Can Allithiamine Help Neuropathy Patients

Today's post from doctorvolpe.com (see link below)is a very interesting piece of new information about a topical cream (or capsules) called Allithiamine, which is a form of Vitamin B1. It is already used as a component of a commonly found version, Bentofiamine but Allithiamine is purely the fat-soluble B1 vitamine and it is commonly used to treat ADHD and Autism, as well as being a cosmetic cream. The point is that it has been shown to provide some dramatic results for people suffering from neuropathy. Now as with all these things, it's wise to err on the side of caution but talking it over with your neuropathy doctor and trying it yourself if you can get hold of it, will prove whether it can help you or not. Tomorrow's video post talks about the same thing and if you're interested, it must be worth while looking at both posts before coming to any conclusions. After that, doing your own research is also advisable.

Allithiamine found to reverse neuropathy 
Dr. Arturo M. Volpe May 20th, 2003

Allithiamine is a fat-soluble form of vitamin B-1. Although vitamin B-1 (thiamin) is most commonly found in its water-soluble form, allithiamine is also a naturally occurring form of this vitamin and is found in many foods, including garlic.

Since it is fat-soluble, allithiamine has the advantage of being excreted at a much slower rate than the common form of thiamin. In addition, while thiamin in any form is associated with health of the nervous system, the fat-soluble form is far more effective in promoting recovery of a damaged nervous system.

The reason for this may be that the nervous system is, in large part, made up of fat. Nerves are encased in a protective fatty cover known as the myelin sheath. Efficient functioning of the nerves is largely dependent on the health of this sheath. Because allithiamine is fat-soluble, it dissolves more easily and is better absorbed in these fatty regions of the nervous system where it can promote recovery.

Vitamin B-1 deficiency is widespread in our society due to the prevalent high-carbohydrate diets. This vitamin is consumed when carbs are digested and used (metabolized) in the body, so the more carbs we eat the more thiamin we need. However refined carbs are a poor source of thiamin and when they become the major component of the diet, people exhaust their thiamin reserves without replenishing them, so they become deficient. In our country some carbohydrate products are enriched with thiamin for this very reason, but the amount added is probably inadequate, at least for a segment of the population (besides, many carbohydrates like French fries are not enriched).

An extreme form of chronic vitamin B-1 deficiency is seen in alcoholics. Alcohol is metabolized like a carbohydrate but provides no nutrients at all and thus robs the body of many vitamins, especially thiamin. This extreme deficiency can lead to a form of dementia known as Wernicke-Korsakoff psychosis that is treated with daily vitamin B-1 injections.

Diabetics are also often deficient in thiamin, although their deficiency is usually not severe enough to cause dementia. A prevalent symptom of deficiency in diabetics is polyneuropathy, a condition characterized by loss of sensation in the extremities. An early sign of this condition is “burning” feet, which explains why many diabetics (and alcoholics) often cannot tolerate sleeping with a blanket covering their feet.

Derrick Lonsdale, MD has found thiamin deficiency to also be prevalent in children with ADHD and autism. Dr. Lonsdale discovered that thiamin deficiency tends to manifest in children as hyperactivity and a sensitivity to touch that he calls “touch-me-not syndrome.”

A recent double-blind controlled study of allithiamine supplementation was performed in Germany on diabetic patients who suffered from polyneuropathy. Patients in the active treatment group were given oral supplements of allithiamine (actually benfotiamine, a form of allithiamine) plus vitamins B-6 and B-12 that have synergistic actions. After the 12-week duration of the study, all patients who received the vitamin combination showed significant improvements. Additional progress was observed nine months later in a group who continued to take the vitamins after the study was completed. Incidentally, no side effects were reported in this study (“A benfotiamine-vitamin B combination in treatment of diabetic polyneuropathy” Exp Clin Endocrinol Diabetes 1996; 104 (4): 311-6).

Allithiamine is also very effective as a piece of the treatment puzzle in children with ADHD and autism when there is a pre-existing deficiency. Although oral administration is highly effective, this vitamin has a viciously bad taste and it is usually administered as a cream to children who are too small to swallow pills.

http://doctorvolpe.com/neuropathy/allithiamine/

GREATER RATES OF MITOCHONDRIAL MUTATIONS DISCOVERED IN CHILDREN BORN TO OLDER MOTHERS

The discovery of a "maternal age effect" by a team of Penn State scientists that could be used to predict the accumulation of mitochondrial DNA mutations in maternal egg cells -- and the transmission of these mutations to children -- could provide valuable insights for genetic counseling. These mutations cause more than 200 diseases and contribute to others such as diabetes, cancer, Parkinson's disease, and Alzheimer's disease. The study found greater rates of the mitochondrial DNA variants in children born to older mothers, as well as in the mothers themselves. The research will be published in the early online edition of theProceedings of the National Academy of Sciences on October 13, 2014.

