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Pernicious Anemia

What is Pernicious Anemia?

Pernicosis anemia is a condition in which the body does not have enough vitamin B12 and not enough healthy red blood cells can be made.
Vitamin B12 is a nutrient found in certain foods. In order for the body to produce healthy red blood cells and the nervous system to function properly, this vitamin is needed.
Patients with pernicious anemia are unable to absorb vitamin B12 to their bodies sufficiently due to the lack of a protein produced in the stomach called intrinsic factor. This leads to vitamin B12 deficiency
Other conditions and factors may also lead to vitamin B12 deficiency. Examples include infections, surgical interventions and nutrition. The term “pernicious anemia teknik is technically a deficiency of vitamin B12 due to the absence of intrinsic factor. Vitamin B12 deficiency, often caused by other causes, is also called pernicious anemia.

Overview
Pernicious anemia is a type of anemia. (Anemia means there are fewer red blood cells in your blood than usual). In pernicious anemia, the body does not have enough vitamin B12 and cannot make enough healthy red blood cells.
If you don't have enough vitamin B12, your red blood cells cannot undergo normal division and become too large. They may have problems transmitting blood from the bone marrow (the spongy tissue in the bones, where blood cells are made).
If you don't have enough red blood cells to carry oxygen to your body, you may feel tired and exhausted. Severe and prolonged pernicious anemia can damage the heart, brain and other organs in the body.
Pernicious anemia can also cause other complications such as nerve damage, neurological problems (such as memory loss) and digestive system problems. In addition, people with pernicious anemia may have an increased risk of developing stomach cancer.

General view
In the past, this condition was called pernicosis (a fatal word) anemia because it often ended in death before vitamin B12 treatment. Today, pernicious anemia can be easily treated with vitamin B12 pills or needles.
With appropriate treatment and ongoing care, most people with pernicious anemia can heal, feel good and live their normal lives.
Without treatment, pernicious anemia can cause serious problems with the heart, nerve and other parts of the body. Some of the effects of this condition can be permanent.

Other Names Given to Pernicious Anemia
Pernicious anemia is one of two major types of anemia, also called “macrocytic” or “megaloblastic emi anemia. These terms refer to anemia in which red blood cells are larger than normal. (Another major type of macrocytic anemia is anemia due to folic acid deficiency.)
Rarely, children are born with an inherited disorder that interferes with the production of intrinsic factor. This disease is called congenital pernicious anemia.
Vitamin B12 deficiency is also called cobalamin deficiency and combined system disease.

What Causes Pernicious Anemia?

Pernicious anemia is caused by a lack of intrinsic factor or other causes such as infection, surgical interventions, medications or nutrition.
Intrinsic Factor Deficiency

Intrinsic factor is a protein in the stomach that helps absorb vitamin B12. In some people, intrinsic factor deficiency is the result of an autoimmune disease.
Autoimmune response occurs when the body's immune system accidentally makes antibodies that attack healthy cells and damages tissues and cells.
In pernicious anemia, the body produces antibodies that attack and destroy parietal cells. These are the cells in the gastric wall that make intrinsic factor. The cause of this autoimmune response is unknown.
As a result of this attack, the stomach stops intrinsic factor production. Without an intrinsic factor, your body cannot absorb vitamin B12 from the small intestine, where it is normally absorbed. This leads to vitamin B12 deficiency
Intrinsic factor deficiency may also occur if all or part of your stomach has been removed. Such operations reduce the number of parietal cells that will perform intrinsic factor production.
Rarely, children are born with an inherited disorder that interferes with the production of intrinsic factor. This disease is called congenital pernicious anemia.
Other Causes

In addition to intrinsic factor deficiency, other conditions and factors may also cause pernicious anemia.

Impaired Absorption from Small Intestine:
Sometimes pernicious anemia can occur because vitamin B12 is not absorbed well from the small intestine. The reasons for this may be:

The wrong kind of bacteria in the small intestine is too many. This is a common cause of pernicious anemia in adults. Bacteria consume vitamin B12 before being absorbed from the small intestine.
Diseases that disrupt the absorption of vitamin B12. An example is celiac disease. This is a genetic disorder in which your body cannot tolerate a protein called gluten. Another example is Crohn's disease. Crohn is an inflammatory bowel disease.
Some drugs that prevent the absorption of vitamin B12 from the small intestine or affect the growth of bacteria. Examples of these drugs are antibiotics and some epileptic drugs.
Surgical removal of all or part of the small intestine.
Intestinal worms. The intestinal worm can feed on vitamin B12 and consume it. Eating fish that is not adequately cooked or infected can cause this type of infection.

Nutrition:
Rarely, some people may develop pernicious anemia because they do not get enough vitamin B12 with food. The richest sources of vitamin B12 are meat, poultry, fish, eggs and dairy products. You can also take vitamin B12 with nutritional supplements.
In strict vegetarians who do not consume any meat or dairy products and do not take vitamin B12 supplements, the risk of pernicious anemia increases.
Children who are breastfed by mothers who are fully vegetarians are at increased risk for pernicious anemia. These babies may develop anemia within months after birth. This is because they do not have enough time to store vitamin B12 in their bodies. Doctors treat these babies with vitamin B12 supplements.
People in other groups, such as the elderly or alcoholics, may also be at risk of pernicious anemia, as they may not be able to get enough vitamin B12 by feeding.

Who is at Risk for Pernicious Anemia?

Pernicious anemia is most common in people of Northern European and African descent.
Older people in the United States are at greater risk. This is due to a lack of gastric acid and intrinsic factor. The lack of these prevents the absorption of vitamin B12 from the small intestine. As people age, they tend to produce less stomach acid.
Pernicious anemia may also occur in younger individuals and other population groups. If the following factors apply to you, your risk of pernicious anemia is increased:

If there is someone in your family who is in this situation.
All or part of your stomach is removed by stomach surgery. Stomach vitamin B12 produces an internex factor, a protein that helps absorption.
If you have an autoimmune disease involving endocrine glands such as Addison's disease, type 1 diabetes, Graves' Disease and vitiligo. According to studies, there may be a connection between these autoimmune disorders and pernicious anemia caused by autoimmune response.
If all or part of your small intestine was removed by surgery. Small intestines are where vitamin B12 is absorbed.
If you have a bowel disease or disorder that prevents the absorption of vitamin B12. Examples include Crohn's disease and intestinal infections.
If you use drugs that prevent the absorption of vitamin B12 in your body. Examples of these drugs are antibiotics and some epileptic drugs.
If you are a full vegetarian who does not consume any meat or dairy products and does not take vitamin B12 supplements, or you usually eat less meat.

What are the signs and symptoms of pernicious anemia?

Signs and symptoms of pernicious anemia are due to vitamin B12 deficiency (vitamin B12 deficiency). If vitamin B12 is not enough, your body cannot produce as many healthy red blood cells as necessary. This causes anemia.
Some signs and symptoms of pernicious anemia can be seen in all types of anemia. Other signs and symptoms are specific for vitamin B12 deficiency.

Signs and Symptoms of Anemia
The most common symptom in all types of anemia is fatigue and fatigue. This symptom is caused by a lack of enough red blood cells to carry oxygen to various parts of your body.
Low red blood cell count also shortness of breath; dizziness, especially when standing up; headache; coldness of hands or feet; pale skin, gums and nails; and chest pain.
Reduction in red blood cells also means that your heart needs to work harder to distribute oxygen-rich blood to your body. This can lead to arrhythmias, heart murmur, heart enlargement and even heart failure.

Vitamin B12 Deficiency Findings and Symptoms
Deficiency of vitamin B12 can cause nerve damage. This can cause pinning and tingling in your hands and feet, muscle weakness and loss of reflex. You can also stagger, lose balance and have problems walking.
Severe vitamin B12 deficiency can cause neurological problems such as blurred consciousness, dementia and depression.
Other signs of vitamin B12 deficiency are related to the digestive tract. These symptoms include nausea, vomiting, burning sensation in the esophagus, abdominal distension and flatulence, constipation or diarrhea, loss of appetite and weight loss. Liver growth is another symptom.
A smooth, red-colored tongue is also a sign of vitamin B12 deficiency and pernicious anemia.
Infants with vitamin B12 deficiency may develop movements that are not normally seen, such as weakening or tremors in the reflexes. These babies may have nutritional problems due to tongue and throat problems. These babies are also very quickly aroused, they can be constantly uneasy. Untreated vitamin B12 deficiency may cause permanent growth problems in infants.

How is Pernicious Anemia Diagnosed?

Your doctor will diagnose pernicious anemia based on your medical and family history, physical examination and test results.
Your doctor will investigate whether this is due to a lack of intrinsic factor or another cause. He will try to find out how severe the situation is and the reason for it to be treated appropriately.

