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1Feb2021

Autism Spectrum Disorder

Autism, also known as Autism Spectrum Disorder (ASD), is a convoluted condition characterized by communicational and behavioral issues. It can be a minor issue or a disease that needs to be addressed and care for a long time in a particular facility.

The problem generally is seen in young children and they have issues while speaking or understanding what others are saying. Because of this, it gets hard for them to express themselves through any way of communication. The symptoms generally develop before a child gets to the age of three and sometimes, they are shown with the birth of a child.

People or children who have autism might have development issues and their mental IQ level would probably below. They might have a hard time learning and communicating. But this kind of people, especially children, are rather good at creative activities like art, maths, memorizing or music. They do tend to do good in analyzing and problem-solving activities.

Signs and Symptoms of Autism

The common symptoms of Autism include:

Autistic people don’t make eye contact easily.
They don’t show much interest in specific topics that people would do or enjoy. normally.
Repeating the same action again and again, like going back and forth or repeating a phrase.
They are very sensitive to smell, light, or noise that is normal in day-to-day life.
Not looking at other people or anything that is being pointed to.
Have trouble making peace with the changes in the daily routine.
Difficulty in communicating through talking, gestures or facial expressions.
Do not want to be cuddled or held.
Talks in a definitive tone of singing, robotic or flat voice.
Drooling is another common symptom.

Types of Autism Spectrum Disorder

Until recently, these disorders were termed separately but now they all fall under the category of ASD. Let’s have a look at these disorders:

Asperger’s Syndrome: This comes as least complicated and comparatively mild on the Autism scale. The children or adults with this syndrome have high intelligence and can excel in particular subjects of their like. The problem is they have a hard time around other people and are not comfortable socially.
Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS): This disorder considers those children whose conditions are more severe than Asperger’s Syndrome but less severe than Autistic Disorder.
Autistic Disorder: This diagnosis is further on the severe side of the Autism scale. The symptoms are the same but they are at a more intense level.
Childhood Disintegrative disorder: This is the most severe type of ASD where the children first develop naturally. After some time between the ages of 2-4 years, they quickly lose interest in their surroundings and start having a communication, socialising, and mental skills problem. Some children when attaining adolescence also have seizure issues.

Causes of Autism

There is no single or definitive cause for Autism. It could happen from the parts of the brain that are responsible for interpreting sensory inputs and language processing. It is more common in boys than in girls. Autism does not have any connection with race, religion, culture or social background. It can happen to anyone.

Some common suspected causes of Autism are:

Genetic mutation
An immediate family member with Autism
Being born from older parents
Pregnant women taking drugs, alcohol or anti-seizure tablets
Exposure to chemical gasses and polluted environment for both pregnant women or newborn baby
A history of viral infections

Autism is also linked to untreated phenylketonuria (PKU) and Rubella (German measles). There is no proof that Autism is caused due to vaccination.

Autism Screening and Diagnosis

It is hard to diagnose Autism definitively. If you take your child for screening, your doctor will focus on development and behavior. Diagnosis usually takes place in two steps for children:

In a developmental check-up, your doctor will look in your child for any signs whether he/she is on the right track like communicating, behavior, moving and speaking and the development is normally going.
Children should be screened if they show any developmental delays at nine months, 18 months, 24 months, or 30 months. At 18 months or 24 months, the child is screened explicitly for any signs of Autism.
If the child shows any problems during the screening, he is taken to a complete evaluation test to test for hearing and vision first. Your doctor might suggest you to another doctor who specializes in Autism disorders.

Autism Treatment

There is no permanent cure for Autism. But it can be managed well if treated at an early age. If you feel your child is not responding well or not developing like other children, go immediately to your doctor.

Treatment may work for one person but do not for another. Your doctor will treat you according to your capacity and level of Autism. The two main types of treatment are:

Applied behavior Analysis (ABA) is a behavior and communication therapy done to promote positive action and discourages negative behavior. Occupational therapy is helpful with life skills such as dressing, eating, etc. Speech therapy is used for improving communication skills. Sensory Integration Therapy is used for treating subjects who have a problem with touch or by sound or smell.
Some medication is also provided to deal with ASD-like symptoms such as anxiety, hyperactivity, etc.

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29Jan2021

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Schizophrenia

Of all the misunderstood mental illnesses, Schizophrenia gets a horrible reputation. The condition is characterized by disordered thoughts, unusual speech and behavior, and an inaccurate view of reality.

It’s often used as the go-to disorder for violent criminals in movies and television shows. Still, schizophrenia affects a diverse range of people, many of whom can lead to regular, satisfying lives with treatments like therapy and medication.

