Injections of Medical Insights

Rhabdomyolysis is a serious syndrome due to muscle injury. It results from the breakdown of muscle fibres and the release of its contents into the bloodstream.  The causes of rhabdomyolysis are categorised into traumatic or non traumatic. Traumatic causes include crush injuries or venom from a snake bite while non traumatic causes include extreme muscle strain or bacterial infections.  The symptoms of rhabdomyolysis varies greatly depending on its cause. However, the most common signs include muscle pain, muscle weakness and dark red or brown urine.  The high levels of potassium released into the bloodstream can cause serious complications. It may lead to cardiac arrest, kidney damage and liver damage.  Early diagnosis and treatment is key to recovering from rhabdomyolysis. Doctors are able to reverse the kidney damage if treated early. Sources: https://www.webmd.com/a-to-z-guides/rhabdomyolysis-symptoms-causes-treatments http://www.emdocs.net/emdocs-cases-evidence-based-recommendation

Influenza, commonly known as the flu, is a viral infection that attacks the respiratory system, including the nose, throat and lungs. Influenza is commonly mistaken with stomach “flu” and the common cold.  The flu usually has the same symptoms as the common cold, which includes a runny nose, sneezing and a sore throat. However, the primary difference is that the tends to develop suddenly whereas colds usually develop slowly. One also feels much worse when suffering from flu.  The flu is spread through influenza viruses which travel through the air in droplets. Influenza viruses are constantly mutating, hence any immunity from previous influenza infections are often ineffective against new strains.  As a result, an annual flu vaccination is recommended for all persons above the age of 6.   With new strains of influenza, there is a constant threat of an outbreak. A recent outbreak was the 2009 H1N1 outbreak. Hence, we should all do our part to lower the risks of yet another outbreak by r

Crohn’s disease is an inflammatory bowel disease which most commonly occurs in the small intestine and colon. However, it can affect any part of the gastrointestinal tract.  The symptoms of Crohn’s disease often develop gradually with certain symptoms becoming worse over time. Early on, it is possible to mistake the symptoms for other conditions such as food poisoning. However, the symptoms may become more severe as the disease progresses., leading to complications such as a perianal fistula, inflammation of the joints and skin and anaemia.   Anti-inflammatory drugs and immunosuppressants are the most common forms of medication prescribed to treat Crohn’s disease. These drugs manage the inflammatory symptoms that are caused by the disease.  Ultimately, if less invasive treatments don’t improve the symptoms, surgery may be necessary. According to Crohn’s & Colitis Foundation, 75 percent of patients will eventually be required to get surgery. Sources: https://www.healthline.com/healt

Chronic stress can cause a patient to feel irritable, moody and have restless sleep. Stress is not always bad, it can help one to stay patient, focused. However, stress over a prolonged period of time can affect brain size, structure, shape and how it functions.  Under stressful situations, the adrenal gland releases cortisol which activates your body for instant action. This explains why we feel a surge of energy under stress. However, high levels of cortisol over a prolonged period of time increases the level of activity and neuro-connections in the amygdala, also know as your brain’s “fear centre”.  With high levels of cortisol, your brain’s hippocampus-the part of your brain responsible for stress control, reading and learning- deteriorates, and hence your ability to control stress.  Abnormal levels of cortisol can also reduces the synapses between neurons and cause shrinking of the pre-frontal cortex. This affects concentration, decision-making and judgement.  https://www.webmd.co

Parkinson’s disease is a progressive nervous system disorder that affects one’s movements. Parkinson’s disease signs and symptoms are different for every individual and may go unnoticed in the early stage. Symptoms typically start on one side of the body and remain worse on that side even after the symptoms begin appearing in both sides of the body.  Generally, the symptoms of Parkinson’s disease include tremors, slowed movement, rigid muscles, impaired posture and balance, loss of automatic movements such as blinking or swinging of arms when walking, and speech and writing changes.  Parkinson’s disease occurs when neurons in an area of the brain that controls movement becomes impaired or dies. These neurons normally produce dopamine. As more neurons become impaired or die, the amount of dopamine produced in the body is reduced significantly, causing the movement problems associated with Parkinson’s disease.  People with Parkinson’s also lose the nerve endings that produce norepinephri

Anesthesia is commonly perceived as the sleeping drug or gas, aimed at putting the patient to “sleep” during surgery so that the surgical team is able to comfortably operate without the patient feeling any pain.  There are 3 types of anesthesia, namely: regional, inhalation and intravenous. Regional anesthesia blocks pain receptors and hence nerve impulses from travelling to the brain in a targeted area. In neurons, anesthesia binds onto the protein channels located on the cell membrane, setting up an “electrical barricade”.  The effects of clinically administered anesthesia are similar to that of cocaine. They have similar molecular structure and hence, their pain numbing effects work in a similar fashion. For surgical procedures which are relatively more intrusive, inhalation is preferred because it targets the entire nervous system. Western medicine started to use a compound called diethyl ether or nitrous oxide (laughing gas for dental procedures).  Along with inhalation, intraveno