Experts in the Diagnosis Process
Primary care physicians, such as family physicians, internal medicine specialists or pediatricians, can help diagnose and treat pernicious anemia. Doctors from other disciplines may also be involved:

Neurologist
Cardiologist
Hematologist
Gastroenterologist (digestive system diseases specialist)

Medical Stories and Family Stories
Your doctor may ask you questions about your signs and symptoms: Your doctor may ask:

Whether you've had stomach or intestinal surgery,
Whether there is a digestive system disorder such as Celiac disease or Crohn's disease,
Nutritional style and medications you use,
Whether your family has anemia or pernicious anemia
Whether you have a history of autoimmune disease in your family (such as Addison's disease, type 1 diabetes, or Graves' disease) According to studies, there may be a link between these autoimmune disorders and the pernicious anemia caused by the autoimmune response.

Physical Examination
During the physical examination, your doctor will check whether the skin color is pale or yellowish and that there is growth in the liver. Can listen to your heart to see if you have a fast heartbeat or a murmur in your heart
Your doctor will also check for signs of nerve damage. It will also check if your muscles, eyes, senses and reflexes work well. Your doctor may also ask questions and perform tests to check your mental state, coordination and gait.
Diagnostic Tests and Procedures
Blood tests and procedures may be useful in the diagnosis and understanding of the cause of pernicious anemia.

Whole Blood Count
Generally, the first test for the diagnosis of many types of anemia is complete blood count (also called CBC / TKS / hemogram). Many parts of your blood are measured on the hemogram. For this test, a small amount of blood will be drawn by a needle into your vein, usually from your arm.
This test measures your hemoglobin and hematocrit values. Hemoglobin is an iron-rich protein in the red blood cells that carries oxygen to the body. Hemotocrit is a measure of the volumetric ratio of red blood cells in the blood. Low hemoglobin or hemotocrit is a sign of anemia.
The normal values ​​of these measurements vary depending on race and population. Your doctor may explain the test results to you.
The hemogram also looks at the number of red blood cells, white blood cells and platelets in your blood. Abnormal results may be indicative of anemia, another blood disease, infection, or other condition.
The mean corpuscular volume (MCV) of the red blood cells is also measured on the hemogram. MCV is a measure of the average size of your red blood cells. This measurement can give a clue about the cause of your anemia. In pernicious anemia, red blood cells are larger than normal (macrocytic).

Other Blood Tests
If your hemogram shows that you have anemia, you may need to take some other tests to investigate the type of your anemia.
The reticulocyte count measures the amount of young red blood cells in your blood. This test indicates whether the bone marrow produces red blood cells at the correct rate. The number of reticulocytes is low in people with pernicious anemia.
Serum folate, iron, and iron binding capacity tests may also be useful to determine if you have pernicious anemia or any other type of anemia.
Your doctor may also require further blood tests to investigate the following conditions:

Low vitamin B12 levels in your blood indicate that pernicious anemia.
Homocysteine ​​and methylmalonic acid (MMA) levels. High levels of these substances in your body are symptoms of pernicious anemia.
Intrinsic factor antibodies and parietal cell antibodies. These antibodies are also a symptom of pernicious anemia.

Bone Marrow Tests
Bone marrow tests show whether your bone marrow is healthy and has enough red blood cells. There are two types of bone marrow tests: aspiration and biopsy.
During the aspiration process, your doctor takes a small amount of fluid from your bone marrow with a needle. For a biopsy, your doctor will remove a small amount of tissue from your bone marrow with a needle. This tissue sample is then examined under a microscope.
In pernicious anemia, red blood cells are larger than normal (macrocytic).

How is Pernicious Anemia Treated?

Doctors treat pernicious anemia by replacing the missing vitamin B12 in your body. People with pernicious anemia may need lifelong treatment.

Objectives of Treatment
Some of the objectives of the treatment of pernicious anemia:

Prevent or treat anemia with signs and symptoms of anemia
Prevention or control of complications such as heart and nerve damage
To treat the cause of pernicious anemia (if found)

Special Treatment Types
Pernicious anemia is usually easily treated with vitamin B12 pills or needles.
If you have a severe pernicious anemia, your doctor may recommend needle therapy first. Needles are usually made from the hip every day or every week until the vitamin B12 level in your body increases. Once the vitamin B12 value in your blood has returned to normal, you may be injected once a month.
For milder pernicious anemia, your doctor may prescribe high doses of vitamin B12 pills. Nasal gel and spray containing vitamin B12 is also available. These products can be useful for people who have difficulty swallowing pills, such as the elderly or stroke sufferers.
Your signs and symptoms may begin to improve within a day or two of treatment. Your doctor may recommend that you limit your physical activity until your condition improves.
If you have an anemia other than intrinsic factor deficiency or a factor-related pernicious anemia, you may also need treatment for it.
For example, medications can be used to treat conditions that prevent your body from absorbing vitamin B12. Your doctor may change the type or dose of medication if the medications you use cause pernicious anemia. Babies of mothers who are fully vegetarian can be given vitamin B12 supplements from birth.

How can pernicious anemia be prevented?
Pernicious anemia due to intrinsic factor deficiency cannot be prevented. Without intrinsic factor, your body cannot absorb vitamin B12, which leads to pernicious anemia.
Rarely, some people may develop pernicious anemia because of insufficient vitamin B12 intake. You can take some precautions to prevent pernicious anemia due to nutritional factors.
Eating foods rich in vitamin B12 may be helpful in preventing the reduction of vitamin B12 levels. Foods that supply vitamin B12 include:

Meats such as red meat, liver, poultry and fish
Fish and shellfish
Eggs and dairy products (such as milk, yogurt and cheese)
Breakfast cereals and other vitamin B12-added foods

Vitamin B12 is also found in multivitamins and B complex vitamin supplements. Doctors may recommend supplements for those at risk of vitamin B12 deficiency, such as those who are fully vegetarian or have undergone stomach surgery.
Elderly may have problems in absorbing vitamin B12. Therefore, doctors may recommend that older adults eat foods enriched with vitamin B12 or take vitamin B12 supplements.



Living with Pernicious Anemia

With appropriate treatment, people with pernicious anemia can heal, feel good and live their normal lives.
If complications of pernicious anemia such as nerve damage have occurred, early treatment may help to heal the damage.

Continuous Maintenance
If you have pernicious anemia, you may need lifelong treatment with vitamin B12. You should see your doctor regularly for checks and continuous treatment. Take vitamin B12 supplements as instructed by your doctor. It may be helpful in preventing these symptoms and complications.
During your follow-up, your doctor will check for signs of vitamin B12 deficiency. Your doctor may re-arrange your treatment as needed.
If you have pernicious anemia, you have a higher risk of developing stomach cancer. You should see your doctor regularly to check for this complication.
Also, tell other family members, especially your children and siblings, that you have pernicious anemia. Pernicious anemia may be hereditary, so the risk of developing this condition may be greater in these people.


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Avitaminosis: Causes, Symptoms and Treatment of Avientaosis

Avitaminosis is a deficiency of one or more vitamins in the body. The degree of development of Beriberi can manifest in different ways, from fragile nails to serious illnesses. Normally, a healthy person with a varied diet should take lots of vitamins, microelements, acids and fats. If the diet breaks or the body doesn't take the appropriate amount of nutrients for any reason, there is a critical vitamin deficiency. Let's talk about the lack of vitamins today - its manifestations, causes of development and methods of treatment.

How to recognize Beriberi

Beriberi's symptoms are very wide and varied. Depending on the deficiency of a particular element, avitaminosis may be manifested by the following symptoms.

