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- Hair loss.
- Heart attack.
- Heat rash.
- Heat stroke.
- Hepatitis A.
- Hepatitis B.
- Hypertension/High blood pressure.
Hair loss
Our hair is made up of keratin, the same protein that is found in nails and the outer layer of our skin.
The average adult has more than 100,000 strands of hair on his scalp. It is normal to lose about 50 to
100 strands every day. Old strands of hair are shed so that new ones can grow out of the hair follicles.
However, various factors, from genes, hormones to stress, can lead to sudden or excessive shedding.
Hair loss is experienced by both men and women, young or old. The most common type of hair loss is
called male pattern baldness or androgenetic alopecia. Its causes have been linked to genes, hormones and age.
Other types of hair loss include an auto-immune condition known as patchy hair loss (alopecia areata), temporary
hair loss (telogen effluvium), compulsive hair pulling (trichotillomania) and traction alopecia.
Signs and Symptoms:
Male pattern baldness (or androgenetic alopecia) accounts for the majority of all hair losses. It is the most common
type of baldness in men, especially older men. It can also occur in some women, though the instances are uncommon.
In male pattern baldness, the hair loss is usually gradual. The hair loss pattern differs between the sexes. In men,
the hair loss usually starts with a receding hairline while in women, there is a diffuse thinning of the crown. Male
pattern baldness in women is usually not as severe as that seen in men.
Besides male pattern baldness, there are various other types of hair loss as follows:
- Patchy baldness (alopecia areata): In this condition, a few bald patches suddenly appear.
Emotional stress appears to be a triggering factor. Once the stress is removed, the hair
loss usually stops. However, the condition can progress to more serious forms in which all
the scalp and body hair may be lost (alopecia totalis).
- Temporary hair loss (telogen effluvium): This causes clumps of hair to fall out suddenly
over a few days. It can be caused by severe stress, childbirth, severe illnesses, surgery
and some medications. As its name implies, its effect is usually temporary. Recovery though
may take a year or longer depending on the cause.
- Compulsive hair pulling (trichotillomania): This causes hairbreakage and usually leaves the
scalp undamaged. It usually affects children and women and has been linked to a psychological cause.
If left untreated, it may lead to permanent hair loss.
- Traction alopecia: This is hair loss caused by certain hairstyles such as ponytails, buns or braids
that pull excessively on the hair.
Causes:
Following are the causes:
Genes (Hereditary): This seems to play a role in determining whether a person will have male pattern baldness or not.
Hormones Androgens appear to play a role in male pattern baldness. These very same hormones trigger the growth of
hair in the pubic, underarm and facial areas at puberty. People with male pattern baldness may have the same male
hormone levels as normal people, but these hormones seem to accumulate in certain areas of their scalp and cause
the hair follicles there to regress. Hair follicles are responsible for producing new hair.
Most women are protected from male pattern baldness because they produce less androgens, and because their female
hormones, estrogen can counter the effect of their male hormones. However, women who produce excess androgens may
have male pattern baldness. Other hormones, such as those from your thyroid glands, can also affect your hair.
For instance, too much or too little hormones from your thyroid gland can cause hair loss.
Stress: Sudden emotional stress can also trigger patchy baldness (alopecia areata) or temporary hair loss (telogen effluvium).
Temporary hair loss may also be triggered by the stress of giving birth or losing a loved one.
Medical conditions: Certain medicines, such as blood thinners (anti-coagulants), birth control pills, anti-depressants, anti-thyroid
drugs or drugs used in chemotherapy, may cause hair loss. Excessive intake of vitamin A appears to have the same effect.
Improper hair care: Choosing a hairstyle that exerts too much pull on the scalp can cause your hair to turn brittle and break.
Hair breakage can also be caused by over-shampooing and the excessive use of chemical treatments such as dyes, tints, bleaches,
and permanent waves. If this continues, it may lead to hair loss.
Treatment and Prevention:
Since there are so many causes of hair loss, it is important to determine the underlying cause before treatment. Most of the conditions
are temporary and can be resolved once the underlying cause such as stress is removed. However, male pattern baldness may have a permanent
effect. In recent years, medical science has made some progress in helping these people regain their crowning glory.