 

Mitochondria are structures within cells that produce energy and that contain their own DNA. "Many mitochondrial diseases affect more than one system in the human body," said Kateryna Makova, professor of biology and one of the study's primary investigators. "They affect organs that require a lot of energy, including the heart, skeletal muscle, and brain. They are devastating diseases and there is no cure, so our findings about their transmission are very important."

The multidisciplinary research team set out to learn whether maternal age is important in the accumulation of mitochondrial DNA (mtDNA) mutations, both in the mother and in the child as a result of transmission. Collaborating with Ian Paul, a pediatrician at the Penn State Milton S. Hershey Medical Center, they took samples of blood and of cells inside the cheek from 39 healthy mother-child pairs. Because mtDNA is inherited only maternally, paternal mtDNA was not a factor in the study. Studying healthy individuals gave the researchers a baseline for future studies of disease-causing mutations.

Through DNA sequencing, they found more mutations in blood and cheek cells in the older mothers in the study. Maternal age of study participants ranged from 25 to 59. "This finding is not surprising," Makova said, "because as we age, cells keep dividing, and therefore we will have more mutant genes." But finding greater rates of mutations in children born to the older mothers did come as a surprise. The researchers believe a similar mutation process is occurring both in the cells of the mothers' bodies and in their germ lines.

The study led to another important discovery about egg-cell development. Although it was known that developing egg cells go through a "bottleneck" period that decreases the number of mtDNA molecules, scientists didn't know how small or large this bottleneck is. "If the bottleneck is large, the genetic makeup of the mother's mitochondria will be passed to her children," Makova explained. "However, if it is tiny -- if there is a severe decrease in mitochondrial molecules during the egg-cell development -- then the genetic makeup of the child might differ dramatically from that of the mother. What we discovered is that this bottleneck is indeed very small."

This finding is especially important for mothers who have a mitochondrial disease. For many mitochondrial diseases, 70 to 80 percent of molecules need to have the disease-causing variant for the disease to manifest itself. But for others, only 10 percent of the mtDNA molecules with the variant are needed to cause disease. "If the bottleneck is very small, as we've found in our study, these percentages can change dramatically," Makova said. "Knowing the size of the bottleneck allows us to predict, within a range, the percentage of disease-carrying molecules that will be passed on to the child."

Knowledge about both the maternal age effect and the bottleneck size is useful in family planning. "We have some predictive power now and can assist genetic counselors in advising couples about the chances of mitochondrial diseases being passed to the next generation," Makova said. "Everyone is concerned about Down syndrome because that is a common genetic problem. We have now added another set of genetic disorders that also might be affected by the age of the mother. It is good for couples to have this knowledge as they make family-planning decisions."

Loam

The last leaves of the Cottonwood

Hang on tightly, resisting the wind.

Cruel cold gusts push through the night

Stealing color and leaving mist in its wake

Roots take stock.

Maple leaves explode with beauty -

a plant that knows she works well with deadlines.

Flowers hide invisibly inside capsules of potential

luring animals to eat her flesh, so she may find

Loam to sleep under

for the winter

Until light and warm rain

Crack her heart open again.

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Is Nerve Decompression Surgery The Answer For Neuropathy

Today's post from dlife.com (see link below) suggests that there is a new surgical treatment for neuropathy but doesn't expand enough to tell the reader that this is a limited option that only applies to people living with trapped nerves with still some element of function. It discusses decompression surgery which relieves the entrapment of a nerve (either by releasing the nerve, or removing the impediment but the vast majority of people with neuropathy have nerves that are so severely damaged that a surgical procedure doesn't have any point any more. This decompression surgery has been around a long time and has led to wild claims from unscrupulous operators that neuropathy can be 'cured'. It can if, as in this case, the nerve is only trapped but not destroyed (through recent injury for instance) but it can't if the nerve has been 'broken' or been stripped of its protective myelin sheath and lost all function (being effectively 'dead'). So yes, if your neuropathy problem falls under the general title of entrapment (herniated discs, carpal tunnel and cubital tunnel syndromes amongst others for instance) decompression surgery is an expensive and risky option and worth exploring with the experts but if your pain, tingling, numbness etc comes from damaged nerves, then surgery can't do the necessary repairs.

