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by Dr.Saurabh Joshi,MD 3. March 2011 08:35

Depression a disorder in which a person feels sad, hopeless, irritable, guilty and helpless. It is a mental condition which could affect physically on the body leading to many complications.

CAUSES: One of the major causes is the trauma of having someone lost in your life. Death of a loved one and loss of financial assets are frequently faced trauma by the depressed individuals. Moreover, brain have specialized transmitter substances that transmit information with the body and brain, change in the levels of those neurotransmitters could markedly cause depression. Hormones, substances produced by different glands in the body could also give rise to depression. Apart from these, genetic traits could also make one individual prone to depression.

Depression could easily give rise to suicidal attempts if not considered for a treatment. The person goes on with his pessimistic thoughts in which he thinks he would find solace in death and then he goes for it. Depression is a state of mental illness and with having one’s mind depressed, physical illnesses like blood pressure change, anxiety, kidney problems and GIT problems could arise.

The patient seems ill, sad and looses sleep. His interest in social interaction and se is reduced markedly and apart from loosing physical vigor, he is unable to make decisions about logical phenomenon. The patient might start crying for no apparent reason and his thinking process is slowed down.

TESTS: Blood tests are taken to check the level of hormones such as testosterone, thyroxin, ESR, infection and electrolytes. Cognitive tests are also performed to check the patient of possible psychosis and dementia.

Social counseling could relieve the depressed patient of trauma of loss. The affected individual is persuaded towards positive aspects of life and prevented from taking things in his life on the negative side. Drugs called as antidepressants such as selective serotonin uptake inhibitors are also advised and electroconvulsive therapy is resorted in extreme cases.

Abstaining from smoking, alcohol consumption, getting enough sleep, making a strong social collaboration, healthy social interaction, exercise, meditation, musical therapy and healthy diet full of vitamins and minerals could minimize the rate of depression an individual might face in his life.

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Dengue Fever

by Dr.Saurabh Joshi,MD 3. March 2011 08:34


            It is a non-contagious disease being spread by mosquitoes to the human community. The virus they carry to human is fatally dangerous and if untreated, the victim could even collapse to death. As evident from the name, it is a fever accompanied by various other hazardous symptoms like low blood pressure, pain and excessive bleeding in abdomen or chest.

CAUSES: The causative agent is DENV virus which enters the body from a mosquito bite and attaches to the body cells into which it replicates and mobilizes to the body’s immune system. It is observed that the body’s defense action after failing to counteract the virus becomes a means of is duplication due to which the disease takes a course of vicious cycle. Mosquitoes carrying this virus could even be found near the cleanest waters. Repeated dengue fever shows infection with each of four different types of DENV virus.

Inhabiting areas of moist climate near rivers or ocean could increase susceptibility to the mosquitoes subsequently to the virus. Second dengue fever due to a different type of DENV virus would be even severer than the previous one.

High temperature, headache, backache, nausea, vomiting, joint and muscle pain, bleeding underneath the skin, suppressed body defense mechanism, generalized damage to vessels all over the body leading to bleeding and pain are all the symptoms of dengue fever.

TESTS: CBC or complete blood count of blood showing decreased white blood cells, decreased platelets and then metabolic acidosis with high hematocrit and low albumin level indicates dengue fever. Physical examination of liver and inspection for ascites along with the tourniquet test in which the cuff for measuring blood pressure is applied for five or more minutes and observation for rashes or purple spots on the arm is made are effective methods to diagnose dengue fever.

No approved vaccine is available for the disease but many are under clinical trials. An important factor is that the vaccine might actually trigger the virus to duplicate instead of sensitizing it.

Remove any water containers nearby before sleeping. Use insecticides, bio-control agents and mosquitos’ repellants to keep them away. Covering the skin with clothes before going to sleep could effectively prevent mosquito from reaching your blood.

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by Dr.Saurabh Joshi,MD 3. March 2011 08:33

Dementia is a collection of symptoms which explain the falling efficacy of an individual at his social, personal and physical reasoning along with decrease in his ability to recognize and recollect from the past the name or numbers related to the environment in which he daily interacts.                     

CAUSES: The causes of dementia are highly variable ranging from stroke, brain trauma, and hypoxia to complex diseases such as Alzheimer’s and Parkinson diseases. Decreased level of hormones produced from thyroid glands of the neck and decreased vitamin B1 level could also cause memory loss. Deficiency of other vitamins and minerals along with viral, bacterial or fungal infections could also trigger gradual loss of memory and cognitive functions.