Schizophrenia is a complicated mental health problem related to psychosis. There are lots of misconceptions about it. Even mental health professionals disagree about it. But the reality is that about 1 in every 100 people get this diagnosis at some point in their life. With the context being set up, in this blog, we will try to explain the various facets of Schizophrenia, starting with its definition.

Schizophrenia is a mental disease that generally appears in a person in early childhood or late adolescence. This mental disorder is characterized by hallucinations, delusions, and several other cognitive impairments. Schizophrenia can be a lifelong struggle for people affected by this disease. People who have this mental disorder may hear sounds and voices that are not there in reality.

Some patients who have schizophrenia can feel and even convince themselves that others are reading their minds, plotting against them, or controlling their thinking. Schizophrenic patients often remain withdrawn and feel distressed or even act fanatically at times.

People living with schizophrenic patients often find it hard to understand what the patient is talking about. On other occasions, schizophrenic patients, when they seem to feel okay, may start explaining what they are genuinely thinking about. It is a very actual fact that mental disease’s effects reach far beyond the patients themselves.

It also affects their friends, families, and society. A sizable proportion of schizophrenic patients have to rely on others for their daily sustenance since they often become unable to hold any job or take care of themselves. Many schizophrenia patients also resist their treatments as they feel normal, and there is nothing wrong with them.

Now that we understand what Schizophrenia entails, let’s look at its symptoms, causes, and possible treatments:

Symptoms:

Many experiences and behaviors can be part of schizophrenia. They can start suddenly, or they might develop gradually over time. Each person’s experience is unique. A doctor might suggest you have schizophrenia if you experience some of the following:

A lack of interest in things
Feeling disconnected from your emotions.
Difficulty concentrating
Wanting to avoid people
Hallucinations, such as hearing voices or seeing things others don’t
Delusions (strong beliefs that others don’t share), including paranoid delusions
Disoriented thinking and speech
Not wanting to look after yourself.

Causes:

No one cause has been linked to schizophrenia. Doctors suspect that genetics may play a role in some cases: A chemical imbalance related to the neurotransmitter dopamine may increase someone’s chances of developing schizophrenia, as can complications during their birth. People with a parent with schizophrenia are more likely to have it themselves, but this is thought to result from a cocktail of genetic factors and not one specific gene mutation. There’s also a clear line between schizophrenia and environmental pressures. Stressful situations can trigger schizophrenia in people who are already predisposed to it. People with schizophrenia are also more likely to abuse substances (up to 50 percent are addicted to drugs or alcohol). Still, it’s not always clear when the behavior exacerbates the disorder or vice versa.

Treatment:

There’s no cure for schizophrenia. If you’re diagnosed with this disorder, you’ll need lifelong treatment. Treatments can control or reduce the severity of symptoms. It’s essential to get treatment from a psychiatrist or mental health professional who has experience treating people with this disorder. You may also work with a social worker or a case manager too. Possible treatments include the following:

Medications: Antipsychotic medication is the most common treatment for schizophrenia. Medication can help stop hallucinations, delusions, symptoms of psychosis. Antipsychotic medications that target the neurotransmitter dopamine are commonly prescribed to patients. Some examples of these drugs include aripiprazole (Abilify), brexpiprazole (Rexulti), and lurasidone (Latuda). Drugs can make life manageable for schizophrenic patients, but they can also come with side effects such as weight gain, constipation, low blood pressure, and even seizures.

Psychosocial intervention: Another treatment option for schizophrenia is a psychosocial intervention. This includes individual therapy to help you cope with stress and your illness.

Schizophrenic patients are at a greater risk for a slew of different mental illnesses. Rates of depression, anxiety, obsessive-compulsive disorder, and post-traumatic stress disorder are higher among people with schizophrenia. Symptoms of schizophrenia can overlap with these disorders: Suicidal thoughts and a lack of motivation and interest in life are schizophrenic symptoms that are also hallmarks of depression.

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19Dec2020

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Critical Care Anesthesia

Keeping patients comfortable, without pain and distress, and continuously monitoring vital signs is what makes this profession so important.

What is Anesthesia?

Anesthesia is a medical treatment that prevents the feeling or sensation of pain with or without loss of consciousness during medical procedures. Anesthesiology also includes traditional intraoperative care and sub-specialties like chronic pain management and critical care.