Hope for Neuropathy
Nerve decompression surgery offers treatment for symptomatic neuropathy. 
By Theresa Garnero, APRN, BC-ADM, MSN, CDE Last Modified Date: January 27, 2014

Many people react with skepticism when hearing that surgery can relieve the pain of neuropathy. Why haven't we heard about this before? Even though it is a relatively novel surgical procedure, it has been performed for over 15 years and is based upon principles learned from more commonly performed operations which surgeons have been performing for decades. Moreover, the results can be life-changing and important for dLife community members to consider.

Have you ever had a pinched nerve or had your arm fall asleep after laying on it? If that's all you've had, consider yourself lucky. How long would it take for your arm to wake up if you had fallen asleep on the nerves for a few years? What if the pressure on your arm nerves continued—would the arm ever wake up? For many people with diabetes, this is the manner in which their nerves become injured and is the reason the symptoms of neuropathy appear. Neuropathy caused by uncontrolled diabetes can be very painful and in severe cases, debilitating. Treatment options typically focus on medications that reduce the painful symptoms while the root cause of the problem, pressure on the nerve, continues (see related article about neuropathy by clicking here).

That was until Dr. Ziv Peled enlightened us with the latest surgical treatment options. Dr. Peled is Director of The Dellon Institute for Peripheral Nerve Surgery and Plastic Surgery in San Francisco, California. He gave a recent educational program on surgical nerve decompression for the Center for Diabetes Services staff at California Pacific Medical Center in San Francisco, California. Dr. Peled explained that the body has many known nerve compression sites where nerves pass through tight tunnels (fascial bands). If the nerves swell within the fixed space of these tunnels (as is the case of people with diabetes), the nerves effectively become compressed or entrapped and the symptoms of neuropathy rear their ugly heads. Common sites include, but are not limited to:

Arms

The median nerve (wrist), which may get caught in the carpal tunnel (i.e. carpal tunnel syndrome).
The ulnar nerve (elbow), which may get caught in the cubital tunnel.
The radial sensory nerve (arm), which may get caught in the dorso-radial forearm.
The radial nerve (just past the elbow), which may get caught in the radial tunnel.

Legs
The common peroneal (knee), which may get caught near the fibular head.
The superficial peroneal nerve, which may get caught approximately 12 cm above the outside ankle bone.
The deep peroneal nerve, which may get caught in the dorsum (top) of the foot.
The distal tibial nerve, which branches to give the medial/lateral plantar nerves (providing sensation to the bottom of the foot), and the calcaneal nerves (providing sensation to the heel region), which may get caught in the tarsal tunnel (behind the inside ankle bone).

Anatomical jargon aside, you can see we have a lot of places along a nerve's path in which these nerves can become entrapped. A nerve that is wrapped up and bound may result in pain and/or decreased sensation, which lead to a higher risk for ulcers, wounds and potentially the need for amputations. The further out the nerve is from the spinal cord, the higher the rate of nerve problems (e.g. the feet are more often involved than the thighs).

Dr. Peled shared his research and multiple cases of surgically released nerves with a resulting dramatic improvement in pain and sensation. If tight compressive band is cut, the nerve can go on doing its job.

Who qualifies?
Not everyone is a surgical candidate. The first step is to be examined so that your doctor can check if the nerve is still able to function (the Tinel sign). In addition, a sophisticated type of neurosensory testing is used to corroborate the severity of nerve dysfunction. This testing with the Pressure Specified Sensory Device (PSSD), detects exactly how much pressure is required to elicit a sensation of being touched. The PSSD has been demonstrated to be more sensitive than a needle conduction study (i.e. EMG) and best of all, is completely painless (needle conduction studies are painful—trust me).

How long is the surgery?
Surgery is usually about a 2-hour outpatient procedure. One extremity (arm or leg) is done at a time; as soon as six weeks later, the other lower extremity can be done. Patients can use their extremity immediately after surgery (walk, use their arm). Many insurance plans cover the procedure.

What kinds of surgeons perform this procedure?
Specialized plastic surgeons who have completed at least a six-month fellowship in peripheral nerve surgery are the most qualified to perform surgical nerve decompression for diabetic neuropathy, a procedure pioneered by Dr. Lee Dellon. For example, after completing his plastic surgery training at Harvard University, Dr. Peled spent an entire year studying these procedures at the Dellon Institute in Tucson, Arizona. Dr. Dellon is an accomplished plastic surgeon as well as a professor of Plastic Surgery and Neurosurgery at the Johns Hopkins University School of Medicine in Baltimore, Maryland. The Dellon Institutes for Peripheral Nerve Surgery owe their name to him.

