Habits and female diseases

Dr. Hooman-Khorasani
Posted in Uncategorized

Interestingly, these or those habits can provoke the appearance of various female diseases and problems, including candidiasis, cystitis, infertility, lack of orgasm, etc.

What can provoke candidiasis?

In the body of almost every woman there is a fungal infection, which until a certain time is in a dormant state. The presence of certain factors (habits) can lead to its activation and, as a consequence, to the development of a fungal disease, an example of which is candidiasis. Nutrition plays an important role in this process, namely: the use of simple carbohydrates (sweets), as well as yeast fermented products, such as beer or kvass. 

As you know, carbohydrates increase the level of glucose in the blood, and, accordingly, the production of glycogen by the vaginal epithelium, which creates favorable conditions for the occurrence of thrush. If we talk about beer, then it contains malt sugar, as well as yeast fermentation products, which can also give the green light to candidiasis. This is especially true for women who have previously had cases of this disease. If a woman has not previously suffered from thrush, the safe daily intake of sugary foods is approximately thirty to one hundred grams. If candidiasis occurs periodically – no more than thirty grams.

Of course, every woman’s body is different. And if for one the use of even a large amount of sweets does not cause such unpleasant consequences, then for the other, symptoms may appear even after a small piece of cake or a couple of sweets. There are many women who know this feature behind them. To solve the problem, there are two options: eliminate such foods from the diet completely, or reduce the portions consumed.

By the way, the habit of wearing tight jeans can provoke the development of a fungal infection, which is caused by constant friction in the perineum and the appearance of stagnation.

Moreover, young girls often begin to wear tight jeans from adolescence, when the pelvic bones have not yet formed. Meanwhile, this is also fraught with consequences. Gynecologists even have such an expression as “jeans basin”. A narrow deformed pelvis, which is completely non-physiological for a woman, is often the result of wearing very tight jeans.

When choosing, you need to give preference to loose jeans. Normally, the palm should pass freely between the belt and the body. This applies to both adult and children’s clothing.

Depilation: inflammation, infections

As practice shows, salon or home depilation, including shaving, opens the door for infection and can lead to various complications. One of the serious complications of depilation is bartholinitis .

In the vestibule of the vagina are two large paired glands called Bartholin’s glands. They are responsible for moisturizing the vaginal opening, including during intercourse. The Bartholin’s gland is connected to the vestibule of the vagina by a thin channel. If the infection gets inside, inflammation of the pathway may begin , accompanied by not very pronounced symptoms – pinpoint redness, discomfort.  

Inflammation of the Bartholin gland, caused by infection, disrupts the outflow of secretion due to blockage of the duct, and it begins to gradually increase in size. It all starts with a small pea-sized formation that can grow to seven to eight centimeters over time. An enlarged Bartholin gland is a medical condition that requires surgical treatment.

For safety reasons, a woman should use her own shaving razor and not be in the habit of taking her husband’s razor , for example. It is advisable to use disposable machines. The reusable machine must be treated with alcohol before use. It is better not to save on health and regularly change this personal hygiene item.  

To disinfect the genitals before depilation, you can mix fifty grams of water and two drops of tea tree oil. After depilation, you can treat the area with a mixture of tea tree oil – three drops and olive oil – twelve drops.

It has been scientifically proven that the use of poor quality toilet paper can cause various inflammations in women, including cystitis, urethritis, and the appearance of an ascending infection of the genitourinary system. Often, toilet paper is made from waste paper, which is treated with chlorine, mercury and many other hazardous agents at the production stage. Plus, dyes, fragrances, deodorizers, etc. are often added to its composition. The habit of using such paper can lead to dysbiosis, allergic complications (allergic urethritis, allergic cystitis). 

When choosing, it is better to give preference to toilet paper, not recycled, but primary processing, made from cellulose without adding any flavorings. Such paper is environmentally friendly and is usually labeled with the abbreviation PCF – Processed Chlorine Free .

What is the threat of the habit of wearing high heels?

Wearing high heels always means a lot of stress on the spine (and, accordingly, on the internal organs), veins, blood vessels, which can cause the appearance of congestion in the small pelvis. Often, even in young girls, during an ultrasound examination (ultrasound), doctors diagnose varicose veins of the pelvic organs, which negatively affects the nutrition of the uterus, ovaries, fallopian tubes. In addition to hormonal disorders and the formation of various kinds of tumors, congestion can cause infertility.

Shoes with high heels, stiletto heels are not intended for daily wear. You need to walk in such shoes no more than two to three hours a day. And the longer the heel, the shorter should be the time spent in the shoes. After wearing heels for a long time, it is useful to take a contrast shower, to provide the legs with an elevated position relative to the body, and to do a massage.

However, the absence of a heel is also by no means good for health, just like a high heel. An excellent option would be shoes with three to four centimeters heels with a loose, not narrow, toe.

Sleeping bed and feminine sensitivity

An improperly selected bed, pillow, mattress can also adversely affect women’s health. The spine is the exit site for most of the nerves that innervate the skin of almost the entire body, providing sensitivity in various places. Problems with the spine can sooner or later lead to a lack of orgasm, in connection with which a woman may begin to consider herself frigid.

Nutrition for fungal diseases

Dr. Hooman-Khorasani
Posted in Uncategorized

Mycoses, or fungal diseases, are very common diseases that can affect the human skin, mucous membranes, as well as nails and even internal organs. The occurrence of such ailments depends on various factors and requires a slightly different approach to treatment. Nevertheless, all mycoses have general principles of therapy, in particular, they require the organization of a special diet.

Why do you need a diet for mycoses?

Diet therapy for various fungal diseases is aimed primarily at:

  • Elimination of “feeding” of fungi. As you know, fungal microorganisms are able to feed on some of the foods that are present in the daily human diet. Such feeding helps pathogens to maintain their own vital activity, and also stimulates their reproduction.
  • Reducing the amount of fat on the menu. An excess of unhealthy fats has an adverse effect on the affected cells and makes it difficult to recover.
  • An increase in the volume of vitamin-containing products. Such food supports immunity and helps fight disease, as well as improves the condition of tissues affected by fungi and stimulates their recovery.  
  • Increase in fluid intake. Such a simple measure helps to remove waste products of fungi from the body, and also helps to cleanse the residues of drugs used to treat mycosis.

It is extremely important to adhere to the principles of dietary nutrition in the first weeks of treatment of the disease. Many doctors believe that adhering to a diet during this period is essential for a successful recovery.

To choose a diet, you need to make an appointment with a doctor

Of course, the basic principles of a diet for various mycoses can be easily found on the Internet yourself. But sometimes standard dietary patterns may not meet all the needs of the patient, for example, because of his particular taste preferences or the presence of certain medical indications.

Nutrition with the development of fungal diseases has certain characteristics:

  • Requires the exclusion of foods containing a significant amount of carbohydrates. It is these substances that are the main food for fungi.
  • Requires the rejection of products, the preparation of which involved the use of yeast or fermentation.
  • Based on the use of freshly prepared food. Insufficiently fresh food can also be a good breeding ground for the activity of pathogenic fungi.
  • Requires the elimination of the use of vinegar. Doctors believe that such a product contributes to a more active reproduction of fungi.
  • Means the ingestion of a significant amount of fresh food that has not been heat-treated.

In general, the diet for the treatment of fungal diseases requires a switch to lighter food, mostly vegetarian. Sometimes such changes in the usual menu become quite difficult for the patient and cause him a general deterioration in well-being, due to a reduction in carbohydrates in the diet. Possible obsessive hunger, a feeling of bloating and mild irritability. But after the restructuring of the body to a new diet, the state of health is normalized by itself, and the malaise is replaced by lightness and cheerfulness.

Prohibited food for fungal diseases

For the successful treatment of fungal diseases, it is necessary to completely abandon the use of:

  • Sugars and sweets such as sweets, cakes, biscuits, chocolate, pastries, and ice cream. It is also important to eliminate the intake of sweeteners.
  • Sweet pastries and white bread. Many doctors advise switching to yeast-free bread during treatment .
  • Sweet fruits and sugar beets.
  • Preserves, honey, jams, condensed milk and all kinds of syrups.
  • Vinegar, vinegar sauces and various marinades.
  • Canned fruits (they contain a lot of sugar), as well as vegetables (they contain a lot of vinegar).
  • All kinds of smoked meats and pickles (in particular, mushrooms, fish, etc.).
  • Fresh milk (it is the source of milk sugar) and moldy cheeses.
  • All kinds of drinks, the preparation process of which is associated with fermentation.
  • Fruit juices (they contain a lot of sugar).
  • Alcoholic drinks (especially beer). Alcohol contains a lot of substances that promote the growth of fungi, and in addition, increases the permeability of the intestinal walls and helps suppress the immune system.
  • Fatty, fried foods, as well as sausages, canned food and semi-finished products.
  • Carbonated drinks.
  • Food containing starch.

