Nail as a diagnostic tool PART 2

Splinter hemorrhage under the nail may result from trauma,psoriasis,rheumatoid arthritis other collagen vascular diseases and bacterial endocarditis. Bacterial endocarditis is the most common systemic disease associated with splinter hemorrhages. These hemorrhages are more common in subacute variety rather than acute variety.Although splinter hemorrhages in subacute bacterial endocarditis have been described as proximally located,no suitable evidence available to confirm this

Leukonychia. These marks are common, nonuniform, white lines found in differing spots on one or more nails. It should not be confused with Mees line(due to arsenic poisoning)and Muehrcke's line which are parallel to the lanula across the entire nail bed and occur in more than one nail.

Beau's lines. This condition presents as a transverse depressions in the nail that result from trauma, exposure to cold, Raynaud's disease, or any episodic disease condition serious enough to disrupt the normal nail growth

Raynauds phenomenon can lead to thinning and longitudinal ridging of nail plate

Muehrcke's line demonstrates as a transverse white bands parallel to the lanula. These bands usually occur in pairs and extend all the way across the nail.

Half and half nail with a white proximal and red or brown distal half is occasionally seen in patient with chronic renal failure

Whitening of nail plates may be related to hypoalbuminaemia as in cirrhosis of the liver

Nail fold erythema is a useful physical sign in dermatomyositis, systemic sclerosis and SLE


References :

Huchisons clinical method

Davidson’s Principles and practice of medicine

Nail disorder index

PART 1

Vaccine for Diabetes ???

Scientists discovered a link between family of viruses and diabetes.A team in Britain found proof that type I diabetes is caused by a virus after they spotted traces of an infection more than 60 % of sufferers.They have claimed that ,they will identify the exact virus involved and subsequently a vaccine to prevent the disease.

Finding:In their study ,the scientist tested the pancreas of 72 young diabetes patients who died of type 1 diabetes over the past 20 years.The findings showed that 60% of cases ,the children’s organ contained evidence of infection by enteroviruses.

READ DETAILS.....

http://www.nhs.uk/news/2009/03March/Pages/DiabetesVirusLink.aspx

Nail as a diagnostic tool PART 1

The appearence of the fingernails and toenails may suggest an underlying systemic disease. Some diseases are very frequently accompagnied with nail problems. Examples of these high frequency nail disease problems are psoriatic arthritis, rheumatioid arthritis, psoriasis, and diabetes. In general nail disorders are frequently observed in cardiovascular diseases,circulatory problems, gastrointestinal diseases, endocrine disorders and viral or bacterial diseases.

In Clubbing, nail itself loses its longitudinal ridges and become convex above downwards as well as side to side.Clubbing occurs in patients with neoplasm of lung and pleura. It may also accompany with other pulmonary diseases like bronchiectasis, lung abscess, empyema, pulmonary fibrosis, and cystic fibrosis.It may also occur in patients with cirrhosis,celiac diseases, congenital heart diseases,arterio-venous malformation or fistulas and endocarditis.

Discoloration of nails may be seen with the effect of certain drugs like antimalarials,antibiotics, and phenothizines.Discolouration and deformity, hypertrophy and abnormal brittleness may result in fungal infection.

Koilonychia are soft, thin brittle and spoon shaped nails commonly seen in iron deficiency anaemia.This abnormality is sometimes a normal nail variant in infants, but it usually corrects itself within the first few years of life.Koilonychia may result from trauma, constant occupational exposure of the hands to petroleum based solvents.In case of spooning of nail without an obvious associated illness, physicians should obtain a complete blood count and ferritin level to rule out iron deficiency and hemochromatosis.

Pitting is caused by defective layering of superficial nailplate.Pitting may be caused by variety of systemic diseases , Reiter's syndrome ,connective tissue disorders, sarcoidosis, pemphigus, and alopecia areata.Moreover any localized growth that distrupts the orderly growth also cause pitting.

Onycholysis occurs by the separation of nail plate from nail bed results in white discoloration of the affected area.Onycholysis may also result from hyperthyroidism(plummer’s nails),warts(periungual warts) ,trauma and onychomycosis.Hyperthyroidism also can cause brown discoloration of nails.

References :

Huchisons clinical method

Davidson’s Principles and practice of medicine

The journal of family practice- Nail disorders and systemic disease: What the nails tell us

Glossary of nail conditions

happy earth day

Lets make mother earth a better place for our children to live!

Quick references to the clinical presentation of cranial nerve lesions.

Olfactory Nerve- Anosmia,(loss of sense of smell) may result from head injuries in which cribriform plate of ethmoid bone is fractured.

Optic nerve:Visual field defects and loss of visual acuity may result from fractures in the orbit, lesion along the visual pathway and diseases of nervous system.

Oculomotor nerve:A lesion in the nerve causes strabismus ,ptosis of upper eyelid ,pupil dilatation,the movement of eye ball downward and outward on the damaged side,loss of accommodation for near vision and diplopia.

Trochlear nerve:In trochlear nerve paralysis,diplopia and strabismus occur.