Person suffering from dementia shows slow responses to a stimulus and takes a lot of time to remember things from his past. The person shows changes in his personality and interaction. He often hallucinates hypothetical objects and is incapable of reasoning.

TESTS: Abbreviated mental test score, mini mental state examination and clock drawing tests are carried out in which the patient is asked to tell the right information about his personality and surroundings. Blood tests for detecting thyroid hormone level, electrolytes, vitamins, enzymes and infection are also carried out. X-ray examination and MRI, another such technique, are also fruitful in diagnosing the condition.

Antipsychotics, anxiolytics and antidepressants are observed to reduce the rate of dementia. Incase of Alzheimer’s disease, ACE inhibitors are co-administered with N-methy-D-aspartate Blockers.

Healthy diet indicating adequate vitamin and mineral intake with regular mental and physical exercise along with adequate brain use could prevent the occurrence of dementia not to mention the importance of avoidance of alcohol and smoking in decreasing dementia.


Delayed Ejaculation

by Dr.Saurabh Joshi,MD 3. March 2011 08:32


                        Normally, a man reaches climax with 2-4 minutes of active stimulation of the genitals after which semen is discharged. In this particular condition, he is unable either to reach the climax i.e. orgasm or is takes a lot of time to ejaculate like 30-45 minutes. Sometimes the condition us caused by psychological disorders where the man can ejaculate upon masturbating but cannot during a normal intercourse. To make the picture more confusing, the condition might vanish for sometime and then return again.


CAUSES: Common psychological causes include a strict religious background, lack of attraction; stress, anxiety, emotional stupor; breakup or even anger might be involved. Physical causes include neurological diseases, birth defects, stroke, hypotension, heart surgery, prostate surgery, nerve block and use of certain drugs that are hazardous to sexuality. Prescribed medications and even the drug abuse could also be an important cause of the condition.

Person’s with economical, mental and physical stress could loose interest in sexuality making them more liable to delayed ejaculation. Aging, alcohol, smoking, depression and antidepressants put the man on high risk for the condition of delayed ejaculation.

Ejaculation upon manual stimulation or oral stimulation after a considerable period of time is a vital symptom of the disease.



by Dr.Saurabh Joshi,MD 3. March 2011 08:31


            When fluid loss exceeds fluid gain, the body goes in a state of dehydration which strains almost every vital system of the body. Any of the pathological condition of vomiting, diarrhea, sweating, excessive urination or decreased intake of water could result in dehydration. Fortunately, this could be reversed by taking solutions taking high osmolarity as this would make the thirst centers of the body in brain to stimulate in the patient of feeling of scarcity of water called as thirst.

CAUSES: High blood glucose causes high blood concentration and the volume is raised due to which more urination occurs, this could lead to excessive water loss from the body. Also in diarrhea or vomiting, possibly due to eating contaminated food, the body looses much of its water content. In extremely hot weather, the body might loose excessive water by skin i.e. sweating. Skin burns causes excessive loss of protein content of blood due to which water, along with proteins, also moves out from the burn sites i.e. edema thus aggravating dehydration.

Dehydration poses potential threat to heart complications including hypotension and angina. Blood volume depletion could lead to increased stress on heart to force it to pump with extra effort to utilize maximally what is left of the blood. Moreover, medications the heart patients might be taking would render this compensatory response ineffective leading to complete inability to maintained sufficient blood supply to all the tissues of the body, most vitally to the brain, in an attempt to maintain stable body functioning. Children and persons with high metabolic activity such as sports men are more susceptible to dehydration.

SYMPTOMS: Easy fatigue ability, sleepiness, dry mouth, decreased urination, headache, lack of sweating, sticky mucous, hypotension i.e. low blood pressure, fast heart beat rate and in extreme conditions unconsciousness and fever might be there. Dark yellow urine of high concentration and low volume is another symptom of dehydration. Decreased mental functioning and cognitive responsive might be a signal to dehydration.


·         Urine analysis to determine urine volume

·         Blood test to evaluate protein content of the blood and electrolyte quantities

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by Dr.Saurabh Joshi,MD 3. March 2011 08:30

It is natural for skin to shed off the surface with time as it is replaced by new skin underneath. But, shedding off of scalp with abnormally high rate in response to unsuitable surrounding environment of the shed site is what is called dandruff in medicine. Sudden change in temperature, i.e. from hot to cold or invasion by any parasite might trigger the process.

