Circle of Concern: How to Spot and Treat Ringworm

What is ringworm?

Ringworm is not a worm-transmitted disease. Dermatophytes are fungi that live on skin, hair, and nail keratin. The skin, hair, and nails might be attacked. Tinea, known by various names for the body and head portions, includes tinea corporis and tinea capitis. They look like a ring-shaped, raised, scaly rash that might be red, irritating, or flaky.

Lots of them:

• Foot itching
• Scrotum itching
• Getting scalp ringworm
• Nail onychomycosis

How it spreads

• Direct contact: With sick skin, animals, or dirty floors and towels
• It spreads particularly in warm and moist environments.
• Indirect contact can occur through unclean towels, gym mats, combs, and similar items.
• To soil (rarely, although some species)

Signs and symptoms

• Red, stinging, scaly flakes
• Clearer-cored ring sores
• Shaggy or lost hair (from scalp disease)
• Disease-related thick, discoloured nails

Note on Public Health

Ringworm accounts for half of the 650 million fungal skin infections worldwide. IIt appears most often on the heads of children.

What causes ringworm?

Dermatophytes are fungi that dwell on skin, hair, and nail keratin. This fungus prefers warm, humid conditions. It can cause tinea corporis, tinea capitis, and tinea pedis in different areas of the body.

Common Dermatophytes

• The dermatophyte Trichophyton affects the skin, hair, and nails of most people.
• Epidermophyton typically affects the skin and nails, while Microsporum can cause infections of the scalp.

Remove ringworm

Use antifungals and clean up to get rid of ringworm. The following steps are based on expert advice:

1. Use skin antifungals

• You can purchase Clotrimazole (Desenex), Miconazole (Cruex), and Terbinafine (Lamisil) lotions or ointments at any store.
• Apply the antifungal treatment twice daily, ensuring to extend it beyond the edges of the rash. Even if your symptoms improve, you should continue the treatment for two weeks.

2. Keep the area clean and dry.

• Wash the area daily with soap and water.
• Pat dry; fungus likes wet locations.
• Wear loose garments over the spot.

3. Stop the spread

• Wash clothes, towels, and blankets often.
• Change underwear daily.
• Do not disclose confidential info.

4. Use oral antifungals if necessary.

• Doctors may prescribe for head, nail, or body infections:
• With itraconazole and rifampin
• Fluconazole

5. Use antifungal shampoo for ringworm.

• Find shampoos with ketoconazole or selenium sulfide to kill fungus.

Also, read https://livlong.com/blogs/diseases/ringworm/everything-you-want-to-know-about-ringworm.

When to see a doctor

• If the rash persists after two weeks, If it spreads quickly or damages hair or nails
• If your defence is weak.

How to prevent ringworm transmission?

You must clean up your personal area, treat ringworm patients, and maintain a clean environment. This guide helps prevent the spread of disease-related thick, discoloured nails.

Personal hygiene

• Start treatment now: Treat painful areas with terbinafine or clotrimazole.
• Skin cleansing and drying: Moisture breeds mould and fungi.
• Do not scratch—it can spread the disease.

Turn off transmission

• Do not share private information: Towels, combs, caps, garments, and mattresses spread it.
• Wear breezy clothes: Tight garments trap moisture and worsen infection.
• Cover the wound: Wear clean clothes or a patch to avoid illness.

Environmental cleanup

• Clean gym equipment, bathroom floors, and communal spaces routinely.
• Wash filthy clothes, towels, and bedding in hot water and dry well.
• Mop and vacuum floors, especially with dogs or kids.

Pet Care

• Check your dogs for these signs: Animals, especially cats and dogs, spread ringworm.
• If your pet develops itchy areas or hair loss, take them to the doctor.

Family and Neighbourhood Advice

• Treat all sick people simultaneously.
• Avoid close contact until wounds heal.
• Inform schools and sporting teams about the spread of the infection.

How is ringworm diagnosed?

• Ringworm is a common fungal skin condition that is not worm-related. Also called tinea or dermatophytosis. How to spot it:
• Know About Ringworm: A circular rash is a red, scaly patch that expands outward. Sides may be elevated and redder, while the middle is clear.
• The region may itch, burn, or feel irritable.
• Flaked skin: Around the rash's margins, skin may flake.

Location-dependent symptoms:

• Scalp: Spots, black specks, or scaling hair loss.
• Cracked, peeling skin between the toes is athlete's foot.
• An inside-leg or buttocks groin itch is red and irritating.
• Thicker, discolored, or stiff skin (Tinea unguium).

Recognition of Early Signs

• Look for symmetry: Ringworm spreads smoothly in circles.
• Look for many lesions. Because of scraping, it may appear elsewhere.
• Watch for changes: The rash can expand faster or slower.

When to seek help

• See a doctor if the rash expands quickly, hurts, or doesn't improve with over-the-counter fungi-killing medicines.
• Prescriptions are generally needed for head and nail cases.

What happens if ringworm is left untreated?

Ringworm can worsen and cause additional issues if untreated, depending on its location and severity. This usually happens:

• The fungus can spread to the skin, hair, nails, and crotch.
• More hurt: Itching, burning, and inflammation may worsen.
• Later bacterial illnesses: Scratching the rash may damage the skin, allowing bacteria to enter and cause additional disease.
• Permanent changes: A long-term infection can scar, redden, or thicken skin.
• Hair loss: Scalp ringworm, also known as tinea capitis, can cause permanent bald areas and hair loss if scars form.
• Nail deformities: Nail ringworm (tinea unguium) can thicken, change colour, and bend nails, making them fragile and difficult to treat.
• Ringworm is very contagious and can spread through touch or contaminated surfaces.

Why early aid matters

Antifungal creams or tablets usually cure the condition in weeks. Delaying care increases risk and complicates recovery.

When to contact the emergency for ringworm?

Ringworm isn't typically a serious medical issue, but there are situations where you may need immediate medical attention. Step up when:

For urgent ringworm treatment

• Serious or widespread infection: If the rash covers a lot of skin or multiple areas (such the feet, groin, or head), especially in immunocompromised patients.
• Signs of a second bacterial attack:
• Pus, foam, or yellow crusts
• Pain, oedema, or warmth worsens

Chills or fever

• Persistent symptoms: If over-the-counter antifungals don't work in two weeks or the rash spreads, visit a doctor.
• Child scalp ringworm: If not treated, it can cause permanent hair loss or a painful, swollen kerion.
• Interest in nails: Oral antifungals and medical supervision are needed for thick, discoloured, or twisted nails.
• Those with poor immune systems: Diabetics, HIV/AIDS patients, and immunological medication users can get serious or uncommon infections.

Read this, clinicians and caregivers.

If a person has ringworm along with symptoms such as fever or malaise, or if the rash is severe or spreading rapidly, they should see a dermatologist or an infectious disease specialist.

Treatment for ringworm

The video explains the home remedy for ringworm

Treatment for ringworm (tinea) depends on its location and severity. It's explained here.

• First-time mild-to-moderate treatments
• Topical antifungals: For two to four weeks, use them once or twice daily:
• Counter purchases:
• Clotrimazole
• Miconazole
• Terbinafine
• Tolnaftate
• When OTC creams fail:
• And ketoconazole
• Ciclopirox

It is important to note that steroid creams can worsen fungal illnesses, so they should only be used if advised by your doctor.

• Oral antifungals cure severe nail, scalp, and fungal infections when topical treatment fails.
• Griseofulvin treats youngsters' scalp ringworm.
• Terbinafine treats skin and nail problems.
• Itraconazole or Fluconazole—For resistant or common cases.
• Treatment might last two weeks to three months, depending on location and efficacy.

Supportive Measures

• Clean and dry skin.
• Avoid sharing clothes, towels, combs, etc.
• Cat bedding and surfaces should be disinfected since pets spread ringworm.
• After contacting something infectious, wash your hands.

In conclusion

Ringworm, a common fungus, causes red, itchy rings on the skin. "Ringworm" is incorrect because it doesn't involve worms. Knowing the symptoms and seeking treatment early will make ringworm simpler to manage. Wash your hands often and don't share private items to avoid infection.

Spotting the Signs of Myeloma Before It’s Too Late

Explain Multiple Myeloma.