Most of the listed products are generally unable to benefit the human body. Therefore, rejection of them will contribute not only to recovery from mycosis, but also to overall recovery.

Allowed Products

Patients with mycoses of various localization can include in their diet:

  • Fermented milk products without additives (flavorings, sweeteners, etc.). Low-fat cottage cheese, natural yoghurts, fermented baked milk, whey and kefir will benefit.
  • A significant amount of a wide variety of fresh vegetables.
  • Unsweetened fruits.
  • Various berries, for example, sea buckthorn, cranberries, raspberries, etc.
  • Lean meat and fish.
  • Cereals, especially brown and brown rice, as well as buckwheat, corn grits, millet and oatmeal.
  • Nuts.
  • Legumes.
  • Eggs.
  • Pasta made from whole grain flour.
  • All kinds of greens.

The basis of the diet for mycoses is a correct, healthy and balanced diet. Doctors usually advise eating about 5 times a day, with an interval of 3 hours between meals. It is also important to maintain an adequate drinking regime – drink about 1.5 liters of clean water per day (in the absence of medical contraindications).  

Fungal infection of ENT organs

Dr. Hooman-Khorasani
Posted in Uncategorized

Fungal infection is currently an urgent problem in medicine. According to WHO, about 20% of the world’s population has diseases of fungal etiology. Diseases caused by fungi are called mycoses. Specialists dealing with the treatment of this pathology are mycologists, infectious disease specialists. However, a fungal infection can occur in the practice of a doctor of any specialty due to the high prevalence and steady growth in the number of diseases of mycotic etiology.

Mycotic infection: causes of development

Physicians are especially worried about severe fungal infections, which are characterized by a long chronic course, severe intoxication of the body, relapses and resistance to therapy. These include mycoses of ENT organs – ear, throat, nose.

If earlier it was believed that mycoses are diseases characteristic of countries with a tropical climate, today they can be found everywhere.

A person can get a fungal infection at any age. The disease is caused by opportunistic fungi – Candida , Geotrichum , Penicillium , Aspergillus , Mucor , etc. However, some people get sick when they encounter a fungus, while others do not. This happens because a healthy organism is able to suppress the growth and reproduction of conditionally pathogenic flora, preventing the development of the disease. With a decrease in protective forces, fungi begin to lead a parasitic lifestyle on their host, fungal diseases develop.

In the modern world, the following factors contribute to the development of mycoses:

  • Increased background radiation;
  • Unfavorable ecological situation;

At risk are patients with the following diseases:

  • Immunodeficiency states;
  • Diseases of the blood; 
  • Oncological diseases;
  • AIDS;
  • Diabetes;
  • Bronchial asthma.

Fungal diseases are more often affected by persons who receive long-term antibacterial, hormonal or immunosuppressive therapy.

Diseases of fungal etiology of ENT organs: pathogenesis

To develop the disease, the fungus needs to go through several stages:

  • Get on the mucous membrane;
  • Attach;
  • Grow and reproduce.

In severe mycoses, the fungal infection spreads into the blood, and then with the blood stream can penetrate into other organs, forming secondary foci. This is how disseminated forms of fungal infection of ENT organs develop. 

The clinical manifestations of a particular fungal infection depend on the location and type of pathogen. But there are symptoms that unite mycoses of ENT organs: 

  • The presence of a discharge on the mucous membrane – it can be crusts, plaque, liquid or thick secretions (the color and consistency of the discharge depend on the pathogen).
  • Pronounced phenomena of intoxication of an organism (fever, weakness, pain in muscles).  

Another characteristic sign of a fungal infection is the imperceptible onset of the disease and a long and persistent course with the presence of periodic exacerbations, the lack of effect from antimicrobial therapy.

Mycotic otitis media

Mycotic ear diseases – otomycosis – occupy a leading position in the list of fungal infections of ENT organs. The disease is characterized by the fact that fungi settle and multiply on the skin of the auricles, external auditory canals, eardrum, and in the middle ear cavity.

The most common cause of mycotic otitis media is the fungus of the genus Aspergillus . It is the most common fungus in nature. The disease caused by these pathogens is called aspergillosis.

In order for otitis media to develop fungal etiology, changes in the human body are necessary:

  • Inflammatory diseases are favorable conditions for the life of a fungal infection in the ear and the development of mycotic otitis media, since the exudate released during inflammation is a good breeding ground for these microorganisms.
  • Also, fungi need moisture, which rises in the external auditory canal in some diseases, for example, eczematous lesions of the ear skin.
  • Another “favorable” human disease for the fungal flora is diabetes mellitus. In “diabetics” the formation of earwax is increased, and glucose is found in its composition – “food” for the growth and reproduction of fungi. 

Typical complaints with fungal otitis media are:

  • Discharge from the ear
  • Formation of crusts, plugs;
  • Itching in the ear;
  • Dull pain or tenderness in the ears;
  • Feeling of congestion;
  • Decreased hearing.

Sinusitis of fungal etiology

Chronic sinusitis is a very common disease in the practice of an otolaryngologist. A large number of sinusitis has a bacterial etiology, but recently more attention has been paid to sinusitis of a mycotic nature, due to the increased frequency of diagnostics of this pathology.

Some authors argue that in almost half of patients suffering from chronic inflammation of the paranasal sinuses, the cause of the disease is fungal flora or fungal- bacterial associations.

Clinically, fungal sinusitis is quite difficult to differentiate from bacterial, because it does not differ in localization – most often it also affects the maxillary sinuses.

Symptoms:

  • Nasal congestion (unilateral or bilateral);
  • The presence of discharge from the nose, the nature of which depends on the pathogen;
  • Itching in the nasal cavity;
  • Headache;
  • Pain along the trigeminal nerve;

Fungal sinusitis is distinguished by a long, persistent course and the absence of a therapeutic effect from the use of antibiotics.

The defeat of the fungal flora of the pharyngeal mucosa is called pharyngomycosis . The causative agent of this disease is most often fungi of the genus Candida , less often Aspergillus .

Pharyngomycosis proceeds with the following symptoms:

  • Unpleasant sensations in the throat: itching, burning, soreness , soreness ;
  • A moderate feeling of pain, unpleasant sensations intensify when eating irritating food – spicy, salty, hot.

These changes can be accompanied by a deterioration in general well-being with a rise in temperature, weakness, etc.

When examining the patient, attention is drawn to the swelling of the pharyngeal mucosa and the presence of plaque on it. The color of the plaque depends on the type of pathogen – it can be white when infected with Candida , yellow when infected with Aspergillus .

The presence of fungal diseases is a “marker” that something is wrong in the body. A healthy person should not become a “victim” of mycotic infection.

Fungi parasitize in the body with a decrease in immune defense, the development of serious diseases (diabetes, AIDS), irrational use of antibiotics, hormonal drugs, unfavorable environmental conditions, and poor living conditions.

Is a fungal infection dangerous – candidiasis?

Dr. Hooman-Khorasani
Posted in Uncategorized

With candidiasis, or, more simply, “thrush” at least once in their lives, 3/4 of women face. Moreover, the disease can affect completely different parts of the body and organs, bringing significant discomfort to the patient. The disease affects men to a lesser extent, but they also occasionally have to ask the question: “What is this?” The symptoms of vaginal candidiasis are sometimes mistaken for a manifestation of a sexually transmitted infection. In fact, in addition to some similarities in symptoms, candidiasis is not a sexually transmitted disease. 

Causative agents of candidiasis

In everyday life, a person constantly encounters yeast-like fungi of the genus Candida spp ., Without noticing it. They are everywhere – in the air, in water, in soil, in food. Being even in the human body, microorganisms do not detect their presence until a certain point. As long as the immune system controls their reproduction. As soon as the body’s defenses weaken, yeast begins to accelerate colonization of the mucous membranes of the oral cavity, vagina and rectum, causing inflammation.

The second provoking factor is taking antibiotics. As a result, not only pathogenic, but also beneficial bacteria are suppressed. The natural balance of microflora is disturbed. The vacant place is immediately occupied by Candida mushrooms, because nothing is holding back their growth. In this case, candidal infection is interpreted as a complication of drug therapy. 

At risk are people with diabetes, hormonal problems, malignant tumors and pregnant women.

Being a non-life-threatening disease, candidiasis, nevertheless, can spoil intimacy, create physiological and psychological discomfort. 

What organs are infected?

The favorite place of “residence” of Candida fungi is the mucous membrane of the oral cavity, genitals, intestines, skin and nails. It is in these organs that the inflammatory process begins as a result of the uncontrolled multiplication of microbes.

The skin lesion usually concentrates in the places most often in contact with water, for example, when visiting the pool and sauna (skin of the toes, nail plates on the legs). If untreated, dermatomycosis (a skin form of a fungal disease) may develop a complication – microbial eczema.

Vaginal candidiasis is diagnosed with inflammation of the vagina, and urethrogenic – the urethra in men.

