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Category: Medicine





     Days passed by hearing the sudden death news of Celebrities like Michael Jackson, Sri Devi, Sema Lagoo, Om Puri due to Heart Disease. Heart disease can occur in 2 ways:  One by birth, family history, diabetes mellitus type 1. Second by cholesterol, lack of exercise, overweight, smoking, diabetes mellitus type 2.  Nowadays a heart attack by diabetes mellitus is getting worse. If we think twice or thrice, the common effect for this disease can be the mistakes and discipline of our daily life activities.

Recently, ‘diabetic heart disease’ is the highly ranked disease crawling among the adults with an age of 45 to 55. Sadly, this evil that will be been weaving around us at the youthful age. As laziness and unhealthy diet take a major place in your life, the art of heart disease gives birth in your body.

Every profession got its own way of stress, tension, sleepless tasks in simpler word ‘difficulties’ as an employee pressurized by the boss, as a boss stressed in maintaining company statistics, as a student tensed about career and future, a doctor diagnosing patients’ diseases we cannot blame anyone for this. But by these effects of stress, tensions, staying in a stationary position for extended periods of time, our body will be prone to chronic disease like diabetes. Diabetes mellitus type 2 is the most entertained disease in our body. How about the stress of the work which damages your nervous system, increases your blood pressure, constricts your blood vessels? Have you ever thought that not only the junk in your body but even the stress, fear, tension taken up during the work affects your body in a soothing way?

How Diabetes Mellitus type 2 starts?

You get to work and end up the day with an entire body filled with tiredness. All this time the brain helped in thinking, calculating, decision making; digestive system extracted some enzymes from food which helps the other organs to work in a proper way and energy distributed all over so that you may not faint in the middle of your work, but stress disturbed them. As tension and stress make your heart beats fast soon blood pumps fast and your blood vessels constrict by pressure, as the blood moves fast in your body the organs of your body attempts to work fast. This means the body is working more than needed. Eventually, the pituitary gland (master gland of the body) secretes hormones in large amount which means hyperfunction takes places in the organ. As concerned to the pancreas, sometimes it cannot be capable of secreting insulin and the glucose cannot be converted into glycogen that brings changes to the blood sugar level. By this, you will be affected by diabetes mellitus type 2.

Symptoms of Diabetes Mellitus type 2:

If you have diabetes mellitus type 2 you will have an Increased thirst and frequent urination (Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues), Increased hunger, Weight loss (Calories are lost as excess glucose is released into the urine), Fatigue, blurred vision (If blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus), Slow-healing sores or frequent infections, Areas of darkened skin (patches of dark, velvety skin in the folds and creases of their bodies — usually in the armpits and neck. This condition, called acanthosis nigricans, may be a sign of insulin resistance). These symptoms of diabetes mellitus type 2 can affect your heart.


How Diabetes Mellitus type 2 affects your Heart?

By regular fast pumping of the heart, it can become weak and irregularity of heartbeat takes place, which may lead to arrhythmia (irregularity of heartbeat) or dilated cardiomyopathy (heart chambers become dilated because of heart muscle weakness and cannot pump blood properly) sometimes heart failure(insufficient supply of oxygen).

As a foodie, a chicken burger with extra cheese in right hand and a cola in the left hand or trying out new fast food seems to be a magic ‘mantra’ for after work stress-relief. You may enjoy that plate of delicious food and get back to sleep. What about the fat summed up in your body?  There is no way for the calories to burn up!

First, calories pile up and there will be no scope to run out of the body. These tiny calories turn and convert into a thick creamy unwanted layer of fat in the body. The unwanted fat slowly turns into cholesterol and lead to obesity. Some of the diluted fats go around the body and stays at a place like heart, bundles up into cholesterol, mostly in a coronary artery, one of the main arteries of the heart. This leads to improper pumping of the blood leading to coronary heart disease. Sometimes, myocardial infarction (heart attack) caused by a blood clot that develops in one of the coronary arteries and can also occur if an artery suddenly narrows or spasms occur.


