testing every 3 years for women ages 21-65.
Women age 30 and older can consider Pap testing every 5 years if the procedure is combined with testing for HPV.
If you have certain risk factors, your doctor may recommend more-frequent Pap smears, regardless of your age. These risk factors include:

1.A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
2.Exposure to diethylstilbestrol (DES) before birth
3.HIV infection
4.Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use

You and your doctor can discuss the benefits and risks of Pap smears and decide what's best for you based on your risk factors.

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Parathyroid hormone (PTH) helps the body maintain stable levels of calcium in the blood. It is part of a feedback loop that includes calcium, PTH, vitamin D, and, to some extent, phosphorus (phosphate) and magnesium. Conditions and diseases that disrupt this feedback loop can cause inappropriate elevations or decreases in calcium and PTH levels and lead to symptoms of hypercalcemia or hypocalcemia. This test measures the amount of PTH in the blood.
PTH is produced by four button-sized parathyroid glands that are located in the neck behind the thyroid gland. Normally, these glands secrete PTH into the bloodstream in response to low blood calcium levels. The hormone works in three ways to help raise blood calcium levels back to normal:

1.PTH promotes the release of calcium from bones into the bloodstream.
2.It stimulates the kidneys to convert vitamin D from the inactive to the active form, which in turn increases the absorption of calcium from food in the intestines.
3.It acts on the kidneys to suppress the excretion of calcium in the urine while encouraging excretion of phosphorus.
4.As calcium levels begin to increase in the blood, PTH normally decreases.

Parathyroid hormone itself is composed of 84 amino acids (sometimes called PTH (1-84)). Intact and fragmented hormone is present in and secreted by the parathyroid gland. The intact hormone represents a smaller fraction, but its portion is increased when calcium levels are low and decreased when calcium levels are high.
Once released into the blood stream, PTH has a very short life span; levels fall by half in less than 5 minutes due to uptake and cleavage in the liver and kidneys. The fragments are referred to as C-terminal fragments and are variably sized, missing anywhere from 6 amino acids to more than half the N-terminal portion of the molecule. C-terminal fragments have a longer half-life, exist in much higher concentrations, and are eventually cleared by the kidneys. Although it was originally thought that the C-terminal fragments were inactive, it now appears that certain fragments may have biologic activities that are able to oppose those of intact PTH.

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Parietal cell antibodies are autoantibodies, proteins produced by the immune system that mistakenly target a type of specialized cells that line the stomach wall. This test detects these antibodies in the blood to help diagnose pernicious anemia.
Pernicious anemia is an autoimmune condition that can occur when the body's immune system targets its own tissues and develops antibodies directed against the parietal cells and/or intrinsic factor.

1.Parietal cells are specialized cells in the stomach that make acid to help in food digestion and also make intrinsic factor.
2.Intrinsic factor is required for the absorption of vitamin B12 from food.

During digestion, stomach acids produced by parietal cells release vitamin B12 from food, which binds to intrinsic factor to form a complex. The formation of this complex allows vitamin B12 to be absorbed in the small intestine. Among having functional roles in the brain and nervous system, vitamin B12 is important in the production of red blood cells (RBCs).
When the body’s immune system mistakenly targets its own tissues and develops antibodies directed against parietal cells and/or intrinsic factor, it can cause inflammation and progressively damage the parietal cells. This autoimmune condition, called autoimmune atrophic gastritis, can disrupt the production or function of intrinsic factor.
Without sufficient intrinsic factor, vitamin B12 goes largely unabsorbed, leading to vitamin B12 deficiency. Deficiency in vitamin B12 can result in megaloblastic anemia, characterized by the production of fewer but larger red blood cells (macrocytes). Vitamin B12 deficiency can also result in nerve-related signs and symptoms (neuropathy), such as numbness and tingling that start first in the hands and feet, muscle weakness, slow reflexes, loss of balance and unsteady walking. Other disorders can cause vitamin B12 deficiency and result in megaloblastic anemia. When it is due to a lack of intrinsic factor, it is called pernicious anemia. Besides anemia, a decrease in the numbers of neutrophils and platelets (neutropenia, thrombocytopenia) may also occur.
The tests for parietal cell and/or intrinsic factor antibodies may be used along with several other tests, such as complete blood count (CBC) and blood smear, to help diagnose pernicious anemia.