Vitamin C is very important for human immunity. If the body is deficient in vitamin C, the skin becomes gray, loses its natural luster and suppleness. A person often feels overwhelmed and lethargic, his performance decreases and the patient feels pain in the muscles. With a critical lack of vitamin C, the gums begin to bleed, teeth may begin to loosen. Due to the lack of ascorbic acid, a reduction in immunity and exacerbation of many chronic diseases can be noticed. One of the most dangerous symptoms of vitamin C deficiency is Tsing's disease. The disease was common in the Middle Ages, usually sick sailors and besieged people in the fortress. The disease is manifested by dizziness, pain in the muscles and joints, severe drowsiness, sagging, pale skin, changes in the structure of the gums. Vitamin C deficiency is very dangerous and can even be fatal.
Vitamin B1 is responsible for a person's psycho-emotional health. With this vitamin deficiency, the patient often feels crushed and irritated, speech and memory deteriorate, mental level decreases, weightiness occurs, working capacity drops significantly.In some cases, vitamin B1 deficiency leads to the deterioration of internal organs - constipation or diarrhea occurs, liver increases, decreases pressure and pain in the stomach and heart.
Vitamin A. With the lack of this substance the body gradually begins to fade. The skin becomes dry and gray, begins to peel, folds and wrinkles appear. Vitamin A deficiency in the body immediately recognizes women - they see how the condition of the skin and face worsens. In many cases, vitamin A deficiency leads to visual impairment - especially in the dusk, their intensity is reduced. The patient may feel dry eyes as well as wearing contact lenses. Vitamin A deficiency can lead to depression, stress, neurosis, memory impairment, insomnia.
Vitamin K is required to maintain the integrity and flexibility of blood vessels. With a lack of vitamin K, the patient is involved in the development of various organs - gums, sores, nose, in the internal organs. With a lack of vitamin K, hematomas occur on the skin even with a small bump or push.
Vitamin E is considered the main female vitamin, because its deficiency affects appearance and gynecological health very quickly.Lack of vitamin E manifests itself with sexual reluctance in both men and women. Moreover, a person can become sneaky, irritable, muscles weaken, often numb. Skin with tocopherol deficiency occurs dry, wrinkled, pigment spots on the surface. For a woman, a small amount of vitamin E in the body is dangerous because it becomes difficult for her to become pregnant and carry the baby.
Vitamin B2 is responsible for many processes in the human body. When it is missing, the oral mucosa is often inflamed, skin sensitivity is reduced, vision is impaired, hair is shed, and cracks and wounds may occur on the corners of the mouth. With riboflavin deficiency, the patient's general condition deteriorates, becomes weak and indifferent, loses appetite and weight. In some cases, dermatological diseases may worsen.
Vitamin PP. With deficiency diarrhea, often have heartburn, nausea, poor appetite, muscle pain. One person becomes indifferent and very tired. One of the worst consequences of nicotinic acid deficiency in the body is Pellagra's disease. It is caused by extensive symptoms ranging from fragile nails and hair to baldness, to the appearance of blemishes on the skin, abnormalities in the digestive tract and even paralysis.
Vitamin D. Responsible for the integrity of bone tissue and calcium absorption. Bones with vitamin D deficiency become brittle, brittle and soft. This vitamin deficiency leads to muscle and joint pain, obesity, a significant reduction in immunity. In addition, there are symptoms such as irritability, aggression or apathy, tears, weakness, fatigue, stress, unstable nerve disease.

We identified the symptoms of essential vitamin deficiency. But how does beriberi develop? What could be the reason?

What causes the development of Neberi

Here are the main factors that can cause avitaminosis.

Often, avitaminosis develops very often if the necessary elements do not enter the body with nutrition. Such a deficiency can occur when strict diets are observed to lose weight. Weight loss should be literate and not just consuming buckwheat or kefir will make you thinner, but will have serious and even dangerous consequences. Mono-diet is one of the main causes of beriberi. In weight loss, the diet should be prepared by an expert.
For the most part, avitaminosis develops when eating fast food and junk food, if the body does not get enough fresh vegetables, berries and fruits.
Avitaminosis usually develops in third world countries when it is not possible to eat normally. In ancient times, avitaminosis and its associated diseases were a common companion of people under siege and blockade.
In some cases, beriberi may be the cause of weight loss. They cause vomiting or prevent the absorption of food.
Prolonged use of sorbents can also lead to avitaminosis, because the sorbent enters the intestine, absorbing not only toxins but also vitamins, and then excreted naturally from the body.
Avitaminosis may be the result of various digestive tracts of the gastrointestinal tract, which may cause digestion. Often this is observed with dysbacteriosis if the microflora is suppressed - there is no beneficial bacteria in the intestine which is necessary for the synthesis of vitamins.
At risk, children and the elderly, because their metabolism is flawed - children are getting better and the senile begins to break.
Often, during pregnancy and lactation develop avitaminosis.After all, at present it is necessary to consume all the useful elements, the baby's needs, and nutrition is often not intended for two, remains rare. For this reason, pregnant and lactating women often lose their hair, break nails and peel the skin.
Antibiotics and medications for the treatment of tuberculosis may also cause avitaminosis.
Avitaminosis is seen in urban residents in winter and spring months, when the number of fresh vegetables and fruits has declined sharply.

Knowing the main causes of avitaminosis, in many cases you can protect yourself from this pathological condition. But what if a child is diagnosed?

Characteristics of the course of avitamosis in a child

Avitaminosis in children can be observed for various reasons. It is often seen in premature infants. The baby's gastrointestinal tract is characterized by immaturity, the baby's body does not know how to absorb only certain vitamins. In this case, breastfeeding of the premature baby is very important. If this is not possible, the selected mixture should be of good quality to contain all the necessary vitamins and minerals. Avitaminosis may develop due to late introduction of complementary foods. The truth is that after six months a child needs additional nutrition because breast milk can no longer meet the needs of the adult body.

Avitaminosis in newborns may be the result of insufficient or unbalanced nutrition of the mother during pregnancy. Transmitted viruses and infectious diseases can also be a prerequisite for avitaminosis of a baby.

Often, children in the first year of life have vitamin D deficiency. Deficiency may be the cause of the development of rickets. As a result - the curvature of the legs, an increase in the skull and chest, weakness of the limbs and spontaneous gait. You can avoid it because vitamin D does not benefit from food, but from sunlight. Vitamin is synthesized in human skin by ultraviolet. For the treatment of vitamin D deficiency, you need to walk further with the child in the sun. You have to go for a walk in the morning, the vitamin is absorbed until 11 pm. It is not necessary to expose the newborn to direct sunlight - leave the child in the shade, the reflected rays have the same effect.

How vitamin deficiency is treated

In most cases, people with symptoms of avitaminosis, in their opinion, try to buy a multivitamin complex that will protect them from all diseases. But this is not the case. Drinking multivitamin complexes without a doctor's prescription is undesirable and even dangerous. After all, an excess of vitamins in the body can also lead to diseases. It is best to take tests and consult a doctor who will prescribe the right drugs. In other cases, you can get rid of this by using nutrition, balanced, varied, healthy. The diet should include cereals, meat, fruits, vegetables, herbs and dairy products every day. And you have to change everything. If you ate buckwheat today, you need to add barley to your diet tomorrow, the day after tomorrow - rice and so on. If there was beef in the diet from meat to the present, you should eat fish tomorrow, prefer the chicken the day after tomorrow. Such a change will allow you to achieve diversity. To eliminate the deficiency of a particular vitamin, you need to know what foods it contains.

Vitamin A - carrots, butter, beef liver, egg yolk.
Vitamin PP - dairy products, green peas, fish, buckwheat, rye bread, fish, pumpkin, tomatoes.
Vitamin E - vegetable oils, nuts, seeds, beans, cereals.
Vitamin C - citrus fruits, kiwi fruit, sauerkraut, cranberries, sea buckthorn, apples.
Vitamin B2 - broccoli, cauliflower, spinach, dill, bell pepper.
Vitamin B1 - wheat bran, buckwheat, beans, peas, soy.
Vitamin D - fish oil, salmon, butter, red caviar, liver.

Being aware of a vitamin deficiency, you will be able to increase the nutrition of some foods that will help to overcome the deficiency and defeat beriberi.

To prevent the development of beriberi, you need to monitor the quality of your diet. Eat seasonal fruits and vegetables and keep vitamins for long winter and spring. In the cold season, prefer nuts and dried fruit. Freeze the adornment of herbs, fruits and berries - they protect most of the nutrients when they don't. Treat your skin with moisturizers and lotions because the dry epidermis carries a risk of cracks and open wounds. In addition to food, you should pay more attention to walking in fresh air and giving up bad habits. In winter and in the spring, you can drink multivitamin complexes, but only after consulting a doctor.He take good care of your body because its health largely depends on your diet and lifestyle.


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How to Prevent Hair Loss, What are Natural Treatment Methods?

Hair loss is one of the biggest fears of many people. People who lose too much hair are at risk of baldness. In order to avoid such a condition, it is necessary to identify the underlying cause of hair loss and apply the necessary treatment. In this article, we will answer the questions about how to prevent hair loss and what are natural treatment methods for hair loss .

WHAT IS HAIR LOSS?

The hair is composed of creatine protein, located in the outer layer of the skin. As new hair cells grow, old ones shed. The average daily hair loss of a healthy person is 50-100. This is not a situation to fear. Because at the time of the new hair strands are coming out. However, this cycle may sometimes vary depending on the disease, malnutrition or pregnancy. Lack of new hair can be seen as a health problem. Treatment methods of this type of hair loss should be applied.
WHAT ARE THE CAUSES OF HAIR LOSS?

There may be many causes of hair loss. The reasons for hair loss are listed as follows;

GENETIC FACTORS

One of the main causes of hair loss is genetic factors. Both men and women may experience hair loss. Untreated hair loss will result in baldness.

HORMONAL PROBLEMS

Hormones imbalance is a major cause of hair loss, especially in women. Thyroid hormone treatment can prevent hair loss.

PREGNANCY

In general, hair loss occurs intensively after birth due to the decrease in estrogen levels in women. This temporary condition will usually improve within a few months.

MALE TYPE HAIR LOSS

The most common is hair loss . It can be seen in men at an early age. It is formed by the combination of genes and testosterone hormone.

