#nodular swelling

[jcmicr]

A rare case of bilateral plantar fibromatosis (Ledderhose’s disease): A case report by Amrutha Viswanath in Journal of Clinical and Medical Images, Case Reports  

Abstract

Ledderhose’s disease, also known as plantar fibromatosis is a rare, benign hyperproliferative disorder affecting plantar fascia with unknown etiology. Clinical presentation of the disease varies according to the stage of the disease and individual characteristics. Diagnosis of the disease is usually based on clinical findings. Histopathological examination, Ultrasound or MRI can be used to rule out other conditions and for confirmation of the disease. Plantar fibromatosis can mimic the features of plantar fasciitis especially in early stages of the disease, hence it should be considered as a differential diagnosis in patients with pain and nodules in plantar aspect of foot. In this case report, we present a case of 24-year-old male with bilateral plantar fibromatosis, which was managed by surgical excision of the nodules due to unresponsive conservative management.

Keywords: Plantar fibromatosis; ledderhose’s disease; heel pain; nodular swelling; plantar fasciitis.

Introduction

Plantar fibromatosis or Ledderhose disease, is a rare benign pathology of the plantar aponeurosis, first described by Dr. George Ledderhose. It is characterised by disordered fibrous tissue proliferation and the subsequent formation of lump or nodules over the plantar aspect of the foot. The Office of Rare Diseases of the National Institutes of Health listed it as a rare disease with frequency about 1–1.75/100,000 [1]. Although etiology of plantar fibromatosis is unknown, it is associated with Dupuytren’s disease (palmar fibromatosis), Peyronie’s disease (penile fibromatosis) [2]. Increased risk of its occurrence is associated with alcoholism, chronic liver disease, diabetes mellitus, long term anticonvulsive treatment for epilepsy and genetic factors [3]. Males are more commonly affected than females. 25% of cases with plantar fibromatosis present with bilateral disease [4]. Diagnosis of Ledderhose’s disease is usually established clinically. Initially the nodule is asymptomatic and it becomes symptomatic as it enlarges in size. Direct pressure on the nodule while walking barefoot, standing for long periods of time and use of restrictive shoes may exacerbate pain and walking disability. Over time, multiple nodules may develop and can cause exacerbation of symptoms, contractures and deformities [5]. Given the benign nature, initial phase of the disease can be managed conservatively and if symptoms persist, definitive management of surgical excision of nodule gives complete relief of symptoms. The nodular swellings affecting the plantar fascia is of greater significance in population with poor socioeconomic status as people prefer to walk barefoot in developing countries.

The similarities of plantar fibromatosis to Dupuytren's disease affecting palmar fascia support the theory that, two conditions are different expressions of the same disorder [6]. Even though much has been discussed about Dupuytren's contracture in the literature; only very few literatures are available regarding plantar fibromatosis. In this case report, we present a case of 24-year-old male with bilateral plantar fibromatosis and aims to discuss the clinical presentation and various management options in plantar fibromatosis.

Case Report

A 24-year-old male presented to our department with dull aching type of pain over the plantar aspect of both feet of 1-year duration. Pain prevented the patient from weight-bearing for long time and walking for small distances. There was no significant familial history of the disease or history of any associated trauma. No associated medical history in the patient. Patient gives history of treatment in another hospital as bilateral plantar fasciitis. Conservative management was given there in the form of analgesics, anti-inflammatory drugs, advice to use footwear with soft insole and gives a history of 3 steroid injections administered 4-6 weeks apart. With persistence of symptoms patient came to our department. On physical examination small, well circumscribed, palpable, firm, nodular, single swelling was present over the medial plantar aspect of his both feet. The swellings measured about 2 x 1.5 cm on the right foot and 1 x 1 cm on the left foot. The skin over the swellings appeared normal and there were no neurovascular deficits or deformities. Ankle joint and foot range of movements were within normal range. On further examination, we found a similar swelling of size 0.5 x 0.5 cm on the palmar aspect of right hand with no restriction of movements and clinical signs. FNAC report showed mild to moderately cellular oval to plumb spindle shaped fibroblastic cells with elongated nuclei arranged in clusters and dispersed pattern associated with myxoid matrix. Cytology findings were suggestive of benign fibroblastic lesion. A provisional diagnosis of bilateral plantar fibromatosis was made, based on clinical and cytological findings. Since conservative management was tried earlier and there was persistence of symptoms and limitation in function surgical excision of the nodules was planned. Surgery was performed under spinal anesthesia. Nodules on both sides were palpated and skin over it was marked for surgical incision. The dissection of skin and soft tissue exposed the nodules on both sides, which were greyish white in colour, firm in consistency and attached to plantar fascia (Figure 3).

Figure 1: Nodular swelling on right foot (dot circle).

Figure 2: Dot circle indicating the nodular swelling on right palm.

Figure 3: Exposed nodule ( Right foot ) intraoperative image.

Figure 4: Excised nodule from right foot (greyish white, measuring 1x0.8x0.2 cm).

Figure 5: Excised nodule from left foot (greyish white to greyish brown, measuring 1.7x1.5x0.4 cm).

Excision of the nodules were done in both feet and primary wound closure was done. The patient was advised for non-weight bearing for 2 weeks and use of soft insole footwear thereafter for 2 weeks. Postoperative period was uneventful and sutures were removed after 2 weeks of surgery.

Figure 6: Postoperative wound before suture removal.

The histopathological examination of the excised nodules revealed spindle-shaped cells with abundant collagen in a fibrous stroma background and features were consistent with the diagnosis of bilateral plantar fibromatosis. On follow up of 6 months, patient reported complete relief of symptoms and improvement in function.

Figure 7: Photomicrograph of HPE slide showing nodular lesion composed of spindle shaped cells in a fibrous stroma background. (H&E staining, x40).

Figure 8: Photomicrograph of HPE slide showing spindle shaped cells with abundant collagen in fibrous stroma(H & E staining , x100).

Discussion

Ledderhose’s disease (Plantar fibromatosis) is a fibrous hyperproliferative pathology affecting the plantar fascia characterised by formation of nodules [7, 8]. The diagnosis of Ledderhose’s disease is usually established clinically and rarely require further investigations for confirmation [9]. Histopathological analysis and diagnostic imaging helps to differentiate between other lesions that can present with similar symptoms such as plantar fasciitis ( The most common disorder of plantar fascia), lipoma , ganglion cyst, leiomyoma, epithelioid sarcoma, rhabdomyosarcoma and liposarcoma [10, 11]. According to the clinical and pathological studies, plantar fibromatosis can be classified into three stages. The first (proliferative) stage of the disease is characterised by cellular proliferation and increased fibroblastic activity. The second stage of the disease which is the active phase is characterised by formation of nodules. It is followed by the third (residual) stage where collagen maturation and tissue contractures occur [11, 12]. Therefore the normal plantar fascia is replaced progressively by abnormal collagen fibres and can present at any stage of the disease with pain, nodule, walking difficulty, contractures or deformities of toes and the treatment is planned accordingly.

Patients presenting in the early stage of the disease with no or mild pain can be conservatively managed with padded shoes with soft insoles or custom offloading to redistribute the weight from the nodules, analgesics, anti-inflammatory drugs and intralesional steroid injections[10,13]. If left untreated, nodules may gradually increase in size and number which in rare cases may result in deformities of the toes due to contractures in later stages. In cases with persistence of symptoms after conservative management, lesions which are progressive, severe limitation of function and in advanced stages of the disease surgical management is considered as the last resort of treatment [14, 15].