Multiple myeloma is a type of blood cancer that begins in plasma cells found in the bone marrow. These cells generally fight infections with antibodies. Plasma cell abnormalities and uncontrolled proliferation crowd out healthy cells and produce defective proteins in myeloma.

Key Myeloma Features

• Origin: Bone marrow plasma cells.
• Natural: Cancerous plasma cells accumulate and disrupt blood cell formation.
• The spine, skull, ribs, pelvis, and shoulders have bone marrow.

Body effects of myeloma

Multiple myeloma interrupts blood cell synthesis and produces aberrant proteins that damage organs and tissues, causing extensive and often subtle effects. A breakdown of its systemic impact:

Bone System

• Pain and fractures: Myeloma cells break down bone, causing osteoporosis and lytic lesions.
• Nerve compression and mobility difficulties might result from vertebral collapse.
• Hypercalcemia: Bone destruction Excess calcium can induce disorientation, constipation, and kidney difficulties.

Immune and Blood Systems

• Depleted red blood cells cause weariness, weakness, and breathlessness.
• Leukopenia and thrombocytopenia: Low white blood cells and platelets increase infection and bleeding risk.
• Low immunity occurs when abnormal antibodies crowd out functional ones, which decreases the body's defence against infections.

Nervous system

• Nerve injury or side effects from treatment can cause tingling, numbness, or pain in the hands and feet.
• Fatigue and metabolic abnormalities can impair concentration and memory.

Renal Function

• Bence Jones proteins block kidney filters, causing renal failure in myeloma.
• Electrolyte imbalance occurs when kidney failure alters the levels of sodium, potassium, and calcium.

Heart, Lungs

• Anemia and excessive calcium might strain the heart.
• Rarely, the buildup of plasma cells might damage lung tissue or cause fluid accumulation.

What are myeloma symptoms?

Bone marrow disturbance, aberrant protein production, and organ damage are the causes of all multiple myeloma symptoms. The overview is structured as follows:

Common Myeloma Symptoms

• Back, hip, and rib bone pain
• Anemia causes fatigue and weakness.
• Immune dysfunction causes frequent infections.

Unexpected weight reduction

• High calcium levels cause nausea or constipation.
• Increasing thirst or urination—kidney damage symptoms
• Nerve compression or peripheral neuropathy—numbness or tingling
• Low platelet levels cause rapid bruising and bleeding.
• Confusion—often caused by hypercalcemia—mind fog

What causes myeloma?

Plasma cell genetic alterations induce multiple myeloma; however, the specific causes are unknown. Researchers' knowledge breakdown:

Root Causes and Mechanisms

• Myeloma begins when plasma cells in the bone marrow acquire abnormalities that lead them to proliferate uncontrollably and create aberrant proteins.
• Monoclonal gammopathy of unknown significance (MGUS), a benign disorder characterized by abnormal plasma cells, frequently progresses. Annually, 1% of MGUS cases develop myeloma. Bone marrow disruption occurs when cancerous plasma cells crowd out healthy blood cells, impairing immunity.

Possible Risks

• Over 60s are the most common.
• Men are slightly more common.
• African-Americans have higher rates.
• Family history: Myeloma or MGUS in close relatives increases risk.
• Exposure: Radiation, benzene, and agricultural pesticides may contribute.

When should I see a doctor?

If you have persistent, unexplained symptoms that may be associated with multiple myeloma, especially if you are over 60, have a family history of plasma cell abnormalities, or have MGUS, visit a doctor. Advice to help you choose

Consult a doctor immediately if:

• Chronic back, rib, or hip bone discomfort
• Fatigue or weakness that fails to improve with rest
• Recurrent infections or sluggish healing
• Unexpected weight reduction
• Hand/foot numbness/tingling
• Increased thirst or urination may indicate renal problems.
• Easily bruising or bleeding
• High calcium levels may cause confusion or concentration issues.

Also see a Doctor 

• If you have abnormal blood or urine test results (e.g., excessive protein levels, anemia, renal disease),
• You have MGUS/smoldering myeloma and new symptoms.
• While being monitored for another ailment, your symptoms intensify.
• Early diagnosis of multiple myeloma is difficult since its symptoms mimic other illnesses. If something feels “off” and lingers, get tested, even if symptoms are mild.

Furthermore, read https://www.singhealth.com.sg/symptoms-treatments/multiple-myeloma.

How is myeloma diagnosed?

Multiple myeloma is diagnosed through blood tests, urine tests, bone marrow analysis, and imaging studies. The overview is structured as follows:

Myeloma Diagnostic Tests Key

1. Blood Tests

• M-protein detection: Myeloma-produced abnormal monoclonal proteins.
• Beta-2 microglobulin: Disease severity.
• Complete blood count: Possibly anemia or insufficient platelets.
• Tests for calcium and renal function are also conducted. CalcElevated calcium levels and impaired renal markers are common findings. Urine Checks

• The The presence of Bence Jones proteins, which are urine M proteins, is a hallmark of multiple myeloma. Bone Marrow Biopsy

• AspiA bone marrow aspiration and biopsy confirm the presence and proportion of aberrant plasma cells. Imaging

• CT, MRI, PET, or X-rays: Examine for bone lesions, fractures, and marrow.

5. Genetic/Cytogenetic Testing 

• FISH and other molecular tests identify chromosomal abnormalities affecting prognosis and treatment planning.

Criteria for diagnosis

• Doctors often analyse organ damage using the CRAB criteria:
• High Calcium
• Renal dysfunction
• Anemia
• Lesions in bones

Treatment for myeloma?

Treatment for multiple myeloma is tailored to manage the disease, alleviate symptoms, and prolong survival. An organized summary of the key approaches:

1. Drug Induction Therapy

• Combination treatments typically involve using 3 to 4 medications, including proteasome inhibitors such as bortezomib and carfilzomib.
• Immunomodulators (lenalidomide, thalidomide)
• Dexamethasone, steroids
• This treatment reduces tumor burden either before a stem cell transplant or as the primary therapy.

2. Targeted Treatment

• Monoclonal antibodies like daratumumab target proteins on myeloma cells.
• SpecT-cell engagers and CAR-T cell treatments show promise for patients with relapsed or refractory multiple myeloma. Stem Cell Transplant

• Autologous stem cell transplantation is a common result of drug therapy.
• It sustains remission but does not provide a cure. Radiotherapy

• Radiochemotherapy is used to treat spinal cord compression or localised bone pain. Support Bone Health

• Bisphosphonates, such as zoledronic acid, strengthen bones and reduce the risk of fractures.
• Consider taking calcium and vitamin D supplements. Maintenance Therapy

• Low-Drugs like lenalidomide are used to maintain remission. Assistance

• It treats conditions such as anemia, infections, kidney problems, and neuropathy.
• Treatment options include physical therapy, psychological support, and pain management.

Treatment plans are tailored according to a patient's age and overall health.

• Disease stage/aggression
• Organ involvement and genetic markers
• Newly diagnosed or relapsing disease

One of the main complications of multiple myeloma is anemia.

• Reduced bone marrow production of red blood cells occurs due to hypercalcemia.
• Anaemia Multiple myeloma can lead to fatigue, weakness, and dyspnea. Bone Injury

• Myeloma cells disrupt bone remodeling, leading to pain and fractures, especially in the spine, ribs, and hips.
• Osteoporosis
• High Elevated calcium levels can lead to confusion or concentration issues. Renal Dysfunction

• Kidney filters may become clogged with abnormal proteins, such as Bence Jones proteins.
• Renal failure and electrolyte abnormalities may also occur.

4. Immune suppression

• Regular plasma cells are replaced by myeloma cells, which limits antibody production.
• Infections and vaccination failures increase.

5. Neurological Issues

• Lesions or spinal fractures can compress nerves.
• Peripheral neuropathy can be either diseased or treated.

6Side effects connected with the treatment.

• Fatigue, nausea, and neuropathy are potential side effects of both chemotherapy and immunotherapy.
• It increases the risk of infection.

Could myeloma be prevented?

• The cause of myeloma is unknown; hence, it cannot be prevented.
• Multiple myeloma cannot be prevented because its cause is not well understood. However, research suggests techniques to either minimize risk or detect precursor symptoms early.

Why Prevention Isn't Possible

• The condition is commonly caused by mutations in plasma cells.
• Unchangeable risk factors include age, race, gender, and family history.