PHYSICAL TRAUMA

Hair loss may occur as a result of accidents, serious surgeries or traumas such as high fever. This condition will become noticeable 3 to 6 months after the trauma. Appropriate treatment can replace the hair loss .

DISEASES

Some diseases trigger hair loss. Especially hair loss occurs due to anemia, diabetes, lupus, syphilis, thyroid and rheumatic diseases. With the treatment of diseases, new hair growth will be possible.

SKIN DISEASES

Skin diseases such as eczema, fungus and psoriasis can cause hair loss as it will be effective on the scalp. Such diseases are generally mistaken for dandruff.

SOME DRUGS

Especially in combination with weight loss and birth control pills, blood pressure, heart, rheumatoid arthritis, gout, depression, diabetes, drugs used in diseases such as thyroid can cause hair loss. If hair loss is high , medication may need to be stopped for a while.

CANCER TREATMENT

Hair loss due to radiation therapy and chemotherapy is seen in cancer diseases. In the treatments applied to the head region, hair will not be able to come back. After chemotherapy , hair can grow in different ways.

PROTEIN LACK

If enough protein does not enter the body, hair loss can be seen. By consuming high protein foods such as meat, eggs and fish, the hair loss problem will be eliminated.

TAKING A LOT OF VITAMIN

Taking too much vitamin A can cause hair loss. In such a case, the hair will start to grow again by stopping vitamin A intake.

WHICH DOCTOR SHOULD YOU GO TO HAIR LOSS?

A person suffering from hair loss needs to see a dermatologist . Dermatologists are experts and educators of scalp.
WHAT ARE HAIR LOSS TESTS?

People with hair loss problems should first consult with the dermatologist. The dermatologist will perform some tests to determine the cause of the hair loss . Hair loss tests can be listed as follows;

Blood test
Tensile test
Scalp biopsy

HOW IS HAIR LOSS TREATED?

After the diagnosis of hair loss, the treatment phase will begin. There are some scientifically proven medications to use in the treatment of hair loss . The most common hair loss treatment are;

Minoxidil : This drug is sold without a prescription. It is used in the treatment of baldness in men and fine hair in women. After the use of this medicine sold in liquid and foam form, hands should be washed.
Finasteride : Only used for male pattern baldness. Sold by prescription. It prevents the overproduction of the male hormone. It is taken by mouth once a day. In regular use, new hair growth will be seen.
Corticosteroid : Cortisone treatment is carried out if hair loss is caused by inflammation in the body. Treatment is possible with cortisone to be injected into the scalp.
Mesotherapy : Mesotherapy, a specially prepared solution, is injected directly. It is used in the treatment of malnutrition and hormonal hair loss. In addition to stopping hair loss , it will be possible to grow healthy hair.


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CIVIL AND ACNE

When we say acne, we first come to our minds. We also adjust our entire skin care routine accordingly. In order to get rid of skin spots and pimples, we apply many products to our faces or we make masks from natural materials at home. What about acne and acne in our body? We should not ignore the acne and blemishes that occur in our body, we must show our care to our body. Acne in the body, especially the back and hip areas are the most common areas. At best, even those who have never faced this problem have suffered from this acne.

WHY CREATE CIVILIZATION?
There are sebaceous glands that secrete sebum on our face and body. These sebaceous glands are located in the pores, except our palms and soles. As the skin cells grow continuously while regenerating, it is expected that dead cells will fall out of the skin. But sometimes dead cells are not spilled, they remain in the pores and they combine with sebum and block the pores. Clogged pores also enter our lives as acne or acne.
Of course, many other factors that contribute to the formation of acne should not be forgotten. There are also important factors that do not attract our attention in daily life, such as the clothes that we wear, completely wrap the body or not being able to shower immediately after sports.

Hormones - Hormonal changes in the body make the sebaceous glands work more actively.

Seasonal Changes - Temperature and humidity in spring and summer increase skin oil production. In winter, the cold air dries the skin, the skin protects against it, tries to prevent it and begins to produce more oil.

Sun Rays - The sun dries our skin. Our skin begins to produce more oil to compensate for this.

Stress - Hormonal changes in the body make the sebaceous glands work more actively.

Wrong Product Use - If you have acne and acne-prone skin, the product you use should definitely match your skin type. When drying pimples, it is important to maintain the moisture level of the skin. Products that dry your skin without moisturizing cause the skin to produce excess oil to protect the skin's oil balance against excessive drying.

To get rid of acne and citrus ...
It is possible to reduce these pimples on the face area, hips, back and legs behind by drying. The most important issue for this is hygiene. Skin clean, makeup and dirt free; For the body, the underwear and clothing worn should be cotton fabric that does not prevent the skin from breathing.

1-Skin Cleansing: Your skin in the morning and evening, dead cells, dirt and excess oil layer of the day you should clean and discipline it. Because the basic rule of getting rid of acne and acne is skin cleansing. You should choose products containing salicylic acid or tea tree. Using tonic for the face also removes excess oil and prevents the formation of acne and pimples. During the day you can also remove excess oil with tonic. You should avoid hard brushes or fibers when applying exfoliating or purifying the skin on acne, spotty skin. Clean gently with a soft cloth or hands. Dry your skin with a towel without rubbing. In the same way for the body, a shower to be taken without scrubbing the skin with warm water in the morning and evening will surely play a big role in removing acne and acne. Prefer shower gel and cleansers containing tea tree, salicylic acid and benzoyl peroxide.

2-Moisturize: Day and night with acne and acne remover cream moisturize your skin. You may think, neden Why should I moisturize oily skin?. But keep in mind that the contents of acne cream or acne cream affect especially when regenerating cells at night. Even if the skin is spotty or acne, it needs moisturizing.

3-Sun Cream: If you are constantly indoors you can skip this step. But if you're exposed to the sun, then choose fine, fluid creams that leave no white residue on the skin. Because many sunscreens often have the effect of blocking the pores.

4-Make-up: BB cream and foundation selection of salicylic acid content products, use again. Choose thin, fluid and semi-concealer products instead of stick foundation or full coverage products. Instead of covering your acne and acne with thick products every day, prefer it only for your special days. While trying to get rid of pimples and acne again try to avoid concealers as much as possible for a while to avoid clogging your pores.

5-Effect of Your Hair Care Products: Products such as shampoo, hair conditioner, mask or jelly have a pore-closing effect when they come into contact with the skin. After showering, rinse your skin and body again.

6-After Sport or Sweating: You should immediately change the clothes you wear after sports. You can clean your sweaty skin by taking a shower immediately or using practical wet skin / face cleaning wipes. The Body Shop's wet wipes with Tea Tree oil can be your biggest help.

Tea tree oil is the most natural and effective ingredient you can use for the removal of acne. Tea tree oil known for its antibacterial properties; Clinically proven to have a positive effect on acne, acne and skin blemishes. Tea tree oil improves the skin after regular use and provides a healthier skin appearance. Some studies have shown that tea tree oil is as effective on the skin as benzoyl peroxide. In Australia, Aboriginals have used the tea tree plant as a natural remedi in health rituals for thousands of years. As a small note, the tree from which tea tree oil is obtained is not green or black tea plants. In fact, this tree is known as the Tea Tree, the Tea Tree, the British sailor and explorer Captain James Cook during the ship with the ship's crew made tea with the leaves of this tree. Therefore, it is known that the name of the tea tree remains.
To apply to your pimples, apply tea tree oil to your cleansed skin with a cotton swab over your pimples or blemishes. Repeat every morning and every evening. After regular use, it is observed that pimples dry out and prevent the formation of new pimples. The Body Shop Tea Tree skin care products include real and organic tea tree. Support your care with clinically proven, positive effects on skin, tea tree matting cream, tea tree solution, tea tree face wash gel, stain remover lotion and other products of the series.


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MuscleTech Advanced Daily Multivitamin for Men & Women, Includes Amino Acids, 18 Vitamins & Minerals (100% Daily Vitamins A, C, D, E, B6 & B12), 90 Count

Centrum Adult (100 Count) Multivitamin / Multimineral Supplement Chewable Tablet, Vitamin D3

Psoriasis patients should pay attention

Psoriasis is a chronic disease with no treatment. It is seen in about 1-3% of the world. Although it usually starts in the thirties, it can also be seen from birth. 30% of psoriasis cases have a family history. In psoriasis, antigens are produced by the cells in the skin. The answer to the question n What is psoriasis? De

In the formation of psoriasis, the body's antigens activate the immune system. The resulting cells return to the skin and cause cell proliferation and the formation of plaques specific to psoriasis. Psoriasis is a chronic disease. In most patients, focus and dandruff are seen on the skin. Spontaneous healing may occur, but this is unlikely. Since it is a chronic case of psoriasis, the patient's idea should be taken in the treatment of the disease. During the treatment process, the patient should comply with the life of the patient while the treatment is being administered.