The nodular swellings affecting the plantar fascia is of greater significance in developing countries with poor socioeconomic status as people prefer to walk barefoot. For the same reason, early surgical management is indicated for symptomatic cases in the developing countries.

Conclusion

The diagnosis of Ledderhose’s disease can be done clinically alone. Diagnostic imaging such as Ultrasound or MRI and histopathological examination may be used, to exclude other conditions and to rule out malignancies [16]. The treatment of the disorder is planned accordingly. Even though plantar fasciitis is the commonest disorder affecting plantar fascia, plantar fibromatosis should be considered as a differential diagnosis in patients presenting with pain and nodules in plantar aspect of foot as it can mimic the features of plantar fasciitis. The recommended treatment approach is to start with conservative management in early stages of the disease and perform surgical excision in unresponsive cases and advanced stages. But the best treatment plan is to establish a personalised approach depending on the individual characteristics, type of symptoms, stage of the disease and recurrence.

Authors Disclosures:

Funding / Grants: Nil.

In this study, there was no competing interests or financial benefits to the authors.

Details of any previous presentation of the research, manuscript, or abstract in any form: Not presented anywhere.

Acknowledgement:

Authors declare no conflict of interest.

In this case report, there is no financial benefits to the authors.

For more details : https://jcmimagescasereports.org/author-guidelines/ 

[dratulkathed]

All About Acne by The Best Skin Doctor in Indore Dr. Atul Kathed

Introduction:

Millions of individuals worldwide suffer from acne, a common skin ailment that may be emotionally and physically distressing. Its causes, varieties, and therapies must be understood in order to manage it effectively. The Best Skin Doctor in Indore, Dr. Atul Kathed, offers insightful commentary and professional acne treatment guidance.

Understanding Acne by The Best Skin Doctor in Indore:

According to Dr Atul Kathed the Best Dermatology in Indore, a skin ailment known as acne arises from the accumulation of oil and dead skin cells in hair follicles. It usually appears on the face, forehead, chest, upper back, and shoulders and frequently takes the form of whiteheads, blackheads, pimples, and cysts. The main causes of acne are inflammation, germs, clogged hair follicles, and excessive oil production.

Types of Acne:

Dr. Atul Kathed, renowned as the best skin doctor in Indore, explains that acne can be classified into different types based on its severity and appearance:

Comedonal Acne: Comedone acne is characterized by blackheads and whiteheads and is brought on by clogged pores.

Inflammatory Acne: This kind contains red, swelling pustules and papules that are swelled as a result of inflammation.

Nodular Acne: Large, painful lumps under the skin’s surface called nodules frequently need to be treated by a professional.

Cystic Acne: The most severe kind, known as cystic acne, is characterized by painful, deep cysts that are packed with pus and may leave scars.

Causes and Triggers:

Acne can be brought on by or made worse by several things. Breakouts can result from hormonal fluctuations brought on by puberty, menstruation, pregnancy, and stress. Moreover, the use of comedogenic skincare products, a diet heavy in dairy and refined carbohydrates, and several medications can all exacerbate acne..

Treatment Options:

As the best skin doctor in Indore, Dr. Atul Kathed emphasizes a tailored approach to acne treatment, considering the severity and type of acne. Common treatments include:

Topical Treatments: Acne can be lessened with over-the-counter or prescription creams, gels, and lotions that contain retinoids, salicylic acid, or benzoyl peroxide.

Oral Medications: For moderate to severe cases, a doctor may prescribe antibiotics, hormonal therapies, or isotretinoin..

Procedures: To properly treat obstinate acne, professionals might use procedures including chemical peels, laser therapy, drainage, and extraction.

Skincare Tips for Acne-Prone Skin by The Best Skin Doctor in Indore:

Dr. Atul Kathed recommends the following skincare tips for managing acne:

Gentle Cleansing: Use a mild, non-comedogenic cleanser twice daily to remove excess oil and impurities.

Moisturizing: For hydrated skin that doesn’t clog pores, use moisturizers that are non-comedogenic and oil-free.

Sun Protection: Every day, use a broad-spectrum sunscreen to avoid hyperpigmentation and sun damage.

Avoid Picking: Refrain from picking or squeezing pimples to minimize the risk of scarring.

To Consult Best Dermatology in Indore Click Here

Conclusion:

Although acne can be difficult to treat, clear skin is possible with the correct advice and care. The Best Skin Doctor in Indore, Dr. Atul Kathed, provides knowledgeable counsel and individualized treatment regimens to assist people in successfully treating acne. Gaining knowledge about the origins, varieties, and remedies of acne will enable you to take proactive measures for improved, more radiant skin.

For more personalized advice and professional acne treatment, consult Dr. Atul Kathed, the best skin doctor in Indore, and embark on your journey to radiant skin

[paul2-health-and-wellness]

#Thyroid Disease

#Autoimmune Disease

There are several types of thyroid diseases, each impacting the production of vital hormones that lead to hypo- and hyperthyroidism. Here are some common thyroid-related conditions:

Hyperthyroidism: The thyroid produces hormones in excess, causing many body functions to speed up. It’s often associated with Graves’ disease or toxic nodular goiter.

Symptoms include restlessness, nervousness, rapid heart rate, weight loss, and bulging eyes (in Graves’ disease).

Diagnosis involves blood tests measuring thyroid hormone levels.

Treatment options include medications, radioactive iodine, or surgery.

Hypothyroidism: The thyroid does not produce enough hormones, leading to symptoms like fatigue, weight gain, and dry skin.

The most common cause is Hashimoto’s thyroiditis, an autoimmune disorder.

Treatment involves thyroid hormone replacement therapy.

Hashimoto’s Thyroiditis: An autoimmune disorder causing inflammation of the thyroid gland, leading to hypothyroidism and swelling (goiter).

Graves’ Disease: Another autoimmune disorder resulting in hyperthyroidism.

Thyroid Tumors: Noncancerous growths (nodules or adenomas) that can release excess thyroid hormones.

Thyroid Cancer: Malignant tumors affecting the thyroid.

Postpartum Thyroiditis: Thyroid inflammation following childbirth.

Remember that some thyroid diseases can be cured, while others require ongoing management. An estimated 20 million people in the United States have thyroid disease, and hypothyroidism is more common than hyperthyroidism.

For individuals with thyroid conditions, including hypothyroidism and Hashimoto’s thyroiditis, there are several reasons why certain foods are recommended to be limited or avoided. Let’s explore each of these:

Dairy:

Sensitivity to Dairy: People with Hashimoto’s thyroiditis tend to have a greater sensitivity to certain proteins found in dairy products. Additionally, a higher incidence of lactose intolerance is observed in those with Hashimoto’s thyroiditis.

Inflammatory Response: Consuming dairy may trigger an inflammatory response in the body, leading to the production of inflammatory chemicals. Chronic inflammation can negatively impact energy levels, mental health, and physical health.

Processed Dairy: Most forms of dairy available today are highly processed, containing added preservatives and hormones that can disrupt the digestive system and trigger inflammation.

Gluten:

Autoimmune Connection: Both hypothyroidism and Hashimoto’s thyroiditis have an autoimmune component. Gluten, found in wheat, barley, and rye, can exacerbate autoimmune responses.