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The pericardium is a two-layered, sac-like membrane that surrounds the heart. Pericardial membranes produce pericardial fluid, a liquid that sits between the pericardium's membranes. The fluid acts as a lubricant for the movement of the heart, reducing friction as the heart pumps blood.

A variety of conditions and diseases can cause inflammation of the pericardium (pericarditis) and/or excessive accumulation of pericardial fluid (pericardial effusion). Pericardial fluid analysis is a group of tests that evaluate this liquid to help diagnose the cause of the increased fluid.

The two main reasons for fluid accumulation in the pericardial space are:

1.An imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. Transudates are most often caused by congestive heart failure or cirrhosis.

2.An injury or inflammation of the pericardium, in which case the fluid that accumulates is called an exudate. Conditions such as infections, malignancies (metastatic cancer, lymphoma, mesothelioma), or autoimmune disease may cause the accumulation of exudate.

Determining if the increased fluid is transudate or exudate is important because it helps narrow down the possible causes of pericardial fluid buildup. Healthcare practitioners and laboratorians use an initial set of tests, including cell count, protein or albumin level, and appearance of the fluid, to distinguish between transudates and exudates. Once the fluid is determined to be one or the other, additional tests may be performed to further pinpoint the disease or condition causing pericarditis and/or pericardial effusion.

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A Peripheral smear is a drop of blood spread thinly onto a glass slide that is then treated with a special stain and examined under a microscope by a trained laboratorian. It is a snapshot of the cells that are present in the fluid portion of the blood (plasma) at the time the sample is obtained. The Peripheral smear allows for the evaluation of these cells:
White blood cells (WBCs, leukocytes) — help fight infections
Red blood cells (RBCs, erythrocytes) — carry oxygen to tissues
Platelets (thrombocytes) — small cell fragments that are vital to proper blood clot formation
These cell populations are produced and mainly mature in the bone marrow and are eventually released into the bloodstream as needed. The number and type of each cell present in the blood is dynamic but is generally maintained by the body within specific ranges.
The drop of blood on the slide used for a Peripheral smear contains millions of RBCs, thousands of WBCs, and hundreds of thousands of platelets. Under the microscope, the stained WBCs can be easily seen and the number and type of cells present can be estimated. The laboratorian can compare their size, shape, and general appearance to the established appearance of "normal" cells. It is also possible to distinguish between the five different types of WBCs and to determine their relative percentages (manual differential). During this examination, the laboratorian can also evaluate the size, shape, and color (indicators of hemoglobin content) of the RBCs (RBC morphology) and also estimate the number of platelets present.
A variety of diseases and conditions can affect the number and appearance of blood cells. Examination of the Peripheral smear can be used to support findings from other tests and examinations. For example, RBCs that appear larger and paler than normal may support other results that indicate a type of anemia. Similarly, the presence of WBCs that are not fully mature may add to information from other tests to help make a diagnosis of infection, malignancy, or other conditions.

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Phosphorus is a mineral that combines with other substances to form organic and inorganic phosphate compounds. The terms phosphorus and phosphate are often used interchangeably when talking about testing, but it is the amount of inorganic phosphate in the blood that is measured with a serum phosphorus/phosphate test.
Phosphates are vital for energy production, muscle and nerve function, and bone growth. They also play an important role as a buffer, helping to maintain the body's acid-base balance.
Phosphorus comes into the body through the diet. It is found in many foods and is readily absorbed by the intestines. About 70-80% of the body's phosphates combine with calcium to help form bones and teeth, another 10% are found in muscle, and about 1% is in nerve tissue. The rest is found within cells throughout the body, where they are mainly used to store energy.
Normally, only about 1% of total body phosphates are present in the blood. A wide variety of foods, such as beans, peas and nuts, cereals, dairy products, eggs, beef, chicken, and fish, contain significant amounts of phosphorus. The body maintains phosphorus/phosphate levels in the blood by regulating how much it absorbs from the intestines and how much it excretes via the kidneys. Phosphate levels are also affected by the interaction of parathyroid hormone (PTH), calcium, and vitamin D.
Phosphorus deficiencies (hypophosphatemia) may be seen with malnutrition, malabsorption, acid-base imbalances, hypercalcemia, and with disorders that affect kidney function. Phosphorus excesses (hyperphosphatemia) may be seen with increased intake of the mineral, hypocalcemia, and with kidney dysfunction.
Someone with a mild to moderate phosphorus deficiency often does not have any symptoms. With a severe phosphorus deficiency, symptoms may include muscle weakness and confusion. An extreme excess of phosphorus may cause symptoms that are similar to those seen with low calcium, including muscle cramps, confusion, and even seizures.