The microorganism can feel great in the intestinal tract (intestinal form) with the development of specific symptoms.

Oral candidiasis is characterized by the occurrence of inflammatory foci on the mucous membrane of the pharynx and esophagus.

Depending on the site of localization of the infection, superficial, visceral and intermediate mycosis are distinguished.

Fungal infection can complicate granulomatous inflammation, often accompanied by the formation of abscesses. In this case, the disease is difficult with general malaise, joint pain, bowel disorder. Ulcers can form not only on the surface of the skin, but also on internal organs such as the liver and lungs.  

Most mycoses pass against the background of a weak immune reactivity of the body. However, additional factors for the development of infection in the oral cavity are mucosal trauma, improperly placed dentures, excessive consumption of simple carbohydrates and foods containing yeast.

Candidiasis in the mouth can be both acute and chronic. In the first case, the duration of the disease should not exceed 2 months. The course of inflammation is possible both with the formation of a whitish plaque in the form of a curdled film, and without it ( pseudomembrane and atrophic forms, respectively). The plaque is easily removed with a spatula, after which an eroded, edematous surface remains . Most often, the patient experiences a sensation of a tightly tightening hoop around the throat.

If the patient experiences a sore throat, then we are talking about an atrophic form. It proceeds without plaque formation. The mucous membrane at the same time looks fiery red and dry, acute soreness is typical. In this case, candidiasis can be distinguished from other throat diseases due to the absence of other body reactions – the temperature does not rise, the lymph nodes do not increase. 

Vaginal candidiasis

Recently, doctors have recorded the growth of vaginal candidiasis almost twofold. At the same time, the number of his relapses also increases. Some patients have to constantly take antifungal drugs, which increases the resistance of the pathogen to antimycotic drugs.

The development of fungal infection of the vagina is additionally promoted by: non-compliance with hygiene rules, overweight, prolonged use of intrauterine contraceptives and birth control pills.

The clinical picture with vaginal candidiasis is pronounced: itching, burning, profuse white discharge. The unpleasant sensations intensify after intercourse, taking a bath and while sleeping. The urinary tract may also be involved in the pathological process, which entails a urinary disorder.

Pregnancy and vaginal candidiasis

Fungal infection is especially active in causing vaginal candidiasis in pregnant women, since pregnancy leads to hormonal changes. This category of women is vulnerable to almost all pathogens of chronic intrauterine infections, which is fraught with infection of the fetus, the development of placental insufficiency, malformations and threats of termination of pregnancy.  

Of course, the placenta becomes a powerful barrier to the entry of fungi. However, with a particularly neglected “thrush” and it will be overcome. But when a child passes through the birth canal, the risk of infection increases significantly. The crumbs will have a white coating on the gums and tongue. The discomfort will make it difficult to suckle at the breast, and as a result, crying and loss of appetite. Development of stomatitis, glossitis, gingivitis is possible.

Treatment of any infections, including parts of the urogenital tract, in pregnant women is associated with certain difficulties – drugs should not have a negative effect on the fetus.

What nails say: 10 signs of disease

Dr. Hooman-Khorasani
Posted in Uncategorized

Occasional cracks, redness, blue discoloration, or whitish lines on the nail are usually seen after minor trauma that gradually heals and the nail bed heals. But if fingernails change color, shape, texture for a long time, then this can be an early warning sign of serious health problems. In the presence of one of the following signs, there is a reason to see a doctor and be examined in order to exclude dangerous diseases.

1. Pale and thin fingernails

If your fingernails look thin and pale, this may be a sign that your body is not getting enough iron. Deficiency of this essential trace mineral reduces the amount of oxygen that the blood carries throughout the body . You should try to increase the amount of foods rich in iron in your daily diet (beef liver, red meat, dark leafy vegetables, legumes, etc.). After consulting with a specialist, you can take a course of vitamins or dietary supplements fortified with iron. 

Since iron deficiency in the body is closely associated with anemia, persistently thin and pale nails may indicate the onset of this unpleasant disease. If, in addition to pale nails, a person often feels fatigue, drowsiness, dizziness, then he needs to get a blood test as soon as possible in order to find out about the exact diagnosis and, if necessary, start treatment. 

2. Pale nails with a bluish base

When sugar is poorly absorbed by the body, lack of energy and nutrients can lead to pale nails, just like iron deficiency. However, in this case, the crescent-shaped base of the nail is usually tinted bluish. Most often this happens with an insulin deficiency or diabetes, when the functions of the liver and pancreas are impaired. This stops the production of enzymes needed to regulate blood glucose levels. If you suspect diabetes (along with other characteristic signs), you need to take a sugar test, consult a doctor and try to limit the consumption of sweets.

3. White stripes

Fingernails marked with several pale gray or white stripes along the horizontal may indicate a lack of protein in the body. Most likely, the person in this case is too carried away by the consumption of fiber and carbohydrates. Meat, legumes, nuts, seeds, fish and others will help add protein to the body. After the diet is normalized, the whitish stripes on the nails usually disappear. In some cases, nails with these streaks can report kidney and liver problems. Only a doctor can correctly diagnose these diseases.

4. Yellowish tint

Loose and brittle nails on the legs and arms with a yellowish tinge most often indicate the presence of fungal diseases on the nail plate and skin of the fingers. Fungal infections develop actively between the nails and skin. It can be very difficult to get rid of this misfortune. The easiest way to do this is at the initial stage of the disease. In an advanced form, treatment can last for several years. However, medications prescribed by a doctor often cause unwanted side effects.

But the fungus is not always to blame for the yellowish tint of the nail plate. This symptom often occurs in those who suffer from liver disease. If at the same time the nails began to grow much more slowly, then, perhaps, there are problems with the functioning of the lungs, including such serious diseases as emphysema or pleurisy.

5. Redness at the base of the nail

If redness is observed at the base of the nails and the color of the nail “crescent” seems brighter than the usual pink tint, then this may indicate poor blood circulation and a bad heart. When redness appears irregularly as reddish lines around the cuticle or the sides of the nail plate, it could be a sign of an autoimmune disorder like lupus. With it, the body begins to attack its own healthy tissues, mistaking them for pathogens or foreign substances. If redness is noticeable on the entire nail plate, it is often associated with erythremia – a type of leukemia, a tumor disease of the hematopoietic tissue.  

6. Bluish or purple nail plate

The bluish-purple color of nails most often indicates problems with the heart, blood circulation and blood vessels. These can be congenital heart defects, arrhythmia, tachycardia, angina pectoris, etc. In this case, poor blood flow deprives the nails of oxygen, so the skin under them turns blue or takes on a cold dark purple hue. To rule out this fact, it is best to take blood tests, undergo a cardiogram and talk to a cardiologist.

7. Dark stripes

If there are one or more dark brown stripes along the entire length of the nails, formed for an undefined reason (not a bruise or a bruise), and dark brown spots and moles began to appear more and more throughout the body, then the development of skin cancer may have begun. If you have such suspicions, you should immediately consult a doctor to clarify the diagnosis and, if necessary, start urgent treatment. In addition to occupational therapy, it is beneficial for cancer to include more antioxidant-rich foods in the diet. This will help slow down the further spread of free radicals that damage healthy cells in the body.

8. Uneven nail plate

Nails marked with many small pits can signal an early stage of psoriasis, an inflammatory skin disease that subsequently leads to large, painful rashes all over the body. Irregularities in the nail plate can also occur with fungal infections, or after physical injury to the nail.

9. Brittle or thin nails

Lack of nutrients has a negative effect on the health of nails: they become thin and brittle. But sometimes this condition of the nails, along with a constant feeling of fatigue for no apparent reason, are symptoms of hypothyroidism – a disease in which the thyroid gland does not produce enough hormones to maintain the body’s metabolism at the proper level. If, in addition to brittle nails, a person experiences bouts of nausea, is rapidly gaining weight and begins to hear poorly, then he should visit an endocrinologist.

10. Flaky nails

Nails exfoliate for a variety of reasons: vitamin deficiency, stress, fungus, lack of calcium, improper care, allergies, injuries, etc. But if the nails begin to exfoliate and easily separate from the nail bed for no apparent reason, then this may indicate an excess of thyroid hormones.

About newborn infections

Dr. Hooman-Khorasani
Posted in Uncategorized

It is extremely important to conduct sanitary and educational work among the population, discuss issues of care in a family where there is a child.

A special place is taken by the care of premature babies, children with developmental defects and in the pathological course of childbirth in the mother. In this risk group, dispensary observation is carried out.

A significant number of postoperative complications are associated with nosocomial infection. The hospital properly isolates infected patients from non-communicable patients. A large number of visitors are not allowed in their rooms.

Infectious processes in newborns can both develop independently and pass in utero from the mother.

