Growth hormone as the name suggests is responsible for the growth of all the tissues of the body. It is produced in the anterior lobe of the pituitary gland, a small pea-shaped gland at the base of the skull. The pituitary gland is commonly referred to as the master gland because it secretes various hormones that have a wide range of effects, either directly on tissues or by acting on other endocrine glands. Normally the level of growth hormone in the body is regulated by the gonadotropin hypothalamic-releasing hormone (GNRH) from the hypothalamus and somastatin from various other organs like the pancreas. These hormones act on the pituitary gland to stimulate growth hormone production and secretion. Sometimes the regulation is disrupted or disease within the pituitary gland leads to excessive secretion of growth hormone. When there is an excess of growth hormone then it causes an ‘overgrowth’ of the body tissues. In adults this is known as acromegaly while in children it leads to gigantism.
The cornea on the outer part of the eye and the lens within the eyeball are responsible for bending light (refraction) so that it focuses on the most sensitive part of the retina. The sharper the image cast on this area, the clearer of vision. The more common vision problems are associated with refractive errors – this means that the light is not bent optimally to cast a sharp image on the eye. Most people are well versed with two common refractive errors that causes myopia (nearsightedness) and hyperopia (farsightedness). Astigmatism is another refractive eye disorder that is less well understood by many yet it is one of the more common refractive errors.
Bloating is common term used to describe the sensation of fullness in the abdomen may or may not correlate with any increase in abdominal size (diameter). It can also be used to describe abdominal distension (visible/measurable enlargement of the abdomen) without any sensation of fullness. Bloating is not an uncommon occurrence – most of us experience a sensation of fullness after a heavy meal or with consuming excessive quantities of carbonated beverages. It usually eases on its own after a short while and belching may help to relieve it. However, the sensation of bloating is also a common symptom of many gastrointestinal disorders like gastritis, peptic ulcer disease and hiatal hernia. Abdominal distension on the hand is not as common – it most likely occurs in a person with some abdominal disorder or even systemic disease.
What is functional bloating?
Functional bloating is the sensation of fullness and/or abdominal distension that is not associated with any disease, either within the abdomen or systemically. Apart from other diseases, it should also not be part of other functional bowel disorders like irritable bowel syndrome (IBS), functional diarrhea or functional constipation in order to be diagnosed as functional bloating. It is important to note that functional abdominalbloating is a prominent feature of irritable bowel syndrome. However, without the abdominal pain associated with change in bowel habit as is seen in IBS, functional bloating is diagnosed on its own.
Stomach irritation is a common term used by many patients to report some discomfort or abnormality believed to be originating from the stomach. It is extremely subjective and variable in meaning because unlike other symptoms it does not denote the actual sensation or disturbance that one is experiencing. However, there are several causes to describe a whole host of primarily gastrointestinal symptoms which a person may report as stomach irritation. Without the presence or reporting of other symptoms though it is difficult to identify possible causes and may warrant the need for further diagnostic investigation. Stomach problems may not always be due to any disease or disorder of the stomach itself. Even pain or discomfort that corresponds with the anatomical position of the stomach may not be gastric in origin but associated with neighboring organs like the esophagus or duodenum or even structures in the surrounding abdominal quadrants.
Normal Gastrointestinal Motility
Food that is consumed undergoes both mechanical and chemical digestion in the alimentary tract. Nutrients are absorbed in the process and water and mucus are mixed with the ingested food at almost every part of the alimentary tract. Large amounts of water are then absorbed in the large intestine thereby transforming the liquid residual matter that enters the colon into a firm yet soft material by the time it reaches the descending colon. This residual and waste material is known as feces and is subsequently evacuated from the body during defecation. In order to facilitate this process, food, chyme (digested food) and residual nutrients with waste has to pass from the mouth to the anus. This movement is achieved by the action of the muscles throughout the alimentary tract in a coordinated process known as peristalsis.