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Platelet antibodies may be allo- or autoantibodies and may be directed to a wide range of antigenic "targets" carried on platelet cytoplasmic membranes. Serum platelet antibody test is optimized to identify the presence of platelet allo-antibodies in the patient.
Platelet alloantibodies are involved in several clinical situations such as:

-Immune mediated refractoriness to platelet transfusions usually due to antibodies to HLA class I and sometimes to antibodies specific to platelet antigens.

-Neonatal alloimmune thrombocytopenia (NAIT)

-Posttransfusion purpura (PTP), which are usually associated with platelet-specific antibodies

This test is not recommended for the diagnosis of immune thrombocytopenia (ITP) or autoimmune thrombocytopenia. Tests that are optimized to detect antibodies bound to the platelets will be useful in these situations; cell-bound platelet antibody (Direct) test is strongly recommended instead (CBPAN / Cell Bound Platelet Auto-Antibody Screen, Blood).

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Platelets, also called thrombocytes, are tiny fragments of cells that are essential for normal blood clotting. They are formed from very large cells called megakaryocytes in the bone marrow and are released into the blood to circulate. The platelet count is a test that determines the number of platelets in a person's sample of blood.
When there is an injury to a blood vessel or tissue and bleeding begins, platelets help stop bleeding in three ways. They:

1.Adhere to the injury site
2.Clump together (aggregate) with other platelets
3.Release chemical compounds that stimulate further aggregation of other platelets

These steps result in the formation of a loose platelet plug at the site of the injury in a process called primary hemostasis. At the same time, activated platelets support the coagulation cascade, a series of steps that involves the sequential activation of proteins called clotting factors. This secondary hemostasis process results in the formation of strands of fibrin that weave through the loose platelet plug, form a fibrin net, and compress to form a stable clot that remains in place until the injury has healed. When the clot is no longer needed, other factors break the clot down and remove it.
Each component of primary and secondary hemostasis must be present, activated at the right time, and functioning properly for adequate clotting. If there are insufficient platelets, or if platelets are not functioning normally, a stable clot may not form and a person may be at an increased risk of excessive bleeding.
Platelets survive in the circulation about 8 to 10 days, and the bone marrow must continually produce new platelets to replace those that degrade, are used up, and/or are lost through bleeding. Determining the number of platelets in blood with a platelet count can help diagnose a range of disorders having to do with too few or too many platelets.

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When a doctor requires a platelet count, then a complete blood count may be ordered. The CBC blood test will include a measurement of platelet distribution width, which is how the PLATELET DISTRIBUTION WIDTH blood test results will be measured. The PLATELET DISTRIBUTION WIDTH is a reflection of how uniform in size a patient’s platelets happen to be. This can help to determine how effectively a person’s bone marrow is functioning and if follow-up tests may be required.
For platelet width, the general rule is that larger platelets are generally younger, while smaller platelets have been around for a few days. Having a high number of large platelets when someone has typically has a low platelet count indicates the bone marrow has stepped up production levels.
Because the PLATELET DISTRIBUTION WIDTH (PDW) is part of a complete blood count, it may be ordered for a wide variety of reasons. The most common issues that doctors will examine are unexplained bruising, bleeding that continues on from small cuts or wounds, numerous nosebleeds, or internal bleeding in the digestive tract. The presence of a continuous rash or purplish spots on the skin may also cause this test to be ordered.
For women, when there is continuous and heavy menstrual bleeding, the PLATELET DISTRIBUTION WIDTH (PDW) blood test may be ordered as well.
If the PDW blood test has abnormal results and if there isn’t a known cause for them, then a doctor may choose to perform additional follow-up tests in an attempt to confirm a diagnosis. This may include testing to find inflammatory conditions, the presence of infectious diseases, kidney failure, or bleeding disorders. Liver disease and iron studies may also be ordered, as will vitamin levels.
In severe instances of abnormality when there is not a definitive cause that can be determined, then a bone marrow biopsy may be ordered.
For patients who live in high altitude area, PDW test results may be affected by an individual’s living habits. Be sure to speak with a doctor about this issue if you have recently spent a at least 30 days in a high altitude climate.
The PDW blood test is generally used as a screening tool to see if a patient is experiencing good health. It is typically ordered as part of a routine health screening. If bone marrow disorders are suspected, however, it may also be ordered. Consider these results, compare them to your own results, and then be sure to speak with your doctor about what this may indicate for you and your unique health history.