Cross-Reactivity: Some proteins in gluten can cross-react with thyroid tissue, potentially worsening inflammation.

Leaky Gut: Gluten consumption may contribute to leaky gut syndrome, which can affect nutrient absorption and overall health.

Soy:

Goitrogens: Soy contains compounds called goitrogens, which can interfere with thyroid function by inhibiting iodine uptake. This can affect thyroid hormone production.

Estrogen-Like Compounds: Soy contains phytoestrogens that can mimic estrogen in the body. Excessive estrogen levels may impact thyroid health.

Genistein: Genistein, found in soy, can inhibit thyroid peroxidase, an enzyme involved in thyroid hormone synthesis.

Wheat:

Gluten and Autoimmunity: Wheat contains gluten, which can contribute to autoimmune responses. In some cases, gluten may worsen inflammation and thyroid dysfunction.

Gut Health: Wheat consumption may affect gut health, leading to leaky gut and impaired nutrient absorption.

Important Note:

Not all dairy products are problematic. Raw and fermented dairy can have redeeming nutritional qualities.

If you suspect sensitivity to any of these foods, consider lab tests or try eliminating them to observe how you feel.

Consult a healthcare provider or a dietitian for personalized advice based on your specific condition and need

[pillsblue]

How to Manage Acne with Acutret 10 MG ?

Acutret 10 MG Capsule is a medicine that contains isotretinoin. It is a naturally occurring derivative of vitamin A. This medicine is used for the treatment of a severe form of acne called nodular acne characterized by large, inflamed, painful acne lesions deep under the skin. It acts on skin glands to reduce the production of a substance called sebum that can cause acne or pimples. It also has an anti-inflammatory action which decreases the redness and swelling associated with acne.

Acutret 10 MG Capsule has some common side effects like cracked lips, dry eye, dry nose, dry skin and dry mouth. Consult your doctor if any of these side effects persist or bother you. Do not take this medicine if you are allergic to it. Acutret 10 MG Capsule should be taken with food.

Take this as prescribed by your doctor. Complete the whole treatment, even if you feel better after taking a few doses. Use skin protective methods like wearing sunscreen and having a balanced diet along with Acutret 10 MG Capsule for the Acne treatment. Acutret 10 MG Capsule is not recommended to be used in pregnancy and breastfeeding.

Inform your doctor if you have liver problems before taking this medicine. It is not recommended for use in children under 12 years of age. Acutret 10 MG Capsule may cause skin sensitivity to sunlight so it is advised that you avoid going out in harsh sunlight or take precautions like sunscreen.

You should avoid alcohol consumption while taking this medicine as it may cause severe side effects. Inform your doctor immediately if you experience and serious side effects like changes in mood or depression, dizziness, ringing in ears, headache, problems with vision, pain behind the eyes, increased thirst and urination while using this medicine.

When not to use?

Allergy

Avoid using Acutret 10 MG Capsule if you are allergic to isotretinoin or any other component present in this medicine. Seek medical help immediately if you notice any symptoms such as skin rashes, itching/swelling, Dizziness, breathing difficulty, etc.

Hypervitaminosis A

Hypervitaminosis A is a condition that occurs when you have too much vitamin A in your body. Symptoms of hypervitaminosis A include vision problems, changes in the skin, and bone pain. In such cases Acutret 10 MG Capsule is not recommended for use as it is also a derivative of vitamin A and it may worsen your condition.

Severe liver disease

Acutret 10 MG Capsule is not recommended for use if you have severe liver conditions as it may worsen your condition.

Dosage

Missed Dose

Do not skip a dose of Acutret 10 MG Capsule. If you forget to take a dose of this medicine, take it as soon as you remember. If it is time for your next dose, skip the missed one. Do not double the dose to compensate for the missed one.

Overdose

If you have taken more than the prescribed dose of Acutret 10 MG Capsule you may experience symptoms like vomiting, flushing, severely chapped lips, stomach pain, headache and dizziness. Consult with your doctor immediately in case of an overdose.

General Instructions

Take Acutret 10 MG Capsule as instructed by your doctor. Follow all the directions mentioned on the label. Do not take more or fewer doses than prescribed.

This medicine should be taken with food. The symptoms might get worse in the initial phase of treatment. It is advisable to avoid sunlight during the course of treatment. Take plenty of water and have a clean nutritious diet. Keep away from the reach of children and pets. Ensure that unused medicine is disposed of properly.

[miraridoctor]

Skin abscesses, also referred to as cutaneous or epidermal abscesses, are localized accumulations of pus that form under the skin as a result of bacterial infections. An abscess initially starts as a reddened, tender swelling that progressively fills... #Mirari #MirariDoctor #MirariColdPlasma #ColdPlasma

[lizseyi]

Why Is Breast Self Examination So Important  -Gibmed International Hospital

How should you check your breasts for signs of cancer?

It is widely recognised that when those who may be at risk of breast cancer take the time to examine their breasts, this can help them to identify any potentially concerning changes, which they can then report to a medical professional.

If you are reading this article, you are likely to appreciate how crucial breast self-examination can be for detecting any possibly worrying symptoms at the earliest possible stage.

It is important not to panic if you do think you feel a lump in your breast, as some women do have some lumps or lumpy areas in their breasts, and the majority of breast lumps turn out to be benign (non-cancerous). Examples of non-cancerous conditions in the breasts, which account for the majority of women visiting a breast clinic, include (but are not limited to) breast cysts, cyclical nodularity (fibrocystic disease), and benign nipple discharge.

Nonetheless, with breast cancer being the most common malignant disease among women, it is important to be alert to any potentially abnormal changes in the breasts. If such changes do turn out to be cancer, detecting them as early as possible will maximise the likelihood of the condition being treatable with good results.

So, with all the above in mind, here are some good tips to follow to ensure you carry out a thorough and effective breast self-examination.

Get accustomed to how your breasts normally look

Before we go any further, we should probably revisit the way we have phrased the title of this article. There is no “should” when it comes to checking one’s own breasts, as there is no right or wrong way to do it. However, if there is one thing that you might be especially well-advised to be mindful of, it is the importance of being aware of how your breasts normally look and feel.

One way in which you might ensure this, is by regularly looking at your breasts in the mirror, with your shoulders straight and your arms on your hips. Indeed, it can be a good idea to begin by looking at yourself in the mirror with your arms down at your sides, and then with your arms up in the air.

Doing this routinely will enable you to maximise your awareness of such things as the normal size, shape, and colour of your breasts, and ensuring they are evenly shaped, with no visible swelling or distortion.

Feel around your breasts for signs of anything unusual

As we referenced above, positioning your body in different ways can aid your efforts to spot anything potentially abnormal about your breasts, and you can further help this process by not only looking, but feeling.

For this reason, many women check their breasts for lumps or anything else unusual from a lying-down position, as well as while standing or sitting. Women have often found that they can feel their breasts more easily when their skin is wet and slippery, so you might try doing your standing-up checks in the shower.

As for how you might do those checks, you may begin by feeling around each breast in a circular motion, before feeling under your arm, and then around the nipple.

Educate yourself on the symptoms that might require medical attention

Of course, even knowing the above processes well might be of limited use if you have little sense of what would constitute a potentially concerning symptom (other than the aforementioned lumps).