Where can I have this done?
To date, this surgery is only available in San Francisco, Tucson, St. Louis, Boston, New York, Tennessee, and Baltimore. For more information, check out www.dellon.com and click on the "contact us" link on the left side of the home page. The clinical results are promising so perhaps this vital procedure will be more widely available in the near future.

http://www.dlife.com/diabetes/complications/neuropathy/garnero_0108

HOMOEOPATHIC REMEDIES FOR MARASMUS

Marasmus is a form of severe malnutrition characterized by energy deficiency. A child with marasmus looks emaciated . Body weight is reduced to less than 60% of the normal (expected) body weight for the age. Marasmus occurrence increases prior to age 1, whereas kwashiorkor   occurrence increases after 18 months. It can be distinguished from kwashiorkor in that kwashiorkor is protein deficiency with adequate energy intake whereas marasmus is inadequate energy intake in all forms, including protein. Protein wasting in kwashiorkor may lead to edema  

Marasmus is caused by a severe deficiency of nearly all nutrients, especially protein, carbohydrates, and lipids.

 Marasmus is commonly represented by a shrunken, wasted appearance, loss of muscle mass and subcutaneous fat mass.Buttocks and upper limb muscle groups are usually more affected than others. Marasmus is not always linked to severe edema. Other symptoms of marasmus include unusual body temperature (hypothermia, pyrexia), anemia, edema, dehydration (as characterized with consistent thirst and shrunken eyes), hypovolemic shock (weak radial pulse, cold extremities, decreased consciousness), tachypnea (pneumonia, heart failure), abdominal manifestations (distension, decreased or metallic bowel sounds, large or small liver, blood or mucus in the stools), ocular manifestations (corneal lesions associated with vitamin A deficiency), dermal manifestations (evidence of infection, purpura, and ear, nose, and throat symptoms (otitis, rhinitis).

HOMOEOPATHIC REMEDIES

TUBERCULINUM 1000- Treatment should be started with this remedy and no other remedy should be given  for the next 24 hours

ABROTANUM 30-An excellent remedy for marasmus , especially of lower extremities with good appetite

BARYTA CARB 30- Child is weak and sluggish with tonsillitis. Abdomen is large

CALCAREA PHOS 6X- An excellent remedy for marasmus . Skin dry and wrinkled

IODUM 200-This remedy in lower potencies reduces weight and in higher potencies increases weight. There is extreme hunger , the child eats well and yet emaciates rapidly. The skin appears yellow and there is a problem with the thyroid gland

MAGNESIA CARB 30- Children who have a tendency to sinking in of the occipital bone or the back of the head and jutting out over it of the parietal bone creating a depression

NATRUM MUR 30-Marasmus of neck in children. Utterly dehydrated . Sad and wistful. Child looks like a tiny hairless monkey

PEPSINUM 30-Marasmus of children fed on artificial food

PICRIC ACID 30- Wasting with great appetite

PLUMBUM MET 30- Emaciation due to anemia

SANICULA 30-Child looks old, dirty and greasy . Progressive emaciation. Skin wrinkled about neck and hands in folds. Mentally obstinate and head strong, constantly changing . Sweating of head at night which wets the pillow. Offensive foot sweat

SYPHILINUM 1000- It should be given after Tuberculinum .Follows it advantageously but it should be given only if there is history of syphilis in the fa

GENES DETERMINE TRACES THAT STRESS LEAVES BEHIND ON BRAINS

Our individual genetic make-up determines the effect that stress has on our emotional centres. These are the findings of a group of researchers from the MedUni Vienna. Not every individual reacts in the same way to life events that produce the same degree of stress. Some grow as a result of the crisis, whereas others break down and fall ill, for example with depression. The outcome is determined by a complex interaction between depression gene versions and environmental factors.

The Vienna research group, together with international cooperation partners, have demonstrated that there are interactions between stressful life events and certain risk gene variants that subsequently change the volume of the hippocampus forever.

The hippocampus is a switching station in the processing of emotions and acts like a central interface when dealing with stress. It is known to react very sensitively to stress. In situations of stress that are interpreted as a physical danger ('distress'), it shrinks in size, which is a phenomenon observed commonly in patients with depression and one which is responsible for some of their clinical symptoms. By contrast, positive stress ('eustress'), of the kind that can occur in emotionally exciting social situations can actually cause the hippocampus to increase in size.