The sense of vision is enabled by several components in the human eye and close to it – the visual apparatus of the eye, the nerves that carry signals to the brain and brain centers that decipher these impulses. Light has to enter the eye unobstructed, be refracted (bent) by the cornea and lens at the optimal angles to strike the most sensitive area of the retina and be perceived as a sharp and clear image. If there is any disruption in the process, there may be visual disturbances. Most diseases that causes visual disturbances like blurred vision or cloudy vision involves the cornea and/or lens. Sometimes the disorder is not limited to cornea or lens but involves the sensory parts, namely the retina and/or optic nerve, or even the visual centers in the brain itself. This can cause a number of visual disturbance beyond blurred, cloudy or hazy vision. It is more likely to lead to partial or complete loss of vision (blindness).
Light entering the eye has to be refracted (bent) so that a sharp image can be focused on the retina of the eye. The retina is the photosensitive inner layer of the eye that converts the light into nerve impulses. Via the optic nerve, these impulses are relayed to the brain and is perceived as the sense of vision. The cornea on the outer part of the eyeball and the lens within the eye are primarily responsible for this refraction of light. Common visual problems in humans are mainly due to refractive errors. This means that the light is refracted in a manner that casts a sharp image short of the retina or just past it. These refractive errors are known as myopia (short sight) or hyperopia (far sight) respectively.
What is Spinal Stenosis?
Stenosis means narrowing of a hollow tube. Spinal stenosis is a condition where there is narrowing of the spinal canal causing compression of the spinal cord lying within it and/or narrowing of the spaces through which the spinal nerves leave the spinal column. Spinal stenosis usually occurs as part of the normal aging process. Compression of the nerves and blood vessels caused by stenosis leads to the typical features of pain. Depending on the nerves affected, there may be symptoms such as weakness, numbness, or pain in the neck, back, arms, or legs. However, not all patients with spinal stenosis develop symptoms.
Spinal stenosis is most common in the cervical (neck) and lumbar (back) regions. Almost 75% of cases of spinal stenosis occur in the lumbar region. Treatment may be conservative, such as rest, medication, physical therapy, and braces. Surgical decompression may be considered when other treatments fail to alleviate symptoms and mobility or quality of life is significantly impaired or in case of progressive muscle weakness with risk of permanent nerve damage.
The clarity of vision (acuity) is dependent on the refraction of parallel light rays and the sharp focus of this light on the retina. Normally the ciliary muscles of the lens can remain relaxed and distant objects can be seen clearly, albeit small depending on the distance. This normal vision is known as emmetropia. To see near objects clearly the muscles have to contract and alter the lens shape and therefore the refractive index of the lens. The parallel rays of light can then be focused clearly on the retina. This is known as accommodation. Some of the more common vision problems in both children and adults is due to a refractive error. This means that the light is not focused on the retina with the sharpness that it should be. The image either falls short of the retina or beyond it and the vision appears blurred. A person may, however, see with some degree of clarity if an object is very near or very far away.
Screening for osteoporosis in high risk groups like postmenopausal women, elderly men, or patients on long-term corticosteroid therapy is always advisable for early detection. Management of osteoporosis also requires recording of the baseline values of parameters for monitoring the progress of osteoporosis therapy. The diagnostic procedure becomes more complex in younger patients without any known risk factors and therefore other uncommon causes of osteoporosis also have to be investigated these individuals. The most important investigations related to early detection and management of osteoporosis are radiological investigation, laboratory tests and biomarker studies.
What is a pancreatic cyst?
A cyst is an abnormal cavity within an organ that is filled with fluid. It is enclosed by an epithelial membrane that separates it from surrounding tissue. Cysts can occur just about anywhere in the body and may be single or multiple. When it occurs in the pancreas, it is known as a pancreatic cyst. These cysts may be non-neoplastic or neoplastic (benign or malignant). Most cysts are non-neoplastic pseudocysts but some are neoplastic masses. From these neoplasms, some types may be benign (non-cancerous) and others malignant (cancerous). Sometime cysts may be present from birth because it arises from a defect in fetal development and these are known as congenital cysts.