Two medications are now available to prevent the development of severe male pattern baldness. Both Finasteride and Minoxidil work
by stimulating the regrowth of hair in hair follicles. Finasteride counteracts the effects of the male hormone testosterone.
It is available only by prescription and is taken orally. It is approved for use only in men and is not recommended in women
because of its link to birth defects. Finasteride takes a few months to show its effect.
Another medication, Minoxidil is available over the counter. . It is applied on the scalp and works by reversing the regression of
hair follicles caused by hormones. However, not every one will respond to the drug, and even if they do, it takes a few months
before any effect can be seen. There is seldom complete regrowth.
Alopecia areata is sometimes treated by steroid injections into the affected scalp areas while any underlying scalp problems such
as tinea capitis (fungal infection) should be treated accordingly. Causes of telogen effluvium should be addressed and given professional
guidance by psychiatrist if necessary. Those due to childbirth should recover spontaneously within a year.
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Heart attack
Heart attack occurs when the blood flow to the heart is critically reduced or completely blocked, causing the person to feel varying degrees
of chest pain. If not treated promptly, the affected heart tissue dies.
Chest pain does not always mean a person is suffering from a heart attack. It can be a sign that there is a problem in another body system
such as in the lungs or gastrointestinal tract.
Prior to a heart attack, most victims experience episodes of angina (chest pain) that, like a heart attack, is provoked by blockage of blood
flow to the heart (ischemia). With angina, blood flow is quickly restored, pain recedes within minutes, and the heart is not permanently
damaged.
However, a third of all heart attacks occur without warning signs. The victims suffer from sporadic interruptions of blood flow to the heart
that, for unknown reasons, are pain free, although they gradually damage the heart tissue. This condition is known as silent ischemia and
can be detected by ECG (electrocardiogram) testing.
Symptoms:
- Prolonged crushing, squeezing or burning pain in the center of the chest.
- Pain that radiates from the chest area to the neck, arms, shoulders or the jaw.
- Shortness of breath.
- Dizziness.
- Nausea.
- Chills and sweating.
- Weak pulse.
- Cold and clammy skin, gray pallor, a severe appearance
Treatment:
Nitroglycerin, Thrombolytic agents and Anticoagulants are used to treat heart attacks. Nitroglycerin dilates the blood vessels to the heart.
It is administered sublingually (under the tongue), and quickly reduces or relieves the chest pain.
Thrombolytics are given intravenously to dissolve the blood clot that is causing the heart attack. Aspirin is an anticoagulant. If you feel
chest pain and suspect that you are suffering a heart attack, take an aspirin even before you get to the hospital. The aspirin will "thin"
the blood and reduce further clot formation. Heparin, another type of anticoagulant, is administered intravenously for a few days after a
heart attack has occurred.
Prevention:
Control your levels of anger and hostility as these may raise your risk of heart attack. Stay in touch with friends and family. Research has
shown that people who lack social support are more vulnerable to heart attacks.
If you are at high risk for heart attack, make changes to your diet and lifestyle, and see your doctor regularly for check-ups. Studies show that
taking an aspirin daily significantly reduces the risk of heart attack. Check with your doctor if this regime is suitable for you.
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Heat rash
Heat rash, or prickly heat, is a common condition experienced mostly in hot, humid climates. It can occur even in cool weather if you
are too warmly dressed. The affected skin feels extremely itchy, prickly or stingy. Heat rash usually appears a few days to a few
months after exposure to a hot and humid climate. It is common in infants, active people and bedridden patients with fever.
Symptoms:
- Small, itchy red bumps on the skin.
- Affected skin feels prickly, stinging or burning.
Treatment:
- Keep the affected areas of skin cool and dry. The rash should clear up in a few days.
- Take cool showers or baths. Calamine lotion or an over-the-counter 1- percent
hydrocortisone cream may be used to relieve the itching. Avoid any oil-based
product that might block sweat glands.
- If a few days have passed and the heat rash does not improve or if the skin becomes infected
where the bumps have burst, prescription medication may be needed.
Prevention:
Avoid situations that can lead to excessive sweating. Take cool showers and baths to stay cool.
Dry your skin thoroughly afterwards and wear lightweight loose-fitting clothes.