When clarifying the causes and mechanisms of the development of the disease, the following main tasks are solved:

– determination of the developmental period at which intrauterine infection could occur (the disease was detected after birth):

– having determined this period, assess the possible harmful effects to which the mother and the fetus could be exposed. Determining the time of the onset of infection is not such a difficult task when it comes to individual diseases, the defeat of which occurs at certain intervals of development of the embryo, fetus and newborn. In the early stages of embryogenesis (embryo development), an inflammatory response is impossible due to the absence of inflammatory cells and immune response in the body of the embryo. However, during this period, harmful factors, acting on the embryo, can cause the formation of defects of organs and systems (the so-called teratogenic effect, from the Greek. “Freak”), And acting on the mother and fetus, when the organs are already formed, most often these factors cannot cause vice. Infections during this period cause organ dystrophy, which, if not leading to fetal death, then affects the child after birth. In dystrophic organs, inflammatory reactions are prolonged more and more progressively, the sensitivity to other infections is high, which sooner or later affects the functions of the organ, leading to its failure and cell death. The factors acting on the fetus in the last months of pregnancy lead to structural changes in the fetus. During childbirth, mechanical damage occurs more often, infection of the mucous membranes and skin. 

Thus, on the basis of the characteristic manifestations in most cases, it is possible to establish the period in which the harmful factor acted. Many factors can even terminate a pregnancy.

There are three stages in the development of the embryo, fetus, newborn:

– embryonic;

– fetal:

a) antenatal (early and late);    

b) intranatal;    

– neonatal.

The embryonic period – from conception to 8 weeks, is characterized by the formation of the head, trunk, limbs, all internal organs. When exposed to teratogenic factors during this period (ionizing radiation, thermal factors, mechanical damage, hypoxia, hormonal disruptions, chemical toxins, hypovitaminosis or hapervitaminosis, anemia, viral, bacterial, fungal and other influences) the state of the embryo is directly disturbed, malformations occur with subsequent defects or fetal death. Diseases during this period are called embryopathies. These include most of the developmental defects confirmed by infectious embryopathies. For the first time, infectious embryopathy was discovered by N. Greg (Sgedd) with measles rubella. In the cells of the embryo, conditions for the development of the rubella virus are favorable, and the mother’s disease with measles rubella in the first 3 months of pregnancy leads to congenital cataract (clouding of the lens), more often bilateral paralysis; in second place are the occurrence of heart defects and microcephaly (a decrease in the total volume of the brain), abnormal development of teeth – their late eruption, the absence of tooth rudiments, insufficient development, violation of enamel formation. The defeat of the lens most often occurs when the mother is sick with rubella in the 5th week of pregnancy; at 6-7 weeks, the disease leads to heart defects; deafness develops at 8-9 weeks. Rubella in a mother during pregnancy for more than four months does not lead to embryopathies, however, damage before conception will lead to malformations. 

The fetal period is divided into antenatal and intrapartum. The early antenatal period (from 9 to 28 weeks) is characterized by rare, but possible occurrence of malformations, the formation of the ability to inflammatory reactions. Thus, an infection affecting the fetus can cause organ dystrophy or miscarriage. Late antenatal period (from the 29th week before childbirth) – manifestations of infectious pathology in this period are usually called late fetopathies. 

The intrapartum period (the period of childbirth) is characterized by possible mechanical effects on the child. Compression of the umbilical cord leads to circulatory disorders, oxygen starvation. Long-term compression of the skull also leads to impaired blood circulation in the brain. A long anhydrous interval (from the discharge of amniotic fluid to the birth of the child) leads to an ascending infection from the vagina into the uterus and fetal damage. During this period, the diseases are called intranatal fetopathies. Here, aspiration pneumonia (inhalation of infected amniotic fluid into the child’s respiratory tract), gonorrheal conjunctivitis, most of the pustular skin lesions, herpes simplex with damage to the mother’s birth canal, and fungal infections can occur. 

The neonatal period lasts up to 28 days of a child’s life (early) and from 28 days – late. In the first week, the flora colonizes the mucous membranes of the skin, the baby’s digestive tract. Infectious neonatopathy occurs relatively often as a result of imperfect defense reactions. Premature babies are especially often affected by infections. 

Infectious diseases of a newborn that arise in utero are classified by different authors as fetopathies, and not as neonatopathies. True neonatopathies include diseases that become infected after the birth of a child. These are diseases such as anphalitis (inflammation of the umbilical residue), which can be complicated by umbilical sepsis, intrauterine staphylococcosis, colibacelosis, candidiasis, pneumonia, erysipelas, etc.

Thrush in women: causes, symptoms, treatment

Dr. Hooman-Khorasani
Posted in Uncategorized

Thrush in women is a fairly common disease. Its causative agent – the fungus of the genus Candida ( of Candida ). In healthy women, this fungus “lives” in the vagina in small quantities. But under some conditions, Candida begins to multiply actively, causing a disease – vulvovaginal candidiasis.

Specialists identify several risk factors that contribute to the development of the disease:

pregnancy
prolonged wearing of an intrauterine device
tight synthetic clothing (especially underwear)
hormonal diseases (for example, diabetes mellitus)
immunodeficiency (for example, in chronic diseases of internal organs – pyelonephritis, bronchitis, tonsillitis, adnexitis, etc.) the
use of certain drugs (for example , antibiotics, hormonal drugs)

Typical manifestations of thrush in women:

itching
burning
cheesy discharge (not always)
pain, burning during urination, intercourse
pain in the lower abdomen
In some cases, thrush can be easily eliminated. But sometimes long-term treatment is required. The disease can come back again and again. This can be facilitated by chronic diseases of internal organs (gastritis, anemia, bronchitis, uterine fibroids, pyelonephritis, etc.), stress, antibiotic treatment, the use of hormonal drugs.

For the treatment of thrush, various antifungal drugs are used ( pimafucin , fluconazole, terzhinan , etc.). In each case, the drug, dose and duration of treatment should be selected by a gynecologist after examination. In addition to antifungal agents, the doctor may prescribe other drugs. For example, anti-inflammatory, tonic or immunomodulators.

Some experts recommend excluding foods that can cause allergies from the diet. Such a diet will help reduce swelling and inflammation of the mucous membranes.

With thrush, it is advisable to limit:

chocolate, sweets, sugar
honey
citrus
exotic fruits (mango, papaya, avocado, etc.)
strawberries
nuts

Research has been reported in the literature that a diet with limited sweets accelerates recovery from candidiasis.

In terms of hygiene, it is recommended to wear only cotton underwear. Synthetic does not allow air to pass through well, which the fungus will really like. Candida also loves humidity. Therefore, after using the toilet, gently pat your genitals with a soft cotton cloth. Try to do without underwear whenever you can (for example, while sleeping). This will improve ventilation, dry out the mucous membranes, which will adversely affect the fungus.

Treatment of thrush with traditional and alternative medicine

Dr. Hooman-Khorasani
Posted in Uncategorized

Unfortunately, now a rare woman does not face the problem of thrush. This fungal disease is accompanied by cheesy discharge and severe itching. The Candida fungus, which causes thrush, is always present in the body of not only women, but also men and even children, but it begins to multiply intensively, only if there is some malfunction in the human immune system.

There are a great many reasons for the onset of the disease – from uncomfortable or synthetic underwear to stress. You will have to deal with this individually with your attending physician (but more on that below).

This disease does not bring serious harm to health, but it sharply worsens the psychological state of the woman and the quality of life, so it is worth starting to fight it as soon as possible.

How to deal with this disease and how to prevent its appearance?

On these questions, the opinions of traditional and traditional medicine differ somewhat.

In the treatment of thrush with drugs, vaginal suppositories or tablets containing clotrimazole , miconazole or other antifungal agents are most often used . In difficult cases, such as chronic thrush or the ineffectiveness of suppositories and tablets, oral antifungal medications may be required.

Of course, drug treatment should be started after consulting your doctor. In parallel with symptomatic treatment, it is necessary to deal with the reason that caused such an unpleasant activity for a woman, a seemingly harmless fungus. Perhaps there are too many sweets in your diet, or the uncontrolled growth of the fungus is caused by taking antibiotics, hormonal drugs, or chronic stress.

The exclusion of all unfavorable factors will be the prevention of this disease.

Supporters of traditional medicine have their own recipes for combating this disease:

For prophylaxis and in parallel with treatment, it is advised to use tar soap for washing. It is also worth doing a comprehensive cleansing and healing of the body.

For the treatment of thrush with folk remedies, douching or tampons moistened with a decoction of medicinal plants are used.

Soda solution is most often used for douching, but this method is fraught with severe irritation of the vaginal mucosa. It is better to use a decoction of oak bark , calendula, sage, chamomile, carrot juice.

The method of treatment with tampons is also convenient. A tampon is made from a piece of cotton wool wrapped in a piece of bandage or gauze and tied with a thread. Tampons can be moistened with kefir or yogurt (this contributes to the formation of normal vaginal microflora). For antifungal effect, the tampon is moistened with a mixture of tea tree oils (2-3 drops) and calendula oil (1 tsp ).