A benign illness called MGUS (monoclonal gammopathy of uncertain significance) can proceed to myeloma, but identifying who will progress is difficult.

Strategy to Reduce Risk

• These steps may prevent myeloma, but are not guaranteed:
• Maintain weight health.
• Avoid exposure to hazardous compounds such as benzene and insecticides.
• Observe radiation limits
• If diagnosed, examine MGUS or smoldering myeloma often.

Research is ongoing on genetic predisposition, viral triggers, and environmental exposures. Iceland's Stop MM program aims to detect myeloma before any symptoms appear.

Conclusion

• Plasma cell cancer, multiple myeloma, interrupts blood production, weakens bones, inhibits immunity, and damages organs, especially the kidneys. Early detection and intensive care can help manage major complications.
• WWhile prevention isn't possible, monitoring high-risk patients, such as those with MGUS, and reducing environmental exposures may help.
• EEarly diagnosis, individualized care, and ongoing monitoring are essential for effective disease management and maintaining quality of life.

How to prevent prostate cancer?

Prostate cancer—Overview

Prostate cancer prevention necessitates healthy lifestyle choices and increased medical awareness. Prostate cancer is treatable when discovered early, although preventative methods are currently being researched. Like other malignancies, prostate cancer is caused by uncontrolled cell growth. This process causes prostate cancer over time. Evidence-based methods may reduce your risk, but there's no guarantee:

Diet and Nutrition

• Increase your intake of fruits and vegetables, particularly antioxidant-rich tomatoes (lycopene), broccoli, and leafy greens.
• Limit the consumption of red and processed meats, as excessive intake may increase the risk of cancer.
• Include soy products and legumes in your diet, as the isoflavones found in soy may offer protective health benefits.
• Citrus fruits, such as oranges, lemons, and grapefruits, may lower the risk of cancer.
• Reduce saturated fats by incorporating healthier options like olive oil and nuts.

Lifestyle Choices

• Try to exercise moderately for at least 30 minutes on most days.
• Control your weight because prostate cancer is more aggressive in individuals who are obese.
• Avoid smoking: smoking may worsen outcomes and increase risk.
• Limit alcohol: Drinking too much can cause cancer.

Medicine Awareness

• Know your family history: Genetics matter. 
• If you have a family history of the disease, speak with your doctor about screening.
• Think about typical exams: This is especially vital if you're over 50 or at risk due to your genes or ethnicity.

Extra Tips

Coffee and green tea may offer some protective benefits against prostate cancer, although the research supporting such benefits is limited.

What causes prostate cancer?

Prostate cancer develops when DNA changes cause prostate cells to multiply uncontrollably. These alterations can be either inherited or acquired. Key causes and risk factors are listed below:

Cellular and genetic changes

• DNA mutations: These activate oncogenes or deactivate tumour suppressor genes.
• BRCA1 and BRCA2 gene mutations are inherited and increase the risk of prostate cancer.

Ethnicity, Age, Family History

• Risk rises dramatically after 50.
• Black men are more likely to develop aggressive prostate cancer.
• If your father or sibling has prostate cancer, your risk doubles.

Hormone Effect

• Higher levels of testosterone may promote the development of prostate cells.
• A strong testosterone derivative, dihydrotestosterone (DHT), may cause prostate growth and cancer.

Ecological and lifestyle factors

• Diet: High-fat, low-fruit/vegetable diets may contribute.
• Obesity increases prostate cancer aggressiveness.
• Chemical exposure: Some research links Agent Orange and other poisons.

Prostate cancer risk factors

This comprehensive review of factors that increase the risk of prostate cancer is based on the latest findings from the American Cancer Society, CDC, and other experts.

Unchangeable Risks

• The biggest risk factor is age. Men 65 and older account for 60% of instances.
• Your risk doubles if your father or sibling has prostate cancer.
• Prostate cancer is more common among men of African descent and results in a higher mortality rate for this group.
• Mutations in the BRCA1, BRCA2, and HOXB13 genes may increase the risk of developing prostate cancer.

Hormones and Biology

• Testosterone: High levels may aid in prostate development.
• Prostate conditions such as prostatitis and benign prostatic hyperplasia (BPH) are not the primary causes of issues but can complicate the screening process.

Environmental and lifestyle factors

• High intake of red meat, dairy, and saturated fats may increase the risk.
• Obesity increases prostate cancer aggressiveness.
• Smoking may increase the risk of prostate cancer and lead to poorer outcomes.
• Toxins like Agent Orange increase danger.

Screening/Detection

• PSA Testing: Elevated PSA levels can detect many cases before symptoms occur.

Why Age Matters

• DNA mutations rise with cellular aging.
• Time-dependent hormonal changes may influence the development of prostate cells.
• Age increases environmental and dietary risk exposure.

Prevention of prostate cancer naturally

These science-backed lifestyle and dietary changes can lower your prostate cancer risk naturally:

Diet and Nutrition

• Increase your intake of cruciferous vegetables, as sulforaphane, found in broccoli, cauliflower, cabbage, and kale, may protect prostate cells.
• Mix tomatoes and melons. Lycopene-rich foods reduce the risk of prostate cancer.
• Soy products, such as tofu, edamame, and soy milk, may lower the risk of certain health issues due to their isoflavones.
• Utilise turmeric: This anti-inflammatory chemical may boost immunity and prevent metastasis.
• Limit dairy and red meat consumption: Excessive intake of high-fat animal products may increase health risks.

Lifestyle Choices

• Regular exercise helps regulate hormones and reduces inflammation.
• Control your weight: prostate cancers are more aggressive when obese.
• Quit smoking: Smoking increases risk and worsens results.
• Limiting alcohol: excessive drinking can cause cancer.

Extra Natural Compounds

• Catechins found in green tea may suppress cancer cell proliferation.
• Antioxidant-rich pomegranate juice may benefit prostate health. 
• Resveratrol, found in grapes and berries, may influence cell growth.

Prevention Mindset

• Regularly evaluate your health, particularly after the age of 50 or sooner if you have a family history of health issues.
• Talk to your doctor about screening options if you have BRCA mutations or a strong family history of prostate issues.

What vitamins benefit prostate health?

Certain vitamins and nutrients enhance prostate health and may lower the incidence of BPH and prostate cancer. Current research breakdown:

Important Prostate Vitamins

• Vitamin D: Controls cell growth and immunity; a shortage increases prostate cancer risk.
• Vitamin E: An Antioxidant that may protect cells, but high dosages may harm them.
• Vitamin C: Immune support and prostate inflammation reduction.
• Zinc: Regulates testosterone and prevents prostate growth.
• The antioxidant selenium may prevent oxidative stress and DNA damage.
• Lycopene from tomatoes may reduce the risk of prostate cancer by lowering oxidative damage.
• Omega-3 fatty acids: Anti-inflammatory; may lower prostatic inflammation.

Supplements contain herbal compounds

• Saw Palmetto: May alleviate BPH symptoms
• Beta-sitosterol: Plant sterol aids urination
• Nettle Root: Supports prostate and urinary health traditionally.
• Prostate health supplements contain these nutrients, but see a doctor before starting any regimen, especially if you're using other medications.

Foods to Avoid for Prostate Health

• Nitrates and saturated fats in red and processed meats may cause inflammation and cancer.
• High-fat dairy: Increased prostate cancer risk in some studies
• Fast and fried foods: Increase risk factors like obesity and inflammation
• Sugary foods can cause insulin resistance and weight gain.
• Alcohol excess: May disrupt hormone balance and raise cancer risk.
• Refined carbs: White bread, pastries, and sugary cereals raise insulin and fat gain
• High salt intake may aggravate prostate-related urine symptoms.

Additional Advice

• Limit charred meats: Extreme grilling can cause cancer.
• Be mindful of your portions: Even nutritious meals can lead to weight gain.

Prostate cancer's 5 early warning indicators

These five warning signs of prostate cancer should never be ignored, especially by those over 50 or with a family history:

5 Prostate Cancer Early Warning Signs

• Urinating frequently, especially at night
• Nocturia may indicate prostatic hypertrophy or blockage.
• Urination starting or stopping issues
• Pressure on the urethra might cause uncertain urine flow.
• Urinating or ejaculating pain or burning
• May signal adjacent tissue inflammation or tumor growth.
• Urine or semen blood
• This rare yet significant symptom requires quick attention.
• ED or painful ejaculation
• Prostate abnormalities can affect sexual function.

