OSTEOPOROSIS

(Abnormal rarefaction of bone)

Definition:

This is a condition of atrophy of bones characterised by reduction of the amount of bone mass in relation to normal volume of bone.

It is the commonest metabolic disease of bone and is found most frequently in elderly women when it is known as post menopausal osteoporosis. It may occur in elderly men (senile osteoporosis) and rarely in younger people (idiopathic osteoporosis).

Causes:

(1) Endocrinal—Hypogonadism, Cushing’s Syndrome, Acromegaly, Thyrotoxicosis. (2) Nutritional— Scurvy, Calcium or protein deficiency, etc. (3) Idiopathic— Juvenility, pregnancy or senility. (4) Inherited. (5) Immobilisation of a limb. (6) Loss of gravity, when in space. (7) Miscellaneous—Rheumatoid arthritis, chronic alcoholism, diabetes, chronic hepatic insufficiency, osteogenesis imperfecta prolonged use of heparin etc.

Definition:

It is a severe form of protein malnutrition. It is not seen in breast fed infants.

Causes

(1) The factors which predispose to marasmus are a rapid succession of pregnancies and early/often abrupt weaning, followed by dirty artificial feeding of the infants with very dilute milk given in inadequate amounts to avoid expense.

(2) Mo less infant.

(3) Lack of food in a family,

(4) Prolonged starvation as a part of treatment of diarrhoea.

(5) Unsterilized feeding bottles leading to infective diarrhoea.

(6) Failure of lactation with no suitable alternative to breast feeding.

Signs and Symptoms

(I) Retardation which is much more marked than that of length.

(2) wasting and subcutaneous fat

What is Hepatic coma?

Alteration in the behavior, consciousness and some other neurological functions that occur in the parenchymatous hepatic disorder are collectively termed as hepatic coma.

Causes:

(1) Virus hepatitis, (2) Cirrhosis of liver, (3) Biliary cirrhosis, (4) Toxic hepatitis, (5) Infantile cirrhosis of liver, (6) Hepato toxic drugs, (7) Carcinoma of liver, (8) Portal hypertension, (9) Toxic nitrogenous products are absorbed from the large gut, (10) Defective synthesis of urea in the liver, etc.

Signs and Symptoms

(A) Stage of pre-coma

(1) Alteration in behaviour.

(2) Impairment of memory and other intellectual functions.

(3) Confusion and even delirium.

(4) Slurring of the speech.

(5) Inversibn of sleep rhythm.

(6) Convulsion—local or generalised.

Definition:

It is an intense itching disorder marked by formation of wheals.

Causes:

(A) General—(l) Allergy — food, drugs, parasites, inhalants etc. (2) Focal sepsis—otitis media, dental sepsis, sinusitis etc. (3) Psychogenic stress. (4) Physical agents—cold, trauma, stings, hot etc. (5) hereditary factors.

(B) Local—(1) Bites as of nettles, caterpillars, bed-bug etc.. (2) Injection of A.T.S., or penicillin etc.

(C) Idiopathic (unknown)

Types :

(1) Physical urticaria—develops after physical pressure or irritation. (2) Chronic—when urticaria persists for more than 6 weeks. (3) Solar—occurs after exposure to s n during summer months. (4) Cold—develops in association with cold wind or cold food or drinks. (5) Aquagenic— occurs in contact with water. (7) Cholinergic— after exercise, hot bathe emotional changes etc.

Definition:

Psoriasis is a common chronic inflammatory skin disease marked by circumscribed dry erythematous scaly macules affecting chiefly the extensor surfaces of the body.

Aetiology:

The exact aetiology is not known. The Probable factors are disturbed fat metabolism, hormonal imbalance, septic 1ocus anywhere in the body, allergy, anxiety states, hereditary influences etc. It occurs in both sexes and all ages.

Clinical Features :

(1) Affects usually extensor surfaces of the body. (2) Dry, well defined erythematous macules, papules are present (3) A candle grease like scale can be repeatedly produced even from the non scaling lesion. (4) Complete removal of a scale produces pin..point bleeding. Itching may be slight or moderate. (5) The felon may develop along the scratch lines. This is called Kebner’s Phenomenon (6) the lesions may heal in the centre thus forming rings.