WHAT IS PSORIASIS?

Psoriasis; It is a skin disease called psoriasis among people due to the observation of white, thick, bright and dry bran on a pink, red, slightly fluffy ground. It occurs in about 2% of the world's population. This disease, which can occur at any age, may appear and disappear unexpectedly. Psoriasis; in some patients it may last several months or several years, while in others it may be intermittent for life. It is not an infectious disease.

Although psoriasis is usually mild, the severity of the rash may vary from person to person. Psoriasis vulgaris is the most common form of psoriasis. The lesions are mostly seen in areas such as knees, elbows, scalp.

WHAT ARE THE CAUSES OF SEDEF?

The causes of psoriasis are still unknown. In a healthy person, skin cells mature in 28-30 days. In psoriasis patients, this period can go down to 3-4 days. Rapidly proliferating cells accumulate on the skin and cause dandruff.

Genetic effects are the most important risk factors for psoriasis. In the family history, it is determined that people with psoriasis are more susceptible to this disease. Some of the conditions that trigger the disease in individuals with prone to psoriasis can be listed as follows:

THROAT OR LEATHER INFECTIONS

Stress
Smoking
Excessive alcohol consumption
Vitamin D deficiency
Some drug treatments

WHAT ARE THE SYMPTOMS OF SEDEF?

The patches on the mother-of-pearl are redness covered with a silver-colored shell. They can be of different shapes and sizes. Dandruff on the scalp form a heap and therefore may not be able to see redness. Symptoms vary according to the types of psoriasis:

PLATE TYPE PSORIASIS: It is the most common form of psoriasis. Plaques can occur anywhere in the body. These plaques, which can be itchy or painful, can sometimes be large and sometimes small.

INVERSE PSORIASIS: This type of psoriasis ; armpit, groin, under the chest, such as folds are limited. Since these areas are moist, it is seen that psoriasis causes redness and swelling without dandruff. Fungal infections can trigger this type of psoriasis.

NAIL PSORIASIS: Psoriasis can also be found in nails and may even be seen only on the nails. In this form of psoriasis; thickening of the nail, discoloration, pits can be seen.

ERYTHRODERMIC PSORIASIS: Erythrodermic psoriasis, the least common form of psoriasis, itchy and burning redness covers the whole body.

PSORIATIC ARTHRITIS: Joint involvement may be observed in some patients. While the hand and foot joints are especially involved, large joints may be affected, although rare.

If psoriatic arthritis is accompanied by spills, the diagnosis can be made easily. Diagnosis is more difficult in patients with joint involvement alone.

How is psoriasis diagnosed?

Diagnosis of psoriasis in most cases is quite simple.

PHYSICAL EXAMINATION AND MEDICAL STORY: The doctor takes the patient's medical history; can diagnose psoriasis by examining skin, scalp and nails.

SKIN BIOPSY: The doctor may occasionally need a small skin sample (biopsy) to diagnose psoriasis. The sample taken is examined under a microscope to determine the type of psoriasis and to eliminate other suspicion of disease.

HOW IS SEDEF DISEASE TREATED?

Psoriasis can be controlled with appropriate treatments. Although dandruffs are reduced or disappeared completely, it is important to remember that there is always the possibility of coming back. Treatment of psoriasis may vary depending on the severity of the disease.

Treatment of psoriasis is basically divided into three:

1.TOPICAL (LOCAL) THERAPIES: This type of treatment cream, ointment and lotion drugs such as direct application to the skin occurs. In the case of mild psoriasis, this will be the most appropriate treatment. Moisturizers used in addition to topical steroids, tar products and vitamin D analogues help to dry the skin and help reduce dandruff.

2. PHOTOTHERAPY: PHOTOTHERAPY; ultraviolet light (therapeutic wavelengths of sunlight) is a treatment of different forms and sometimes using special tablets. This method is used when psoriasis is very common, does not improve with tropical treatments, or recurs immediately after treatment.

The simplest and easiest way of phototherapy treatment is to take controlled amounts of sunlight.

3. SYSTEMIC THERAPIES: It is the type of treatment applied with oral medications. Because of the side effects of the treatment, this treatment is not applied if the disease can be controlled in more simple ways. Before starting the treatment, the doctor makes the necessary explanations to the patient about the risks of the treatment. Female patients should not conceive during systemic treatment. Male patients are also advised not to have children while taking this treatment.

POSSIBLE PATIENTS SHOULD BE CONSIDERED

People with psoriasis should first get rid of psychological triggers. Away from negative emotions such as stress, sadness and anxiety; it will be a positive development for treatment to turn to things that make them feel better.

Scratching the skin, rubbing, shelling the skin can lead to new rashes should be avoided as much as possible.

The sun and the sea have the effect of reducing psoriasis. The duration of sun exposure should be controlled as much as possible. Sunbathing to burn can increase psoriasis rashes.

In winter, the moisture content of the skin decreases and makes it more dry. Moisturizing creams and lotions should be used more carefully in winter as dry skin will cause more itching in psoriasis patients.


41AXX
Centrum Adult (100 Count) Multivitamin / Multimineral Supplement Chewable Tablet, Vitamin D3

Garden of Life Vegetarian Multivitamin Supplement for Kids - Vitamin Code Kids Chewable Raw Whole Food Vitamin with Probiotics, 60 Chewable Bears

SYMPTOMS AND TREATMENT OF ADULT DEFICIENCY IN ADULTS

We have shared scientific articles about ADHD for children who are our specialty. But do adults not have attention deficit and hyperactivity disorder (ADHD)?

Especially if you are the parent of a child with ADHD, you should consider this question well because one of the causes of ADHD is genetic factors. Attention deficit and hyperactivity disorder (ADHD) is more common in children, but it is not only a disease specific to children. Adults (adults) may also have ADHD . Let's remember :
attention deficit in adults

Lack of attention: Inability to concentrate, concentrate or maintain attention on a job.

Hyperactivity : Discomfort that causes undesirable situations such as excessive mobility, quick boredom and unintentional decision-making.
MentalUP Attention Exercises support the development of attention in both children and adults by automatically determining the level of difficulty specific to the user. Examine now!
WHAT ARE THE SYMPTOMS OF ADULT DEFICIENCY IN ADULTS?

The symptoms of attention deficit in adults are not the same as those of children with attention deficit. While children often have learning difficulties, adults may experience problems in work and social life. If you are concerned about your lack of attention, you can use the list below. Do the following attention deficit symptoms refer to you?
HOW TO UNDERSTAND ADULT ATTENTION?

Difficult to listen for a long time while talking to you, not to go down to details
While you are talking, you start daydreaming and breaking away completely.
If you can't deal with two things at the same time, you're doing a good job and focusing more than usual on the outside world. Example: Not seeing people entering or leaving the office while performing an operation on a computer
To be late in the morning to work, to postpone the work constantly, to put things in a sort
Forget about wallets in the office or in the car, forgetting your cell phone at the desk, or losing favorite items or forgot to take them with you.
Speak without thinking, behave impulsively and then regret
Glare at a time, anger control difficulty.

Even if you are experiencing only one of the above conditions, there may be signs of attention deficit. You may be living some or all at the same time. In this case, you must take immediate action. You may need to solve the attention deficit test and do attention exercises. We will soon discuss the issue of attention deficit therapy in adults, but we should also quickly examine the title of hyperactive symptoms for adults. Continue reading .
CAN I BE HYPERACTIVE?

Are the following hyperactive symptoms familiar to you? Do you observe such behavior in yourself?

To be impetuous, to be impatient. Example: Moving the vehicle slightly while waiting at the red light or getting angry with the vehicles in front in traffic.
Reacting frequently from the environment in the form of tez very alive tez
Being anxious, panicking
Bored quickly from a job or activity
Seeking excitement and doing risky work
Talk a lot

The conditions mentioned in the above items are indicative of adult hyperactivity. If one or more of the items is “yes sizin for you, it shows ADHD symptoms; perhaps you need to be treated for ADHD. Consider these possibilities and get help from a specialist psychiatrist. If your complaints are not big enough to prevent your life, you can take precautions with various exercises and foods.
Attention Deficit Treatment in Adults

Exercise and Nutrients

The best choice of people who do not want to use medication, who do not have the complaints to use medication and who want to overcome the lack of attention with their own means , will be to regulate their own habits. For example, reducing the use of sugar and drinking carrot juice is good for lack of attention. As an exercise, taking care of sports activities and brain exercises are good for lack of attention. One of the point shot solutions in particular is to do brain exercises.

In order to find a solution to this issue, you should definitely examine the official Pedagogical product certified MentalUP Brain Exercises application developed with the support of TUBITAK. MentalUP, which is a multifaceted mental development tool in children, is recommended and frequently preferred by experts as it is a solution to adult attention deficit problems. You can use the application designed in the form of a game on your computer and mobile phone. For public transport, waiting times or resting times, it is enough to reserve 20-30 minutes per day. You can be sure you will see the benefit. You can also track your level of attention in your performance reports.

