Osteomalacia - Causes, Symptoms and Treatments

Osteomalacia, or soft bones, often develops because of a lack of vitamin D. It causes severe bone pain and muscle weakness. In Victorian times the condition often affected children and was called rickets, but today osteomalacia usually affects adults, especially the elderly and/or people of South Asian origin.

The causes of adult osteomalacia are varied, but ultimately result in a vitamin D deficiency:

• Insufficient nutritional quantities or faulty metabolism of vitamin D or phosphorus
• Renal tubular acidosis
• Malnutrition during pregnancy
• Malabsorption syndrome
• Hypophosphatemia
• Chronic renal failure
• Tumor-induced osteomalacia
• Long-term anticonvulsant therapy
• Coeliac disease
• Cadmium poisoning, Itai-itai disease

Symptoms of osteomalacia can include:

• pain felt in your bones – usually felt in your legs, groin, knees and feet
• muscle weakness – usually affects your thighs, shoulders and main trunk of your body
• back pain
• pain caused by slight cracks in the bone (partial fractures) – sometimes these cracks can turn into complete breaks (complete fractures)

As the condition gets worse, pain can be felt everywhere and any movement can be painful.

Osteomalacia in adults starts insidiously as aches and pains in the lumbar (lower back) region and thighs, spreading later to the arms and ribs. The pain is symmetrical, non-radiating and is accompanied by sensitivity in the involved bones. Proximal muscles are weak, and there is difficulty in climbing up stairs and getting up from a squatting position.

Due to demineralization bones become less rigid. Physical signs include deformities like triradiate pelvis and lordosis. The patient has a typical "waddling" gait. However, those physical signs may derive from a previous osteomalacial state, since bones do not regain their original shape after they become deformed.

Pathologic fractures due to weight bearing may develop. Most of the time, the only alleged symptom is chronic fatigue, while bone aches are not spontaneous but only revealed by pressure or shocks.

It differs from renal osteodystrophy, where the latter shows hyperphosphatemia.

Patients who have osteomalacia can take vitamin D, calcium, or phosphate supplements, depending on the individual case. For instance, people with intestinal malabsorption (the intestines cannot absorb nutrients or vitamins properly) may need to take larger quantities of vitamin D and calcium.

Other treatments to relieve or correct osteomalacia symptoms may include:

• Wearing braces to reduce or prevent bone irregularities
• Surgery to correct bone deformities (in severe cases)
• Adequate exposure to sunlight

10 Early Signs and Symptoms of Prostate Cancer

Prostate cancer is one of the 10 most common diseases that afflict man. Unfortunately, men often are not aware of him until the disease is spread and more difficult to treat. This could be due to too many symptoms. At least, there is a way to recognize the symptoms of prostate cancer. Let us look at the following signs and symptoms:

1. Difficult urination

Could be a feeling of wanting to urinate but nothing comes out, stop when you're urinating, there is still a feeling of wanting to urinate or have to travel frequently to the toilet to urinate due out a little bit. This phenomenon is due to enlargement of the prostate gland is around the urinary tract due to a tumor in it so disturbing voiding process. The prostate gland will be greater with age a person. So check with your doctor to distinguish whether only prostate enlargement or cancer.

2. Pain during urination

This problem is also due to prostate tumors that suppress the urinary tract. However, pain can also be a symptom of prostate infection called prostatitis. It could also be a sign of prostate hyperplasia is not cancerous.

3. Bleeding during urination

These symptoms are rare, but should not be ignored. Immediately see a doctor even if only a little blood ejected, or only faint faint pink. Sometimes a urinary tract infection can also cause these symptoms.

4. Hard erection or sustain an erection

Prostate tumors may cause blood flow to the penis which should increase the time of the erection becomes blocked so hard erection. Could also cause an erection can not ejaculate after. But once again, an enlarged prostate may cause these symptoms.

5. Blood in semen

These symptoms, such as blood in the urine, may arise not so clear. Blood in large quantities and not just cause the color changed to pink. Still worth on alert.

6. Difficult defecation and no other gastrointestinal problems

The prostate gland is located below the bladder and in front of the rectum. As a result, when there is impaired intestinal tumors. But remember, difficult defecation Persistent could also lead to an enlarged prostate gland due to pressure on a continuous basis. Difficult defecation and gastrointestinal disorders may also indicate colon cancer.