Cardiac automaticity is the intrinsic ability of the heart to spontaneously depolarise, sending action potentials throughout heart muscles and myocardium. Unlike most organs in the human body, it does not require a nerve impulse to contract.  Surrounding the heart are nodal cells which send electrical signals throughout the heart. They comprise the following nerves in order: SA node, AV node, bundle of His, left and right bundle branches and the Purkinje fibres. The SA node (sinoatrial node) is the “pacemaker” and sets the rhythm for the heart. It sends action potential throughout the nodal cells, causing the myocytes to contract. This ability of intrinsically contracting is what makes heart transplants possible. Thus, only oxygen is needed to be supplied so that it can “live” outside the body. https://www.livescience.com/44460-heart-facts.html https://youtu.be/1kX6Tp8CWFw

A urinary tract infection (UTI) is an infection in any part of the urinary system, with most infections involving the lower urinary tract - the bladder and urethra.  The severity of the UTI depends on where the infection is. The closer to the kidneys the infection is, the more severe the infection. Symptoms of UTIs include a strong persistent urge to urinate, a burning sensation when urinating and urine that appears cloudy or bloody.  UTIs occur when bacteria enter the urinary tract through the urethra and multiply in the bladder. These bacteria then grow into a full-blown infection in the urinary tract.  Women are more prone to UTIs than men.  This is because a woman has a shorter urethra than a man, which shortens the distance the bacteria has to travel to reach the bladder. To prevent UTIs, one is encouraged to wipe from front to back to prevent bacteria from the faeces from entering the urethra. Sources: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptom

Haematuria is the discharge of blood through urination. Typically, the main cause of haematuria is internal bleeding of any organ found in the gastrointestinal tract. It is important to take note when blood is discharged throughout urination. For example, if haematuria is initial or towards the end of urination, the site of the cause is primarily from the end of the bladder towards the end of the urethra. Whereas if haematuria happens throughout urination, the site of bleeding is most likely from the bladder or kidneys.  Haematuria can be caused by various infections and growth. Some growth include tumors, kidney stones, and polycystic kidney disease. Infections which cause haematuria include UTI and benign prostatic hyperplasia (BPH) which is also called prostate gland enlargement. https://www.nuh.com.sg/Health-Information/Diseases-Conditions/Pages/Microscopic-haematuria.aspx https://www.mayoclinic.org/diseases-conditions/blood-in-urine/symptoms-causes/syc-20353432

Iron is a mineral that the body needs for growth and development. It is widely known to be required in the production of haemoglobin, however there are other functions of iron as well.  Iron is found in muscle cells called myoglobin. Myoglobin also contains a haem group, which allows it to bind reversibly to oxygen. Myoglobin is responsible for accepting, storing, transporting and releasing oxygen.  Iron can also be stored as ferritin and can be found in cells and circulating the blood.  Ferritin level blood tests are often used to diagnose certain diseases. Low levels of ferritin can be a sign of iron deficiency or anaemia, whereas high levels of ferritin may be an indication of leukemia or type 2 diabetes.  Iron is important for our health and is often replenished through consumption of red meat and beans. However, when iron stores are exhausted, the patient will suffer from a condition known as iron depletion. Further decreases may be diagnosed as iron-deficient erythropoiesis or ir

Vitamin D can be introduced into the body in 2 ways. Either from foods such as egg yolks and milk or UV rays from the sun. It is a fat soluble hormone and is also known as cholecalciferol (CCF). Our skin stores a fat molecule called 7-dehydro-cholesterol converted into CCF through up rays from light. CCF is then converted into its active form known as 1,25-DOH-CCF (1,25-dehydroxyl cholecalciferol). This increases calcium absorption in blood and also increases the absorption of macrophages to sites where there are high concentrations of virus. Active CCF enters the immune cells such as macrophages and activates the DNA to make specific proteins which help to fend off viruses. One of which is called beta defensins. They punches holes in cell membrane in virus cells/ viral envelopes, causing the virus cells to die out. There is a correlation between vitamin D deficiency and COVID-19 mortality rate. In liver failure or chronic kidney disease (renal failure) there is decreased vitamin D act

Snake venom contains a mixture of proteins and glycoproteins aimed at immobilising and incapacitating its victim. It exhibits various enzymatic activities and mainly affects platelet aggregation and blood coagulation. Viper venom can comprises of proteins such as snake venom serine proteases, snake venom metalloproteinases, disintegrins, snaclecs, and type II phospholipases A2. Snake venom is deadly because it interferes with the homeostatic system of blood. Certain snake venom toxins are proteins which inhibit blood coagulation in the patient, it does so by inhibiting the pathway which turns fibrinogen into fibrin causing the patient to bleed out, and dying due to a loss of blood. However, snake venom can also increase the action of coagulation by causing a massive blood clot, altering the state of blood into a “jelly” like consistency. This can cause cardiac arrest and stroke. Antibodies, made from ingesting small amounts of venom into a horse, is extracted from its blood and adminis