Many early-stage prostate tumours produce no symptoms. Early detection requires regular screening (PSA and digital rectal exams).

Also, read https://www.moffitt.org/cancers/prostate-cancer/faqs/prostate-cancer-prevention/.

How fast can prostate cancer spread?

Prostate cancer spreads at varying rates according to type and stage. According to current medical knowledge, it is as follows:

Type of Cancer Determines Growth Rate

• In slow-growing prostate cancer, the tumour may persist in the prostate for years without symptoms.
• Incidental and may not need immediate treatment.
• Rapidly spreading aggressive prostate cancer can affect adjacent tissues, lymph nodes, and bones.
• High metastatic risk requires immediate treatment.

Timeline of Spread

• It can take up to 8 years for Stage IV prostate cancer to spread to bones or lymph nodes.
• Gleason score, PSA, and genetic alterations predict tumor growth.

Common Spread Sites: Bones (particularly spine and pelvis)

• The lymph nodes
• Less common: liver, lungs
• Monitoring Tools
• PSA velocity: PSA increase rate.
• Imaging and biopsy: Assess tumour aggressiveness and spread.

Where does prostate cancer spread first?

• The initial spread of prostate cancer is to adjacent tissues and lymph nodes. This is its typical progression:
• Local tissues are the initial sites of spread. Seminal vesicles and connective tissue often suffer early.
• Pelvic lymph nodes: Most metastases start here.
• Later Sites of Spread: Bones, particularly the spine, pelvis, and ribs. Bone metastases characterise advanced prostate cancer.
• Lungs and liver: Rare but possible in aggressive or late-stage cases.

Detection Method

• MRIs, CTs, and bone scans track spread.
• PSA: Rapid PSA rise may indicate metastases.

Conclusion

Prevention is attainable with a plant-rich diet, frequent exercise, weight management, and restricting red meat, alcohol, and smoking. Lives saved by early detection: Regular PSA screening and monitoring of signs like urine changes or sexual dysfunction are essential for men over 50 and those with a family history. Age, BRCA mutations, ethnicity (African-American men are at higher risk), and lifestyle choices are risk factors.

Natural support: Vitamin D, zinc, lycopene, and green tea may maintain prostate health. Progress varies: Some prostate tumors develop slowly, while aggressive ones spread quickly to lymph nodes and bones.

A guide to manage tremors

Explain Tremor

One or more bodily parts shake rhythmically and involuntarily during a tremor. This movement disorder can be mild or severe, and it can be continuous or intermittent. Tremors are primarily characterized by involuntary movements that cannot be controlled. Shaking is rhythmic. It usually affects hands, arms, head, legs, vocal cords, and torso. Impact: Can hinder writing, eating, and dressing.

Involuntary movements

Causes

• This can lead to conditions such as Parkinson's, MS, and stroke.
• Excess caffeine, stress, and weariness.
• Tremors can result from some medications.
• Idiopathic essential tremor is a condition for which no known cause has been identified.

Types of Tremors

• A resting tremor occurs when muscles relax.
• The action tremor occurs during voluntary movement.
• Holding against gravity causes postural tremor.
• When reaching for a cup, intention tremors worsen.
• Tremors can be upsetting and burdensome, depending on their severity and place of origin.

Common Tremor Symptoms

• Repetitive, involuntary shaking can affect various parts of the body.
• Shaky hands are the most common symptom, particularly noticeable when writing or handling objects.
• Tremors may cause head nodding or shaking.
• Voice tremor: Shaky voice.
• Fine motor skills: Trouble eating, grooming, dressing, or typing.
• Tension or weariness can worsen tremors.
• Postural instability: Balance and posture can become difficult.
• During deliberate motions like reaching, certain tremors occur.

Affected Regions

• The hands and fingers
• Arms and legs
• Head and face
• Vocal cords
• Body or trunk

There are two types of tremors: Parkinson's and essential tremor.

Parkinson's and essential tremor are distinct.

These are Parkinson's symptoms:

• Parkinson's disease is a progressive neurological illness characterized by hand tremors that occur during rest.
• Involuntary tremors on inactivity, muscle rigidity, delayed movement, and ‘freezing.’
• Parkinson's disease is caused by a deficiency of dopamine, a neurotransmitter that regulates muscle movement.
• Multiple Sclerosis (MS) is an autoimmune condition that causes tremors when a person reaches for something. Possible illnesses

Essential tremor 

• Causes trembling at the onset of movement and can worsen
• Essential tremor is a neurological condition that causes rhythmic shaking of the hands and arms during movement. 
• The head, voice, and legs may also be affected, and factors such as stress, fatigue, and caffeine can exacerbate symptoms. 
• The etiology of essential tremor is unknown, but genetics plays a role in its development. Medication or deep-brain stimulation is used to manage the symptoms of this condition.  

Symptoms

• Action Synergistic tremor: Shaking that occurs during goal-directed activities, such as writing or holding a utensil, tends to intensify afterwards.
• The condition usually affects both hands and arms symmetrically, but it can also impact the head (causing nodding), voice (resulting in a shaky tone), or lower limbs.
• It can start at any age, but it most commonly begins during adolescence or midlife (ages 40 to 50).
• Early tremors are usually minor but tend to intensify over time.

Causes and risks

• Familial tremor occurs in 50–70% of cases of essential tremor.
• The reason for this is unknown, but it is suspected that the cerebellum and other brain regions responsible for muscle coordination are involved.
• Triggers: Stress, exercise, caffeine, and drugs might worsen symptoms

Diagnose and treat

• The neurological test results and the family history indicated the diagnosis. Lab tests rule out other conditions.
• Treatments: Although there is no cure, various therapies can help manage symptoms.
• Medication: Beta blockers are often first-line.
• Assistive devices enhance daily life.
• Tremors can be reduced by the use of botulinum toxin.
• Electromyography (EMG) examinations evaluate muscular electrical activity and rule out other reasons, including x-rays, blood tests, MRIs, and CT scans.
• Surgery options, such as deep brain stimulation or targeted ultrasound, can treat severe conditions when medication is ineffective.

Cause of essential tremor

Essential tremor is more common than Parkinson's disease. According to estimates, one in five individuals aged 65 and older are affected.

A genetic relationship is suspected, although the exact reason for essential tremor remains unknown. Every child of an essential tremor patient has a 50 per cent chance of inheriting it. If multiple family members have essential tremor, the illness is called ‘familial tremor.’ Medication side effects and environmental pollutants, such as mercury, can cause tremors.

Influences on vital tremors

• Some variables worsen it, including:
• Emotional stress • Physical exercise
• Consuming caffeinated drinks can lead to weariness, poor sleep, and alcohol withdrawal symptoms in some individuals.

How essential tremor affect life quality

• Uncontrollable shaking can lower the quality of life in various ways:
• Difficulties with daily tasks, such as writing, dressing, or eating, can lead to frustration, tension, social embarrassment, and exhaustion.

Treatment for essential tremor

The video explains how ultrasound treats tremor

No cure exists for essential tremor. Treatment suppresses involuntary motions. A neurologist can help you choose the best treatment options. 

Options for treatment include:

• Strategies for stress management include avoiding triggers such as alcohol and coffee.
• Some drugs used to treat heart disease, such as beta blockers, and epilepsy, like anticonvulsants, have been effective.
• Treatment options for tremors include medications, deep-brain stimulation, and brain surgery aimed at modifying the affected region of the brain.
• MRI-guided focused ultrasound (not reimbursed by Medicare in Australia) for some essential tremor patients
• If the tremor is mild and doesn't affect daily life, regular monitoring may be the only treatment.
• Alcohol may lessen tremors. Long-term alcohol use is unhealthy; hence, this treatment is not advised.

Essential tremor drugs

If you find your job or daily tasks challenging, your doctor may prescribe medications such as:

• Propranolol is a beta-blocker, while primidone is an anti-seizure medication.
• Alternative treatments
• Physiotherapy or occupational therapy may help your tremor.
• After attempting alternative therapies, your doctor may recommend surgery for severe shaking.
• Surgery for essential tremor may involve 'deep brain stimulation.' Surgery is rarely needed.