7. Continuous pain in the lower back, pelvis or upper thighs

Frequently, prostate cancer spreads in these regions, ie at the lower back, pelvis and hip pain that is difficult to explain in this section can be a sign of disturbance

8. Frequent urination at night

If you often wake up at night more than once just to urinate, check immediately to the doctor.

9. Urine dripping or not strong enough

These symptoms similar to urinary incontinence (wetting). Urine can not be held until slowly out and drip. Or if it was not strong enough flow out.

10. The age of 50 and have risk factors

Because it does not cause symptoms, men who have risk factors should be screened routinely. These risk factors include a family member who had cancer, especially if it's the father, obesity / overweight and smoking is a risk factor for prostate cancer.

Staging of Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma is a rare tumor arising from the epithelium of the nasopharynx.

Nasopharyngeal carcinoma is difficult to detect early. That's probably because the nasopharnyx isn't easy to examine and symptoms of nasopharyngeal carcinoma mimic those of other more common conditions.

Three subtypes of NPC are recognized in the World Health Organisation (WHO) classification [20]:

• type 1: squamous cell carcinoma, typically found in the older adult population

• type 2: non-keratinizing carcinoma

• type 3: undifferentiated carcinoma

Possible noticeable symptoms of nasopharyngeal carcinoma include:

• A lump in your neck caused by a swollen lymph node
• Blood in your saliva
• Bloody discharge from your nose
• Nasal congestion
• Hearing loss
• Frequent ear infections
• Headaches

Staging of Nasophayngeal Carcinoma

Staging of Nasophayngeal Carcinoma is based on clinical and radiologic examination. Most patients present with Stage III or IV disease.

Stage I is a small tumor confined to nasopharynx.

Stage II is a tumor extending in the local area, or that with any evidence of limited neck (nodal) disease.

Stage III is a large tumor with or without neck disease, or a tumor with bilateral neck disease.

Stage IV is a large tumor involving intracranial or infratemporal regions, an extensive neck disease, and/or any distant metastasis.

No sure way exists to prevent nasopharyngeal carcinoma. However, if you're concerned about your risk of nasopharyngeal carcinoma, you may consider avoiding habits that have been associated with the disease. For instance, you may choose to cut back on the amount of salt-cured foods you eat or avoid these foods altogether.

Treatment for nasopharyngeal carcinoma usually involves radiation therapy, chemotherapy or a combination of the two. You can work with your doctor to determine the exact approach depending on your particular situation.

Hyperthyroid Crisis (Thyrotoxic Storm) - Self-Care at Home

Thyroid storm, also referred to as thyrotoxic crisis, is an acute, life-threatening, hypermetabolic state induced by excessive release of thyroid hormones (THs) in individuals with thyrotoxicosis.

Symptoms of Thyroid Storm

• Rapid heart beats (palpitations)
• Greatly increased body temperature
• Chest pain
• Shortness of breath
• Anxiety and irritability
• Disorientation
• Increased sweating
• Weakness
• Heart failure

Diagnosis of Thyroid Storm

The following tests are usually performed to diagnose thyroid storm:

• blood cell count,
• electrolyte levels,
• blood sugar level,
• liver function, and
• thyroid hormone levels.

Investigations of Thyroid Storm

• Investigations for any underlying precipitant - eg, infection screen.
• TFTs: elevated T3 and T4 levels, elevated T3 uptake, suppressed TSH levels.
• Indications of decompensation of homeostasis - eg, renal dysfunction, elevated creatine kinase, electrolyte imbalance (due to dehydration), anaemia, thrombocytopenia, raised white cell count, abnormal LFTs (raised levels of transaminases, lactate dehydrogenase, alkaline phosphatase and bilirubin), hypercalcaemia, hyperglycaemia.
• ECG.
• CXR.
• Arterial blood gases and pH.

Thyroid Storm Self-Care at Home

People experiencing thyroid storm are not able to function normally. Thyroid storm is always a medical emergency. People experiencing symptoms of thyroid storm should be taken to the closest hospital, because thyroid storm is a life-threatening condition.