Anesthesiologists are specialized doctors who administer anesthetics to patients, depending on the patient and the pain relief required. The various anesthetics administration routes include injection, inhalation, topical lotions, sprays, skin patches, and eye drops. Anesthesia is usually administered to patients who undergo complicated procedures like surgeries.

What are Anesthetics?

Anesthetics are drugs that reduce or prevent pain. There are mainly three types of anesthetics used.

In a restricted area of the body, local anesthetics are drugs that, upon topical application or local injection, cause a reversible loss of sensory perception, especially pain.

Regional anesthetics are local anesthetics that block the sensation perception from a larger body area, such as an arm, leg, or abdomen.

General anesthetics are drugs that cause a reversible loss of consciousness, immobility, muscle relaxation, and sensation, especially pain.

When local anesthetics or regional anesthetics are administered, the patient remains conscious, but during the administration of general anesthetics, the patient is unconscious and unaware of his/her surroundings. Anesthetics given to patients in critical care units are usually general anesthetics.

What do you mean by critical care?

Critical care or Intensive care is a specialized type of care administered to patients with life-threatening injuries and illnesses. They need constant monitoring and comprehensive care and are usually admitted to intensive care units (ICU).

Health-care providers use a lot of different equipment like catheters, dialysis machines, feeding tubes, etc. Devices also monitor the patient’s vital signs and display them on monitors. These machines help keep patients alive, but they can also increase the risk of infection.

Critical care anesthesia

Critical care anesthesia is a specific type of anesthesia where specialized anesthesiologists care for patients who have recently undergone major surgery or suffer from the effects of severe infections or trauma.

Critical care anesthesiologists possess the medical knowledge and technical expertise to deal with emergencies. They work in intensive care units as essential doctors of care, also known as intensivists. They have the training to deal with cardiac and pulmonary resuscitation, airway management, advanced life support, and airway control; stabilizing the vitals.

They know how to stabilize and prepare patients for emergency surgeries. They coordinate and work closely with other specialists like surgeons to manage treatments for patients and deliver a full range of care. They act as a connecting link between surgeons and physicians to ensure that they work together effectively and for the same purpose.

Critical care anesthesiologists continue to care and check on patients multiple times throughout the day and even at night.

Some of the standard protocols critical care anesthesiologists follow are –

-Monitor the electrical activity of the heart

-Monitor the blood oxygen saturation

-Monitor vital signs like blood pressure, respiratory rate, and heart rate.

Usually, patients in the ICU are given intravenous saline so that they stay hydrated.

During the coronavirus pandemic, the importance of critical care anesthesia has risen up. Anesthesiologists are working tirelessly to provide the necessary care required for an excessive amount of patients.

The management of COVID-19 patients includes specialized anesthetic care for patients with suspected and confirmed COVID-19, intubation outside operation theatres, oxygenation and ventilation support for acute hypoxemic respiratory failure, emergency management and participation in other patients care aspects.

Anesthesiologists have to be very careful as they will be handling most of the patients with respiratory disorders. Some requirements that need to be followed are

-All suspected patients must be kept in isolation rooms before their procedure.

-Anesthesiologists must wear Personal Protective Equipment at all times.

-Operations, when conducted, should be done in a negative pressure or positive pressure isolation rooms.

Effect on patients

Critical care can have a significant impact on patients. Before being administered with anesthesia, patients must undergo a diagnostic assessment to determine his/her ability to survive the stress of anesthesia and surgery.

Some difficult decisions must be made if the patient is critically ill or closer to death. Some patients may have to be resuscitated. Others can live but only with the aid of machines. The outcomes of these decisions must ensure that the patient undergoes minimal suffering. The entire team of healthcare workers and the patient’s family are involved in making these decisions.

Anesthesiologists around the world work long hours and fatigable work shifts. Critical care anesthetists have more stress while handling multiple patients and continuously monitoring their vital signs. The coronavirus situation has heavily impacted the work-life of these anesthesiologists, causing even more challenges.

Anesthesiologists are like the heroes behind a mask who ensure the patient’s safety while other specialists carry out their procedures. We have to thank them to keep us comfortable, pain-free, and in good health.

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14Dec2020

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Coronary Angiography

Coronary angiography is a diagnostic procedure performed to check the blood flow and presence of any obstruction (blockages) in coronary arteries that supply blood to the cardiac muscles.

How Coronary Angiography is done?

This procedure is done through the radial artery that is present in the wrist and the femoral artery (thighs). Anyone location is chosen to do this procedure. The sheath is placed within the artery using a needle. A tube-like structure known as the diagnostic catheter is passed through the artery towards the aorta ( the biggest blood vessel arising from the heart). The end of the catheter is placed at the opening of the arteries and a contrast dye is injected into the coronaries.