However, there are various breast changes that, if you notice them, would make it a good idea to reach out to a medical professional. These include any unexpected changes in the size, outline, or shape of your breast, as well as any rash, redness, puckering or dimpling on the skin of the breast.

A discharge of fluid from either of the nipples, any change in nipple position, and/or a new lump, swelling, thickening, or bumpy area in one breast or armpit that you do not recall coming across previously, could give you further reason to contact a medical expert as soon as possible.

Seeking help in this way will enable you to rule out breast cancer as a possible cause of the concerning symptoms – and if cancer is detected, it will allow for quick and suitable treatment to be provided.

To learn more about the breast screening in Gibraltar that we can provide here at GibMedInternational in support of your breast health, please don’t hesitate to contact us.

[365chemistspharma]

About Resoten 20 Capsule 10's

Resoten 20 Capsule 10's belongs to a class of drugs called retinoids (a synthetic form of vitamin A) primarily used to treat a severe form of acne known as nodular acne that cannot be cleared by any other treatments, including antibiotics. Nodular acne is severe acne that occurs due to excessive production of oil in the skin cells, causing swollen, red and tender lumps in the skin. Acne nodules are larger in size than typical pimples.

Resoten 20 Capsule 10's contains 'isotretinoin', a form of vitamin A that works by reducing sebum (skin's natural oil) production on the skin's surface by decreasing the activity and size of sebaceous glands. Thereby unblocks pores and kills acne-causing bacteria.

Take Resoten 20 Capsule 10's as prescribed. Your doctor will advise you on how often you need to take Resoten 20 Capsule 10's based on your medical condition. Some people may experience chapped lips, dryness of skin, eyes, nose, or lips. Most of these side effects of Resoten 20 Capsule 10's do not require medical attention and gradually resolve over time. However, if the side effects persist or worsen, please consult your doctor.

If you are known to be allergic to Resoten 20 Capsule 10's or any other medicines, please tell your doctor. Do not take Resoten 20 Capsule 10's if you are pregnant or breastfeeding as it may cause adverse effects on the baby. If you have depression or any suicidal thoughts while taking Resoten 20 Capsule 10's or after stopping treatment with Resoten 20 Capsule 10's, please consult a doctor. Avoid sun exposure while using Resoten 20 Capsule 10's as it may make the skin more sensitive to sunlight and cause sunburn. Wear protective clothing and use sunscreen while going out to protect your skin from sunburn.

Uses of Resoten 20 Capsule 10's

Nodular acne

Medicinal Benefits

Resoten 20 Capsule 10's is a synthetic form of vitamin A used to treat a severe form of acne. Resoten 20 Capsule 10's reduces sebum (skin's natural oil) production on the skin's surface by decreasing the activity and size of sebaceous glands. Thereby unblocking pores and killing acne-causing bacteria. Also, Resoten 20 Capsule 10's reduces swelling in the skin.

Directions for Use

Take Resoten 20 Capsule 10's with food or as advised by the doctor. Swallow it as a whole with a glass of water. Do not break, crush or chew it.

Storage

Store in a cool and dry place away from sunlight

Side Effects of Resoten 20 Capsule 10's

Chapped lips

Dryness of skin, eyes, nose or lips.

[dranirudh-1234]

What Is Cirrhosis?

Our livers are capable of self-healing and regeneration. However, as scar tissue eventually forms, it loses some of its ability to perform as intended. Circulatory flow to the liver reduces as the number of scars rises. The liver's fundamental functions are also impaired. This may occasionally result in liver failure and even death. Cirrhosis claims more than a million lives annually throughout the world.

In addition to managing difficult liver surgeries, Dr. Aniruddha Bhosale Head of Liver Transplant and HPB Surgery  at His Hospital in Pune, has decades of experience treating liver cirrhosis as well. He is renowned for offering the best Liver cirrhosis treatment in Pune. due to his extensive training and experience.

Let's learn more about cirrhosis today, including its diagnosis and treatment.

Cirrhosis of the liver is a disorder brought on by persistent liver injury. The liver becomes hard and nodular in this syndrome. Fibrosis replaces the liver tissue. When cirrhosis develops, liver damage is permanent. The cirrhotic liver can no longer regenerate.

Cirrhosis classification

1. Compensated Cirrhosis

It is simply a liver that has been damaged yet is still largely functional.

2. Defamed Cirrhosis

The beginning of the signs and symptoms of liver dysfunction is represented by the advanced stage of cirrhosis.

Why may cirrhosis be harmful?

Cirrhosis causes a number of complications, including

Ascites (abdominal fluid)

Edoema (limb fluid)

(Vomiting blood) Variceal bleeding

The encephalopathy of confusion

Hepatorenal Syndrome, or malfunction of the kidneys

Lung condition (Hepatopulmonary syndrome, Hepatic hydrothorax)

liver tumour

The signs of cirrhosis

The symptoms of liver disease that progresses from early fibrosis to cirrhosis typically take years to appear. Early on, there are frequently few, if any, symptoms.

When symptoms appear, they are occasionally misdiagnosed, disregarded, or linked to additional potential causes. However, if the condition worsens, the symptoms could become more obvious. These signs consist of:

Fatigue Confusion

Weakness

Itching

reduced appetite

Loss of weight

Nausea

Simple bruising

Jaundice

ankle, foot, and leg swelling

Bloating due to ascites in the abdomen

Cirrhosis causes

Cirrhosis is most frequently brought on by:

1. Alcohol-related liver disease: This condition is often brought on by   years of heavy drinking.

2.Hepatitis B is a common contributor to cirrhosis.

3.Hepatitis C is the main predictor of liver transplants and one of the    common causes of cirrhosis.

4.Non-alcoholic fatty liver disease: Cirrhosis is more common in people who have diabetes, high blood pressure, obesity, and high cholesterol. With the prevalence of lifestyle disorders rising in our community, this is fast becoming one of the most common causes of liver cirrhosis.

Among the uncommon causes of cirrhosis are:

First Sclerosing Cholangitis

Wilson's disease and other hereditary illnesses

Hepatitis auto-immune

Hemochromatosis

Celiac illness

Medication

Cirrhosis diagnosis

1: liver biopsy

It is the most precise method for determining the stage of cirrhosis. Nowadays, liver biopsies to diagnosis cirrhosis are rarely performed due to advances in radiological techniques.

2. Magnetic resonance elastography or an ultrasound

These methods for detecting cirrhosis are non-invasive.

3. Blood examinations and imaging devices (CT and MRI)

These can be used to track the development of diseases.

Cirrhosis of the Liver Treatment

In Pune, cirrhosis is frequently treatable before it worsens and a liver transplant is necessary.

The cause and severity of the disease play a major role in cirrhosis therapy.

But after diagnosis, treatment should start right away.

The only known treatment for cirrhosis is liver transplantation.

To slow the growth of liver scarring, you should follow the steps listed below, which include:

Avoid consuming alcohol and drugs that can harm the liver.

Avoid over-the-counter herbal supplements and medications because some of them have been linked to liver damage.

The risk of liver damage from prescription drugs is increased by cirrhosis. As a result, the effects on the liver of every prescription should be carefully considered.

Avoid eating raw shellfish that might have bacteria in it. In those with advanced liver disease, it can potentially result in a serious infection.

Exams and hepatitis A and B vaccinations

antiviral medication for treating hepatitis B and C.

Detection and treatment of bile duct obstructions caused by ursodiol, one of the secondary causes of cirrhosis.