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Pleural fluid is found in the pleural cavity and serves as a lubricant for the movement of the lungs during inhalation and exhalation. It is derived from a plasma filtrate from blood capillaries and is found in small quantities between the layers of the pleurae - membranes that cover the chest cavity and the outside of each lung.

A variety of conditions and diseases can cause inflammation of the pleurae (pleuritis) and/or excessive accumulation of pleural fluid (pleural effusion). Pleural fluid analysis comprises a group of tests used to determine the cause. There are two main reasons fluid may collect in the pleural space:


1.Fluid may accumulate in the pleural space because of an imbalance between the pressure within blood vessels—which drives fluid out of blood vessels—and the amount of protein in blood—which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. This type of fluid usually involves both lungs and is often a result of either cirrhosis or congestive heart failure.

2.Fluid accumulation may be caused by injury or inflammation of the pleurae, in which case the fluid is called an exudate. It usually involves one lung and may be seen in infections (pneumonia, tuberculosis, sarcoidosis), malignancies (lung cancer, metastatic cancer, lymphoma, mesothelioma), rheumatoid disease, or systemic lupus erythematosus.

Differentiation between the types of fluid is important because it helps diagnose the specific disease or condition. Doctors and laboratory scientists use an initial set of tests (cell count, albumin and appearance of the fluid) to distinguish between transudates and exudates. Once the fluid is determined to be one or the other, additional tests may be performed to further pinpoint the disease or condition causing pleuritis and/or pleural effusion.




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Pleural fluid is a liquid derived from the blood in the tiny blood vessels (capillaries) in the lungs. It is found in small quantities between the layers of the pleurae – membranes that cover the chest cavity and the outside of each lung. It serves as a lubricant for the movement of the lungs during breathing.
A variety of conditions and diseases can cause inflammation of the pleurae (pleuritis) and/or excessive accumulation of pleural fluid (pleural effusion). Pleural fluid analysis is a group of tests that evaluate this liquid to determine the cause of the increased fluid.

The two main reasons for fluid accumulation in the pleural space are:

1.An imbalance between the pressure of the liquid within blood vessels, which drives fluid out of blood vessels, and the amount of protein in blood, which keeps fluid in blood vessels. The fluid that accumulates in this case is called a transudate. This type of fluid more commonly involves both sides of the chest and is most frequently a result of either congestive heart failure or cirrhosis.
2.An injury to or inflammation of the pleurae, in which case the fluid that accumulates is called an exudate. It more commonly involves one side of the chest and may be seen in infections (pneumonia, tuberculosis), malignancies (lung cancer, metastatic cancer, lymphoma, mesothelioma), or other causes of inflammation (sarcoidosis, autoimmune diseases).
 
Determining the type of fluid present is important because it helps to shorten the list of possible causes of pleural effusion. Healthcare practitioners and laboratorians use an initial set of tests (cell count, protein, albumin, and lactate dehydrogenase (LD) level, and appearance of the fluid) to distinguish between transudates and exudates. If the fluid is an exudate, additional tests may be performed to further pinpoint the disease or condition causing pleuritis and/or pleural effusion. See the "The Test" tab for more on this.