According to the results of the study, just how stressful life events impact on the size of the hippocampus depends on more than just environmental factors. There are genes that determine whether the same life event causes an increase or decrease in the volume of the hippocampus, and which therefore defines whether the stress is good or bad for our brain. The more risk genes an individual has, the more negative an impact the "life events" have on the size of the hippocampus. Where there are no or only a few risk genes, this life event can actually have a positive effect.

Examining life crises

As part of the study, carried out at the University Department of Psychiatry and Psychotherapy (led by Siegfried Kasper), the study team obtained quantitative information from healthy test subjects about stressful life events, such as deaths in the family, divorce, unemployment, financial losses, relocations, serious illnesses or accidents.

A high-resolution anatomical magnetic resonance scan was also carried out (at the High-Field MR Centre of Excellence, Department of MR Physics, led by Ewald Moser). The University Department of Laboratory Medicine (Harald Esterbauer and colleagues) carried out the gene analyses (COMT Val158Met, BDNF Val66Met, 5-HTTLPR). At the University Department of Psychiatry and Psychotherapy, primary author Ulrich Rabl measured the volume of the test subjects' hippocampi using computer-assisted techniques and analysed the results in the context of the genetic and environmental data.

"People with the three gene versions believed to encourage depression had a smaller hippocampus than those with fewer or none of these gene versions, even though they had the same number of stressful life events," says study leader Lukas Pezawas, describing the results. People with only one or even none of the risk genes, on the other hand, had an enlarged hippocampus with similar life events.

The study highlights the importance of gene and environment interaction as a determining factor for the volume of the hippocampus. "These results are important for understanding neurobiological processes in stress-associated illnesses such as depression or post-traumatic stress disorder. It is ultimately our genes that determine whether stress makes us psychologically unwell or whether it encourages our mental health," explains Pezawas.

The study, published in the Journal of Neuroscience, was funded by a special research project of the FWF (Austrian Science Fund) (SFB-35, led by Harald Sitte) and presented as a highlight at the international conference on "Organization for Human Brain Mapping."

Cymbalta Not Only For Chemo Related Neuropathy

Today's post from drugs.com (see link below) talks about Cymbalta (antidepressant - duloxetine) being both approved and promoted for the relief of chemotherapy-induced neuropathic pain. It is already approved for other disease related neuropathies and is often seen as an alternative to Lyrica (anti-convulsant - pregabalin). As you know, there are many causes of neuropathy but the symptoms remain the same for the vast majority of people: the distinction between chemotherapy, diabetes, HIV, alcohol-related neuropathies is often emphasised when the symptoms are pretty much universal to them all. There are two other points to bear in mind here:
Pfizer, the manufacturers of Lyrica have withdrawn their own approval of Lyrica for diabetes and HIV-related neuropathy, (May 2012) due to its proven inefficiency and the high incidence of serious side effect issues and yet the drug is still widely prescribed for all forms of neuropathic pain!
Both Cymbalta and Lyrica have the potential for serious side effects, which affect considerable numbers of people. As far as the chemotherapy trial is concerned, if you regard a 59% success rate in the study as being conclusive, then fair enough but these drugs are prescribed for neuropathy despite being originally meant to treat other diseases. The theory is that they can influence pain receptors and sodium channels and thus reduce pain but just as with all other drugs used to treat neuropathic symptoms, what works for one doesn't work for the other. If your doctor prescribes either Cymbalta or Lyrica for you, it might be advisable to do your research before beginning and start a serious discussion with your doctor as to whether they are the best option for you. Armed with as many facts as possible, you will be able to make more reasoned choices. Remember also, that stopping either drug 'cold turkey' is not advisable; you will need to be weaned off gradually.

Antidepressant Lessens Chemo-Related Pain
TUESDAY April 2, 2013


 -- The antidepressant drug Cymbalta can help relieve chronic pain caused by certain cancer drugs, a new clinical trial reports.

The study, appearing in the April 3 issue of the Journal of the American Medical Association, tested Cymbalta on patients with chronic cases of chemotherapy-related peripheral neuropathy -- pain, tingling and numbness in the limbs that arises when certain chemo drugs damage the nerves.

Of 115 patients who took the antidepressant for five weeks, 59 percent got some degree of pain relief, compared with 38 percent of patients given a drug-free placebo.