Medicated Treatment

Various antidepressants or synthetic stimulants may be prescribed after diagnosis / diagnosis by specialist psychiatrists. Attention deficit medications are recommended for those with advanced attention problems.

Prescribed drugs may not produce good results in the first place. Therefore, your doctor may go to trial and error with several different drugs. You won't get hurt during this process, but you shouldn't abandon treatment immediately because you don't get good results on the first try.
Therapy

Cognitive-behavioral therapy can be applied with the help of specialist psychologists. In the patient with attention deficit problem, various awareness can be created and various task lists and habits can be managed.

Social support

The patient's immediate surroundings (relatives, colleagues, etc.) are informed that the patient is suffering from attention deficit or hyperactivity disorder and should be treated accordingly. However, it may be ensured that they meet with other people with the same disease.

Example : a forum page or an organization. In this way, individuals with attention deficit can discuss and develop the methods they find themselves; Those with hyperactive symptoms can also discuss and improve how they cope.


40AXX
Garden of Life Vegetarian Multivitamin Supplement for Kids - Vitamin Code Kids Chewable Raw Whole Food Vitamin with Probiotics, 60 Chewable Bears

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Beriberi

Beriberi Vitamin B-1 (thiamine) is a disease caused by deficiency.

There are two types of disease: wet beriberi and dry beriberi. Wet beriberi can interfere with cardiac function and in extreme cases can cause heart failure. Dry beriberi damages nerves and can cause loss of muscle strength and muscle paralysis over time. Untreated and untreated, beriberi causes death.

If you have access to foods rich in vitamin B-1, you have a low risk of developing beriberi. Meat, dairy products and whole grains are excellent sources of Vitamin B-1 and can prevent the development of the disease.
Causes and Risks

The main cause of Beriberin is a poor diet for Vitamin B-1. This disease is very rare in areas with access to vitamin-supplemented foods. Other factors that can contribute are:

Alcohol abuse can make it difficult for your body to take and store Vitamin B-1.
Genetic beriberi is a rare condition that prevents the body from absorbing Vitamin B-1.
Pregnant women and those with hyperthyroidism (overactive thyroid gland) need extra vitamin B-1.
Prolonged diarrhea may make it difficult for your body to take Vitamin B-1.
Certain diseases (eg liver disease) disrupt your body's ability to use Vitamin B-1.
Infants with low vitamin B-1 or babies drinking breast milk.
Kidney dialysis can increase your risk of beriberi.

symptoms

Symptoms of Beriberi vary according to wet or dry type. The following are symptoms of wet beriberi:

shortness of breath during physical activity
high heart rate
swelling on the lower legs
wakefulness

Symptoms of dry beriberi include:

Decrease in muscle function, especially on the lower legs
tingling or loss of sensation in feet and hands
pain
mental confusion
difficulty in speaking
vomiting
involuntary eye movement
paralysis

In extreme cases, the disease can lead to Wernicke-Korsakoff syndrome. This is a type of brain injury that causes mental confusion and memory loss. This is most common in cases of alcoholism.
Diagnosis

You need a series of medical tests to determine if you have beriberi. A blood test will measure how much Vitamin B-1 is in your blood. A urine test will check the thiamine concentration. Any difficulty in taking your body's thiamine arises with high thiamine concentrations in your urine.

After a neurological examination, doctors look for signs of lack of coordination, difficulty walking, falling eyelids, and deterioration of reflexes. In more advanced beriberi stages, memory loss, confusion or delusions occur.

A physical examination will alert your doctor to any heart problems. Rapid heart beat, swelling of the lower legs and / or breathing difficulties are all possible manifestations of beriberi.
Treatment

Beriberi is treated with thiamine supplements. Your doctor may prescribe a thiamine injection or pill. Your progress is usually monitored by follow-up blood tests that show how much your body is absorbing vitamin.

Your doctor may also prescribe a specific diet that includes whole grains, eggs, meats, beets, nuts, seeds and thiamine-rich foods, including tomatoes or orange juice. Food such as ground rice, shrimp and raw meat can make your body difficult to absorb Vitamin B-1 and may need to be limited.
Prevention

To avoid Beriberi, eat a healthy and balanced diet that emphasizes thiamine-rich foods. Pregnant and nursing mothers should be checked regularly for any vitamin deficiency. Baby foods should also be checked for adequate thiamine. Those who abuse alcohol should be checked for Vitamin-B deficiencies.
Expectation

Beriberi prognosis is very good if caught early and treated. Any nerve and / or heart injury caused by Beriberi can also be reversed if caught early.

Beriberi cases caused by alcoholism may cause permanent brain damage if allowed to progress to Wernicke-Korsakoff syndrome.


39AXX
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Gastroenterology

Our Gastroenterology department offers you health service with its experienced, dynamic and specialized staff. Our unit has been established on a qualified and strong infrastructure with the understanding of excellence, and examinations and controls of outpatients are performed in our outpatient clinic. Endoscopy laboratory facilities equipped with state-of-the-art endoscopic imaging and intervention equipment for diagnostic purposes and interventional treatments are available for our patients when needed. Inpatients who need medical support and follow-up are treated in our service units with a design focused on medical practices and patient ergonomics.

WHAT IS GASTROENTEROLOGY? WHICH ISSUES WORK?

Gastroenterology is a branch of science dealing with gastrointestinal system diseases and treatment of digestive organs. Gastroenterology specialists are competent and experienced in the evaluation of complaints and findings of the organs involved in digestion, diagnosis and treatment of the underlying diseases. Diseases and areas of application are very wide. We can divide this large area into two main groups. The first group consists of diseases of the mouth, esophagus, stomach, duodenum, small and large intestines, anal region (breech) called gastrointestinal tract. The second group is liver, biliary tract, gall bladder, pancreas diseases.

WHAT ARE THE COMPLAINTS OF GASTROINTESTINAL SYSTEM DISEASES?

Complaints caused by diseases of the mouth and esophagus

Bad breath, swallowing disorders, the feeling of stinging the bite through the esophagus, the return of edible foods or stomach contents to the mouth, burning in the upper abdominal region or behind the chest bone, pain and pain can be caused by diseases of the mouth and esophagus. Pain from these diseases can sometimes mimic heart pain.

Complaints caused by diseases of the stomach and duodenum

Complaints such as pain, indigestion, feeling of fullness, vomiting, black discoloration in the feces, blood vomiting, weight loss, and vitamin B12 deficiency, which are mostly felt in the upper abdomen and sometimes arousing from sleep, can be seen in these diseases.

Complaints caused by diseases of the small and large intestine

Complaints such as diarrhea, constipation, bloody or black-colored defecation, weight loss, vomiting, abdominal pain, fever, inability to go to the toilet frequently (Tenesmus) and feeling of defecation can be seen in these diseases.

Complaints caused by diseases of the liver and biliary tract

Abdominal pain, bloating due to fluid collection in the abdomen, long-lasting weakness, nausea, vomiting, anorexia, yellowing of the skin and eyes, swelling of the legs, itching of the skin, darkening of the color of urine, stool discoloration (stool in the form of glasspaste), fresh red or cherry brown Complaints such as the presence of blood can be seen in diseases of these organs.

HOW IS DIAGNOSIS IN GASTROINTESTINAL DISEASES? WHICH METHODS ARE USED?

Numerous non-gastrointestinal diseases can cause the above-mentioned complaints and symptoms. For example, in diabetic patients, immunocompromised patients using chemotherapy and drugs that weaken the immune system, such as cortisone, may develop opportunistic infections in the esophagus such as fungi and viruses. Diseases of the gastrointestinal tract itself may cause similar complaints. Reflux disease, for example, occurs as a result of gastric contents escaping back into the esophagus and is one of the most common complaints in those patients with burning behind the breast bone or the upper abdomen.

Many different methods are used in the diagnosis. Your doctor will ask you some questions, listen to your complaints and decide which diagnostic methods to use after examining you. Diagnostic tests are generally; In addition to laboratory tests such as blood count, blood biochemistry, fecal examination, radiological imaging such as ultrasonography, X-ray, computed tomography (CT), magnetic resonance (MR), and interventional methods such as endoscopy, colonoscopy, ERCP (Endoscopic imaging of biliary tract) It occurs.

Endoscopy in Diagnosis and Treatment

The high-end device, called Endoscope (FIG. 1), consists of a fiberoptic tube with a diameter of 1 - 1.5 cm with a bendable, light source and camera through which air, biopsy and water channels pass (FIG. 2). It can be easily swallowed and can travel through the intestine after the stomach. Your gastroenterologist will then be able to easily visualize the internal parts of the organs in these areas and can take fragments from intact or diseased tissues contained therein and examine them in the pathology laboratory. In this way, the causes of the observed and abnormal findings can be revealed. For example, a biopsy from a polyp in the stomach or intestine can tell the pathology laboratory whether it is benign or malignant. In the same way, tissue samples taken from the inner membranes of the stomach tell us gastritis, gastric germ (Helicobacter pylori), cellular changes that may pose risk in future periods, and so on. can provide invaluable information on matters.