But the most effective is an integrated approach to the treatment of this unpleasant disease with the methods of traditional and traditional medicine!

Itsenko-Cushing’s disease

Dr. Hooman-Khorasani
Posted in Uncategorized

Certainly, diseases occurring with disruption of the hypothalamic-pituitary-adrenal system are attracting more and more attention today. Itsenko-Cushing’s disease is no exception to the rule.

Itsenko-Cushing’s disease is a severe multi-symptomatic neuroendocrine chronic disease, in the pathogenesis of which the leading role belongs to the defeat of the hypothalamic-hypophyseal region, as well as to the violation of the regulatory mechanisms that control the hypothalamo-pituitary-adrenal system, the clinical picture of which is due to increased production corticosteroids (in particular, glucocorticoids) hyperplastic under the influence of increased secretion of ACTH by the adrenal glands. Hyperproduction of glucocorticoids can be a consequence of various pathogenetic changes, however, the clinical manifestations will be the same, since they do not depend on the cause of the hypersecretion of corticosteroids. In children, this disease is especially difficult, disfigures the appearance, leads the patient to disability. However, itsenko-Cushing’s disease is practically unusual for children. In adolescents, the disease often begins during puberty. Most often, this disease affects women aged 25-45 years. Itsenko-Cushing’s disease in the general population of people occurs in 0.1% of the population and determines the development of 0.5% of all cases of arterial hypertension. In 1932, H. V. Cushing described the clinical picture of this disease, but even earlier, in 1924, our domestic Voronezh neuropathologist N.M. Itsenko published his observations on patients. Along with the pronounced external manifestations of the disease, he found changes in the area of ​​the gray tubercle and in other parts of the hypothalamus. The assumptions of N.M. Itsenko that the defeat of the hypothalamic region is the leading one in the development of this syndrome was fully confirmed. That is why this disease is rightly called “Itsenko-Cushing’s disease.” It is important to distinguish between such understood as illness and Itsenko-Cushing’s syndrome. The latter term is used for adrenal tumors or for ectopic tumors of various organs (bronchi, pancreas, liver).

Development reasons

It should be noted that questions about the causes of Itsenko-Cushing’s disease are not among the finally resolved. According to most scientists, this disease can arise under the influence of various factors, which, in turn, cause all kinds of changes in tissues and organs, leading to the development of pronounced manifestations of pathology. Factors that have a damaging effect include traumatic brain injury, inflammatory changes in the brain (including the part of the hypothalamus that produces corticoliberin), all kinds of neuroinfections. The development of the syndrome after encephalitis with damage to the diencephalic sphere in patients is not often observed.

It is possible that the disease occurs in bronchogenic cancer, cancer of the thymus, thyroid and pancreas, uterus and ovaries.

Also, Itsenko-Cushing’s disease can manifest itself in various stressful situations, during puberty, pregnancy, after childbirth (which is explained by the special vulnerability of the hypothalamic and other parts of the central nervous system of the female body) and in other situations, which, in turn, can lead to a violation of control secretion of ACTH. The role of the hypothalamus in Itsenko-Cushing’s disease is undeniable, since the production of not only ACTH, but also other hormones changes. A decrease in the production of growth hormone in children is the root cause of a strong lag in physical development, and this pathology is rarely amenable to correction. Of particular importance in the development and course of the disease is attached to tumors of the pituitary and adrenal glands, primary cancer of the thymus gland. Many foreign scientists attribute Itsenko-Cushing’s disease to pituitary pathologies, developing in the form of an adenoma from cells that produce ACTH.

Pathogenesis, clinical picture and diagnosis

Throughout the history of the development of the doctrine of Itsenko-Cushing’s disease, various data were obtained that significantly enriched knowledge about this pathology. However, many questions related to the pathogenesis of the disease remained unclear. The mechanism of development of Itsenko-Cushing’s syndrome to this day seems to be a rather controversial phenomenon. The study of the pathogenesis of this disease has come a long and difficult path in its development. Some researchers gave preference to the functional significance of the hypothalamic-hypo-fizar-adrenal system. The defining cause of the disease, in their opinion, is a violation of the functions of the pituitary gland or adrenal glands. Other researchers did not exclude the possibility of participation in the development of the syndrome of impaired activity of the central nervous system. Today, most authors tend to give preference to the pituitary theory of the formation of Itsenko-Cushing’s disease, according to which it appears due to macro- or microadenoma of the pituitary gland, which produces a large volume of the hormone ACTH. Studies have shown that hypercortisolism (excess production of the hormone cortisol in the human body) is invariably found in Itsenko-Cushing’s syndrome. Accordingly, all the main clinical manifestations of pathology are associated with hypercortisolism. In modern medicine, it is accepted that the hypothalamus, adenohypophysis and the adrenal cortex form a single functional system, which determines the development of Itsenko-Cushing’s syndrome. With excessive production of ACTH, the adrenal glands increase in size and begin to intensively synthesize glucocorticoids. As a result, significant hormonal changes occur in the patient’s body. Nerve impulses begin to enter the hypothalamus, which stimulate its cells to produce a huge amount of special substances that activate the release of ACTH (adrenocorticotropic hormone) in the pituitary gland. Thus, an increase in the production of ACTH, which occurs as a result of the disease, causes bilateral hyperplasia of the adrenal cortex, a more significant production of corticosteroids, which, disrupting the metabolism in the body, eventually lead to pathological abnormalities (Itsenko-Cushing’s disease). Of course, bilateral hyperplasia is quite common, but small-nodular hyperplasia of the adrenal cortex can also occur. It is the adrenal cortex under the influence of ACTH that secretes into the blood an increased amount of steroid hormones, primarily cortisol. As a result, the development of characteristic syndromes of the disease is realized. The secretion of ACTH by the adenohypophysis is stimulated by the hypothalamus. This is how these three components function, forming a single system. The hypothalamus, in turn, is structurally and functionally associated with the cerebral cortex. With Itsenko-Cushing’s syndrome, significant changes occur in the functioning of the hypothalamic-pituitary-adrenal system. For example, this is expressed not only in a violation of the feedback mechanism, but also in a violation of the circadian rhythm. The content of 17-OCS (oxycorticosteroid hormones) in blood plasma during the day does not decrease to those values ​​that are characteristic of healthy people. The secretion of cortisol is increased, and at the same time, ACTH continues to be actively produced.

The diagnosis of Itsenko-Cushing’s syndrome in pronounced forms is not difficult, it is based on the clinical picture and the results of laboratory research. In addition, it is characterized by a rather pronounced symptomatology: an obese body with thin limbs, a round red face, a short neck, growth retardation and sexual development
with premature appearance of sexual hair growth , hypertension, osteoporosis (in particular, a change in the configuration of the vertebrae like fish vertebrae, spontaneous bone fractures), violation of fat, protein, carbohydrate and mineral metabolism. It is important to note that different clinical symptoms of the disease occur with different frequencies.

There are 2 degrees of severity of Itsenko-Cushing’s disease:

– mild form with moderately pronounced signs in the absence of complications; 

– a severe form, which is distinguished by the severity of the symptoms and the presence of complications (cardiopulmonary failure, steroid diabetes, severe mental disorders). 

Depending on the rate of development of clinical symptoms, a rapidly progressive (hypercorticism develops in 3-6 months) and torpid course of the disease (from one year or more) are distinguished. And finally, according to the international classification of diseases of the World Health Organization, Itsenko-Cushing’s disease is of the following types: unspecified, iatrogenic, idiopathic, pituitary origin, ectopic ACTH syndrome, cortisol hypersecretion.

