Ankylosing spondylitis ( AS )

~ Is a form of arthritis.

~ Late diagnosis may result in inflammation which spreads up from the spine and cause the bones in the rib cage to fuse ( jointed together ) resulting in breathing difficulties.

~ In severe cases , the heart and eyes may be affected.

~ Ankylosing ( Greek word ) - fusing together spondylitis - inflammation of the vertebrae.

~ Is a condition when some or all of the bones at the spine fuse or join together.

~ Involve genetic factors ( abnormal gene called HLA - B27 )

~ Three times more common in men.

~ There is inflammation outside the little joint between the spine where the ligament and tendon's are attached to the bone.

~ To heal the body,the spinal bones create new bone matter over the existing bones causing them to become stiff and inflexible.

~ Then stiffen the rib cage,affecting lung and heart function.

~ Main treatment is to relieve pain and stiffness to prevent or delay complications or spinal deformity.

~ Experience early morning stiffness and pain,wear off or reduce in intensity throughout the day with increased mobility or exercise.

~ Feel better after exercising and worse after rest,especially prolonged rest.

Atherosclerosis

~ The narrowing of arteries due to plaque building up causes the space inside the artery to narrow and flow of blood becomes restricted.

~ Cholesterol gets deposited in the arteries and get clogged.

~ The narrowing causes ischaemic heart disease ; lack of blood supply to the heart muscles.

~ Almost half of those heart attacks are found to have normal cholesterol levels.

~ Hardening of arteries is another attributed to inflammation of the arteries.

~ Inflammation of the lining of the arteries is more of the root cause.

~ Inflammation,a protective response of the body against infection and injury,may damage blood vessels if it goes out of control.

~ High cholesterol,high blood pressure,diabetes,smoking and a sedentary life style are the main causes of heart disease.

~ Precursors of inflammation are actually trans-fatty acids,saturated fat,sugar and carbohydrates.

~ Trans-fatty acids are mostly found in hydrogenated oil ( margarine )

~ Important factor in choosing carbohydrates is the Glycaemic Index ( GI ) - an indicator of how fast carbohydrates and sugars in the certain food raise blood sugar levels.

~ High GI ( refined carbohydrates ) - potatoes,table sugar break down in the body rapidly and raise blood sugar levels in a short time.

~ The spike in blood sugar levels generated may cause inflammation as high blood sugar levels,even if transient,favour a process called glycation,which damages and distorts body structures and functions triggering an inflammatory response.

~ Difference between an angina and a heart attack is : - 

( i ) Angina,the heart muscle lacks oxygen but undamaged.

( ii ) Heart attack,the heart muscle dies due to the shortage of oxygen caused by a total occlusion of the coronary artery.

Lymph Node

~ An integral part of the lymphatic system.

~ Forms a very important component of the body's immune system.

~ Lymphatic system is made out of lymph nodes and lymphatic ducts.( spreads throughout the body )

~ Transport lymph ( fluid ) washed the tissues around the cells.

~ Lymph contains a lot of white blood cells ( lymphocytes,which produce antibodies to counter foreign substances ( bacterias & viruses ) that enter the body ),fluid from the intestines(chyle) and some red blood cells.

~ Lymph re-enters our blood vessels through our veins.

~ Lymph nodes are clusters of cells that are surrounded by a capsule.

~ The lymphatic ducts enter and come out of them.

~ Lymph nodes are " clean up " centres in the body where bacteria and viruses are forced to go through ( thus encountering massive numbers of lymphocytes )

~ One of the biggest clusters of lymph nodes is located in the spleen.

~ Most lymph nodes are very small and bean-shaped.

~ They enlarges when there is an underlying disease process going on in the body.

~ They enlarges or swollen in your neck,under your chin,in your armpits,in your groin,( any lymph node throughout the body can be enlarged )

~ Causes a lymph node to swell : -

( i ) Infection : number of white blood cells fight the foreign body invasion multiply.)

( ii ) Inflammation : infiltration with inflammatory cells during an infection.

( iii ) Cancer : Infiltration with cancer cells in a process called metastases. ( cancer cells are " brought " to the node through lymph flowing from the primary cancer )

( iv ) blood cancers : uncontrolled,malignant multiplication of lymphocytes as in lymphoma or leukaemia result in enlarged nodes.

