Injections of Medical Insights

Tinnitus is a hearing condition often described as ringing in the ears. Tinnitus can also cause other types of noise in your ears such as: buzzing, roaring, clicking, hissing and humming.  The pitch heard from tinnitus can vary from a high squeal to a low roar, this can affect the patient’s ability to detect tinnitus from external sounds Tinnitus can develop gradually over time or occur suddenly. It is often associated with: age-related hearing loss, inner ear damage, earwax build-up and middle ear infection However, one in every three people with tinnitus doesn't have any obvious problem with their ears or hearing. Sources: https://www.mayoclinic.org/diseases-conditions/tinnitus/diagnosis-treatment/drc-20350162 http://www.webmd.com/a-to-z-guides/understanding-tinnitus-basics

Pompe disease is a rare genetic condition where the body is unable to break down complex sugars. This is due to a deficiency in an enzyme called acid alfa glucosidase (GAA). Mutations in the GAA gene causes this disorder and results in a build up of glycogen in cells.  Pompe disease can appear in patients from within a few months of birth, at about 1 years old and even during the teenage years.  Those with Pompe disease usually inherit the disease from their parents. However, the allele for the disease is recessive, and may not be expressed in the parents. This disease is typically associated with weak muscles, poor muscle tone and an enlarged liver. However, there are many complications with regards to the respiratory system and motor skills which can also develop.  Enzyme replacement treatment is used for all Pompe patients. A drug called aglucosidase alfa is given intravenously, which acts as a replacement for GAA. Sources: https://my.clevelandclinic.org/health/diseases/15808-pompe-

The trigeminal nerve, or the cranial nerve V is responsible for sensations in the face and motor functions such as biting and chewing. It originates from 3 sensory nuclei and 1 motor nucleus, which send fibres to form its tracts and is associated with 3 separate branches. Ophthalmic branch (V1), the maxillary branch (V2) and the mandibular branch (V3). The mandibular (lower jaw bone) branch has both the sensory and motor component whereas the ophthalmic and maxillary (smell and sight) only has sensory components.  Being an extremely important and the largest of the 12 cranial nerves, conditions such as trigeminal neuralgia can affect both motor and sensory functions of the face, having a significant impact on the patient’s life. Sources: https://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/symptoms-causes/syc-20353344

  Dyscalculia is a math learning disability which impairs an individual’s ability to learn number related concepts and perform accurate mass calculations reason and problem solving. It is also sometimes called “math dyslexia”.  Dyscalculia is present in about 11% of children with attention deficit hyperactivity disorder (ADHD). Although the exact cause of dyscalculia is unknown, research points to issues in brain development and genetics, as the disability is known to run in families. Furthermore, it is possible to develop acquired dyscalculia due to brain injuries.  Similar to other learning disabilities, there is no cure for dyscalculia. Special teaching and therapy is required to fill in the gaps in the often shaky math foundation of these patients. Moreover, certain arrangements such as extra time for tests are often given to help children with dyscalculia. Sources: https://www.additudemag.com/what-is-dyscalculia-overview-and-symptom-breakdown/ https://www.understood.org/en/learnin

  Melatonin, also known as the sleep hormone, is found naturally in the body. The hormone binds onto melatonin receptors which are found throughout the body in places such as the brain, the retina of the eye, the cardiovascular system and many others. Melatonin regulates night and day cycles or sleep-wake cycles. Darkness causes the body to produce more melatonin, which prepares the body for sleep. Light decreases melatonin production and wakes the body. Some people who have trouble sleeping have low levels of melatonin may require supplements to aid sleep. People with insomnia have trouble falling asleep, staying asleep, or both. When symptoms last a month or longer, it’s called chronic insomnia. Sources: https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work?amp=true https://www.healthline.com/nutrition/melatonin-and-sleep

Lymph nodes are part of the lymphatic system and are small glands that filter lymph. These lymph nodes store white blood cells which are responsible for killing invading organisms. They are most commonly found in the armpit, on the neck and under the jaw.  Lymph nodes become swollen in response to illness, infection, or stress. It is a sign that the lymphatic system is working to get rid of pathogens. However, immune system disorders or cancers can also cause the lymph nodes to swell.  A swollen lymph node can take on many different sizes. They are painful to the touch and can also hurt when making certain movements. They are most often accompanied by other symptoms such as fatigue, fever, and chills. If the swollen lymph node does not subside within a few days, it is advisable to see your doctor. Sources: https://www.healthline.com/health/swollen-lymph-nodes https://my.clevelandclinic.org/health/diseases/15219-swollen-lymph-nodes