When listing the complaints that lead the patient to see a doctor, it is probably necessary to highlight general weakness due to rapid fatigue, multiple changes in the skin. More rare are complaints associated with stomach ulcers and urolithiasis. Thus, complaints about a slowdown in age-related growth rates and sexual development in children and adolescents in combination with obesity with preserved normal mental development should lead a doctor to suspect that the patient has Itsenko-Cushing’s disease. Many children and adolescents may not have a clear centri-petal distribution of fat even in the presence of the disease. The suspicion is enhanced only with a combination of complaints of general weakness and rapid fatigue with a centripetal distribution of fat and characteristic changes in the skin and its appendages. The skin of patients is very thin, through it the subcutaneous vascular bed shines through, which is why the skin acquires a purple-cyanotic color (especially on the face). A marbled or reticular vascular pattern of the skin may be seen. For such patients, hypertrichosis (increased hairiness) on the face, chest and back is common, which occurs when exposed to an excess of androgens, the formation of which sharply increases with adrenal tumors and, for example, ovarian tumors. In children, increased hair growth appears on the forehead, cheeks, pubis, back and in the lumbar region. Fungal lesions of the skin and nails on the hands and feet are very common. It is important to note that in children and adolescents with Itsenko-Cushing’s syndrome, due to the high age-related metabolism, catabolic processes in the skin are much less pronounced than in adults, and this, in turn, greatly complicates the clinical diagnosis of the disease. As for obesity, excess fat accumulation occurs in 60-90% of patients with this syndrome, and in Itsenko-Cushing’s disease, the mass of adipose tissue is much higher than in patients with ordinary obesity, incorrect localization of fat cells in the body is formed: mainly on the abdomen, face, back, shoulders, neck, mammary glands, in the area of ​​the collarbones. The face takes on characteristic puffy forms, there is a hyperemia of the skin of the cheeks. The cause of obesity in Itsenko-Cushing’s syndrome lies in the phenomenon of hypersecretion (excess production) of the hormone cortisol, which increases appetite, and also increases the formation of glucose, which is certainly necessary for the synthesis of fats. On the surface of the abdomen, shoulders and other surfaces, characteristic stains of all kinds of color are formed – striae. They are the result of stretching the skin from increased fat deposits. The color of the stretch marks is determined by the color of the vessels located directly under the skin. With this disease, the formation of striae also occurs due to a pathological violation of protein metabolism, as a result of which the skin acquires increased sensitivity and is easily injured (due to atrophy of the epidermis and connective tissue). Any wounds heal extremely slowly, and this is the source of various postoperative complications. Edema of the lower extremities is common, but the cause is not heart failure, but increased capillary permeability. Spontaneous tendon ruptures are very rare. Also, one of the early signs of the manifestation of this disease in children and adolescents is a slowdown in the age-related growth rate. Along with a decrease in anabolic processes of protein synthesis and an increase in catabolism, bone growth lags in length. The growth and differentiation of the forearm bones in children with Itsenko-Cushing’s syndrome are, on average, 3 years behind. Cortisol, by decreasing collagen synthesis, stimulates the excretion of calcium from the bone. In addition, the absorption of calcium in the intestine is greatly reduced and its loss in the urine increases. After successful treatment of the disease, an improvement in recovery processes is observed first in the lower extremities, lumbar vertebrae, gradually spreading upward. Such processes occur more intensively in children and adolescents.

An integral symptom of Itsenko-Cushing’s disease are diffuse atrophic processes in the striated muscles, which result from a decrease in the amount of amino acids in the muscles.

This can be especially clearly noted on the example of the leg muscles in the standing position. Reduced muscle strength in the upper extremities. The manifestation of muscle hypotonia can proceed so strongly that the patient is not able to rise to his feet from a sitting position without additional help. Atrophy of the muscles of the anterior abdominal wall leads to an increase in the size of the abdomen. In patients with severe symptoms of the syndrome, changes in the cardiovascular system are often manifested. This is indicated by multiple disturbances in hemodynamic parameters. They are the main cause of death in patients with Itsenko-Cushing’s syndrome. Some have tachycardia, which is the result of increased activity of the sympathoadrenal system. Muffled heart sounds are possible. With a long course of Itsenko-Cushing’s disease, changes are found that indicate a decrease in the contractility of the myocardium (muscle tissue of the heart). Another manifestation of this disease can rightfully be considered arterial hypertension. Moreover, it was noted that an increase in blood pressure in the syndrome is more typical for children than for adults. As a rule, arterial hypertension is stable. In medical practice, an increase in systolic pressure to 220-225 mm Hg was noted. Art. and diastolic up to 130-145 mm Hg. Art. Here the main role belongs to corticosteroids. With the help of the latter, the level of sodium in the body and the amount of water in the walls of argeriol increase, and at the same time their clearance decreases. All this leads to hypertension, which, with a prolonged course, contributes to left ventricular hypertrophy and the development of heart failure, as well as a violation of the heart rhythm. This syndrome often occurs due to altered carbohydrate metabolism (due to a large amount of glucocorticoids). They contribute to the development of hyperglycemia. Despite hyperglycemia, serum insulin levels are also elevated. The detection in patients with this pathology of diabetes mellitus (in 15-35% of patients) or glucose tolerance of the diabetic type (in 20-90% of patients). There are few examples of a certain tendency of such patients to pneumonia, their abscession and more severe course. Patients have described gingivitis, loosening and loss of teeth, atrophy and hemorrhage in the cancellous substance of the maxillary and mandibular bones. There is evidence of a decrease in the production of gastric juice and the acid-forming function of the stomach. X-ray observation reveals edema of the mucous membrane and submucosa of the stomach, as well as gastritis. In addition, patients have pylorospasm, decreased intestinal motor function, hypotension, and weakening of the contractility of the intestinal muscle layer. Lesions of the kidneys and urinary tract in Itsenko-Cushing’s disease are very diverse and occur quite often. Patients are diagnosed with disorders in the functioning of the excretory system (kidneys), manifested in albuminuria, hematuria, cylindruria. There is also a decrease in the concentration of the kidneys. Pathological changes are found in urine tests, in the release of phenolsulfaphthalein, in samples for urine concentration. Other examined patients have urolithiasis, accompanied by chronic, sluggish pyelonephritis. The occurrence of kidney stones occurs due to osteoporosis of the skeletal system and increased excretion of phosphates and calcium with urine flow, which contributes to the formation of phosphate ioxalate stones. In addition to hypercortisolism, in patients with Itsenko-Cushing’s disease, disorders of the functioning of other endocrine glands are very often revealed. Changes in the sex glands are usually reversible. In boys, underdevelopment of the testicles and penis is observed, in girls, the development of the mammary glands and the formation of the menstrual cycle are inhibited. In most cases, menstrual irregularities are one of the first signs of illness. As for hematological changes, many authors note the presence of erythrocytosis in the active form of the disease. Almost half of the observed increase the number of leukocytes and granulocytes in the peripheral blood. Polycythemia and an increase in hemoglobin in the general blood test are noted, which occurs due to too high levels of male hormones (androgens). Also, about 50% of those suffering from Itsenko-Cushing’s disease have all kinds of mental disorders of varying severity and severity. Sometimes they even precede various physical manifestations of Itsenko-Cushing’s disease. The most common disorders are depression, mania, paranoia, memory impairment, euphoria, sleep disturbances or depressions, irritability, emotional instability and sometimes psychosis. Depression becomes more pronounced with an increase in the patient’s body weight. Careful monitoring of such patients is required to prevent suicide attempts. Along with the definition of all of the above symptoms, when making the final diagnosis, first of all, laboratory research methods should be used, which allow fixing the increased function of the adrenal cortex, i.e., hypercortisolism. Such tests include, for example, the determination of the rate of cortisol secretion, the content of corticosteroids in the plasma, the excretion of total 17-hydroxycorticosteroids in the urine, the determination of the plasma concentration of corticotropin, etc. When conducting a test with ACTH, for example, in sick children, there is a significant increase in blood and urinary excretion of 17-hydroxycorticosteroids (in the presence of an adrenal tumor, the content of 17-OCS in daily urine does not change with the introduction of these substances). Due to the action of dexamethasone, there is a decrease in the secretion of hydrocortisone and adrenal androgens. Methapyrone, in turn, leads to disruption of the synthesis of hydrocortisone and corticosterone. As a result, an increase in the release of intermediate products of hydrocortisone and corticosterone is observed in the blood and urine. If, after a test with methapyrone, the child’s urinary excretion of total 17-hydroxycorticosteroids increases, therefore, in this case, we are dealing with Itsenko-Cushing’s disease. According to the scintigraphy of the adrenal glands, after the administration of 19-iodine-cholesterol, hypertrophy of the contours of both adrenal glands is revealed, and in the presence of a tumor, one of the adrenal glands. A blood test shows polycythemia, lymphocytopenia, eosinopenia, and neutrophilic leukocytosis. The content of electrolytes in the blood serum often fluctuates within normal limits (except for potassium, the content of which in the blood serum is low), and in severe cases hypokalemic alkalosis and hypernatremia are observed. In addition, it is necessary to conduct hormonal tests, the essence of which is as follows: first, patients donate blood for hormones (corticosteroids), then take the medicine (de-xamethasone, synacthen, etc.) and after a while they take the analysis again. For a full-fledged diagnostic study, it is necessary to clarify the nature of the disorders of the circadian activity of the hypothalamic-pituitary-suprarenal system. It is necessary to determine the binding capacity of trans-cortin (a protein that binds cortisol and transfers it to a temporarily inactive state). To confirm the diagnosis of Itsenko-Cushing’s disease, it is necessary to identify an increased secretion of ACTH and corticosteroids.

A radioimmunological method of blood examination reveals a slight increase in the level of the hormone.