The eye has a rich blood supply similar to other highly active parts of the body. The retina which is the photosensitive inner layer of the eyeball responds to light stimuli and generates impulses that travel via the optic nerve to the brain. This accounts for the sense of vision. The central retinal artery supplies blood to most of the retina. It is a branch of the opthalmic artery which arises from the internal carotid artery. As with any artery in the body, an occlusion will reduce the flow of oxygenated blood to the target area. The tissue in this region is deprived of oxygen and undergoes damage (ischemia) or death (infarct). When it occurs in the eye, it is referred to as an eye stroke.
What is a spinal cord injury?
A spinal cord injury is a medical emergency which requires immediate treatment. It may occur due to direct trauma to the spinal cord itself or indirectly as a result of damage of the bones and soft tissues surrounding it. In any serious accident, a spinal cord injury should be assumed to be present, especially when the patient is unconscious. It is possible that the injury may be present despite of the spinal cord being intact. If a spinal cord injury is suspected at the accident site, the patient should be moved with extreme caution. The patient may be “log-rolled” to a semi-prone recovery position in order to provide basic life support.
Calcium and vitamin D, specifically D3 or cholecalciferol, are essential for maintaining the strength and structural integrity of bones. While other nutrients also play an integral in bone development and strength, it is a deficiency of these two nutrients that have the most marked effect on integrity of the bone. Depending on the extent of the deficiency, it may lead to osteoporosis, osteomalacia (adults) or rickets (children). Both calcium and vitamin D are derived from the diet although the latter is also formed in the skin through sunlight exposure. The bones also serve as a reservoir for calcium. Deficiencies may be linked to dietary factors or underlying diseases that hamper the digestion, absorption or proper utilization of these calcium and vitamin D.
Osteoporosis is a condition characterized by reduced bone mass and disturbed bone architecture. It can result in spontaneous fractures or fractures from minimal trauma. Osteoporosis is a major reason for the increased the risk of fracture in majority of postmenopausal women and to a certain extent in men, particularly older men. More than 50% of women and about 25% of men suffer from osteoporosis related fractures with advancing age. The body of the vertebrae, radial bone near the wrist joint, and the femur near the hip joint are most commonly fractured bones in osteoporotic individuals. Other bones are also susceptible to fracture in osteoporotic individuals as the bones in general remain easily fragile. The severity of osteoporosis and risk for fractures increase considerably with advancing age.
In osteoporosis there is an imbalance in the bone formation and the bone resorption (breakdown). This is directly related to the imbalance between deposition of calcium in the bones and its removal. The calcium balance is normally maintained by hormones like calcitonin, parathormone and the vitamin D. The treatment of osteoporosis aims at shifting balance in favor of bone formation. Irrespective of the type of osteoporosis, similar therapeutic approaches are useful in minimizing bone loss and increasing bone density.
The blood glucose (sugar) level is maintained with a narrow range that is sufficient for the cells to have an adequate supply of nutrition for energy production. High glucose levels can damage or even destroy cells over time while low levels will prevent cells from functioning optimally and lead to key systems in the body shutting down. Glucose like all other nutrients are derived from the food we eat. The food is digested and absorbed within the alimentary tract that runs from the mouth to the anus. The stomach and intestines (gastrointestinal tract) are the main sites for digestion and absorption. The nutrients then enter the bloodstream and travel to the liver where it is processed further. Other organs like the pancreas play a role in managing the nutrient levels within the body and its availability to the body’s cells. The pancreas specifically impacts on the blood glucose levels by secreting the hormone insulin which lowers blood glucose levels by promoting the cells to take up more glucose from the bloodstream and stimulating the liver to convert the glucose into other storage forms like glycogen and even fat.
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