Trigeminal nerve:Injury results in paralysis of muscles of mastication and loss of sensation of touch and temperature.Neuralgia of one or more branches of trigeminal nerve is called trigeminal neuralgia.(Tic douloureux)

Abducens nerve: With the damage to this nerve, the affected eyeball move laterally beyond the midpoint and the eye is usually directed medially.

Facial nerve:Injury produces paralysis of facial muscles called bell’s palsy,loss of taste and loss of ability to close the eyes even during sleep.

Vestibulocochlear nerve:Injury to the cochlear branch may cause tinnitus or deafness.Injury to the vestibular branch may cause vertigo,ataxia, and nystagmus.

Glossopharyngeal nerve:Injury results in difficulty during swallowing,reduced secretion of saliva,loss of sensation in the throat and loss of taste.

Vagus nerve:Damage to this nerve in the upper body interfere with swallowing,paralyses the vocal cords,and interrupts the sensation from many organs.

Acessory nerve:Damage to this nerve results in paralysis of sternocleido mastoid and trapezius muscle present with inability to raise the shoulder and turning the head.

Hypoglossal Nerve.Injury results in difficulty in chewing ,speaking and swallowing. The tongue when protruded turn towards the affected side and the affected side become atrophied,shrunken,and deeply furrowed.

Further reading

Cranial nerve examination

LINKS for Medical professionals

Resources for Homoeopaths.....

Homoeopathy resources on internet
http://www.shirleys-wellness-cafe.com/homeopathy-resources.htm

http://www.homoeopathy-course.com/appr-p-2.htm Illustrates Philosophy and Utility of Miasm,Miasmatic Diagnostic Classifications,Miasmatic Diagnosis of Clinical Classifications,Miasmatic Ancestral Tips,Miasmatic Repertory,Miasmatic Weightage of Medicines by Bengal allen institute

Similima,the largest portal on homoeopathy, designed by post graduate homoeopaths,it includes, latest information on homoeopathy,research articles ,study materials , and educational materials for exam preperation by Dr.Mansoor ali and team

hpathy- A Portal for Homeopathic Medicine, Homeopathy Remedies, Cures, Treatment, Books, Information about Software & Doctors

Modern homoeopathy-An evidence based Homoeopathy site includes Online Treatment, Articles, Cured Cases, Online Journal by Dr. Pawan S Chandak.

Homoeopathic forum by abchomoeopathy http://abchomeopathy.com/forums.php

Resources for all Medical professionals.......

Enjoy the animated graphics and extensive discussions of topics in
cardiology. http://www.heartpoint.com/gallery.html

gatrolab.net -featuring image library,endoscopic piture archieves,endoscopic learning center,links to gastrointestinal websites and much more…

http://www.gastrolab.net/index.htm

List of sites offering links to audible examples of normal and abnormal Breath Sounds on loop recordings that you may listen to on your computer.
http://medzoom.net/breathsounds.html

Flash video of cardiac cycle: http://library.med.utah.edu/kw/pharm/hyper_heart1.html

Dermatology atlas database: http://tray.dermatology.uiowa.edu/DermImag.htm


MARTINDALE'S The virtual medical centre

http://www.martindalecenter.com/MedicalClinical_Exams.html#EXAMS-ALL

X-Plain.net- includes interactive patient education programs that use illustrations and animations to simplify concepts, narration to read the text, and questions to verify understanding.



Updated monthly............

Cardiovascular fitness against Aerobic fitness

Cardio vascular fitness

It is the efficiency of the heart, lungs, and vascular system in delivering oxygen to the working muscle tissues so that prolonged physical activity can be maintained. Cardiovascular fitness is good for the health , heart and the rest of your body

To achieve this, exercise 15-30 minutes/ four times a week without worrying about your heart rate(unlike aerobic fitness). Someone who exercises regularly may have a resting heart rate of 55 or 60 beats per minute. A person who does no regular exercise may have a resting rate of 70 or more beats a minute. The heart of a fit person with a resting rate of 50, beats nine million less each year than an average person’s heart with a resting heart rate of 70,there by reducing the work load of your heart

Aerobic fitness

It gives everyone, the ability to sustain significant activity for a longer period of time. Though it is a necessity for athletes, everyone can follow it as a good health practise.

The American Heart Association recommends that you do exercise that increases your heart rate between 50 and 75% of your maximum heart rate ( maximum heart rate is 220 beats per minute minus your age. For eg.Consider a person of 40 yrs., his maximum heart rate = 180.(220-40) )

So by Involving in an exercise which will raise the heart rates to 50-75% of your maximum heart rate will definitely improve your fitness. However a beginner may not be able to attain this range in the initial phase. During the first few days, do exercise for 10-15 minutes/day. Gradually set the duration as 30-60 minutes/ 4-5 times a week.You should "warm up" and "cool down" for about 5 minutes before and after your exercise. If the exercise is walking or jogging, walk slowly as a warm up. Stretching is an excellent way to warm up and cool down.

links

Excercise for health

Heart rate and excercise

Cardiovascular fitness