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Heat stroke
Heat exhaustion, heat cramps and heatstroke can occur if the body is exposed to prolonged and high temperatures.
In such a situation, the body attempts to cool itself by increasing the blood flow to the skin, leaving less blood
for the brain, muscles and other organs. Muscles feel weaker and mental capacity is affected. If not properly managed,
the condition can be deadly.
Symptoms - Heat exhaustion:
- Fatigue or weakness.
- Confusion or anxiety.
- Drenching sweat and cold, clammy skin.
- Slowed or weakened heartbeat.
- Dizziness and fainting.
Symptoms - Heat cramps
- Severe cramps in the hands, calves or feet.
- Hard, tense muscles.
- Hot, flushed and dry skin.
- Decreased sweating.
- Increased breathing rate.
- Increased heart rate: to 160 - 180 beats per minute.
- Body temperature above normal 37 degrees Celsius.
- HeadacheM.
- Dizziness.
- Fatigue.
- Confusion or loss of consciousness.
- Convulsions.
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Hepatitis A
Hepatitis A is a viral infection that causes the liver to become enlarged, inflamed and tender.
There is no chronic (long-term) infection. The virus is excreted in faeces and transmitted through
contaminated food and water. Eating shellfish taken from sewage-contaminated water is a common means
of contracting hepatitis A. It can also be acquired by close contact with individuals infected with
the virus.
A person is infectious for 2-3 weeks before he or she experiences symptoms and during the first week of illness.
Symptoms:
- jaundice.
- fatigue.
- fever.
- loss of appetite.
- nausea and vomiting.
- pale coloured stools and dark urine.
- itchy skin.
Prevention of Hepaptitis A:
Hepatitis A vaccination is the best protection. Immune globulin can be given for short-term protection. It is given
before and within 2 weeks after coming in contact with hepatitis A virus. The vaccine is recommended for travellers
travelling to developing countries, sexually active homosexual men and people with chronic liver disease.
Always wash your hands with soap and water after using the toilet, before preparing and eating food.
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Hepatitis B
Most damage from hepatitis B virus (HBV) is caused by the body's response to the infection. This immune response
against the infected liver cells (hepatocytes) damages the cells, causing the liver inflammation known as hepatitis.
As a result, liver enzymes (transaminases) leak out of the liver into the blood, causing transaminase blood levels to
be elevated. The virus impairs the liver's ability to produce the clotting factor prothrombin, increasing the time
required for blood clot formation (prothrombin time).
Liver damage also impairs the body's ability to rid itself of bilirubin (a breakdown product of old red blood cells),
causing jaundice (yellow discoloration of the eyes and body) and dark urine. In a small percentage of patients, an
overly vigorous immune response to the infection leads to fulminant hepatic failure.
Symptoms:
- jaundice.
- fatigue.
- malaise.
- loss of appetite.
- nausea and vomiting.
- low grade fever.
- pale or clay coloured stools.
- generalized itching.
- abnormal urine colour, dark urine.
- abnormal taste.
- abdominal pain.
- abdominal indigestion.
- point tenderness over the liver.
- joint aches (arthralgia).
- nosebleed.
- depression.
Treatment:
There is no treatment for acute HBV infection. Interferon-Alfa and lamivudine are the two FDA-approved antiviral
drugs used for chronic HBV infection.
There are two types of chronic infections: the replicative phase where there is active reproduction of
the HBV virus in the liver resulting in severe chronic hepatitis with the person being very infectious; and the
non-replicative phase where there is very minimal liver injury.
Interferon and lamivudine are only recommended for those with chronic replicative HBV infection.
Interferon is given over a four-month period either on a daily or three times per week basis. About 40% of patients
treated with interferon will have a positive response.
Another drug, thymosin alpha-1, has been approved in countries outside the US and has shown considerable promise
as a booster to the immune system's own defenses against Hepatitis B. Studies are ongoing in the US to gain
FDA approval.
Prevention:
Immunisation: Hepatitis B is a preventable disease. 10% of people who get hepatitis B do not recover completely.