CAUSES: Glands situated in the scalp secrete sebum, a secretion that is known to increase skin shedding. Parasitic invasion by certain fungi or bacteria and increase in the population of normally occurring fungi in the scalp are the chief causes. Temperature change which in turn could lead to increased or decreased sweating of scalp is also a vital factor. Diseases like eczema and psoriasis and dryness of skin with low usage of shampoo are other causes of dandruff

The disease is accelerated on inadequate application of oil on the skin. Risk factors of the disease are also associated with sex as males have more sebum producing glands. People having inadequate dietary supply of vitamin-D and zinc could render their scalp nourishment deficient hence increased dandruff. Reduced immunity of the body leads of increased fungal and bacterial population on the skin thus increasing dandruff further. The disease might be linked with seborrhoeic dermatitis as the latter is defined on a broader spectrum of body sites susceptible to flaking off of superficial skin.

Dandruff victims show increased quantity of skin flakes in their hair often accompanied by itching and irritation. Symptoms are more likely to be exaggerated in the season of winter.



by Dr.Saurabh Joshi,MD 3. March 2011 08:28


The disease is associated with the inflammation of the tendons of two muscles which have synergistic action of extending the thumb. Victim is unable to clench his fist or move the thumb repeatedly as in playing music, lifting objects or doing so would result in pain and discomfort.


CAUSES: Inflammation of the tendon results because of the overuse of the muscles associated with the tendons which in this case are extensor pollicis brevis and adbuctor pollicis longus muscles. Direct physical trauma to the outer side of the wrist at the base of the thumb might initiate the inflammation. Also in rheumatoid arthritis, a disease of joints could be the cause. The condition is still to be researched on as the cause of the disease seems much more complex.

While the patient grips something, the outer side of the wrist pains over the side of the thumb. The area becomes tender and swollen due to underlying inflammation of the two tendons. A fluid filled cavity might appear and a feeling of friction in the tendons might be felt.

TESTS: The specific condition is diagnosed by performing a physical method called as Finkelstein’s test. In this test, the doctor asks the patient to deviate his hand opposite to the thumb and grasps his thumb in the direction of the deviation, if the pain radiates in the same direction, the patient is suffering from the disease. The condition should be differentiated from intersection syndrome in which the pain radiates towards the back of the arm and hand.

The treatment involves both drug administration and physical manipulation. Anti-inflammatory drugs and cortisone are mostly prescribed. Physical manipulation includes rest, splinting ice, immobilization of the wrist and even surgical approach in extreme cases.


Deep Vein Thrombosis

by Dr.Saurabh Joshi,MD 3. March 2011 08:26

Blood is composed of plasma and cells. The plasma portion of the blood contains specific proteins that coagulate upon injury or inflammation in the tissues and even in the vessels of the body. Coagulation of the blood in one of the deep veins of any organ of the body causes a solid lump formation in the vessel which further causes swelling and the resulting pain in the vein. Such occurs frequently during a long flight in which you might be sitting in a same position for a considerably long time.

CAUSES: Primary cause is the decreased flow of blood which leads to static blood in that particular vein. Moreover, physical trauma and the infection by bacteria or viruses in that vein could result in coagulation and thrombus formation in that vein. Compression of the vein results in intermittent or no blood flow through veins. Since blood in veins is pumped by muscular compressions and movement, hospitalization and immobility are other causes of DVT.

If one’s heart fails to pump blood effectively, this could lead to lowering of blood flow and stasis of blood followed by clotting of the blood. Further more, when the blood has clotted in one of the deep vein of the individual, it could be move to other veins which is termed as embolism further spreading the blockage of blood. Deep vein thrombosis could also block the blood flow in the superficial veins possibly through embolism and result in stasis of blood which could further cause oozing out of blood fluids into the tissues i.e edema and swelling. Statistical analysis shows increased chances of clot formation in people taking oral contraceptives to prevent pregnancy. Such orally administered contraceptives are composed of estrogen or progesterone, hormones that interrupt the implantation of baby in the womb. Such pills should only be taken upon doctor’s recommendations strictly according to schedule and dosage. 

DVT often isn’t accompanied by any physical symptoms but pain, swelling and inflammation. The affected organ that might be a limb appears pale colored and cool impacted by decreased blood flow to the region surrounding the vein.