At the same time, fluoroscopy is done which permits the visualization of the flow of the dye through the coronaries and can be seen on a screen. Fluoroscopy uses X-rays to visualize the coronaries. Images are then acquired at diﬀerent angles to get a complete idea of the coronaries. The catheter is removed along with the sheath from the artery. The wound is then dressed and heals with proper post-care.

Is it painful? Does it create a wound?

A small puncture hole on the skin about 2 mm in diameter is created using a needle puncture. It is done under local anesthesia and does not require any stitches. When properly done it is painless and all that is felt is a tiny prick of the needle.

Does it require admission to the hospital?

It can be done as an out-procedure and the patient can go home on the same day itself. Usually, patients can be discharged after 4 hrs when done via the radial artery and 6 hours when done via the femoral artery.

Is it a dangerous or life-threatening procedure?

It is a relatively safe procedure and needs to be done only by an expert. As it is an invasive procedure, complications may arise depending on various factors involved in a patient’s medical history. Some minor complications that may arise include hematoma at the puncture site, vasospasm, minor allergic reaction to the dye. Very rarely, life-threatening complications like myocardial infarction, arrhythmias, anaphylaxis, stroke, renal failure, or death may occur. However, these are extremely rare cases and occur in less than 1% of patients.

Can coronary angioplasty be done immediately after angiography?

Yes. Angioplasty which involves stenting the blockages seen on angiography can be performed immediately after angiography depending on the clinical circumstances.

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29Nov2020

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Root Canal Treatment

A root canal, or more specifically, a root canal treatment, is a procedure dentists use to save a badly infected tooth instead of removing it altogether.

The pulp is the root’s innermost area, which is richly supplied with blood vessels and nerves. Any kind of sensation of the tooth, like sensitivity or pain, arises from this area.

The root canal by itself is a region of space in the root of the tooth.

What is Root Canal Treatment?

This is also known as endodontic therapy, endodontic treatment, or root canal therapy. It involves the cleaning, disinfection, decontamination, and filling of the infected area of the root canal.

Removal of the tooth’s pulp and subsequent filling can prevent further microbial contamination and the spread of this infection. However, if the tooth is too damaged, dentists will most likely remove the tooth and replace it with dental implants or partial dentures.

Why do we need this root canal treatment?

When a tooth gets infected, the bacteria attack the enamel first and slowly make their way through the dentin and eventually into the pulp.If the pulp gets infected, it can lead to tooth abscesses. Symptoms include:

Terrible toothaches that can radiate to the jaw and bone.
Increased sensitivity to extreme temperature changes
Pain while biting
Fever may be present

More severe cases of infection can also cause bone decay and tooth loss.

The Procedure

Root canals previously would be excruciating procedures. With newer methods and better technology, it’s a procedure that will not cause a lot of pain and keep teeth healthy and clean.

Local anesthesia is usually administered to patients undergoing this treatment. An opening is made through the tooth’s crown, and specific instruments are guided into the tooth’s innermost pulp area.

The infected pulp is then removed. Once the tooth is completely clean, the dentist will fill it with inert materials like gutta-percha, a cement made up of zinc-oxide eugenol.

Epoxy resin is used as a binder for gutta-percha. Antiseptic materials like paraformaldehyde containing N2 may also be used.

Complications

Although this procedure aims to eliminate infection and pain in the mouth, a couple of complications could occur.

Infection: infection after a root canal is not common, but if present, it can cause damage in and around the area of the root canal.
Accumulation of unwanted materials: Cholesterol crystals can accumulate and cause irritation and lesions.
Immune response: this procedure can trigger an overactive immune response that leads to adverse health impacts.
Toxic materials: Filling materials such as amalgam contain mercury and other metals, which can be harmful.

Modern technology and recent findings have made complicated procedures such as root canals easier to carry out with a higher success rate. The pain caused due to a root canal is tolerable than the pain of an infected tooth.

Moreover, having a lax attitude can also spread the infection to other teeth in the mouth. Regular checkups, good mouth hygiene, and eating healthy foods can help prevent any kind of complication to the teeth.

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Welcome

Category Archives: Health care

Autism Spectrum Disorder

Signs and Symptoms of Autism

Types of Autism Spectrum Disorder

Causes of Autism

Autism Screening and Diagnosis

Autism Treatment

Schizophrenia

Symptoms:

Causes:

Treatment:

Critical Care Anesthesia

What is Anesthesia?

What are Anesthetics?