Regarding the treatment of people with cirrhosis, nutrition is crucial.

As soon as you receive a cirrhosis diagnosis, you should start treatment. To get the finest care after the diagnosis, you should always speak with a skilled and experienced liver specialist in Pune.

[juniperpublishers-nutrition]

A Review on Diabetic Nephropathy: New Insight into Established Therapeutic Approach

Abstract

Background: Diabetic nephropathy (DN) is a principle cause of morbidity and mortality in both type 1 and type 2 diabetes mellitus. DN plays a major role in development of cardiovascular disease, in particular heart failure, the incidence of which is about 15-fold greater in patient with diabetic nephropathy. Approximately 30-35% of patients with type 1 type 2 diabetes develops diabetic nephropathy. DN is represented by microalbuminuria and macroalbuminuria and morphological changes as like glomerular thickening, interstitial fibrosis, formation of nodular glomerulosclerosis and decreased endothelial cell fenestration. Additionally, the association of renin-angiotensin-aldosterone system, wnt signaling pathway and genetic factors are the major pathway in the progression of diabetic nephropathy.

Conclusion: This review is intended to establish a new insight into traditional therapeutic approach for diabetic nephropathy. Along with potential targets, novel approach such as epigenetic drugs and miRNA modulators may compliment the current therapeutic approach to improve renal function.

Keywords: Diabetic nephropathy; Microalbuminurea; Macroalbuminuria; Glomerulosclerosis

Introduction

Diabetic nephropathy is associated with increased albumin excretion, decreased glomerular filtration rate, glomerular lesion and increased arterial blood pressure [1]. DN can be divided into 5 stages of kidney dilapidation, and symptoms appear in stage 4. All patient should be screened for albuminuria at least once per year for kidney complication. The significant signs of step 4 are swelling of ankles, legs and hands because of water retention, hematuria, fatigue and nausea. If this condition remains untreated may lead stage 5, end-stage renal disease (ESRD) [2]. In stage 5, the kidney can no longer function to meet the daily requirement and microalbuminuria (>300mg/24h), progress to extensive proteinuria (>500mg in 24 h). Various factors linked with end-stage renal diseases are hemodynamic changes, inflammation and hyperglycemia [3]. The mechanism involved in the progression of DN is still on the question. Many researchers have determined an interrelationship between the degree of hyperglycemia and progression of DN complications [4]. As because a number of pathways involved in diabetic nephropathy, treatment should be multi-targeted, encouraging a healthy lifestyle and molecular targets associated in progression of DN. Available treatment procures only symptomatic alleviation and incapable of treating the underlying pathophysiology of diabetic nephropathy.

Pathogenesis of Diabetic Nephropathy

Role cytokines in diabetic nephropathy

Studies suggested that patient suffering from diabetic nephropathy have increased serum and urine level of tumor necrosis (TNF)-alpha [5]. It had been reported that TNF-alpha, IL-6, IL-1 associated in the progression of DN, found to be involved in the impairment of interglomerular hemodynamic [6].

Genetic association in diabetic nephropathy

Angiotensin-converting enzymes (ACE)

The dysfunctional ACE gene produce excess amount of aldosterone which causes fibrosis of blood vessels and aldosterone is also found to be associated with formation of extracellular matrix and fibronectin by mesangial cells by activation of the smad2-dependent TGFB1 pathway [7].

Oxidative stress in diabetic nephropathy

Oxidant species produced by oxygen metabolism and are required in different biological operation such as cell signalling, degenerative disease, aging etc [8]. Various pathophysiological mechanisms involved in DN pathogenesis in which increased oxidant species have been recognized as the single underlying strenuous event therefore, elevated oxidant species accommodates a decisive central and significant role in the pathogenesis of diabetic nephropathy. In vitro and in vivo experimental models of diabetes have determined that metabolic (hyperglycemia, dyslipidaemia) and hemodynamic (systemic and glomerular hypertension) insults define the two principal drivers of oxidative stress in the diabetic kidney [9]. Overexpression of glucose transport because of metabolic- hemodynamic interaction, synergistically fuels an increase in oxidant species production and development of DN and other diabetic microvascular diseases. Oxidant species causes the damage in all the layers of the glomerular filtration barrier, functional alterations of the interaction between glomerular endothelial cells with glycocalyx layer and podocyte [10].

Conventional Drugs for Diabetic Nephropathy

Glucose lowering agent in diabetic nephropathy

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been used for reducing hyperglycemia because SGLT2 is responsible for reabsorbing of the glucose in the glomerular infiltrate. Empagliflozin, an SGLT2 inhibitor, slower the progression of kidney diseases [11]. Dipeptidyl peptidase -4(DPP-4) inhibitors such as linagliptin and saxagliptin (SAVOR-TIMI 53 trial) known to reduce the amount of albuminuria [12].

Cyclooxygenase (COX) and Xanthine oxidase (XO) inhibitor in diabetic nephropathy

Aspirin as a non-specific and others specific COX-2 inhibitors improve glomerular lesion, in pre-clinical models of diabetes [13]. Purine xanthine oxidase (XO) inhibitor reduce inflammation and oxidative stress in diabetic nephropathy [14].

Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and diabetic nephropathy

It was reported that statins amend renal dysfunction and reduce renal injury by inhibition of isoprenylation of Ras and Rho GTPases. Which may lead to decreased monocyte/macrophage infiltration and activating protein-1 (AP-1) in the glomerulus, adhesion of molecules, decreased mesangial proliferation and decreased accumulation of extracellular matrix and fibrosis [15].

Endothelin receptor antagonist in diabetic nephropathy

Avosentan, an endothelin-1 receptor A antagonist, found to reduce albuminuria. A study conducted on randomized controlled trial on 56 patients treated with oral bosentan for 4 weeks improves peripheral endothelial function [16].

Antioxidants against diabetic nephropathy

Pyridoxamine can remove free radicals and carbonyl product, and block the synthesis of AGEs. Pyridoxamine phase II trials showed the normal renal function had lower average serum creatinine level. Currently PIONEER -CSG -17 trial investigating to prove such benefit about use of pyridoxamine [17]. It has been reported that teneligliptin is a DPP-4 inhibitor with antioxidant.

MicroRNA and diabetic nephropathy

Under hyperglycemia conditions, up regulated micrRNAs result in pathogenesis of diabetic nephropathy [18]. It was suggested, miR-192 & miR-200 contribute to stimulate of TGFbeta 1 and fibrosis, which may consequently cause renal damage [19]. Therefore, miRNA may inhibit diabetic nephropathy by regulating various biological processes. Application of kidney protective miRNAs and knockout of inducing miRNA could be some of the approaches to restoring renal function in diabetic nephropathy [20].

Future Prospect of Drugs for Diabetic Nephropathy

Recent studies are gathering the evidence about involvement of autophagy with DN because of its cryoprotective activity in the kidney [21]. mTOR may suppress autophagy. mTORC1 inhibitors such as rapamycin or sirolimus have been found to be effective as renoprotective agents except for the negative effect on renal function and proteinuria [22].

Update on Recent Clinical Trials

Due to the distinct and complicated pathogenic mechanism associated with DN the failure rate of potential new drugs in clinical trials above 90% with only a fistful of these therapies achieving phase III trials. Summarizing the outcome of recently completed clinical trials in the past 5 years (2013-2018) and shown in Table 1 [23].