Also, read https://patient.info/doctor/history-examination/tremor-pro.

Why are my hands shaking randomly?

Stress, worry, caffeine consumption, neurological illnesses (such as Parkinson's and multiple sclerosis), thyroid issues, and side effects from medications can cause shaking hands. Tremors may occur due to alcohol withdrawal, low blood sugar, or exhaustion. Watch for when the shaking occurs, and consult a doctor if it persists or causes you concern.

Common lifestyle causes

Stress and anxiety can lead to the release of adrenaline, triggering a "fight-or-flight" reaction that results in muscle tension and shaking. This effect can persist in cases of chronic stress.

• Ingesting too much caffeine or stimulants can shake your hands.
• Fatigue: Sleep deprivation might increase tremors.
• When someone quits drinking, they shake.
• Skipping meals can lead to shaking due to hypoglycemia.

Overactive thyroid:

• Hand tremors can result from hyperthyroidism.
• The adverse effects of medication may also contribute to these symptoms. 
• Medications like those for asthma, antidepressants, and steroids can cause tremors. 
• Vitamin deficiencies, like B12 deficiency, can also cause shakiness.

When to consult a doctor.

• For a proper diagnosis, consult a doctor if the shaking is severe, persistent, or interferes with everyday life.
• A doctor can evaluate whether the shaking is transient or a sign of a serious ailment that requires treatment.

Conclusion

If a doctor can diagnose the problem, they can prescribe tests to help determine the best course of treatment.  A tremor is, in and of itself, an uncontrollable movement.  You can regain some control, though, by managing the underlying illness.

How to Manage Antisocial Personality Disorder Efficiently

Antisocial Personality Disorder—Overview

APD, sometimes known as sociopathy, is a persistent mental health disorder that causes disdain for right and wrong, violation of others' rights, and lack of empathy, regret, or guilt. This disorder can manifest as manipulation, deception, or aggression. ASPD sufferers may commit crimes or exploit others due to social difficulties.

Challenges and Prognosis

Antisocial Personality Disorder (ASPD) is a lifelong condition, but its symptoms may improve as individuals age. Legal, relationship, and substance misuse troubles are common. Early childhood/adolescent intervention improves outcomes.

Antisocial personality disorder symptoms

Main behavioral symptoms

• No respect for morality. The individual frequently violates laws and social conventions.
• Deceitfulness: Constant lying, aliases, or deception for personal advantage.
• Impulsivity, poor planning, and inattention to consequences are common traits.
• This behaviour can manifest as restlessness, aggression, or even physical aggression.
• Being careless about safety endangers oneself or others.
• Constant recklessness undermines job, finances, and family.
• Not apologising, rationalising, or feeling remorse after harming or stealing.

Early Signs (usually Childhood or Adolescence)

Deception/theft, aggressiveness toward people or animals, property destruction, and major rule infractions are conduct disorders before 15.

Social and Emotional Skills

• Charm can appear charismatic or compelling.
• The individual exploits others for their own selfish gain.
• Lack of compassion: Not understanding or caring about others' feelings.

ASPD diagnosis

Since the age of 15, there has been a persistent disdain for and violation of others' rights, demonstrated by three or more of the following behaviors:

Repeated illegal acts

• Lying, using aliases, deception
• Lack of planning or impulsivity
• Excessive fighting or assault
• Impulsive disregard for personal or social safety
• Chronic neglect of work or finances
• Indifference or rationalization of harm
• The individual must be at least 18 years old.
• Aggression, stealing, damage, or major rule infractions before age 15 indicate conduct disorder.
• Antisocial conduct is not limited to schizophrenia and bipolar disorders.

Assessment Tools

• Behavioural history and clinical interviews
• Psychology tests (MMPI-2, PCL-R for psychopathy)
• Family, legal, or social history collateral

Differential Diagnoses

• Differentiate ASPD from:
• Borderline Personality Disorder
• NPD
• Problems with drugs
• Disorders like schizophrenia or bipolar

Antisocial personality disorder causes

Antisocial Personality Disorder (ASPD) is caused by multiple biological, psychological, and environmental variables. An organized review of the most common causes:

Biofactors

• A family history of ASPD or other personality disorders increases risk. Twin and adoption studies show inheritance.
• The structure and function of the brain in ASPD patients have frontal lobe differences that affect judgment and impulse control.
• Serotonin and dopamine abnormalities may cause impulsivity and violence.

Environmental and developmental factors

• Neglect or abuse of childhood: Early physical, emotional, or sexual maltreatment increases risk.
• Substance misuse or mental illness by parents might hinder emotional development.
• Early conduct disorder: Aggression, stealing, and rule-breaking commonly precede ASPD before age 15.
• Violence: Growing up in violent or chaotic environments may normalize antisocial conduct.

Social and psychological factors

• Negative attachment/bonding: Early insecure relationships can impede empathy development.
• Low socioeconomic status: Poverty and lack of education and assistance increase risk.
• Peer influence: Adolescents with delinquent peers may be more antisocial.

Important Notes

• Not everyone with risk factors develops ASPD.
• Safe connections, early intervention, and supportive circumstances reduce risk.

Brain Differences

A recent neuroscience study has shown that people with Antisocial Personality Disorder (ASPD) have different brains:

• Key Brain Regions Affected: Prefrontal Cortex
• Function: Controls impulses, decisions, and social behavior.
• Low volume and activity in this region are associated with poor impulse control and moral reasoning.
• The Amygdala processes emotions such as fear and empathy.
• Findings: ASPD patients have lower amygdala volume and response, causing emotional detachment and empathy deficits.

The Anterior Cingulate Cortex (ACC)

• Function: Error detection, emotional modulation, empathy.
• Findings: ACC dysfunction may impair emotion regulation and consequence evaluation.

Insula

• Function: Combines body with emotions.
• Results: Abnormalities may influence social decision-making and emotional awareness.

Neurochemical Differences

• Misbalanced Serotonin and Dopamine
• These neurotransmitters affect mood, aggressiveness, and reward-seeking.
• Impulsivity and risk-taking may result from dysregulation.

Imaging and Research Results

• In the aforementioned regions, MRI and fMRI studies consistently indicate structural and functional abnormalities.
• While not diagnostic, these variances help explain behavioral traits, including impulsivity, violence, and lack of remorse.

Antisocial personality disorder treatments

Managing Antisocial Personality Disorder (ASPD) is difficult yet achievable. An organized summary of current methods:

Main Treatment Methods

• Psychotherapy
• CBT helps people detect problematic thought patterns and adopt healthier actions.
• Schema Therapy: Addresses childhood beliefs.
• Group Therapy: May enhance relationships, although success varies.

Medication

• No pharmaceuticals are licensed for ASPD; however, they may help:
• Aggression: Lithium-based mood stabilisers
• Depressed or anxious: Antidepressants like SSRIs
• Antipsychotics/anticonvulsants for impulsivity

Long-term or residential care

• Structured environments may help with a severe or co-occurring substance use disorder.
• Substance Abuse Treatment
• Many ASPD patients are addicted; comprehensive programs are necessary.
• Motivational Interviewing fosters trust and engagement in therapy, particularly for individuals who oppose it.
• Support from family and friends can assist in tracking progress and promote excellent behavior.

Earlier Intervention

• Addressing youth conduct problems may prevent ASPD.
• Problems with treatment
• People typically lack understanding or motivation to change.
• Manipulation can harm therapeutic relationships.
• Customization and long-term commitment are crucial.
• Handling Antisocial Personality Disorder

Managing antisocial personality disorder (ASPD) requires autonomy, organization, and practicality. For ASPD sufferers and supporters, here is an organised guide based on expert views:

For ASPD Patients

1. Understand yourself

• Track impulsive and conflict-causing behaviors.
• Consider manipulative or indifferent behavior.

2. Manage Emotions

• Mindfulness or breathing can reduce anger and frustration.
• Observe emotional escalation and behave slowly.

3. Communication Skills Improvement

• Even if it's uncomfortable, try to listen and show empathy.
• Avoid sarcasm, threats, and dismissals in interactions.

4. Have Personal Goals

• Maintaining a job and keeping commitments are simple, realistic tasks.
• Celebrate progress to encourage positive behavior.

