Hepatocarcinoma
Malignant hepatoma, which is primary cancer of the liver is termed hepatocarcinoma. Hepatocarcinoma is secondary in about 20% to either a viral hepatitide infection (hepatitis B and C) and about 80% to cirrhosis. In some cases, it is metastasis of cancer, spread from elsewhere in the body. It is also associated with chronic alcohol abuse. Hepatocellular carcinoma is relatively rare in the United States but quite common in the African and Southeast Asian countries. Infact, this is the fifth most common tumor worldwide. In some African countries the disease onsets between late teens and 30s although the normal occurrence is in patients over age 50. Hepatocarcinoma is more common in males than females.
Hepatocarcinoma patients are put under surveillance with ultrasound. Possibly the best method of diagnosis involves a CT scan of the abdomen. This is done using intravenous contrast agent and three phase scanning, enabling the radiologist to detect subtle tumors as well. Another possible alternative to a CT imaging is MRI, using contrast agents which is used to detect the presence of a tumor capsule. Diagnosis is further confirmed by percutaneous biopsy and histopathological parameters.
Treatment for hepatocarcinoma depends especially on the size of the tumor and staging. Some of the treatment options are liver transplantation, which is to replace the liver with a cadaver liver or a live donor lobe; surgical resection wherein the tumor is removed if diagnosed early; Percutaneous ethanol injections in case of solitary tumors and transcatheter arterial chemoembolization for large tumors.
Sometimes sealed source radiotherapy is used to destroy the tumor from within. Here, the radioactive particles are deposited to the area of interest using a catheter. Radiofrequency ablation uses high frequency radio waves to ablate the tumor. As an adjuvant therapy in resected patients, intra-arterial-iodine-131-lipiodol administration is performed. High intensity frequency ultrasound is a relatively new but powerful technique used to treat the tumor. Hormonal therapy and adjuvant chemotherapy are other treatment modalities adopted. Cryosurgery is yet another new technique that can destroy tumors in a variety of sites, in the brain, breast, kidney, prostrate and liver.
Anxiety disorder
Any kind of prolonged psychological or physical sickness can lead to anxiety disorders. The person spends a day packed with needless fears and anxiety with major reason to instigate it. Everything looms large, right from family relationships, finances to job environment.
Factors contributing to generalized anxiety disorder
- Levels of the neurotransmitters are unequal. Neurotransmitters are chemicals that transmit signals across nerve ends.
- Norepinephrine, GABA (gamma-aminobutyric acid) and serotonin are the neurotransmitters that govern anxiety.
- Substantial changes in the levels of these neurotransmitters cause anxiety levels to differ.
- Alcohol abuse and substance abuse are major culprits when it comes to anxiety disorders and need to be treated first before treating anxiety disorders.
- Thyroid disorder such as hyperthyroidism can cause this disorder.
There are other factors contributing to the anxiety disorder such as environmental factors and biological factors.
- Heredity is a major reason for anxiety disorders.
- Environmental stress factors such as work, relationships etc.
- Irregular sleep patterns, either lack of sleep of deficiency of sleep.
- Financial concerns and health concerns
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) is a life-threatening condition when the body has practically no insulin. This insulin deficiency results in extremely high blood sugar levels. Consequently, the muscle, fat and liver cells cannot use glucose for fuel. These cells are converted into glucose by hormones such as glucagon and adrenalin and turned into ketones through oxidation. As a result, the body uses fat for fuel. The increased levels of blood sugar are not flushed through urination. DKA is usually noticed in patients suffering from Insulin-dependent diabetes. A person can suffer from diabetic ketoacidosis if there has been severe dehydration and consequently the blood chemistry has been affected. There is accumulation of organic acids and ketones in the blood. Elevated ketone levels in the body upset its blood pH and make the blood acidic thereby triggering a toxic condition for the body's cells. Diabetic ketoacidosis is noticed when hyperglycemia exceeds over 300 mg/dL. If diabetes ketoacidosis is not attended in time, it can lead to coma and death. Surgery, infection, trauma, stroke or heart attack can also trigger diabetes ketoacidosis. Insufficient fluid intake, pancreatitis and alcohol abuse can trigger diabetes ketoacidosis.
Symptoms of diabetes ketoacidosis include excessive thirst and general weakness. There is frequent urination, loss of appetite and vomiting. Other symptoms of diabetes ketoacidosis are weight loss and abdominal pain. A person suffering from DKA tends to experience low blood pressure and increased heart rate. High ketone levels can give rise to a fruity-scent on the breath and vomiting. The patient will be restless and agitated. The skin will be hot and dry and appear flushed. Patients suffering from diabetes must check their blood glucose levels if they notice any symptoms of diabetes ketoacidosis. Poor diabetes management can lead to DKA.
Acidosis can be checked by testing the pH of the blood. Normal blood pH ranges from 7.35 to 7.45. If it is observed to be below 7.35, acidosis may have set in. Ketosis, acidosis and hyperglycemia can be diagnosed through blood tests. The patient will need fluid replacement till the body is sufficienty rehydrated. Electrolytes must also be suitably replaced as they are essential to the working of major organs and nerve cells. Electrolyte imbalance can lead to severe health hazards. Intravenous insulin aids in using up glucose for energy. Thus the breakdown of fat is stopped. Consequently acidosis and ketosis processes will be reversed.
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