Endoscopy is an important tool not only for diagnosis but also for therapeutic purposes. Endoscopes play an important role in stopping bleeding of the gastrointestinal tract. Treatment success can be achieved with endoscopic dilatation in constrictions that make it difficult to pass food through the duct, such as stenosis caused by surgeries or radiation therapy applied to cancer patients. Endoscopic examination of the masses, which should not normally be observed, polyps (FIG. 3), foreign bodies and so on. they can often be removed without surgery with the help of endoscopes and equipment (FIG. 4), and patients can be fully recovered.

TREATMENT METHODS AND OBJECTIVES

There are many diseases affecting the gastrointestinal system and organs. These illnesses range from mild ambiguous to marked severe degrees in terms of the complaints they cause. One of the two main groups that stand out in the treatment options for these diseases is endoscopic / interventional therapies and drug therapies. In addition to this, the patient's condition and preferences can be customized by the gastroenterologist with the help of special dietary treatments, lifestyle changes and recommendations. As a result of this general approach, it is aimed to maintain a normal life with full cure or symptomatic relief depending on the typical characteristics and behavior of the diseases.

LOSANTE GASTROENTEROLOGY ENDOSCOPY LABORATORY FACILITIES AND EQUIPMENT

The recently opened endoscopy laboratory complex is located within the daily surgery center of our hospital, which has Endoscopy, Colonoscopy, ERCP (Endoscopic retrograde cholangiopancreatography), EUS (Endoscopic ultrasonography) equipment and related equipment. With these devices, both gastrointestinal system and organs can be visualized and interventional procedures can be applied (FIGURE.5).


38AXX
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Vitamin deficiency and pica disease in cows and sheep

When feeding animals, nutrients, minerals and vitamins should be balanced. Some problems may be seen in deficiency or excess of nutrients, minerals and vitamins. Therefore, nutrition in animals and living things should be balanced.
If the nutrition is not balanced in animals, nutritional deficiency or excess, mineral deficiency or excess, vitamins deficiency or excess in situations such as what is the problem is useful to specify briefly.

Problems in deficiency and excess of nutrients

Protein deficiency: The importance of protein taken during feeding in living things is of great importance. Protein deficiency causes growth retardation in living organisms. Therefore, low yield and material losses may occur.

Protein surplus: Protein surplus can be a problem as well as lack. Kidney disorders can also be foot diseases from excess protein buildup.

Fat deficiency: The importance of fat in animal nutrition is important as in all living beings. Oil deficiency May cause skin rash. Weight loss can be seen. It may cause material losses.

Fat excess: Obesity problems may be experienced in living organisms due to excess fat in tissues during excessive feeding.

Lack of fibrous foods: Causes digestive system disorders in animals. Therefore, loss of efficiency is experienced. Property damage may occur.

Excess fibrous food: Digestive system disorders may occur. May cause constipation and swelling of the digestive tract. Loss of efficiency is experienced.


Problems in mineral deficiency and excess

Sodium deficiency: Sodium deficiency, which is one of the important minerals for animals, can cause problems such as inability to maintain body fluid balance, loss of appetite, exhaustion and stagnation. Therefore, sodium deficiency can cause loss of yield and material losses.

Excess sodium: May cause hypertension, heart disease and vascular and circulatory disorders in living organisms. Therefore, excess sodium can cause loss of yield.

Calcium deficiency: In living things, calcium deficiency can cause loss of growth and bone structure, as well as loss of appetite and fatigue.

Excess calcium: Caution should be paid to the excess calcium that causes skeletal disorders in all living things.

Phosphorus deficiency: Problems with calcium deficiency are also encountered here.

Phosphorus excess: Problems with excess calcium are experienced in excess phosphorus. In fact, it is necessary to maintain a good balance of calcium phosphorus in the body.

Magnesium deficiency: Magnesium has an important place in animal nutrition. Magnesium deficiency causes anorexia, growth retardation and disruption of muscle tissue in animals.

Excess magnesium: Excess magnesium in living things causes kidney and urinary tract problems.


Problems in deficiency and excess of vitamins

Lack of vitamins: Vitamins are very important in all live nutrition. Vitamins can be taken from many foods as well as external supplements. During the lack of vitamins it is useful to take or use the necessary vitamins from outside. Lack of vitamins, loss of appetite, regression in growth, foot diseases, eye problems, digestive disorders and circulatory disorders cause.

Excess of vitamins: Excess of vitamins as well as deficiency of vitamins can cause problems. As the excess of vitamins causes skeletal disorders, calcium-related problems can be experienced as the excess of vitamin D will disturb the calcium balance.

In animals, nutrition, nutrients, minerals and vitamins should be given balanced. Unbalanced intake of nutrients, minerals and vitamins will result in loss of yield in animals, resulting in material losses. Therefore, it is necessary to feed the animals balanced.

Pica disease:
Pika is a disease caused by ingestion of non-food substances. It is known as a disease in animals and particularly in children with intestinal parasites and thus iron deficiency.

Pika disease takes its name from the Magpie. Magpie is a long-tailed bird from the crow family, as it is known, and is famous for eating whatever it finds. It is considered normal to eat worms, carrion and insects without picking whatever is in the mouth of the magpie.

Pica occurs in farm animals, especially cattle. Cattle walls, boards, litter, non-food substances chewing, licking occurs. Problems such as urination, licking urine are also signs of pica. Rubber or plastic, eating sand, feces, sheep feathering, and scavenging of cattle grazing near the garbage dump are also considered as pica signs. Although some cows have accepted pica by eating cows after they have eaten their husbands (their wives, fry membranes), there are also those who accept this behavior as instinctive. Many scientists have reported that the last meal is an instinctive behavior of the cow in order to protect its offspring from wild animals.

Pika itself is a disease that can cause other problems as well as problems. Boticism, foreign body disease (RPT) and tongue rounding may occur due to pica. Pica can sometimes be combined with ketosis. In such cases, the cow rejects concentrated feed, but consumes roughage.

Grazing cows near garbage can swallow foreign bodies or eat scavengers because of pica. In cows eating spoiled substances and carcasses, symptoms such as imbalance, paralysis, muscular weakness, difficulty in swallowing and chewing, side-lying position and excessive salivation result in botulismus disease and the cow dies.

Pica is a disease that can be confused with magnesium deficiency, neural form of ketosis, brain inflammation and poisoning.

Calves lick each other's belly is a sign of pica.
There are many causes of pica. A cow may have one or more causes. Certainly the reason is not easy to find and say. Magnesium, zinc, iron, copper, potassium, phosphorus, cobalt mineral deficiencies are among the leading causes. Stress, internal parasites, digestive and nutritional disorders, poor quality forages, protein, energy imbalances or deficiencies, phosphorus and calcium imbalances, cellulose deficiency, latent ketosis or latent acidosis, metabolic diseases can lead to Pika.

Pika is also a disease that is included in the herd as a bad habit. Bad habits in the herd can become learnable and lasting. The problem should be uncovered and eliminated with early detection. Because sometimes the pica can continue even if the causes are eliminated. This issue is described as a learned bad habit. Sometimes the problem is in vain. Pika is rapidly spreading within the group. In order not to have Pika, the feeds must be balanced and the ration should be arranged in a way that does not cause mineral, protein, energy and cellulose deficiency. After the development of Pica disease, the same arrangements should be made, mineral additives should be added to the feed, regulation of the ration, blood and feed analysis should be done, the situation should be investigated in terms of hidden ketosis and acidosis.


37AXX
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What is Spina Bifida?

Spina bifida means discrete or open spine. It is one of the most common congenital diseases. Spina bifida can be seen in many ways affecting the spinal cord, especially myelomeningocele.

If you have spina bifida, something went wrong during the development of your spinal cord before your birth. In general, the spinal cord is a closed tube of nerves. These nerves move the muscles by transmitting orders from your brain to the nerves in your muscles. It also makes us feel these nerves. If the baby is born with spina bifida, this tube called the spinal cord is not closed. Therefore, the spine and skin covering the spinal cord are also not closed. The baby was born with an opening in his back and has difficulty in passing orders through his nerves. When there is no proper connection between the nerves and the brain, various degrees of paralysis (loss or inability to move and feel) occur.

Which nerves are affected depends on where the back opening is located. The higher the opening in the back, the more nerves are affected and the more severe the paralysis is. Therefore, some people with spina bifida use no or few devices, while others have to use a wheelchair. The affected muscles are not the only muscles to move, but the muscles that control urine and feces are involved in many patients.