Researchers said the findings support what some doctors have seen in everyday practice, since Cymbalta is already used to treat the chemo side effect.

That use has been based on the fact that Cymbalta helps with other types of pain, said Dr. Michael Stubblefield, who was not involved in the study but treats patients with chemo-induced peripheral neuropathy at Memorial Sloan-Kettering Cancer Center in New York City.

In the United States, the drug -- known chemically as duloxetine -- is approved to treat diabetes-related peripheral neuropathy, as well as fibromyalgia and chronic pain from arthritis.

Until now, cancer specialists have had to "steal" from evidence that Cymbalta helps with those forms of nerve pain, Stubblefield said.

"This is the first study of its kind to show that this works against chemotherapy-related neuropathic pain," he said.

It is estimated that 20 percent to 40 percent of patients treated with certain cancer drugs -- including so-called taxanes and platinums -- will develop peripheral neuropathy. For most, the problem improves once their chemo is over, said Ellen Lavoie Smith, the lead researcher on the study. But for some, she added, the nerve pain becomes chronic -- lasting for months or years after their chemo ends.

"This study focused on those patients," said Smith, an assistant professor of nursing at the University of Michigan School of Nursing, in Ann Arbor.

"The findings show that there is a medication that may be effective for reducing their pain from neuropathy," Smith said. But, she added, it didn't help everyone; the majority of Cymbalta patients improved, while others saw no change -- and 10 percent got worse.

The study included 231 patients with nerve pain that had persisted for at least three months since their chemo regimen ended. Half were randomly assigned to take Cymbalta for five weeks, while the other half took placebo pills. The two groups then switched treatments. None of the patients knew when they were taking the real drug and when they were on the placebo.

Of the patients given Cymbalta first, the average pain score fell by a point on a scale of 0 to 10. That's considered to be a "clinically important" change, Smith said, meaning it's an improvement patients notice in their daily lives.

The Cymbalta patients were also twice as likely to have a 50 percent decrease in pain scores versus the placebo users, and overall they reported improvements in their daily functioning and quality of life.

It is not clear how the antidepressant helps with nerve-related pain, but it is thought to act on certain brain chemicals involved in transmitting pain signals.

The findings are encouraging, Stubblefield said. But, like Smith, he pointed out that not everyone responds to Cymbalta. "This doesn't mean I'll be putting all my patients on it," he said.

There are other treatments for chemo-related pain -- although they have not yet been shown to work in rigorous clinical trials. One option, Stubblefield said, is Lyrica (pregabalin), which is another drug approved to treat other forms of nerve-damage-related pain.

Stubblefield said Lyrica tends to have fewer side effects than Cymbalta, and at least some patients may be able to tolerate it better. Cymbalta's side effects include fatigue, insomnia and nausea, which were reported by 5 percent to 7 percent of patients in the current study.

On the other hand, Stubblefield said, if a patient with nerve pain is also feeling depressed, it makes sense to try Cymbalta first.

There's also cost. Cymbalta is not yet available as a generic, and runs close to $200 a month. It is scheduled to lose patent protection at the end of 2013, so cheaper versions may become available.

Smith said there are still many questions to sort out: How well can patients tolerate Cymbalta over a longer term? Does the drug help nerve pain in patients who are still on chemo?

"We anticipate that it would help," Smith said. "But to what degree? Would it be enough to make a difference in their lives?"

As better treatments are helping more cancer patients survive, chronic peripheral neuropathy is emerging as one of the most difficult side effects of the treatments, said Dr. Sandra Swain, president of the American Society of Clinical Oncology.

Even minor actions, like picking up your keys, become difficult, Swain said. "It really affects your everyday living," she said.

Swain said the bottom line for patients is that "this drug may actually work, and it's something you can discuss with your doctor."

Still, Swain added, more research is needed -- not only into Cymbalta, but into other treatments for chemo-related pain.

Eli Lilly, the company that makes Cymbalta, provided the drug for the study. The work was funded by government and non-profit grants, and none of the researchers reported financial ties to Eli Lilly.

More information

Learn more about chemo-related neuropathy from the American Cancer Society.

http://www.drugs.com/news/antidepressant-lessens-chemo-related-pain-43944.html

Early Pregnancy Headaches

Early Pregnancy Symptoms

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Early Signs Pregnancy

Early Pregnancy Symptoms By Week

TODAY Parents is the premiere destination for parenting news, advice community. Find the latest parenting trends and tips for your kids and family on TODAY.com..View the latest health news and explore articles on fitness,t, nutrition, parenting, relationships, medicine, diseases and healthy living at CNN Health..Diabetes Causes Headaches Diabetes Causes Headaches :: diabetes management 2015 - The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days..WebMD experts and contributors provide answers to your health questions..Medical news and health news headlines posted throughout the day, every day.