They become hepatitis B carriers who appear well but carry the virus and spread the virus to others. Hepatitis B carriers
may develop complications such as chronic hepatitis, liver cirrhosis, liver failure and liver cancer. Those who recover
completely from hepatitis B infection are immune for life.
Immunisation is recommended for all persons and currently, all newborns born in hospitals are immunised. The HBV
vaccine provides protection for up to 15 years and is considered to be safe and effective. It is given in three
injections scheduled at 0, 1, and 6 months. For babies born to infected HBV mothers, hepatitis immune globulin
(HBIG) is given immediately after birth, followed by the first dose of the hepatitis B vaccine.
Avoiding high risk activity:
Hepatitis B virus is carried in the blood and body fluids and can be spread by high risk activities which should be avoided:
- sexual contact with a carrier or an infected person.
- use of contaminated skin piercing instruments such as in acupuncture,
body piercing, tattooing and the sharing of injection needles.
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Hypertension/High blood pressure
Hypertension, or high blood pressure, refers to a condition in which the blood is pumped around the body at too high a pressure.
It is a silent disorder and the only way to detect it is to have your blood pressure checked.
A blood pressure reading of 120/80 is read as 120 over 80 millimetres of mercury. The top number is your systolic pressure.
This is the pressure in your arteries when your heart pumps. The bottom number is your diastolic blood pressure. This is
the blood pressure in your arteries when your heart relaxes between pumps.
Blood pressure may vary from 90/60 in a young healthy woman to 120/80. Hypertension is present when your blood pressure
is persistently above 140/90. People with diabetes or kidney disease must strive to maintain their blood pressure at around
120/80 because they are at higher risk of complications of hypertension.
Symptoms:
Hypertension usually causes no noticeable symptom but can lead to damage of various organs in the body if the blood pressure
remains high persistently. It is thus often called the silent killer. Over years it can lead to damage to the heart and blood
vessels, making it more likely that the individual will develop a stroke or heart attack. Occasionally, especially when the
blood pressure is extremely high, the individual may experience headaches, dizziness, or alterations in vision.
If hypertension is severe, you may have:
- tiredness.
- confusion.
- vision changes.
- nausea.
- vomiting.
- anxiety.
- excessive perspiration.
- pale skin.
- redness of the face or other areas.
- muscle tremors.
- angina-like pain: crushing substernal chest pain.
Causes:
In 9 out of 10 cases, there is no definite known cause and it is known as essential hypertension.. Older people and men are
more likely to develop high blood pressure. It also tends to run in families. Although, you may inherit the tendency to get
high blood pressure, other lifestyle choices (eating a healthy, balance diet, not smoking, exercising) will determine if you
get the disease. The other 10% of high blood pressure cases can come as a result of kidney disease, glandular (hormone/endocrine)
problems, and as a side effect of some medications and is called secondary hypertension.
Listed below are some of the causes of secondary hypertension:
- adrenal gland tumours.
- Cushing's syndrome.
- kidney disorders.
- glomerulonephritis.
- renal vein thrombosis.
- renal artery occlusion.
- renal artery stenosis.
- renal artery embolism.
- renal failure.
- use of medications, drugs, or other chemicals.
- pregnancy or use of oral contraceptives.
- hemolytic-uremic syndrome.
- Henoch-Schonlein purpura.
- periarteritis nodosa.
- radiation enteritis.
- retroperitoneal fibrosis.
- Wilms' tumor.
Treatment:
Every hypertensive patient or a person at risk of developing high blood pressure should adopt a healthy lifestyle.
This means eating wisely: a diet with reduced salt, low fat and a high fibre diet. You will also need to keep your
weight in the healthy range, exercise regularly, not smoking and managing your stress better.
Occasionally, marginally raised blood pressure comes back within the normal range when the patient loses weight,
exercises more and cuts down salt intake. If these measures are not successful, then drug treatment is necessary.
It has been shown to cut down the complications of hypertension and prolong life. Once medication is started, it
important to continue with treatment as well as continue with healthy lifestyle practices. Treatment for most people
is life-long.
The goal of treatment is to reduce blood pressure to a level where there is decreased risk of complications. Your
doctor will try to prescribe a single drug with minimal side effects to control your hypertension. But if a single
drug does not work, he will prescribe two or more drugs.
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