5. Seek Therapy

• CBT can change negative mental habits.
• Schema and DBT may also help.

6. Control Impulsivity

• When furious or aroused, delay decisions.
• Track impulses and results with journaling or apps.

Also, read https://www.hancockhealth.org/mayo-health-library/antisocial-personality-disorder/

Family and Supporters

1. Set Limits

• Maintain explicit behavior standards.
• Avoid condoning wrongdoing.

2. Promote Treatment

• Promote therapy and medication compliance.
• Use calm, strong communication to avoid conflict.

3. Safeguard Your Health

• Try treatment or support groups.
• Maintain self-care to avoid emotional fatigue.

Additional Advice

• Join organised anger or substance abuse programs if needed.
• Use checklists or peer mentors for accountability.
• Avoid antisocial, high-risk places.

Conclusion

Complex and long-lasting antisocial personality disorder is a pervasive contempt for social norms and others' rights. ASPD often starts in childhood and lasts throughout adulthood due to genetic, neurological, and environmental causes. Limited understanding and reluctance to change make treatment difficult, but structured psychotherapy, tailored medication, and early intervention can improve outcomes. 

Energy healing is safe with traditional treatments

Energy healing—what is it?

Energy Healing: A Whole-Health Plan

Energy healing, sometimes called energy medicine, restores energy system balance and flow. Despite not being scientifically proven, it is often utilized and considered safe when paired with traditional medical treatments.

Essential Ideas

• Everything is energy, and energy healing is based on the idea that our thoughts, feelings, and bodies are energy fields.
• Practitioners say energy channels link mental and physical wellness.
• Restoring flow: Energy imbalances are removed to promote healing and vitality.

Common Energy Healing Methods

• Reiki is Japanese energy channeling using gentle touch or hovering hands.
• The Chinese practice of Qi Gong involves breathing, movement, and meditation.
• Healing Touch: Hand movements alter energy.
• Crystal healing uses chakra-communicating stones.
• Pranic healing manipulates prana without touching the body.

Possible Benefits

• Relaxation and stress relief
• Clarity and emotional release
• Benefits include enhanced well-being and supplementary physical healing assistance.

Essentials to Remember

• Medical treatment cannot be replaced by energy healing.
• Scientific evidence is scarce, and results vary.
• Consult your doctor before trying any alternative therapy.

How does energy healing work?

Beginning Energy Healing: A Guide for Novices

Energy healing is a centuries-old, multicultural technique. Start your adventure:

Comprehensive Energy Healing Guide

1. Try Different Methods

Discover numerous energy healing methods first:

• Reiki is Japanese energy therapy used worldwide.
• Medical healing touch
• The non-physical pranic healing technique stresses life force.
• Qi Gong, Shamanic, Crystal, and more
• Each has unique training methods and philosophies.

2. Self-Learning and Intuition

• Attend basic workshops, watch videos, and read.
• Breathwork, meditation, and mindfulness boost energy awareness.
• Start by focusing on your energies and feelings.

3. Join an accredited program

• Find reliable Reiki, healing touch, and other courses.
• Many companies provide Level 1 – Master certifications.
• There are online and offline opportunities worldwide.

4. Practice Daily

• Use visualization, grounding, and chakra balance.
• Use intuitive scanning or muscle testing to read your body.
• Give friends or relatives (with permission) therapeutic sessions to enhance confidence.

5. Join a Community: 

•  Join forums, neighborhood associations, or retreats to meet other healers.
• Sharing experiences helps boost your skills and expertise.

6. Stay moral and grounded

• Respect others' boundaries and never promise cures.
• Energy healing should supplement medical care.
• Advance your practice.
• Energy healing's benefits

Potential Benefits of Energy Healing

Body Benefits: 

• Reiki and Healing Touch can alleviate chronic pain in certain individuals.
• Through relaxation and stress reduction, energy healing may strengthen the immune system.
• It is often used with established treatments to speed recovery after surgery or illness.

Mind and Emotion Benefits

• One of the main benefits is stress reduction. Energy healing promotes deep relaxation.
• Emotional balance: Releases trauma and emotions for calm and clarity.
• Better mood and sleep: Many people report feeling happier and sleeping better.

Spiritual and Holistic Benefits

• Increased self-awareness: Fosters inner understanding.
• Energy alignment: Clears meridians and chakras to restore energy.
• Peace and purpose: Some found it strengthened their spirituality or life purpose.

Energy healing therapy—what is it?

Energy Healing Therapy: A Whole-Health Plan

Energy medicine, also known as energy healing therapy, restores the flow and balance of the energy system. It assumes energy system disruptions can cause physical, emotional, or spiritual disorders.

It contains

• Non-invasive methods: Use hands-on, hands-off, or distant approaches to impact body energy.
• Energy flow emphasis: The goal is to balance and clear energy channels like chakras and meridians.
• Recovery on all levels—physical, emotional, and spiritual—is facilitated by mental, physical, and spiritual harmony.

User-stated benefits

• Relaxation and stress relief
• Enhanced emotional clarity and physical recovery support
• Better well-being

The video explains how to achieve energy healing.

What does energy treatment accomplish?

Energy therapy promotes balance and healing.

• By balancing the body's energy systems, energy treatment enhances mental, emotional, and spiritual well-being. Despite the lack of scientific evidence, numerous civilizations continue to utilize this centuries-old practice for its intended purpose.

Fundamental Energy Therapy Goals

• Restore energetic balance: Practitioners say energy flow abnormalities create emotional distress and illness. Energy treatment addresses disturbances.
• The body may heal itself if energy channels like chakras or meridians are realigned.

Relax and lessen stress: 

• Deep relaxation is produced by Reiki, Healing Touch, and other therapies, which also lower stress hormones and enhance health.
• Energy therapy helps patients release emotional tension and trauma, boosting emotional resilience and mental clarity.
• Complement conventional medicine: It complements medical treatments to improve comfort, reduce side effects, and speed recovery.

More General Goals

• Be mindful and self-aware.
• Improve mind-body-spirit harmony
• Inspire vitality, purpose, and peace.

Also, read https://energia.sg/blog/energy-healing-what-it-is-and-how-it-works/.

What does an energy therapist do?

Energy therapists balance and harmonize the body's energy systems to improve physical, emotional, and spiritual health. According to them, illness can result from imbalances in energy flow, and healing can be aided by restoring it.

Essential Tasks

• Practitioners check for energy imbalances by identifying blocked or slow energy through observation, intuition, pendulums, or muscle tests.
• Therapeutic methods that their education may allow them to use include:
• Reiki (hands-on or off)
• Healing touch is mild hand motions that impact energy fields.
• Acupressure, chakra balancing, or crystal treatment

Encourage relaxation: 

• Meditation, guided breathing, and peaceful locations can help clients relax.
• Encourage emotional release: Clients often feel lighter or clearer after sessions.
• Empower and educate: therapists may teach clients energy hygiene, grounding, or lifestyle behaviors to maintain balance.

Working Conditions

• Private clinics
• Integrative hospitals and care institutions
• Retreats and spiritual centers
• Remote or online sessions

Ethics & Training

• Reiki Master and Healing Touch Practitioner qualifications are common among energy therapists.
• They follow moral principles, including informed consent, patient privacy, and never replacing medical care.
• Energy therapists complement traditional treatment by encouraging the body's natural healing processes.

Is Energy Therapy Real? Closer Look

• Many complementary healers use energy therapy, although its scientific validity is uncertain. Current insights show:
• Advocates of holistic care, such as energy treatment, believe that the body has subtle energy systems like meridians and chakras that impact health. Reiki, Healing Touch, and Pranic Healing aim to balance these systems.
• Results: Many report feeling less stressed, emotionally clear, and content after sessions.
• Clinical integration: Some hospitals and integrated medical centers offer energy therapy for relaxation and recovery.

What Science Says

• Despite some studies claiming benefits like improved mood or decreased pain, there is no factual evidence that energy fields exist or that changing them heals.
• Placebo effect: Opponents say calm, focus, and belief may provide benefits rather than energy manipulation.
• Energy medicine is recognized by the National Center for Complementary and Integrative Health in the US, although its methods have not been scientifically confirmed.