SYPHILIS AND HOMEOPATHIC MANAGEMENT

                                                                          SYPHILIS

                Syphilis is a STD (sexually transmitted disease) caused by a spirochaete called TREPONEMA PALLIDUM.

                Treponema palladium is a slender, spiral-shaped, thread like, actively motile organism measuring 6-14 in length. It is identified under the microscope by a special technique known as a dark ground illumination.

EPIDIMIOLOGY:-

                The disease is widely prevalent especially in large cities, industrial areas and sea ports. The northern parts of India especially Kashmir, himachal Pradesh and uttar Pradesh are heavily infected. It has been estimated that nearly 5 percent of the population in India is infected with syphilis. The infection rate varies from 4 to 7.5 percent to a maximum of 13 percent in different parts of the country.

The disease may be either congenital or acquired.

CONGENITAL SYPHILIS:-

                Syphilis transmitted to the foetus during intrauterine life is called congenital syphilis. During the early months of pregnancy, syphilis may cause still birth. If the child is born full term, certain stigmata of the disease are either present at birth or develop subsequently during early childhood.

                Stigmata during 1-2 years of age.

1.       The child may be born premature or fails to gain weight afterwards.

2.       A scaly yellow or copper coloured rash may be present over the napkin area or around the genitals. Such rashes may sometimes be present over the palms and soles.

3.       Syphilitic rhinitis (snuffles) develops within a month or two and is persistant. This ultimately leads to failure of development of the nasal bones producing the typical depression of the bridge of the nose (saddle shaped nose).

4.       Cracks and fissures (rhagades) appear at the angles of the mouth. These heal leaving behind prominent scars radiating from the angles of the mouth.

5.       Condylomata may appear over the perineum or under the arms.

6.       Spleen and liver may be a palpable.

7.       Syphilitic basal meningitis may occur producing hydrocephalus.

STIGMATA APPEARING LATER IN CHILDHOOD:-

1.       Bony changes – periostitis with bowing produces the typical sabre shaped tibia. Localized elevations over the frontal and parietal bones produce frontal and parietal bossing (also known as parrot’s nodes or hot cross bun appearance).

2.       Hutchinson’s teeth – the teeth are widely separated. The permanent upper central incisors are peg-shaped, tapering from the gum margins with notches present over the cutting edge.

3.       Eye changes – interstitial keartitis may occur and cause blindness.

4.        Otitis media or gummatous destruction of the internal ears may occur resulting in deafness.

5.       Nervous lesions – juvenile tabes dorsalis and general paralysis of the insane are possible but extremely rare. Mental deficiency or dementia may occur but is rare.

6.       Cardiovascular lesions – syphilitic aortitis and aortic incompetence are rare manifestations of congenital syphilis.

7.       Joints – painless effusion may occur inside the bigger joints.

ACQUIRED SYPHILIS:-

                 The infection is almost always acquired through sexual intercourse. Rarely, the infection may be acquired by handling infected material or implanted during kissing by an infected person.

                The incubation period varies from 10 days to 3 months. The disease occurs in all age groups but is more common in adults. It passes through three well defined stages primary, secondary and tertiary.

PATHOLOGY:-

                Syphilis is a notorious disease in the sense that it can affect almost any organ in the body and that the lesions, though apparently looking healed, are essentially chronic and slowly progressive. Syphilis is a chronic granuloma infiltration of round cells occurs around a central zone of necrosis. The arteries are particularly affected causing endarteritis obliterans and possibly thrombosis.

                The primary lesion, known as primary sore or chancre is a hard, indurated, exudative and painless lesion. The organism is present in the exudates. A chancre heals in 6-8 weeks but always leaves behind extensive scar. A chancre occurs usually on the genitalia but may occur on the lips, fingers or elsewhere. Treponemes thereafter, pass to the regional lymph nodes and then invade the blood stream.

                During the secondary stage, the infection is generalized. Lymph nodes, especially the posterior cervical group, axillary and the epitrochlear glands are enlarged. Various types of rashes appear due to chronic inflammatory reaction around the cutaneous blood vessels.