Conclusion

Diabetic nephropathy remains one of the most prevalent and life-threatening complications of diabetes. Diabetic nephropathy cases increasing rapidly around the world. Recently available therapies provide only symptomatic relief and not capable to treat underlying pathophysiology of diabetic nephropathy. This review has discussed the many factors and pathophysiological mechanisms associated with the progression of diabetic nephropathy, targets and therapeutic approaches to reduce renal impairment and improve kidney function. It also provided with new insights into the treatment of diabetic nephropathy. Novel biomarkers holding strong potential requires further clinical studies. The review also focused on the future prospect of drug for the treatment of diabetic nephropathy and update of recent clinical trials of targets for the treatment of diabetic nephropathy. A combination of therapies with epigenetic drugs and miRNAs modulators may fulfil the current treatment strategy of diabetic nephropathy.

To Know More About Nutrition and Food Science International Journal 

Please click on: https://juniperpublishers.com/nfsij/index.php

For more Open Access Journals in Juniper Publishers

please click on: https://juniperpublishers.com/index.php

[rootcure]

What can be the reason for a lump in Breast or Fibroadenoma?

#FIBROADENOma (Lump in Breast)

Definition: Fibroadenoma or Lump is a swelling protuberance, bulging or bump in the breast that feels different from the normal breast tissue.

It is a solid Benign tumor which is a non cancerous tumor in which epithelial cells are arranged in a fibrous stroma.

CAUSES OF FIBROADENOMA

Breast Cysts: Fluid filled sacs in breast tissue are usually benign.

Infection

Trauma

Fat necrosis

Fibrocystic breast

Lump of breast varying in size

It can be identified with the help of breast size whether it becomes fatal (dangerous) or not.

1. 1 cm/less – Small Fibroadenoma considered

normal.

2. Upto 3 cm-Large Fibroadenoma considered

3. More than 3cm – Giant Fibroadenoma considered Disease.

Symptoms

Age – Incidence usually occurs with menstruating females at any age.

Painless swelling (lump) in the breast.

Smooth, firm to hard consistency, freely movement of lump in breast.

Elderly age patients may not have a characteristic feature due to fibrosis occurring in the breast.

COMPLICATIONS

1. Simple Fibroadenoma have no family history of breast cancer and have no risk of cancer.

2. Complex Fibroadenoma show cyst, sclerosis adenosis, calcification have increased risk of cancer may show some symptoms:

Frequency of pain increased.

Bleeding does not stop.

Poor wound healing.

Treatment

Homeopathic treatment is effective in stabilizing the health of an individual, affected by fibroadenoma and its effects at various stages of fibroadenoma which help in dissolving internally the lump in breast. Homeopathy medicines will be prescribed on the basis of the cause or etiology of the disease or clinical condition i.e. sign and Symptoms.

Here are a few Homeopathic remedies that help In the treatment of fibroadenoma and thus, reducing the intensity of symptoms:

Top 5 Homeopathic remedies for Fibroadenoma:-

1. CONIUM MACULATUM:

This medicine very effective in the treatment of fibroadenoma.

Indicated in “mammary gland are hard and sore with inflammation of the Breast Tissue”.

The region of breast becomes hard, nodular, tender to touch with burning and stinging pain in the breast.

Also there is a discharge of pus from the nipple and if lesions occur then it may lead to the fibrosis.

2. BARYTA CARBONICA:

When there is inflammation i.e.redness, swelling with induration and enlargement of the lump in breast.

The lump in breast is hard and sensitive to touch with infiltration.

Edges of the lump are sharply defined with a bloody discharge from the nipple and it becomes sensitive to cold and complaints become worse when anything is taking cold.

3. HYDRASTIS CANADENSIS:

The patient has a tendency to indurated glands.

The patient is weak and emaciated, fainting due to improper assimilation.

Mammary gland is swelling with Fat Necrosis and glandular cell myoblastoma are common in this remedy.

Patient complains of pain and tenderness with an engorged nipple, cracks and discharge of watery fluid.

4. CALCAREA FLUORICA:

This remedy is indicated in the fibroadenoma of the breast.

Lump in breast which is hard, movable with clear margins and sharp in nature.

Nodules are in upper right quadrant.

Patients are very sensitive to cold air/ atmosphere.

Pain at the tip of urethra, back extending to the sacrum..

This remedy acts well after surgery on the breast

5. PHYTOLACA DECANDRA:*

Mammae full of hard, painful nodosities.

Breast is full of stony hard and painful especially when suppuration occurs.

Pain in the breast occurs when child nurse pain goes from nipple all over the body.

Cracks and small ulcers around nipple

Irritable in breast before and during menses. ( homeopathy benefits )

[physicianclinic]

Dr Akshay Narawad (General Physician) -What Causes Thyroid? What are its Types and Treatments?

Do you experience concerns with chills, hair loss, mental fog, or weight gain? maybe in the opposite direction? Are you clammy, pumped up, or worried? Does exhaustion affect your day in and day out? If you experience the listed symptoms, your thyroid gland may be to blame. This incredible controller of the mind and body might malfunction occasionally. The symptoms are typical of women, and receiving the appropriate treatment is essential if you don't want to keep feeling lethargic.

The thyroid gland is what?

The thyroid gland is a ductless gland on the front of your neck that has a butterfly shape. The gland creates hormones that control how quickly your metabolism moves. The system aids the body in utilising energy. When you have a thyroid issue, your metabolism drastically slows down because the production of thyroid hormones is interrupted. A variety of symptoms brought on by the fluctuation in hormone levels can impair your body's regular operations. Hyperthyroidism, hypothyroidism, goitre, thyroid cancer, and thyroid nodules are a few examples of thyroid conditions. The thyroid gland also produces calcitonin, one of the hormones required for calcium metabolism, in addition to the thyroid hormones T3 (tri-iodothyronine) and T4 (thyroxine). To validate the level, a thyroid test must be performed.

What varieties of thyroid disorders are there

Thyroid diseases come in two different varieties:

1. Hypothyroidism is a condition in which a person's thyroid gland is underactive. This condition manifests as sluggishness, lethargy, cold intolerance, reduced appetite, weight gain, drooping upper eyelids, high cholesterol, constipation, increased sleep, swelling of the face and limbs, coarse skin, irregular menstrual cycles, and infertility.

2. Hyperthyroidism: When a person has this ailment, their thyroid gland becomes overactive, which causes palpitations, trembling, anxiety, insomnia, heat sensitivity, diarrhoea, weight loss despite increased appetite, protruding eyeballs, irregular menstruation, and low cholesterol.

What triggers a thyroid condition?

Thyroid diseases can have a variety of reasons.

The following are illnesses that result in hypothyroidism:

Thyroiditis is the medical term for thyroid gland inflammation. The amount of thyroid hormones generated is decreased.

The most prevalent types of hypothyroidism are caused by Hashimoto's thyroiditis. It is a genetic, painless immune system condition.