  Flat foot is a congenital condition when a patient has lost the medial longitudinal arch of the foot. It is caused by the talus bone. This bone is hypermobile and comes out of its natural alignment. The talus bone is located inside the ankle joint, and provides the foundation for the mid foot. When pressure is exerted, the talus bone slides out and the medial longitudinal arch collapses.  Patients will typically feel pain in the arch of the foot, inside and even outside of the ankle  Treatment for flat foot is typically reserved for patients who are experiencing pain or those who experience symptoms. These patients normally turn to orthotics, tendon injections and/or physical therapy for treatment. However, if the pain resurfaces or persists, surgery may be used for a more permanent correction. Sources: https://health.mountsinai.org/blog/what-causes-flat-feet/#:~:text=%E2%80%9CFlat%20feet%20are%20typically%20caused,stone%2C%20then%20the%20bridge%20collapses . https://www.health.harva

Bone spurs, also known as osteophytes, are smooth and hard bumps of bone that forms at the end of a bone. They are most often found in joints such as knees, hips and hands.  The most common cause of bone spurs is joint damage, typically from diseases such as osteoarthritis. Alternatively, it can also form as a response to an injury, where the body adds extra bone to “fix” the injury.  Bone spurs may cause pain and stiffness in the joint. It can also cause weakness and muscle spasm if the bone spur presses against a nerve. Bone spurs can also break off, becoming a loose body and potentially causing the joint to lock up.  Typically, painkillers and steroids are prescribed to reduce pain and inflammation in the joints. However, surgery may also be used to remove the excess bone from the joint. Sources: https://www.webmd.com/pain-management/what-are-bone-spurs https://footeducation.com/bone-spurs/

  Microsurgery is a discipline in general surgery where procedures are performed on very small structures like the nerves and blood vessels using specialized instruments (under a microscope).  Various specialists use microsurgery such as: otolaryngologists (ear, nose, and throat doctors), ophthalmologists (eye doctors), urologists and gynaecologists and plastic surgeons. Equipment used in microsurgical procedures magnify the operating field, providing precise instrumentation for easier maneuvering under high magnification, and makes it possible for the surgeons to be able to operate on structures that are barely visible to the naked eye. Microsurgical instruments have distinct differences compared to conventional instruments. They are designed to make delicate manipulation of small structures possible and they come with handles large enough to hold securely and comfortably. Sources: https://www.google.com.sg/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiLh

  Glioblastoma is an aggressive type of tumour which can occur in the brain or the spinal cord. It is formed from cells called astrocytes, which support nerve cells.  Glioblastoma can cause terrible headaches, seizures and vomiting. However, it is extremely difficult to treat and cure is often not possible.  Treatment often includes surgery, chemotherapy and radiation therapy as well as different forms of clinical trials. The Netflix series “Lenox Hill” follows some top neurosurgeons as they tackle several cases of glioblastoma, and shows the impact of such a disease. Even after treatment, it is very possible to suffer from yet another glioblastoma in the future. Sources: https://www.mayoclinic.org/diseases-conditions/glioblastoma/cdc-20350148 https://www.netflix.com/sg/title/80201728 https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Glioblastoma-Multiforme

  Cleft lip is the opening of the upper lip or palate. It is a facial structure that is a result of under development of the baby. It is one of the most common birth defects but is also associated with many inherited genetic conditions or syndromes.  Usually, cleft lip is easily identifiable at birth. It is easily fixed with a few surgical procedures which leaves minimal scarring on the patient, he/she can proceed to live a normal life. During birth, tissue on the baby’s face fuse together to form a complete upper lip, this occurs 2-3 months into pregnancy. For babies with cleft lip, this fusion does not occur properly, or at all. Sources: https://www.mayoclinic.org/diseases-conditions/cleft-palate/symptoms-causes/syc-20370985 https://www.google.com.sg/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjnm5m8u4LwAhUSeisKHRYPDoIQFjAVegQIJhAD&url=https%3A%2F%2Fwww.nhs.uk%2Fconditions%2Fcleft-lip-and-palate%2F&usg=AOvVaw1ezc2D7-BU3s5lapPhlHhH