Hydrocephalus is also seen in more than 85% of patients with spina bifida. Hydrocephalus is the excessive increase of fluid circulating in the brain and spinal cord as a result of disruption of this circulation and causing high pressure in the cavities within the brain. In infants, the head bones are not yet fully hardened and the head grows to try to reduce this pressure. However, if not treated in the early period, the brain will be damaged. If the development of hydrocephalus and brain damage can be prevented by timely treatment, the intelligence of children with spina bifida is not different from normal.

How does it occur?

This is a very important question that we are trying to answer today. The only thing we know is that no one's to blame for a baby being born with spina bifida.

A vitamin B group (folic acid) may have a role. Folic acid is believed to help close the spinal cord tube. If the mother does not have enough folic acid, the baby's spinal cord may not close properly. Some vitamins and minerals other than folic acid are thought to play a role. It is also known that spina bifida can occur for some hereditary reasons; because in some families, spina bifida is more common. A drug used by the mother (valproic acid) to prevent seizures is known to cause spina bifida. It is thought that many other reasons that are unknown for today may be effective.

When does it appear?

Spina bifida occurs in the very early stages of pregnancy, in the third week of life in the womb. For this reason spina bifida is called a congenital disorder. It is different from spinal cord damage at a later stage of life, for example as a result of a traffic accident. Although a person with such a spinal cord has difficulties in walking, bladder and bowel control, hydrocephalus does not develop in them. In these types of injuries, the leg muscles are well developed, since there were no prior problems and the person could walk before the accident.

Who can have a child with spina bifida?

Any pair can have a child born with spina bifida. There are 10 million spina bifida in the world. In developed countries, one in every thousand children is born with spina bifida. In a study carried out by our association, approximately 37,000 births were recorded in İzmir city center in 2000 and the incidence of spina bifida was found as high as 1.5 per thousand . In a previous study conducted in Ankara, this ratio was found to be 4 per thousand, indicating that there are differences between regions. Turkey's level of socioeconomic development in the region to obtain these rates were better than others in less developed regions, suggesting the possibility that the higher this ratio.

What is the treatment?

If the babies with spina bifida are born with myelomeningocele, the sac in their back is closed with surgery in the first days. Those with hydrocephalus develop a drainage system called shunt, which drains excess fluid from the brain into the bloodstream. In recent years, a new surgical method called “third ventriculostomy yerine has been used instead of shunt. It is reported to be a more natural method and the complications caused by shunting are not seen in this.

Can he recover completely after treatment?

Usually no. Surgeries are often performed to prevent further problems in maintaining the current state. Surgeries or some treatment methods try to make these patients' lives as close to normal as possible. Although they cannot become completely healthy, they are able to live independently. However, this depends to a large extent on the elimination of barriers to social life as well as medical support.

Is it possible to prevent this disease?

For today it is not possible to completely eradicate. Studies in recent years have shown that this disease can be prevented to a great extent with folic acid vitamin taken in the pre-pregnancy period. Nowadays, in many developed countries, all expectant mothers are taking folic acid before they become pregnant. Because when the mother finds out that she has become pregnant, time has passed to prevent spina bifida.

To find out if the baby has spina bifida, it is important to check whether the baby is 16-18. A blood test (AFP) and a detailed ultrasound examination is required between If the baby spina bifida with these 75-80% is diagnosed. The family may decide to terminate the pregnancy during this period by talking to an experienced and knowledgeable doctor. However, there are also many families who choose to continue their pregnancy and take care of their babies as well as they can, although they know that a different life awaits them in the future. In this case, it is the duty of the physician to respect this and to inform the family in the best way and to allow the baby to be born under appropriate conditions and to perform medical interventions.

Situation in Turkey

the nutritional status of pregnant women in Turkey, there are studies showing that good. In one study, folic acid (a group B vitamin), which is now accepted to be deficient in spina bifida, was found to be deficient in 60% of pregnant women. In addition, serious deficiencies were detected in other important vitamins. These resources are available from our association.

The majority of spina bifida babies still are born in Turkey before it can be diagnosed before birth. The responsibility here is in the family if she has not applied to a physician or Maternal and Child Health Centers before birth and during pregnancy. However, unfortunately, many children who have a regular pregnancy under the supervision of a physician and whose baby is said to be normal will be born with spina bifida. In this case, 16-18. If the patient does not have the tests to be carried out in weeks, the responsibility should belong to the physician. However, lack of information in the society prevents families from seeking rights.

There are still families who do not think that babies with spina bifida will not survive after birth at home and uncontrolled births, and that unfortunately cause death or starvation. It is not possible to estimate the number as they are not recorded. Unexpectedly, some of the babies born with spina bifida in hospital end up in a similar way, sometimes unfortunately with the advice of a physician. But we should note that the number of these doctors is decreasing with each passing day and the number of physicians and midwives who give information to the family about spina bifida and guide them to get the necessary treatment is increasing. If these patients can be referred under appropriate conditions, the first operations can be performed in the Neurosurgery Clinics in the big cities.

One out of every ten people with disabilities such as the world is in general in Turkey. Spina bifidals are also included in this number. Unfortunately, in developed countries to be disabled in Turkey it is much more difficult. Education, employment opportunities, social life are extremely limited. There are special schools for some physically disabled people, but spina bifidal people want to go to schools where normal children go, not private schools. This is their most natural desire from the human rights declaration. However, the vast majority of schools do not respond to their needs, but do not eliminate the barriers.


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Restless Legs Will Relax!

Are you moving your legs irresistibly? If this feeling doesn't allow you to sleep, you may have Restless Leg Syndrome. Restless legs syndrome is seen in about 3 to 10 percent of the population equally in men and women. It usually occurs in middle and advanced ages, but also occurs in childhood. "

THE RESTFUL LEGS WILL MIX!

Are you moving your legs irresistibly? If this feeling doesn't allow you to sleep, you may have Restless Leg Syndrome. Restless legs syndrome is seen in about 3 to 10 percent of the population equally in men and women. It usually occurs in middle and advanced ages, but also occurs in childhood. "

What is restless leg syndrome and when does it occur?

Restless leg syndrome can be described as a deep, uncomfortable feeling that occurs in the legs during a resting period of inactivity or falling asleep. It can also be described as a kind of sleep disorder because it affects sleep quality.

- How do patients describe this feeling?

It is difficult for patients to describe this feeling. This feeling is not a form of pain. Patients often describe this uncomfortable sensation as itching on their legs, rarely on their arms, needling, shuddering in the legs, burning, drawing, stretching, tingling. To relieve this strange emotion, there is an unbearable urge to move the legs and this feeling decreases with movement. This sensation emerges during long periods of inactivity in bus and airplanes and often before falling asleep at night.

Who has Restless Leg Syndrome and how often?

Restless legs syndrome is seen in approximately 3 to 10 percent of the population, equally among men and women. It usually occurs in middle and advanced ages, but is also found in childhood.

-What is the cause of this disease?

Although the reason is not well known, it is thought that some of the chemicals released from our brain are caused by the effects on the movement system. There are two forms of restless leg syndrome (primary) whose cause is unknown and secondary to another disease. Peripheral neuropathy caused by iron deficiency anemia and damage to the arm and leg nerves are the most common causes of restless leg syndrome. There are many causes of peripheral neuropathy, the most common of which is peripheral neuropathy due to diabetes. Restless leg syndrome can also occur during pregnancy, but the symptoms disappear soon after birth. Many other diseases such as magnesium deficiency, vitamin B12 deficiency, renal insufficiency and rheumatoid arthritis can cause restless leg syndrome.

-What triggers this syndrome?

With many of the diseases listed above, some medications exacerbate the symptoms of restless leg syndrome. Examples include antidepressant drugs, lithium, alcohol, caffeine.

- How is it diagnosed?

If the patient has a long-term inactivity in the legs and an uncomfortable feeling that occurs before sleeping, and this uncomfortable feeling causes an irresistible urge to move the legs, this condition may impair sleep quality and cause insomnia and lack of attention during the day, headache, sleepiness. a physician. The causes of restless leg syndrome are investigated in these patients, the patient's history is learned and neurological examination and detailed blood tests are performed. EMG is performed to investigate underlying peripheral neuropathy. After all these examinations, the patient may need a sleep test to investigate the sleep disorder.

- What diseases can be confused with restless leg syndrome?

Neuropathic pain caused by Parkinson's disease, fibromyalgia, muscle disorders, joint pain, circulatory disorders and diabetes can mimic restless leg syndrome.

- How is it being treated?

- The first principle in the treatment of restless leg syndrome is to avoid the substances or foods that cause the exacerbation of the disease. Avoiding substances such as alcohol, caffeine and nicotine can reduce symptoms. The patient's medications should be reviewed and medications that may increase the symptoms of restless leg syndrome should be discontinued. Diseases such as anemia, diabetes, nutritional disorders, kidney disease, goiter, varicose veins or parkinson's disease should be treated. If there is no response to these precautions, drug treatment should be started.


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