The following are illnesses that lead to hyperthyroidism:

When someone has Graves' disease, their thyroid gland becomes overactive and secretes an excessive number of hormones. The thyroid gland enlarges as a result. Additionally called diffuse toxic goitre. In a condition known as thyroiditis, the thyroid gland releases hormones that have been held there, leading to hyperthyroidism for a few weeks or months. Nodules that form in the thyroid gland and begin secreting too much thyroid hormone are known as toxic adenomas. The body's chemical balance is disrupted by this. A toxic autonomously functioning thyroid nodule refers to a single nodule, whereas a toxic multi-nodular goitre refers to several nodules. There is too much iodine in several cough syrups, cold remedies, and sinus medications. This could lead to the thyroid produces either too little or too much

Thyroid disease treatment

Thyroid hormone pills are an effective treatment for the majority of hypothyroid patients. The dose must be regularly monitored. On the other hand, medicine is an option for the treatment of hyperthyroidism. For a full recovery, surgery and radioiodine therapy may occasionally be required. Even when a huge goitre causes disruptive and compressive symptoms or is just for aesthetic purposes, surgery is required. The kind and stage of thyroid cancer will determine if surgery, chemotherapy, or radiation is necessary.

For More Information about Thyroid Related problem Contact us at—The Physicians clinic

[ceyhanmedya]

What is goiter? What are the symptoms and treatment methods? 2023

New Post has been published on https://bankakredin.com/what-is-goiter-what-are-the-symptoms-and-treatment-methods/

What is goiter? What are the symptoms and treatment methods? 2023

Goiter is a disease that occurs as a result of abnormal growth of the thyroid gland. The thyroid gland is a butterfly-like organ located in the front of our neck. The thyroid gland is the place where thyroid hormones, which have very important roles in metabolism and brain functions, are secreted. 

Causes of goiter

The most common cause of goiter all over the world is iodine deficiency. Iodine is very effective in the production of thyroid hormone, so in the absence of iodine, enough thyroid hormone cannot be produced and the brain constantly stimulates the thyroid gland to make hormones. This causes the thyroid gland to enlarge. Like iodine deficiency, excess dietary iodine intake can also cause goiter.

The second most common cause of goiter is Hashimoto’s thyroid. In Hashimoto’s thyroid, the thyroid gland is destroyed by the immune system. The destroyed thyroid gland cannot produce enough hormones, and in this case, the pituitary gland constantly stimulates the thyroid gland to make hormones. As a result, an enlargement of the thyroid gland, that is, a goiter, develops. 

In Graves’ disease, the immune system secretes thyroid stimulating immunoglobulin. As a result, goiter and hyperthyroidism develop. 

There are two types of goiter as nodular and nodular. In nodular goiter, the thyroid gland is symmetrically enlarged and soft. Nodular goiter occurs when the thyroid gland cannot produce enough thyroid hormone. In nodular goiter, however, there is insufficient production of the hormone, but cells in some regions respond to the stimuli from the brain. As a result, nodules develop in the thyroid gland. There is a risk of thyroid cancer in 4-20% of thyroid nodules. 

Pregnancy is another cause of goiter. HCG hormone secreted during pregnancy leads to enlargement of the thyroid gland. Thyroid cancer may present its first sign as goiter. 

Symptoms of goiter

While goiter does not cause any symptoms in some patients, it may cause difficulty in swallowing, cough, shortness of breath and pain in addition to swelling in the neck in some patients. In goiter, symptoms related to the secretion of more or less hormone by the thyroid gland are also seen. In case of insufficient hormone secretion, weight gain, drowsiness, lethargy, dry and rough skin, constipation, weakness and hair loss can be seen. When more than normal hormones are secreted, diarrhea, palpitations, headache, tremor, irritability and nausea may occur. 

In whom is goiter more common?

Goiter can occur in patients of any age. However, it is more common in middle-aged people and women. Iodine deficiency, heredity, previous viral infections, lithium use, radiation, pregnancy, menopause and smoking are the most common causes of goiter. 

Goiter diagnosis

In the diagnosis of goiter, the physician requests thyroid tests and thyroid ultrasonography after examining the thyroid gland. Thyroid scintigraphy and fine needle biopsy can also be performed in necessary cases; thyroid antibodies can be checked. 

goiter treatment

In the treatment of goiter , one or more of the drug treatment, radioactive iodine treatment and surgical treatment methods can be applied. If hormone deficiency is detected in the patient, hormone drugs are used. On the contrary, if there is an excess of hormones, drugs to suppress the thyroid hormone and radioactive iodine treatment are applied. Surgical treatment can be applied in nodular goiter. In surgical treatment, part or all of the thyroid gland can be removed. The decision for surgery in goiter is made by considering the patient’s hormone level, presence of cancer, swallowing or breathing disorders, or cosmetic reasons. Goiter surgeriesSome complications may occur. Hoarseness after the operation occurs as a result of damage to the vocal cords. If the parathyroid glands are accidentally removed during the surgical operation, calcium deficiency develops in the patient. In this case, it is necessary to give calcium as a medicine to the patient. 

When to go to the doctor?

If you have noticed swelling in your neck while shaving or looking in the mirror; However, if you have symptoms such as palpitations, irritability, persistent diarrhea, constipation, insomnia or excessive sleepiness, tremors in the hands, weight gain, difficulty in swallowing and breathing, you should consult your nearest internal medicine specialist.  

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[alphasurgical]

All Information about Pleomorphic Adenoma and Mucoepidermoid

➢ The most frequent salivary gland tumour, pleomorphic adenoma, is also referred to as a benign mixed tumour due to its dual origin from myoepithelial and epithelial components. It makes up to two-thirds of all salivary gland tumours, making it the most prevalent of all. The pathogenesis and presentation of plemorphic adenoma are described in this exercise, which also emphasises the care of the condition by an interprofessional team.

➢ On palpation, the swelling was warm, non-tender, and had a firm consistency. Both the upper skin and the underlying structures were attached to it. Examined facial and ocular movements were normal. An intraoral clinical examination revealed nothing unusual. Consideration was given to a preliminary diagnosis of benign tumour of the left parotid gland.

➢ The most likely differential diagnoses included pleomorphic adenoma, Warthin's tumour, and neuroma of the facial nerve (nerve sheath tumour). Warthin's tumour typically affects elderly men who have smoked in the past, does not induce eversion of the ear lobe, is found in the lower parotid (at the angle of the mandible), and occurs in 10-15% of cases bilaterally.

➢ The low incidence rate of benign tumours of nerve sheath origin in the parotid gland (0.2% to 1.5%) makes preoperative diagnosis challenging. Additionally, it seems difficult to preoperatively diagnose a parotid tumour as a neuroma in the absence of facial nerve impairment.

➢ Pleomorphic adenomas are typically found as an asymptomatic tumour during a normal medical examination. Head and neck glands are the source of PA, which typically presents as a mobile, slowly growing, firm swelling without any symptoms that doesn't irritate the mucosa above it.

➢ When removed, the majority of these tumours are 2–6 cm in size. The overlying skin or mucosa, however, may be viewed as a single, uneven nodular mass in big tumours. The tumor's weight might range from a few grammes to over 8 kilos. The parotid gland PA is often seen above the angle of the mandible and below the lobule of the ear.

➢ The most typical kind of salivary gland cancer is mucoepidermoid cancer. In the parotid glands, most begin. They less frequently appear in the minor salivary glands inside the mouth or the submandibular glands. Although they occasionally have intermediate or high grades, these malignancies are mostly low grade.

➢ The majority of salivary gland tumours are benign, which means they are not cancerous and won't spread to other body areas. Almost rare do these tumours pose a threat to life.