Conclusion: Accepting Energy Healing with Awareness

Energy healing is the ancient art of regulating the body's subtle energy systems to improve physical, emotional, and spiritual health. Despite the lack of scientific proof, many report stress relief, emotional clarity, and greater vitality.

Reiki, therapeutic Touch, and other energy therapies can complement orthodox medicine by giving a peaceful, non-invasive path to inner calm. The key is discernment, investigation, and holistic self-care.

Navigating Life with Prader-Willi Syndrome

Define Prader-Willi syndrome.

Prader-Willi syndrome (PWS) is a complicated genetic disorder that causes people to be famished all the time. This can cause them to be very overweight, have growth problems, and have behaviour problems.  Infancy is marked by weak muscles and trouble eating, and later childhood is marked by constant hunger and a high risk of becoming overweight.  Some other traits are intellectual disability, short stature, small hands and feet, genitalia that aren't fully formed, and unique facial features.

Boy with Prader-Willi syndrome

Prader-Willi Syndrome Causes?

• Genetics: Defects in the genes on the paternal copy of chromosome 15 cause PWS.
• Mechanisms:
• Deletion of father's chromosome 15 genes.
• In cases of uniparental disomy (UPD), the father has no copies of chromosome 15, while the mother has two.
• Imprinting errors: Genes are present but unactivated.

Early Infant Signs

• Floppy muscles and weak tone are hypotonia.
• The infant exhibits a poor sucking response and experiences an increase in weight during feeding.
• Sitting and walking are delayed.

Prader-Willi syndrome symptoms?

Prader-Willi syndrome (PWS) has specific symptoms that change throughout adulthood. The breakdown is structured as follows:

Infancy

• Severe hypotonia: Floppy muscles, slow reflexes.
• Weak sucking, low weight gain.
• The patient struggles with sitting, crawling, and walking properly.

Childhood hyperphagia: 

• Insatiable appetite occurs between ages 2 and 4.
• Fast weight gain: Often causes obesity.
• Growth hormone insufficiency causes short stature.
• Developmental delays: Speech and motor skills lag behind peers.
• Problems with behavior:
• Temper tantrums
• OCD tendencies
• Picking skin

Cognitive and Emotional Features

• Modest intellectual disability
• Learning issues
• Social issues: Impulsivity, routines.

Endocrine and Physical Features

• Hypogonadism: Underdeveloped genitals, delayed puberty.
• Reduced muscle mass
• High pain tolerance
• Features of the face:
• Small forehead
• The almond-shaped eyes
• Thin upper lip

Adulthood

• Maintaining food supervision
• The risks of complications from obesity include cardiovascular disease, sleep apnea, and type 2 diabetes.
• Symptoms include anxiety, depression, and psychosis.

Why These Genes Matter

• Brain development, hormone regulation, and metabolic control genes are at 15q11-q13.
• Due to their silence on the maternal chromosome, these genes' absence or inactivity on the paternal side causes PWS symptoms.

Diagnostics of Prader-Willi syndrome

Clinical observation and genetic testing diagnose Prader-Willi syndrome (PWS). A clear breakdown:

First: Clinical Suspicion

Infancy symptoms may suggest PWS to doctors:

• Floppy muscles, severe hypotonia
• Feeding issues
• Delays in development
• Distinct facial features
• Later indicators include hyperphagia, low height, and behavioral difficulties.

Step 2: Genetic Testing

• Genetic tests confirm and explain the diagnosis:
• Analysis of methylation reveals aberrant imprinting on chromosome 15. Most accurate: >99% case detection
• FISH: Fluorescent In Situ Hybridisation. Finds paternal chromosome 15 deletions, missed UPD, and imprinting errors
• The microarray or DNA sequencing Finds deletions, duplicates, UPD for thorough genetic profiling

Why Methylation Testing Matters

• This test can find missing pieces of DNA, issues with genes from the mother, and problems with gene expression, all of which are important for understanding Prader-Willi syndrome
• This is the most reliable method for confirming PWS2.

Early Diagnosis Matters

• Growth hormone therapy, nutritional support, and behavioral management can start early.
• Long-term results and life quality improve

The video explains the benefits of treatments

Treatment for Prader-Willi syndrome?

Multidisciplinary, lifelong Prader-Willi syndrome (PWS) treatment manages symptoms and improves quality of life. The overview is structured as follows:

Main Treatment Methods

• Hormone therapy: Growth hormone for stature, muscle tone, metabolism
• Nutrition: Dietary supervision to prevent obesity and hyperphagia.
• Behavioural therapy: Enhancing emotional regulation, compulsive habits, and social skills
• Physical therapy improves muscle strength and motor development.
• Speech therapy: Helps with communication and delays.
• Anxiety, sadness, and psychosis treatment
• Puberty induction and sexual development may require sex hormone replacement.
• Emerging Therapies
• Some new hyperphagia (excessive hunger) drugs have been approved.
• Clinical trials are investigating appetite- and behaviour-modulating medicines.

Care Team Participation

• Care teams typically include:
• Endocrinologist
• Psychologist or psychiatrist Dietitian
• PT/OTs
• Language pathologist
• Genetic advisor

Hormonal therapies

• Prader-Willi syndrome (PWS) is managed with hormones to improve growth, metabolism, and sexuality. Current clinical recommendations provide a clear breakdown:
• Primary Hormone Therapy for PWS: Growth Hormone (GH) increases height, muscle tone, metabolism, and composition. Beginning in infancy or early childhood, it needs sleep apnea and glucose monitoring.
• The sex hormones during adolescence promote puberty and sexual development. It can be delayed or incomplete without therapy.
• Thyroid hormones treat hypothyroidism. As needed, monitor thyroid function routinely.
• Adrenal hormones support stress response (if deficient). Rarely needed Surgery and illness can affect cortisol levels.

Growth Hormone Is Key

• The growth hormone plays a crucial role in reducing fat and increasing lean body mass, while also supporting motor development and cognitive function.
• Increases energy and bone density

Monitoring and Safety

• Regular sleep apnea, blood sugar, and bone age checks
• A PWS-experienced endocrinologist should guide hormone therapy.
• Food and weight control

Also, read https://radiopaedia.org/cases/prader-willi-syndrome.

Prader-Willi syndrome (PWS) patients' particular appetite and metabolism make feeding and weight management crucial. This systematic guide follows professional advice:

PWS Nutritional Phases

• Researchers have discovered seven dietary stages.
• Phase 0: Poor fetal and infant nutrition and appetite.
• Phase 1a: Hypotonia and feeding difficulties (0–9 months).
• Phase 1b: Healthy appetite and growth (9–25 months).
• Phase 2a: Weight gain without appetite (2–4 years).
• Phase 2b: Food interest and appetite (4–8 years)
• Phase 3: Unsatisfied hyperphagia (8+ years).
• Phase 4: Adult appetite decline (maybe not universal).

Weight Control Methods

• The weight control methods include locking up food storage, ensuring regular meals, and preventing unsupervised access.
• Nutrient-rich, low-calorie diet: Low muscle mass and energy expenditure mean 30–40% fewer calories than peers.
• Structure and routine: Predictable mealtimes lessen stress and food cravings.
• Behaviour support: Reward non-food rewards and food-obsessive coping techniques.
• Growth hormone treatment: Improves metabolism and body composition, indirectly promoting weight control.

Insights into metabolism

• PWS patients have enhanced insulin sensitivity and leptin resistance, causing early weight gain and hyperphagia.
• Hypothalamic dysfunction impairs appetite regulation, rendering satiety cues ineffective.

Preventing Prader-Willi syndrome?

Prader-Willi syndrome (PWS) is caused by a spontaneous genetic mistake after conception and cannot be prevented. A clear breakdown:

Why Prevention Isn't Possible

• Chromosome 15 anomalies disrupt paternal copy genes, causing PWS.
• Deletions, maternal uniparental disomy (UPD), and imprinting abnormalities are usually random and uninherited.
• Lifestyle, environment, or parents cannot prevent these genetic events.

Can it be detected early?

• If there is a risk or an abnormal ultrasound, PWS can be detected by prenatal genetic testing.
• PWS newborn screening is not routine but may be done if hypotonia and feeding problems occur.

Family Planning Concerns

• Genetic counseling may help parents of children with PWS understand the likelihood of recurrence.
• Imprinting center flaws may increase PWS risk in rare individuals.