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Porphyrins are a group of compounds defined by their chemical structure. These compounds are by-products of heme synthesis and are normally present at low concentrations in blood and other body fluids. Porphyrin tests measure porphyrins and their precursors in urine, blood, and/or stool.
Heme is an iron-containing pigment that is a component of hemoglobin and a number of other proteins. It consists of an organic portion (protoporphyrin) bound to an iron atom. The synthesis of heme is a step-by-step process that requires the sequential action of eight different enzymes. If there is a deficiency in one of these enzymes, the process is impeded and intermediate porphyrins such as uroporphyrin, coproporphyrin, and protoporphyrin build up in the body's fluids and tissues. The precursors that accumulate depend on which enzyme is deficient, and they can exert toxic effects.
Porphyrin tests are used to help diagnose and monitor a group of disorders called porphyrias. There are seven types of porphyria, and each one is associated with a different enzyme deficiency. Most porphyrias are inherited, the result of a gene mutation. They may be classified according to the signs and symptoms of the disease as neurological, cutaneous, or both.
The porphyrias that cause neurological symptoms present with acute attacks lasting days or weeks. Signs and symptoms during the attack include abdominal pain, constipation, confusion, hallucinations, and/or seizures. There are four neurologic porphyrias: acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), and the very rare ALA dehydratase deficiency porphyria (ADP). Some cases of VP and HCP may also have skin-related symptoms.
The cutaneous porphyrias are associated with photosensitivity that causes redness, swelling, a burning sensation, blistering, skin thickening, hyperpigmentation, and/or scarring. There are three cutaneous porphyrias: porphyria cutanea tarda (PCT), erythropoietic protoporphyria (EPP), and congenital erythropoietic porphyria (CEP). For more information about each disease, see the article on Porphyria.

To diagnose porphyrias, clinical laboratories measure porphyrins and their precursors in urine, blood, and/or stool. Testing may include measurement of one or more of the following:

1.Porphobilinogen (PBG), a porphyrin precursor, in urine
2.Delta-aminolevulinic acid (ALA), another porphyrin precursor, in urine
3.Porphyrins (uroporphyrin, coproporphyrin, and protoporphyrin) in urine, blood, or stool

Specialized laboratories may offer testing for one or more of the affected enzymes. The most commonly measured enzyme is porphobilinogen deaminase (PBG-D) in red blood cells, which tests for acute intermittent porphyria. A few laboratories offer genetic testing for specific gene mutations that cause one of the porphyrias, but this type of testing is not widely available.
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The postcoital test (PCT) (also known as Sims test, Huhner test or Sims-Huhner test) is a test in the evaluation of infertility. The test examines interaction between sperm and mucus of the cervix.
The PCT is scheduled close to ovulation when mucus is abundant, and the infertile couple is asked to have sexual intercourse, preferably in early hours of morning. Several hours later (usually 2), the woman is examined by the physician. The mucus is aspirated from cervical canal and spread on a glass slide. Smear from posterior fornix is used as control. 10-50 motile sperms per high power field are considered normal. Rotatory or shaky motion of sperms indicates presence of antispermal antibody. Cervical mucus is examined for quality, viscosity and fern test.

A poor PCT may indicate sperm or mucus problems, including perhaps presence of immune factors that inactivate sperm. Also ovulatory problems and poor coital technique may affect the PCT. The test is useless in presence of cervical infection.

With the application of principles of evidence-based medicine the role of the PCT has been questioned and its use has become controversial.
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Potassium is an electrolyte that is vital to cell metabolism. It helps transport nutrients into cells and removes waste products out of cells. It is also important in muscle function, helping to transmit messages between nerves and muscles. This test measures the amount of potassium in the blood and/or urine.
Potassium, along with other electrolytes such as sodium, chloride, and bicarbonate (total CO2), helps regulate the amount of fluid in the body and maintains a stable acid-base balance. Potassium is present in all body fluids, but most potassium is found within the cells. Only a small amount is present in fluids outside the cells and in the liquid part of the blood (called serum or plasma).
We get most of the potassium we need from the foods that we eat and most people have an adequate intake of potassium. The body uses what it requires and the kidneys eliminate the rest in the urine. The body tries to keep the blood potassium level within a very narrow range. Levels are mainly controlled by aldosterone, a hormone produced by the adrenal glands in the kidneys.
Because the blood concentration of potassium is so small, minor changes can have significant consequences. If potassium levels are too low or too high, there can be serious health consequences; a person may be at risk for developing shock, respiratory failure, or heart rhythm disturbances. An abnormal potassium level can alter the function of the nerves and muscles; for example, the heart muscle may lose its ability to contract.


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