➢ There are numerous varieties of benign salivary gland tumours, which go by names such Warthin tumours, oncocytomas, and pleomorphic adenomas. Surgery typically always eliminates benign tumours. Very rarely, if untreated for a long time or if they are not entirely removed and grow back, they may develop into cancer. It is unclear precisely how benign tumours develop into cancer.

➢ There are three levels of mucoepidermoid carcinoma cell types: low, moderate, and high. Squamous epithelial and intermediate cells make up the majority of high-grade tumours, which have weak differentiation. Mucus-secreting and squamous epithelial cells make up the majority of low-grade tumours, which are well differentiated and well-developed.

➢ Tumors with intermediate histologic grades fall somewhere in between. Indicators of prognosis for mucoepidermoid carcinomas of the main and minor salivary glands include histologic tumour grade. The clinical stage, location, grade, and success of the surgery all affect the prognosis.

➢ Although there is debate about the best way to treat mucoepidermoid carcinomas of the larynx, most authors concur that various treatment modalities should be used depending on the histologic grade and tumour subsite.

➢ As with high-grade tumours of the major and minor salivary glands, high-grade tumours are often treated more aggressively, with surgery serving as the main treatment option. Regarding the proper management of low-grade tumours, there is less consensus.

➢ Some have suggested total laryngectomy for subglottic tumours and partial laryngectomy for low-grade supraglottic malignancies. Others have suggested methods that retain laryngeal function as long as tumor-free margins are achieved all around the resection.

[sugandaskincare]

5 TYPES OF ACNE YOU SHOULD KNOW ABOUT

Acne is one of the most common skin concerns, but there are many forms of it and hence the treatment is complex. You would have noticed that everyone’s acne is different. It is critical to recognize and diagnose the type of acne you're dealing with in order to treat it (you may have more than one).

Let’s try and understand the various types of acne, so you can manage it better.

PAPULES (REGULAR PIMPLES)

These are classic pimples that form when excess oil, dead skin cells, and bacteria become trapped in the deeper layers of the skin, causing inflammation which can later lead to swelling and redness.

Pustules (Large pimples)

Pustules are a type of acne that occur when papules (the mild type of acne) get worse. The initial pimple becomes larger, filled and enlarged with more oil and fluid because the skin attempts to deal with the problem on its own.

Most teens with acne have a mixture of papules and pustules.

NODULAR ACNE (DEEP PIMPLES)

Large and painful breakouts are called acne nodules which are caused by severe inflammation.

Acne nodules are larger than standard pimples, and they affect deeper layers of the pores and skin.

BLACKHEADS (OPEN COMEDONES)

One of the most common forms of comedonal acne is blackheads (a.k.a open comedones). Comedones form when the cells lining the sebaceous duct multiply (cornification) and sebum production increases. A blackhead appears when the debris blocks the sebaceous duct and hair follicle.

WHITEHEADS (CLOSED COMEDONES)

Tiny white bumps that appear on the skin are another type of clogged pore, called white heads. They’re occasionally referred to as closed comedones because, unlike blackheads, the head of the white bump is protected by a thin layer of skin. As the pore is not exposed to the air, it doesn’t oxidize or turn black.

Acne additionally is available in various severity and it affects everyone differently. The most widely used classification of acne is simple: mild, moderate, and severe. Your skin can move between these grades because acne tends to increase and decrease on its own.

Based on the severity, you can determine the best course of action.

Mild acne: Whiteheads and blackheads, with a few papules and pustules, are called mild acne. It can usually be treated with over-the-counter acne medications. However, if it is not treated immediately, it can develop into more serious forms.

Moderate acne: Both papules and pustules in multiples covering less than half of your face are called moderate acne.

Moderately severe acne: Numerous papules and pustules with occasionally inflamed nodules on more than half of your face are categorised as moderately severely acne.

Topical retinoids and topical antibiotics (for non-inflammatory acne) individually or a combination of both are the most commonly used topical acne treatments for moderate acne.

Severe Acne: Numerous painful, large and inflamed pustules, nodules, or cysts, usually affecting most of your face are categorised as severe acne. It's difficult to get severe acne under control, and hence, dermatologist consultation is required.

[breastpenisskincare247]

Regular Treatment for for Cellulite

What is cellulite and how can I get rid of it?

Cellulite is a multifactorial problem. It concerns approx. 86-97% of women. Cellulite is a skin appearance dysfunction and these changes are commonly called “orange peel” effect. The irregular bumps are mostly visible on thighs, belly, shoulders, or buttocks – exactly where the most fat is stored. These imperfections are very unaesthetic, however, you can effectively get rid of them.

This is a condition that gives the presence of little knocks and waves under the skin. The knocks are brought about by the hidden fat cells becoming excessively enormous and extending the normal fiber compartments that hold the skin to the basic layers of tissues.

Ladies will in general have cellulite more frequently than men since they have an upward example of collagen in the basic layer that holds the fat cells, and when the fat cells become extremely enormous, they swell out of the chambers and show up as cellulite.

In men, the example of collagen is tighter, in a slanting example, and they have thicker skin, so there is less swelling of the singular fat cells. One more factor in cellulite is significant degrees of estrogen since this chemical directly affects the holding limit of fat cells through the increment of alpha-adrenoreceptors, the synthetic entryways that advise your fat cells to clutch their substance. Terrible eating routine, awful flow, and poor lymphatic dissemination would all be able to add to the presence of cellulite. Learn more

What causes cellulite?

As we have already mentioned, cellulite can be caused by many factors. The most frequent are:

genetic predispositions

sedentary lifestyle

low physical activity

bad diet (too many carbohydrates and fats)

salt abuse, which causes water accumulation within your body.

hormone problems

nervous system dysfunctions, including stress

microcirculation problems alcohol, cigarettes

pregnancy

obesity

The most frequent cause of the problem is connected to lots of factors, which are hard to eliminate. However, how can you fight this “orange peel” effect?

How to fight cellulite?

Skin dimpling and nodularity that mostly accumulates on thighs and buttocks, are for most women the cause of complexes and bad mood. It is important to feel good in your own skin. So what can you do to get rid of this serious problem?

Keep in mind that cellulite is a complex problem. Therefore, a complex approach is required. Physical activity, healthy and balanced diet, proper moisturization, skin massage, and most importantly – a proper supplementation from the inside.

It is essential to take a proven and effective product. Such product is Perfect Body Cellulite. The capsules are effectively eliminating the “orange peel” effect and the results are visible after just a few days. The skin dimpling and nodularity slowly disappear, it becomes firm and smooth.

Perfect Body Cellulite is effective and safe

Women, who have decided to undergo expensive and invasive treatments or take strong pharmaceuticals, know that they may turn out to be ineffective and cause lots of side effects. The secret of Perfect Body Cellulite is its natural composition, which is safe and fast. Perfect Body Cellulite gets rid of the orange skin and prevents it from appearing – that is why many women take the capsules as a preventive method, due to their health beneficial properties.

Do you want to have smooth and firm skin?

Do you want to get rid of the unaesthetic look of your skin?

Do you want to have a properly moisturized skin?

Do you want to show your body without shame

If you have answered YES to any of the above questions,  then you must try Perfect Body Cellulite!

Perfect Body is a fast and effective way to fight with cellulite. This progressive problems concerns most women, however, it does not mean that you have to struggle with it as well! If you dream about a beautiful and smooth body, without the "orange peel" effect.

Click here learn more.

[hemorenkrema]

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