Prioritize Early Intervention

While prevention is impossible, early diagnosis and treatment—especially growth hormone therapy and behavioral support—can greatly enhance quality of life and reduce consequences.

Prader-Willi complications

Prader-Willi syndrome (PWS) affects the brain, endocrine system, metabolism, and behavior, causing many difficulties. A organized summary of the most common and serious complications:

Major PWS Complications

• Metabolic Obesity:
• Diabetes type 2:
• Endocrine:
• Hypogonadism:
• Hypothyroidism:
• Neurological Sleep issues
• High pain tolerance
• Temperature disorder
• Behavioral/Psychiatric
• Common compulsive actions
• Temper tantrums and OCD-like tendencies
• Psychosis, mood disorders
• Respiratory/Cardiac
• Heart disease In addition to obesity and diabetes
• Skeletal scoliosis and osteoporosis

Conclusion

Genetic origin: PWS is a rare condition caused by paternal gene abnormalities on chromosome 15, impacting hypothalamic function. The condition impacts physical growth, hunger regulation, cognitive development, and behavior throughout life.  PWS cannot be prevented; however early diagnosis and treatment enhance outcomes and quality of life.

Crush H. pylori disease: Know the Signs, Get Treated

Helicobacter pylori Infections—Overview

Gastritis, peptic ulcers, and stomach cancer can result from H. pylori infections, a frequent stomach bacterial infection. While many people don't have any symptoms, those who do may have nausea, bloating, dull or burning stomachaches, and loss of appetite. Contact with infected bodily fluids or contaminated food and water may spread infection. 

Transmission and causes

A spiral-shaped bacterium that thrives in the acidic environment of the stomach is Helicobacter pylori.

• Transmission: It is uncertain how H. pylori spreads, although it is thought to be transmitted through:
• Polluted food or water
• Direct contact with infectious saliva, vomit, or stool
• Unsanitary practices
• Prevalence: It affects half the world's population and is typically contracted in childhood.

Infection Aftermath

Once inside the stomach, H. pylori:

• Evades stomach acid by settling into mucus.
• It leads to the development of gastritis and has the potential to damage the stomach lining.
• It can cause stomach ulcers and, rarely, cancer.

Symptoms

While many H. pylori infections go unnoticed, inflammation or ulcers can cause symptoms like

• Symptoms may include a dull or searing abdominal discomfort, particularly when the stomach is empty.
• Bloating
• Frequent burping
• Nausea, vomiting
• Appetite loss
• Unexpected weight reduction
• Anemia

Complications

• Gastritis: Stomach inflammation.
• Peptic ulcers: Stomach or upper small intestine sores.
• Stomach cancer: Long-term infections may raise stomach cancer risk.

Cancer H pylori symptoms

H. pylori infection increases the risk of gastric cancer, especially non-cardia adenocarcinoma. While many H. pylori patients never develop cancer, persistent infection can cause precancerous stomach lining alterations.

These symptoms may indicate stomach cancer progression in H. pylori patients:

• Potential H. pylori-Associated Stomach Cancer Symptoms
• Chronic upper abdominal pain
• Unexpected weight reduction
• Appetite loss
• Early satiety after small meals
• Bloody vomiting or nausea
• Stools black or tarry (gastrointestinal hemorrhage)
• Anemia-related fatigue
• Treatment-resistant bloating or indigestion

These symptoms can mimic benign illnesses like ulcers or gastritis; therefore, persistent or increasing signs should be evaluated.

H pylori treatment

Treatments for H. pylori infections include acid-suppressants and antibiotics. Here's an organized overview based on the latest ACG guidelines:

Standard Treatments

1. Bismuth Quadruple Therapy (Preferred when antibiotic resistance unknown)

• Medications:
• Bismuth subsalicylate
• Metronidazole
• PPIs such as omeprazole or lansoprazole may be used with tetracycline.
• Duration: 14 days

2. Concomitant Therapy Medications: 

• Clarithromycin Amoxicillin Metronidazole/tinidazole PPI
• 10–14 days

3. Treatment with Levofloxacin If initial therapy fails or resistance is recognized, use

• Medications:
• Levofloxacin, Amoxicillin, PPI ± Bismuth or other adjuncts
• 10–14 days

Cure Test

• It is recommended to stop treatment 4 weeks post-treatment.
• The urea breath test or fecal antigen test should be used, but not serology.
• Important: Stop PPIs 2 weeks before testing to avoid false negatives.

Important Considerations

• Avoid reusing antibiotics if initial treatment fails.
• Clarithromycin and levofloxacin resistance is growing.
• Newer regimens may use potassium-competitive acid blockers like vonoprazan.

How to remove stomach H pylori

The best way to eradicate Helicobacter pylori (H. pylori) from the stomach is using antibiotics and acid suppressants. A structured guide:

First-Line Medicine

• Gold standard: triple or quadruple therapy
• Antibiotics: Clarithromycin, amoxicillin, metronidazole, and tetracycline are usually two types.
• Proton-pump inhibitor: It lowers stomach acid to assist antibiotics in working.
• Optional bismuth compound: Improves bacterial elimination
• The duration of treatment is approximately 10–14 days. Follow-up: A “test of cure” (urea breath or stool antigen) is done 4 weeks after treatment.

Also, read https://matsusurgical.com/h-pylori-bacteria/.

Supplementary Natural Remedies

These may reduce bacterial load or relieve symptoms but do not cure H. pylori:

• Probiotics (Lactobacillus, Saccharomyces boulardii): May minimize antibiotic side effects and improve eradication.
• Aloe vera and honey: Have mild antibacterial and anti-inflammatory qualities
• Broccoli, garlic, and green tea: Compounds that suppress H. pylori growth

Important Notes

• Natural therapies cannot replace antibiotics.
• Avoid NSAIDs and smoking, which harm stomach lining.
• Eradication and ulcers or stomach cancer prevention require retesting.

Hpl test

Diagnose and treat

• Diagnosis: H. pylori can be detected by breath, feces, blood, or upper endoscopy with a biopsy.
• Antibiotics and stomach acid-lowering drugs are given for 14 days to treat the infection.
• H. pylori testing is necessary to diagnose gastritis, peptic ulcers, and cancer risk. An organized summary of the main diagnostic options

H. pylori Test Types

• Urea Breath Test The patient consumes a urea solution; H. pylori breaks it down, generating gas. Highly accurate, non-invasive For accuracy, avoid PPIs 2 weeks prior.
• H. pylori proteins are found in feces by the stool antigen test. Non-invasive, good for first and follow-up The stool antigen test may exhibit inaccuracies when applied to acid blockers.
• The blood test detects antibodies to H. pylori. Simple, readily available Can't tell past from current infection
• Endoscopic biopsy Direct tissue sampling and viewing Useful for ulcers or cancer concerns Costly, invasive, sedative

Best Practices

• Initial diagnosis and eradication are best with urea breath or stool antigen tests.
• To prevent false negative results, stay away from PPIs, antibiotics, and bismuth for two weeks prior to testing.
• Complex cases or cancer suspicions require endoscopy.

Curable H. pylori?

H. pylori is usually curable with therapy. A clear breakdown:

• Combination treatment: Two antibiotics and a proton pump inhibitor (PPI) to fight bacteria and heal.
• The healing process takes approximately 10–14 days.
• Success rate: 80–90% with first-line treatment, higher with personalized regimens.

What if it failed?

• Retesting: A urea breath or stool antigen test is done 4 weeks following treatment as a “test of cure.”
• Second-line treatment: If the initial antibiotic fails, doctors switch antibiotics or quadruple therapy (bismuth).

Supportive Measures

• Probiotics: May minimize adverse effects and boost elimination.
• Stay away from smoking, NSAIDs, and alcohol, which can increase symptoms and slow healing.

Conclusion

• Gastritis, peptic ulcers, and gastric cancer can result from H. pylori, a common stomach bacterium.
• Children are commonly exposed to it through tainted food, water, or close contact.
• Many are asymptomatic, but prolonged infection might cause major problems.
• Urea breath and stool antigen testing are non-invasive diagnostics.
• Combining antibiotics and acid suppressants works well.
• Curing is possible, but follow-up testing is needed to confirm and prevent recurrence.