Hyperlipidemia is a term which refers to abnormally high levels of fat in the blood. The two main types of lipids found in the blood are triglycerides and cholesterol. Hence, hyperlipidemia is otherwise referred to as high cholesterol.  There are two main types of cholesterol, low-density lipoproteins (LDL) and high-density lipoproteins (HDL).  LDL cholesterol builds up in the artery walls, causing atherosclerosis, while HDL cholesterol clears up the amount of LDL. Hyperlipidemia occurs when there is an excess of LDL and insufficient HDL.  Although hyperlipidemia does not have any presenting symptoms, it can result in severe complications. It can often lead to atherosclerosis, which then leads to a series of problems such as strokes or heart attacks.  Lifestyle changes have to be undertaken to manage and prevent the onset of hyperlipidemia. One key method is to consume healthy fats, instead of saturated fats and trans fat. Beyond restricting one's diet, active exercise is essential

Lyme disease is commonly transmitted by tick bites because more than 50% of ticks are carriers. It can cause a variety of symptoms such as fatigue, arthritis, facial palsy and erythema migrans. Ticks require mammalian blood to survive. Hence, humans and various mammals are the most common prey to Lyme disease. Small rodents are primary reservoirs of Lyme disease. An insect known as the ixodes tick bites these rodents and hence, spreads the disease airborne. Subsequently, the ixodes tick can either bite humans, infecting them, or colonise and lay eggs on a host, continuing the cycle. Ticks pass the pathogen to us through tick saliva. Tick saliva contains an anesthetic, rendering the bites unnoticeable. It also has an anticoagulant, keeping the blood from clotting. Finally, it also has an immunosuppressive substance, this makes the host unable to fight off the infection.  Sources: https://www.youtube.com/watch?v=TtBb_pBZUaQ https://www.hopkinsmedicine.org/health/conditions-and-diseases/l

  People with the disorder pica compulsively eat items with no nutritional value. In some cases, these people eat relatively harmless items such as ice. However, there are also instances where these people eat dangerous items such as metal. These can lead to severe complications, such as lead poisoning in the latter case and intestinal blockages.  This disorder is most common in pregnant women and children. It is also seen in persons with intellectual disabilities.  There is no single cause for pica. Pica can be caused due to an underlying deficiency in a nutrient. However, it can also be caused by dieting and malnourishment, where eating non food items is a last resort to feel full.  Sources: https://www.healthline.com/health/pica https://www.nationaleatingdisorders.org/learn/by-eating-disorder/other/pica https://theswaddle.com/what-is-pica-an-eating-disorder-that-involves-eating-non-food-items/

The pacemaker is a device which delivers an electrical impulse to control your heart rhythm, typically for patients who suffer from bradycardia (an abnormally slow heartbeat). The sinoatrial node is the natural pacemaker of the heart. It sends action potential to depolarise nodal cells in the heart to create rhythmic contractions. For patients with an irregular heartbeat rhythm, the pacemaker aids and maintains consistent contractions. They can also be implanted temporarily to treat a slow heartbeat after a heart attack, major surgeries, or drug overdose. Permanent pacemakers are highly recommended for patients with a slow or irregular heartbeat or, in some people, heart failure. It is implanted in the soft tissue beneath the skin in the chest. It is typically inserted in the chest below the collarbone. Sources: https://www.mayoclinic.org/tests-procedures/pacemaker/about/pac-20384689#:~:text=Pacemakers%20are%20implanted%20to%20help,to%20help%20treat%20heart%20failure .