                The tertiary stage is marked by formation of gummas. Gumma is a chronic granuloma which is comparatively avascular due to endarteritis obliterans affecting the small blood vessels. A gumma heals by extensive scarring and destroys part of the organ at the site of its formation.

SYMPTOMS:-

1.       PRIMARY STAGE:-

There is history of sexual contact, after a period varying from 3 weeks to 3 months, a red small indurated lesion forms on the penis or the labia. In the following 2 – 3 weeks, the lesion becomes harder and more indurated. This is the primary chancre. The regional lymph nodes are enlarged. The primary chancre heals in about 2 months time leaving behind a scar.

2.       SECONDARY STAGE:-

The secondary stage usually starts 4 weeks after the appearance of the primary chancre and lasts up to 2 years. This is the stage during which the infection becomes generalized.

a.       Generalized, painless enlargement of the lymph nodes, especially the posterior cervical, axillary and the epitrochlear glands.

b.      Various types of papular or maculopapular rashes appear over the trunk and the limbs. The rashes are symmetrical in distribution, brownish in colour and with no itching.

c.       Warty lesions called Condylomata may occur over the moist surfaces of the body around the anus, vulva or the under surface of the breasts.

d.      Typical lesions may be seen over the mucous membrane of the buccal cavity. Linear streaks or furrows, grayish white in colour may be present over the fauces or the soft palate. The tongue is swollen, red and often fissured.

e.      Hairs may fall out resulting in either generalized or localized alopecia.

f.        Features of syphilitic meningitis or Meningo vascular syphilis may be present, later often causing cerebral thrombosis.

3.      TERTIARY STAGE:-

Tertiary stage appears 2-15 years after the primary infection. The typical lesion during this stage is a hard, localized swelling known as gumma. Gumma can form simultaneously at various sites and causes localized destruction of the affected organs.

a.       Skin gumma may form over the legs or elsewhere over the skin surface producing deep sated punched out ulcers. Painless perforating ulcers may develop in the soles.

b.      Bones – syphilitic involvement of the bones is the nature of a chronic inflammation. Long bones are more commonly affected. A deep boring pain occurs which is worst at night. Gumma may form over the bones of the face and the nose leading to their destruction and disfigurement.

c.       Internal organs - gumma may form inside any of the internal organs such as the liver, testes, lungs, heart, tongue, pituitary or adrenal glands. In the heart formation of gumma may be responsible for conduction defects or localized degeneration of the myocardium. Chronic inflammatory changes may affect the aortic valve.

d.      Neurological changes – these include basal meningitis and menigovascular syphilis, general paralysis of insane and formation of a gumma inside the brain that behaves like a cerebral tumour.

INVESTIGATIONS:-

1.       During primary or secondary stage, Treponemes can usually be isolated from the exudates and identified by dark ground illumination.

2.       Wassermann reaction and khan tests.

3.       The venereal disease research laboratory test (VDRL) – it is a flocculation test that detects a non-specific antibody like reacting substance present in the serum of syphilitic persons. Though the test is non-specific, it is still an easy, cheap and fairly reliable test for syphilis.

4.       Tests using specific treponemal antigens.

DIAGNOSIS:

        The diagnosis is based on

-          History of an irregular sexual contact.

-          Typical clinical features or symptoms and

-          Positive Wassermann reaction and VDRL test.

-          During the primary stage, a chancre may be confused with a chancroid. During the secondary stage, syphilitic skin rashes may be confused with several skin disorders. During the tertiary stage, A gumma may be confused with a carcinomatous lesion.

TREATMENT:-

-          Treatment should be started as early as possible, even without waiting for the Wassermann test to become positive.

-          Pencillin is still the best drug for syphilis.

-          Pencillin twice a day for 8-10 days should be given unless the patient is sensitive to pencillin.

HOMEOPATHIC TREATMENT:-

              Some of the main remedies for syphilis in homeopathy are given below.

1.       ARSENICUM IODUM.

2.       AURUM METALICUM.

3.       AURUM MURATICUM.

4.       KALI IODUM.

5.       KALI SULPH.

6.       LAUROCERASUS.

7.       MERC SOUL.

8.       MERC COR.

9.       NITRIC ACID.

10.   PHYTOLACCA.

11.   SILICEA.

12.   STILLINGIA SYLVATICA.

13.   SYPHILINUM.

14.   FLOURIC ACID.

15.   GRAPHITIS.

16.   LYCOPODIUM.

17.   STAPHYSAGRIA.

18.   SULPHUR.