Sarcoidosis is a disease characterised by the growth of granulomas (collections of inflammatory cells), most commonly in the lungs and the lymph nodes.  The cause of sarcoidosis is unknown, but experts hypothesise that it results from response of the body’s immune system to an unknown substance.  In mild cases, sarcoidosis doesn’t present any symptoms and goes away on its own. However, this disease can also last for many years and cause organ damage.  The symptoms of sarcoidosis are dependent  on where the sarcoidosis is found. However, many patients also experience complications that are not directly related to the granulomas found on the organs. These symptoms include fatigue, vitamin D dysregulation, and small fiber neuropathy.  Vitamin D dysregulation occurs due to an increase of an enzyme that converts the inactive form of vitamin D into the active form, raising vitamin D levels in the patient.  Small fiber neuropathy is a type of peripheral neuropathy which causes an unpleasant t

Hypertensive crisis is an umbrella term for hypertensive emergencies and hypertensive urgencies. Both conditions occur when blood pressure is extremely high, and there is a possibility of organ damage.  A hypertensive urgency occurs when the blood pressure spikes, to a reading above 180/110 mm Hg. However there is no damage to any organs, and the blood pressure can be brought down using blood pressure medication.  In contrast, a hypertensive emergency occurs when the blood pressure is even higher, and there is danger of organ damage. The blood vessels can become inflamed, causing leakage of fluid or blood. As a result, the heart is unable to pump blood effectively and there are risks of organ damage. In such a situation, the patient must be immediately admitted to an intensive care unit in a hospital.  Sources: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/hypertensive-crisis/faq-20058491 https://www.webmd.com/hypertension-high-blood-pressure/guide/h

Conjunctivitis, also known as pinkeye, is an inflammation of the conjunctiva, the transparent membrane that covers the white part of the eyeball.  The telltale sign on conjunctivitis is redness in the eyes. However, there are other symptoms such as itchiness and even discharge from the eyes.  The first cause of conjunctivitis is bacterial or viral infections. Most cases are typically caused by adenovirus, but other viruses such as herpes simplex virus and even COVID-19 can cause conjunctivitis. Both types of infections are very contagious.  Conjunctivitis can also be caused by allergens. In response to allergens, the body produces an antibody, immunoglobulin E. IgE triggers mast cells in the mucous lining of the eyes and airways to release inflammatory substances.  Lastly, conjunctivitis can be caused by irritation. This form of conjunctivitis usually clears up on its own within a day. Sources: https://www.mayoclinic.org/diseases-conditions/pink-eye/symptoms-causes/syc-20376355 https:/

Celiac disease is an immune disease in which the consumption of gluten leads to an immune response in the small intestine. The gluten damages the villi of the small intestines and prevents it from absorbing nutrients.  This disease can lead to diarrhoea, weight loss and abdominal pain, and even symptoms such as anaemia and osteoporosis due to the malabsorption.  As a result, people with this disease have to remove gluten from their diet. Gluten is a family of storage proteins, found in cereal grains such as what and barley. Luckily, the increasing awareness of gluten intolerance has led to greater gluten-free options, allowing for greater convenience and variety even when following such a diet. Sources: https://www.medicalnewstoday.com/articles/318606 https://www.healthline.com/nutrition/what-is-gluten#food-sources https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220 https://www.beyondceliac.org/celiac-disease/

The anterior cruciate ligament (ACL) is o ne of the major ligaments in your knee. It provides rotational mobility in the knee and prevents the tibia from sliding out of the femur. ACL tears are some of the most common injuries amongst athletes performing at a high level, whereby they are required. There are various risk factors which can increase your risk of an ACL injury. Participation in certain sports which are strenuous on the knee such as soccer, basketball and rugby. Poor conditioning can also increase your risk regardless of physical activity. Last, sudden movements and distribution imbalances of the weight on lower limbs.  Depending on the severity of the ACL injury, a range of treatments may be employed. A mere strain only requires simple exercises, rest and rehabilitation. If deemed serious, surgery is required to replace the torn ligament followed by rehabilitation. The patient’s knee may swell, feel unstable and become too painful to bear weight, and is oftentimes treated

Mercury poisoning refers to a toxicity due to consumption of mercury. This condition is largely linked to eating seafood, either due to consumption of certain types of mercury-containing fish or eating too much fish.  Previously, it was possible to develop mercury poisoning if a mercury thermometer broke, which led schools in Singapore to phase it out from the labs. Mercury poisoning is most notable for its neurological impacts. Anxiety, depression, memory problems and tremors are just a few of the many symptoms that can develop due to this condition. Mercury can also harm the kidneys and thyroid.  Organic mercury compounds are able to reach high levels in the central nervous system, leading to neurotoxicity. Although the exact mechanism of how mercury induces neurological damage is unclear, it is able to disrupt cell cycle progression and induce apoptosis in several tissues.  There is no known cure to mercury poisoning. The best way to treat it is to remove the source of mercury, by r