Alcohol poisoning is a serious consequence of drinking excessive amounts of alcohol in a short period of time. Alcohol poisoning can lead to vomiting, seizures and slow and irregular breathing. In some cases, alcohol poisoning can be fatal.  Ethanol, which is found in alcoholic beverages, is the commonest cause of alcohol poisoning. However, other forms of alcohol such as isopropyl alcohol (found in lotions and cleaning products) and ethylene glycol (found in paints) can also cause poisoning. High levels of alcohol in the bloodstream causes critical areas of the brain to shut down, leading to various complications.  The body will naturally get rid of the alcohol over time. However, using home remedies can sometimes be ineffective and dangerous. For example, a popular home remedy is to take a cold shower. However, the shock of cold can instead lead to the loss of consciousness. Sources: https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/symptoms-causes/syc-20354386 https:/

  Skin grafting is a surgical procedure that transplants healthy skin from one area of a body to a damaged area of the body. This surgery may be done if a part of your body has lost its protective covering of skin due to burns, injury, or illness. Surgeons use an instrument called the dermatome to remove the skin from areas usually hidden by clothes such as the buttocks and the inner thigh. Once removed, a graft is placed on the area in need of covering.  Aside from burn patients, skin grafts can also be used in aesthetic plastic surgery such as breast or nose reconstruction, and for extensive skin loss due to infection, and removal of large skin cancers. Sources: https://www.healthline.com/health/skin-graft https://emedicine.medscape.com/article/1129479-overview

Gigantism is a rare condition that causes abnormal growth in children. This occurs as a result of an excess of somatotropin, a growth hormone which is produced by the pituitary gland.  The commonest cause of gigantism is a pituitary gland tumour. The growth of the tumour makes the pituitary gland produce an excess of hormones.  Children with gigantism are much larger than their peers. However, they may also have flat noses and large heads. The symptoms of gigantism also depends on the size of the tumour, with a larger tumour resulting in the symptoms being more prominent.  Oftentimes, the tumour will have to be removed through surgery. Despite the removal of the tumour, the child may still be much larger than his peers if the tumour is not removed early. Sources: https://www.healthline.com/health/gigantism https://www.yourhormones.info/endocrine-conditions/gigantism/

  Acute cholecystitis is inflammation of the gallbladder. Its main symptom  is a sudden sharp pain in the upper right side of your abdomen that spreads towards the right shoulder. The causes of acute cholecystitis can be grouped into 2 main categories: calculous cholecystitis and acalculous cholecystitis. Calculous cholecystitis develops when the main opening to the gallbladder, called the cystic duct, gets blocked by a gallstone or by a substance known as biliary sludge. This increases the pressure inside it and causes inflammation. Acalculous cholecystitis is the accidental damage to the gallbladder during major surgery, serious injuries or burns, blood poisoning (sepsis), severe malnutrition or AIDS.  Sources: https://www.msdmanuals.com/en-sg/professional/hepatic-and-biliary-disorders/gallbladder-and-bile-duct-disorders/acute-cholecystitis https://www.healthline.com/health/acute-cholecystitis

  Buruli ulcer is a disease caused by the bacterium Mycobacterium ulcerans . It is found in tropical regions such as Africa and Australia and mainly affects the skin, but can also affect the bones.  It is not known how the bacterium is transmitted, but it has been found in animals such as horses, dogs and alpacas. The disease causes the skin to swell and if left untreated, the skin will become destroyed and gangrenous.  Procedures such as skin grafts are useless, as the disease will also destroy it. Instead, doctors are required to prescribe strong antibiotics, which are also used to treat leprosy and tuberculosis. The treatment also leads to other side effects such as fatigue and nausea, and can also cause sweat and tears to turn orange. Even after the disease is treated, surgery may be required to cover skin defects and correct deformities. Sources: https://www.cdc.gov/buruli-ulcer/index.html https://www.cdc.gov/buruli-ulcer/transmission.html https://www.cdc.gov/buruli-ulcer/signs-sy

  Dandruff is a common condition that causes irritated and oily skin on the scalp to flake. It is also known as seborrheic dermatitis. A fungus called malassezia triggers dandruff. This fungus normally lives on your scalp. If a patient has too much of it, skin cells multiply more quickly than usual. Certain factors can cause malassezia to multiply, the most common including: age, hormones and stress. Dandruff isn’t curable. Most people will have to manage symptoms over the long term. Usually, the flakes will come and go. Treating dandruff with a special shampoo can manage the condition and prevent itching and flakiness. Mild dandruff can be easily treated by regularly shampooing hair containing chemicals such as  pyrithione zinc ( Head and Shoulders ) and selenium sulfide ( Selsun Blue ). If standard shampoo does not improve the condition, one should visit a dermatologist for further treatment. Sources: https://www.healthline.com/health/skin-disorders/dandruff-vs-dry-scalp#:~:text=The%