With the presence of a pituitary adenoma in the history of the disease, the increase in this hormone becomes significant. However, along with ACTH in the blood plasma of persons with Itsenko-Cushing’s syndrome, the presence of all kinds of peptides, for example, / 3- and d-lipotrophins, is noted. In contrast to ACTH, these peptides are more stable, and their plasma level practically does not change. Therefore, the determination of their increased content in blood plasma is an important diagnostic sign of the presence of Itsenko-Cushing’s disease in a patient. Plasma cortisol levels are also significantly increased in the presence of this syndrome. An important role is played by special functional tests with stimulation and suppression of the activity of the hypothalamic-pituitary-adrenal system (metapyrone test, dexamethasone tests (Liddle’s test), insulin-tolerant test, test with corticotropin-releasing factor, test with lysine-vasopressticolib, proberin ), as well as other special research methods that provide topical diagnosis of changes in the adrenal glands. In controversial situations, to detect the presence of endogenous and functional hypercorticism, a small test with de-xamethasone is performed. A negative small test with de-xamethasone and a positive large test allow the diagnosis of a pituitary tumor. With the help of X-ray examination, osteoporosis of the bones of the skeleton is revealed. Over the past decade, the principles and methods for the detection and subsequent treatment of Itsenko-Cushing syndrome have undergone dramatic changes, primarily due to the emergence of the latest developments in imaging the pituitary and adrenal glands. So, useful information about the state of the adrenal glands can be obtained by radioisotope and ultrasound examination. In addition, angiographic studies and computed tomography are widely used. These methods make it possible to identify tumors in cases where all other research methods give negative results, as well as to establish the exact location of the tumor, its size, direction of growth and relationship with the surrounding tissues. The presence of a microadenoma characteristic of Itsenko-Cushing’s syndrome is detected only through the use of computed tomography or tomography based on magnetic resonance. To study the state of the adrenal glands, arterio- and venography is used, however, this test is associated with a certain risk due to the reduced resistance of the body to infections in such patients. Itsenko-Cushing’s disease must be distinguished from obesity. For these purposes, it is necessary to study the content of hormones in the blood and their excretion in the urine, including conducting a test with dexamethasone, methapyrone (in obese patients, they give the same results as in healthy people). Also, obese patients have moderate arterial hypertension, impaired carbohydrate metabolism, and sometimes moderate hirsutism; striae are white and very rarely pink, the skin is not thinned, there is no muscle atrophy. Obesity is uniform. Among other things, it is required to make a strict distinction (ie, differentiate) Itsenko-Cushing’s disease with hypothalamic syndrome that develops during puberty. In the presence of this syndrome, patients have an increase in adipose tissue, high growth, a slight increase in blood pressure, pathological changes in monthly menstruation, sometimes even a violation of the carbohydrate balance in the body.

Treatment

Treatment of Itsenko-Cushing’s disease in children, as well as in adults, is a very difficult problem. Itsenko-Cushing’s disease is accompanied by a decrease in the body’s resistance to infections, and if treatment is not carried out, about 50% of sick children die from infections concomitant with the disease. Therefore, it is very important to carry out diagnostics in a timely manner and begin to carry out effective therapy for this syndrome as soon as possible. Treatment in the presence of this disease is advised to be carried out under the supervision of the staff of the endocrinology department. For each patient with this syndrome, his own method of treatment should be selected, which would be the only necessary and final one. The main indicator of what kind of treatment is preferable is considered primarily the year of birth of the patient, the nature of the course of the disease, indicators of the boundaries of the pituitary adenoma, the presence or absence of its increase, etc. It is obvious that in Itsenko-Cushing’s disease, treatment is aimed at stabilizing the secretion of ACTH and cortisol. Thus, the main goal of treating children with this disease is to trigger the reverse mechanism, i.e., to reduce the main manifestations. The main goal is: stabilization of cortisol and ACTH indicators in blood plasma, as well as balancing their daily metabolism and stabilization of cortisol indicators in daily urine. If a patient, 6 months after complete remission of the disease, re-develops the clinical and hormonal picture characteristic of this disease, and there is a continued growth of the pituitary adenoma, then this condition is considered a relapse. In the middle of the XX century. the only treatment for this disease was X-ray irradiation of the interstitial pituitary region. Radiation therapy is currently considered the most common treatment for this pathology. The effectiveness of such a therapy is based on the direct effect on a specific lesion focus, i.e., the pituitary gland. Currently, along with rational irradiation, drug, combined (radiation therapy in combination with unilateral or bilateral adrenalectomy) and surgical treatment are widely used. Of course, each method has indications and contraindications in a particular clinical situation. However, despite the success in the treatment of Itsenko-Cushing’s disease in children, many of them remain disabled. X-ray therapy is carried out according to fractional-intensive technique with increasing doses. X-ray irradiation is effective only in 50% of cases; it gives a pronounced effect only in a small part of patients at the very beginning of the disease. When using y-therapy, a small number of side effects are observed, but the therapeutic effect is only slightly higher than that of X-ray therapy. Usually, after a course of u-therapy, patients are prescribed reserpine – 1 mg per day for 4-6 months. In recent years, irradiation of the pituitary gland has been carried out using special “proton beams”. This method is called pituitary adenoma radiosurgery. It is more gentle than X-ray yi therapy and also more effective. However, it is used only for the treatment of patients with endosellar adenomas of the pituitary gland (and the size of the sella turcica should not exceed 15 mm in diameter), and it is not recommended for the treatment of children under 8 years of age. Patients 10-25 years of age with minor changes in the body and small pituitary hypertrophy are prescribed therapy with the primary use of proton irradiation of the pituitary gland. The efficiency of proton irradiation can be adequately assessed only 8-12 months after irradiation. Doctors refer to the advantages of proton irradiation: the need for only a single procedure that gives maximum efficiency with minimal changes from nearby tissues, as well as the lowest risk of subsequent complications. Proton therapy as an autonomous method of therapy for Itsenko-Cushing’s disease gives especially good and rapid results at a young age, with slight pituitary hypertrophy and in the absence of complications of the disease. Another method of treating the disease is d-therapy (in this case, irradiation is carried out using a d-apparatus, in which the source of ionizing radiation is cobalt), but it cannot be used as the only method of therapy. In addition to all the listed methods of radiation therapy, the implantation of radioactive metals (yttrium or gold) directly into the concentration of the adenoma is often used. Resorption of pituitary neoplasms often occurs after exposure to very low temperatures (cryosurgery). When carrying out this type of treatment, it is necessary to pay great attention to the proper nutrition of the child. Sick children are recommended a protein-vegetable diet, fasting days, food intake with a sufficient content of vitamins and minerals, as well as exercise therapy and taking anabolic drugs with severe osteoporosis. In addition, symptomatic therapy with potassium preparations, antidepressants, sedatives is carried out. Drug treatment is prescribed either as an independent method of therapy, or as an additional one (for example, to radiation therapy). Its advantage is the absence of irreversible consequences, of course, with the correct selection of doses of the drugs used. Drug therapy is prescribed when the body is normal, without sharp manifestations of the disease and neoplasms in the structure of the pituitary gland. Drug treatment of patients with Itsenko-Cushing’s syndrome is aimed at reducing the secretion of hormones corticotropin or cortisol into the blood. However, drugs usually cause an improvement in the patient’s condition only during their use; they do not cure the disease. Drug treatment consists in the appointment of drugs that reduce the formation of ACTH, and blockers of the biosynthesis of steroid hormones in the adrenal glands. The drugs that reduce the activity of the secretion of hormones of the adenohypophysis include: diphenine, reserpine, sodium valproate, y-aminobutyric acid, antiserotonin drugs: cyproheptadine (peritol, deseril) and methergoline; parlodel (bromcrip-tin). The main side effects are changes in appetite and increased sleepiness. Treatment is indicated for children with Itsenko-Cushing’s disease in preparation for surgery on the pituitary gland or adrenal glands. Parlodel is also used to treat this syndrome, but the effectiveness of such therapy is low. The adrenal cortex function blockers include: chloditan, trilostane, aminoglutethimide (elipten, orimethene) and its derivatives (mamamit), ketoconazole derivatives. Chloditan is a persistent drug; it persists for a long time in the patient’s adipose tissue (even 22 months after stopping therapy). The standard dose of 5-6 g, which is taken within 48-50 days, is well tolerated. Increasing the dose can cause anorexia, vomiting, diarrhea, and other side effects. The main negative manifestation of chloditan is considered to be its significant toxicity, as a result of which many patients are stopped from treatment, even without having completed half of the main course.

Prescribing chloditan therapy is unacceptable in women of reproductive age who are planning to give birth to a child in the near future (4-6 years).