Symptoms of Heart Disease:

You should be aware of what is happening in your body.

When you feel an unbearable pain that travels through the body (for example from the chest to the arms, neck, back, abdomen, or jaw) light-headedness and dizzy sensationsprofuse sweating nausea, and vomiting clearly shows that your heart is in trouble. It is not getting enough oxygen to pump up the blood. Immediately run to the hospital.


Medications for Heart Disease:

The main medications in use are statins (for lowering cholesterol), aspirin, clopidogrel, and warfarin, (for preventing blood clots), beta-blockers (for treating heart attack, heart failure, and high blood pressure), angiotensin-converting enzyme (ACE) inhibitors (for heart failure and high blood pressure). The doctor will work to find a medication that is safe and effective. They will also use medications to treat underlying conditions that can affect the heart, such as diabetes before they become problematic.


‘Prevention is better than cure’

The only way to get rid of the disease is proper diet and regular exercise. When you wake up a 5-minute meditation or yoga will give fresh start and calmness to your mind which controls your anxiety, stress, tension for the entire day, regular breakfast, minimum 30-minutes exercise per day, power naps, healthy diet, avoid smoking, avoiding or reducing junk food and soda will be helpful to get a good health. By this, you will be healthy and have a great immunity in your body.

Clinical case of Dermatology

Clinical case of Dermatology

A 63-year-old woman presents to the dermatology clinic with an enlarging scar-like area behind her ear. The area has grown progressively over 2 years and has become increasingly tight, uncomfortable and pruritic. The area is hard, raised and erythematous with central scarring and atrophy. Her medical history is significant only for hypertension and osteoarthritis.

  1. What is the most likely diagnosis?
  2. What are the potential complications of this disease?
  3. What are the treatment options?


i. Based on this patient’s clinical presentation, the most likely diagnosis is morphea, an inflammatory disease in the dermis and subcutaneous structures. The main variants include plaque-type, linear and generalized morphea.

The most common variant is plaque-type morphea, which is characterized by the development of erythematous to violaceous plaques that expand radially over several years with central sclerosis. The lesions are usually asymptomatic, but more advanced lesions can cause discomfort and skin tightness owing to the progressive scarring and induration of the skin. Although these lesions usually resolve spontaneously over a course of years, they can lead to permanent atrophy and changes in pigmentation. Relapsing disease is uncommon in plaque type morphea.

Linear morphea is a clinical variant that often presents as a linear, inflammatory streak or an initial plaque-type lesion that extends longitudinally to form a scar band. One specific type of linear morphea is known as morphea en coup de sabre, which refers to linear morphea of the forehead and scalp. Generalized morphea is a rare clinical variant that occurs when multiple plaque-type lesions arise at once and become confluent to involve almost all of the total body skin surface area.

ii. Morphea is a disease process that is localized to the skin and does not involve internal organs. However, in the linear morphea variant, the underlying fascia, muscle and bone can be involved, leading to impairment of mobility. High-risk areas are those overlying the joints, which can lead to joint immobility. Morphea en coup de sabre can also involve underlying muscles and osseous structures and rarely progress to involve the eye, meninges, or brain. In the generalized form, the diffuse sclerosis can lead to vasoconstriction leading to symptoms such as difficulty breathing as a result of impaired thorax mobility and inflammation ofthe intercostal muscles.

iii. Although typical plaque-type morphea regresses spontaneously over several years, there are several treatment options available to expedite resolution. Phototherapy with UVA1 or bath PUVA therapy is efficacious in providing faster clinical improvement and longer periods of remission. For systemic treatments, immunosuppression with oral corticosteroids or methotrexate can be helpful during the acute inflammatory stages. There is some evidence supporting the efficacy of oral vitamin A derivatives such as etretinate or acitretin. Topical therapy plays a smaller role in the treatment of morphea. High-potency topical steroids, calcineurin inhibitors and vitamin D derivatives may help reduce local inflammation in acute lesions, but overall are ineffective by themselves in resolving the lesions.

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