Complete blood count is taken to asses the clotting factors and cellular composition to rule out the cause of coagulation. D-dimer is a degradation product of the clot, the presence of which in the blood test would indicate positive deep vein thrombosis. Ultrasound examination of the clot and physical examination is often helpful in diagnosing DVT.

DVT is commonly cured by administering the patient with anticoagulants such as heparin, a drug that blocks the process of clot formation in blood. Vitamin-K is an essential component of the clotting process; drugs that block the action of vitamin-K are also administered. Compression stockings are applied which are elastic and as the organ moves, the blood moves with more feasibility reducing the chances of clotting. Thrombectomy involving cutting out of the clot is adopted in extreme cases.

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by Dr.Saurabh Joshi,MD 3. March 2011 08:24

Aphasia is a language disorder in where there is a problem with language modality which may lead to difficulty in expression both in verbal communication and in written. It all depends on the brain damage and specifically, the area of brain damage. A person with aphasia may be able to speak well but can’t write or he/she able to write but have problem with is/her speech. It can be associated with impairment of articulation or stammering or inability to deal effectively with or manipulate objects as a result of a brain lesion also called apraxic.

Aphasia can be diagnosed in many ways, starting with clinical assessment during hospitalization to session of tasks that look into vital language components and communication. Diagnosis of aphasia depends mostly, with patient  age, position and size of lesion, and the type of aphasia.

Aphasia can be classified using the following model:

·        Fluent, non-fluent and "pure" aphasias which include: Receptive aphasias: the patient has the problem with how receive words, sentences by hearing. Examples of receptive aphasias include conduction aphasia, and transcortcal aphasia. We have aphasias patient who are classified by what they can perform and can’t perform for example a patient who have can read but can’t write or can write and can’t read. Expressive aphasias the patient has difficult with his/her articulation but his hearing remain very good. Example include Global aphasia and Broca’s aphasia

·        Primary and secondary aphasia

·        Cognitive neuropsychological model

·        Acquired childhood aphasia



Aphasia patient mostly express the following signs and symptoms:

  • Poor speech
  • Difficult to form words
  • Always repeating words
  • confusing letters, syllables or words
  • has problem to communicate grammatically correct
  • problem with pronunciation
  • excessive creation
  • not able to repeat phrases
  • Doesn’t use complete sentences
  • Difficulty in reading 
  • Difficulty in writing
  • limited verbal output
  • have problem with naming things

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Ankylosing spondylitis

by Dr.Saurabh Joshi,MD 2. March 2011 15:36


Ankylosing spondylitis is a chronic inflammation that mainly affects joints in the spine and the sacroilum in the pelvis, and can cause eventual fusion of the spine. Sacroiliac joint is a joint in the bony pelvis that is between the sacrum and ilium of the pelvis. It is joined together by a ligament.  The spine is supported by the sacrum. The joint is very strong and bears the weight of synovial joint. The inflammation in sacroiliac joint causes stiffness and pain in the spine


 Genetic factors play a greater role in the causes of ankylosing spondylitis that is thought to pass from one parent to the off spring and affects particular ethnic individuals.

Ankylosing spondylitis may be started by bacteria or viruses which in turn activate an immune system which will not stop even after the infection has been contained causing autoimmune disease which a condition where  the leucocytes attack the body  tissues.

Men are more likely to have ankylosing spondylitis associated with the inflammation of the spine, pelvis, chest wall, and shoulders while women will have inflammation of the pelvis, hips, knees, and wrists.



Early symptoms of ankylosing spondylitis usually begin in early adulthood. They begin gradually and include:

  • Tiredness
  •  back pain
  • Stiffness in the low back
  • hip pain and stiffness
  • The pain usually begins low and slowly progresses up the spine

·         neck pain

  • morning stiffness and pain relieved by movement and not by rest
  • Fatigue
  • Weight loss

·          Cannot expand the chest

·           Motion spine and hips is limited

·          Shoulders, knees, and ankles experience pain and swelling

·         Heel pain  Fever

·         Loss of appetite

·         Weight loss

·          Inflammation of the eyes



There are medicines that the doctor can prescribe to you like the nonstreroidal anti-inflammatory drugs. Exercising daily will help to form a good posture and flexibility and some point reduces pain. Surgery is an option in very serve case which involve joint replacement.

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About the author

Dr.Saurabh Joshi,MD  is a medical doctor offering live advice online. He is a partner in a Medical Private Practice and can answer questions related to almost all medical specialties.

He can be contacted for a Live Onine Consultation HERE