Trilostane, on the other hand, has less pronounced therapeutic properties, although it is used to treat Itsenko-Cushing’s syndrome along with other drugs. The daily dose is 30 mg 4 times a day. The dosage is gradually increased under the supervision of a physician. In the case of using aminoglutemide, only 42% of patients showed clinical improvement and normalization of blood biochemical parameters. In the first 10 days after taking the drug, a rash may appear as a side effect. These studies have reliably confirmed that the combined treatment with ketoconazole and aminoglutemid promotes particularly severe atrophy and deterioration of adrenal function. In the treatment of the disease, the fastest and most pronounced positive result is given by the appointment of hormone therapy (estrogen). As medications, non-steroidal drugs (amphenone, methapyrone) are used, which by the mechanism inhibit the functioning of the adrenal cortex and disrupt the synthesis of hydrocortisone. However, in children, amphenone has not received widespread use, since with prolonged use it has a toxic effect on the liver, kidneys and nervous system. Unlike amphenone, the toxicity of metapyrone is very small, and this allows it to be widely used to treat Itsenko-Cushing’s disease. The course of treatment ranges from 2 to 60 months. Imidazole derivatives – ketoconazole and eto-midate have also found wide application in the treatment of this syndrome. The first drug has long been used as an antimycotic (antifungal) agent, but it was later proved that ketoconazole is able to reduce blood cortisol by blocking cholesterol synthesis. Etomidate also inhibits the synthesis of cortisol, when administered intravenously, it very quickly reduces the level of cortisol in the blood serum. It is important to note that all of the above drugs are used to treat Itsenko-Cushing’s disease in combination with various types of radiation and surgical therapy. Itsenko-Cushing’s disease is a very serious disease, the main characteristic of which is its inevitable progression. The prognosis for this disease depends on the duration, severity of the disease and the patient’s age and is not always considered favorable. Early detection of the disease predicts the most favorable outcome from the prescribed treatment. The prognosis is unfavorable in the presence of such a pathology as a neoplasm of the thymus gland; improves when it is localized only in the interstitial space. Therefore, with a long and severe illness, children are shown surgical treatment. Surgical interventions on the adrenal glands are considered the most difficult to carry out and quite dangerous. The risk of complications in the early postoperative period is especially great. The indications for surgical intervention are the rapidly progressing course of the disease, as well as the lack of effect from conservative treatment methods. It gives a rather quick clinical effect, but it leads children to chronic hypocorticism, for which they must use glucocorticoid replacement therapy for life. Single or bilateral adrenalectomy should only be used in combination with radiation therapy. Very often, after bilateral adrenalectomy, patients develop chronic adrenal insufficiency. Today, transsphenoidal adenomectomy is widely used (it is considered the safest and most effective). Its introduction into clinical endocrinology opened a new era in the treatment of Itsenko-Cushing’s disease. The purpose of the use of adenomectomy is made in the presence of strict and clear boundaries of the pituitary neoplasm. It is unacceptable to use this method in the presence of the last degree of severity of the disease or in the presence of unfavorably predicted somatic abnormalities. This type of treatment for Itsenko-Cushing’s disease can be repeated at any time after a previous neurosurgical intervention, as well as in case of recurrence of a pituitary tumor. In the opinion of most scientists, adenomectomy in the coming years should gain particular popularity due to its rapid and beneficial effect (in most successfully operated patients, there is an improvement in well-being, a decrease in appetite, headaches and a decrease in the main clinical manifestations of the disease, i.e., a decrease in blood pressure, weight loss body, as well as a decrease in the level of cortisol in blood plasma and in daily urine), no need for long-term substitution treatment and a short rehabilitation period. The final assessment of the effectiveness of adenomectomy is carried out no earlier than 6 months after the operation. In recent years, the method of destruction of the adrenal glands has been widely used, usually in combination with radiation therapy or adenomectomy. Complications associated with surgical intervention on the adrenal glands can be divided into 2 groups; operating and postoperative. The most common surgical complications include opening the peritoneal cavity, opening the pleural sinus, bleeding from the central adrenal vein and inferior vena cava. Early postoperative complications: widespread suppuration of the surgical wound, limited suppuration of the surgical wound, acute cardiovascular failure, post-injection abscess, etc. However, such children cannot live a full life like their peers. Due to great weakness and rapid fatigability, the full school load is difficult for them. Children grow poorly, boys do not develop sexually. In the future, many sick children become disabled. With a prolonged course of the disease, patients often do not have pathological abnormalities in the cardiovascular and skeletal systems that require special therapy. In addition to lowering hormone levels, doctors are also involved in the treatment of clinical manifestations of the disease. So, for example, with severe obesity, the patient is prescribed a diet with limited consumption of carbohydrates, triiodothyronine, and sometimes diuretic drugs. For the treatment of arterial hypertension, antihypertensive drugs are used, for the treatment of diabetes mellitus – special hypoglycemic drugs, in case of osteoporosis, the patient is prescribed vitamin B preparations or fish oil. For the treatment of other manifestations of Itsenko-Cushing’s disease, diuretics are used, as well as cardiac
glycosides. In addition, some patients after total adrenalectomy develop a pituitary tumor. In the treatment of Itsenko-Cushing’s disease, great importance is attached to surgical intervention on the adrenal glands in combination with non-operative methods. Sometimes positive effects are achieved when using combined treatment – unilateral total adrenalectomy with further X-ray therapy or drug treatment. Observations prove that embolization of the adrenal gland vessels can eliminate the hyperfunction of its cortical layer and avoid suprarenectomy. This observation is an example of effective treatment of Itsenko-Cushing’s disease by means of combined therapy – embolization of the arterial system of one adrenal gland and surgical removal of the other. With the appointment of further courses of treatment, patients have a significant drop in body weight. At the same time, there is a visible improvement in physical and mental health.

How to protect yourself from fungus

Dr. Hooman-Khorasani
Posted in Uncategorized

Everyone knows firsthand about the fungus. And probably everyone has met this insidious disease, which is also called mycosis. The disease belongs to infectious diseases and is caused by fungi. Fungi belong to the lowest class of plants that can live well on human tissues.

The fungus is used to multiplying in a weak alkaline or alkaline environment. But human skin has an acidic environment and fungus cannot develop in such an environment. But when a person begins to sweat, then such an environment becomes the most optimal for reproduction.

The most common type of fungus develops on the feet and between the toes. This type of disease is transmitted from one to another. It is not difficult to become infected with a fungus, because infected scales constantly fall from the skin. The most optimal environment for growing fungus is high humidity. Therefore, the most common places for infection are swimming pools, saunas and showers.

Most often, the fungus is located in the foot area due to excessive sweating and improperly selected shoes. These parasites perfectly tolerate dry air and lower temperatures, they just stop multiplying in such an environment. In the fallen off scales of the affected skin, parasites live for a very long time.

Symptoms and causes of the appearance of fungi on the feet and nails

1) Itching

2) Burning

3) Peeling between the toes and heels

4) The appearance of cracks

5) The skin may thicken

6) Scales appear

7) Nails become yellowish, greenish or brownish

8) The nail plate collapses

9) The nail becomes noticeably thicker or thinner and deforms

10) Spots, white or yellowish stripes may appear on the nails.

The causes of nail fungus can be reduced immunity, vascular disease on the legs, poor blood supply to the legs, diabetes mellitus, foot injuries, poor poor-quality shoes, increased sweating of the feet.

Preventive measures against fungus

If you follow a few rules, you can safely avoid meeting with a fungus:

1) It is worth choosing high-quality shoes so that the foot breathes. Don’t buy tight shoes, everything should be in size.

2) Do not walk with bare feet in public pools, saunas and showers.

3) Do not cut your nails with someone else’s scissors.

4) The material at the socks should be cotton, cotton allows the skin to breathe.

5) Wear gloves when washing dishes, floors and washing.

6) Don’t bite your nails. This is not only ugly, but also very harmful.

7) Everyone in the family should have their own towel.

Treatment of fungus on feet and nails

You can buy special anti-fungal creams and ointments at the pharmacy. Before applying ointment or cream, you need to thoroughly wash your feet with soap and dry thoroughly. It is also recommended to use a deodorant if you sweat heavily. It is also sold at the pharmacy. But all creams and ointments are very expensive, so folk methods can easily replace them.

1) There is an opinion that soda copes best with fungus. For such a fight, mix soda with water to make a gruel. And apply the resulting mixture on the nails and under them so that the soda gets on the skin. Let it sit for ten minutes and rinse well.

2) Great for fighting thyme fungus. Add three tablespoons of thyme to a glass of water and put on fire. Boil for five minutes. Then turn off the heat and cover. The mixture must be cooled. After it has cooled down, you need to treat the fungal spots with this mixture.

3) Apple cider vinegar will also help. Pour water into a bowl and add enough apple cider vinegar to tolerate. If your fungus manifests itself with ulcers and erosion, then this method will not work for you. Do this in the evening before bed for a week. After the procedure, you need to dry your feet well and put on clean socks.

4) Garlic will help. Take two to three heads of garlic. Pound to make a gruel. Add salt to the slurry and apply to the affected areas as an ointment.

5) An effective method that can help to cope not only with the fungus, but also with the sweating of the feet. Before the procedure, wash your feet with soap and dry. Then apply iodine to the affected areas. Take clean socks and add one teaspoon of boric acid. Put on your socks and wear them for a day. Usually, after one such procedure, the fungus disappears.