~ Lymph nodes with infection are tender to the touch appear and swell quickly ( 1-2 days) accompanied with signs and symptoms of the infection . ( fever,sore throat,cough,etc) they subside to their normal size when the infection is treated .

Kawasaki's disease

~ Also called Kawasaki's syndrome,described as a " vasculitic syndrome"  - disease of the blood vessels

~ Disease of childhood.

~ First described by a Japanese doctor named Tomisaku Kawasaki in 1967.

~ Common in infants aged from 6-12 months.

~ Also occur in children older than 5 years.

~ Most common in boys rather than girls.

~ Researchers suspect something infectious such as viruses or bacterias.

~ It trigger off immune reactivity and the child's own " altered " immune system than turn against his own body to his blood vessels.

~ Having a prolonged fever 39 degrees celsius and unresponsive to antibiotic.

~ Changes in the hands and feet such as swelling,redness or rash and peeling of skin ( desquamation )

~ Not wish to move the hands and feet much,find it difficult to walk. ( happens in 75 % of all cases,2 weeks after the fever's onset )

~ Conjuctivitis of both eyes ( 85% of cases )

~ A rash occurs throughout the body ( 80% of cases ) some occurs in the groin or legs .

~ Enlarged neck lymph nodes.

~ Changes in the lips like swelling,redness or dryness and fissuring.

~ Have a strawberry tongue-(red and the papillae stands clearly out )

~ Fever and rash phase last for 1-2 weeks during this time,heart muscle and the layer surrounding it may be inflamed.

~ After the fever comes another phase until week four,- no appetite,continue to have conjuctivitis,skin changes in the hand and feet are noted.

~ Internal blood vessels(especially the coronary arteries) develop aneurysms-weakening of the vessel walls leading to a bulge.This phase is at the highest risk of death.

~ After the second phase comes the recovery phase the aneurysms are still present the child may have to live with aneurysms for the rest of the life.

~ Aneurysms may come back to haunt him when they rupture during adulthood.

~ The treatment is actually to decrease the severity of the immune reaction.

~ 2% die due to heart attack or heart complications.

Thalassaemia

~ A blood disorder that inherited the day conceived.

~ Caused by charges to the genes that control the production of oxygen-carrying molecules (haemoglobins) in red blood cells.

~ These changes may produce less haemoglobin or haemoglobin that are less efficient in carrying oxygen.

~ Their red blood cells tend to get destroyed faster too.

~ When that happens,they do not have enough haemoglobin or red blood cells ( anaemia ) to carry oxygen around their body.

~ May appear pale and feel fatigued.

~ 2 major types : ( i ) alpha thalassaemia ( ii ) beta thalassaemia,some have delta thalassaemia

~ Patients require regular blood transfusion to have enough healthy red blood cells that can carry enough oxygen to all parts of the body.

~ Signs & symptoms : Fatigue,weakness,shortness of breath,pale appearance and a protruding abdomen.

~ symptoms starts as earlier as at the age of 6 months.

~ Diagnosis is usually made in the first year of life.

~ Poor feeding and poor growth,pale and abdomen is distended due to an enlarged spleen and liver.

~ Diagnosed by a series of blood tests.

~ First blood test evaluates the quality,shape and size of the red blood cells.

~ If not normal,further tests including tests to evaluate the haemoglobin and DNA to diagnose the diseases.

~ Regular transfusions can cause iron to accumulate in the patient's body.

~ Therefore,they need treatment to remove excess iron from their bodies.

~ Can be cured with bone marrow transplantation ( BMT )

ｐｏｌｉｏ

～　ｃａｕｓｅｄ　ｂｙ　ｔｈｅ　ｐｏｌｉｏ　ｖｉｒｕｓ　．
～　ｓｐｒｅａｄ　ｔｈｒｏｕｇｈ　ｃｏｎｔａｍｉｎａｔｅｄ　ｆｏｏｄ　，　ｗａｔｅｒ　，　ｔｈｒｏｕｇｈ　ｃｌｏｓｅ　ｃｏｎｔａｃｔ　．
～　ｉｔ　ｃａｕｓｅｄ　ｐａｒａｌｙｓｉｓ　ａｎｄ　ｄｅａｔｈ　．
～　ｔｈｅ　ｐｏｌｉｏ　ｖａｃｃｉｎｅ　ｉｓ　ａ　　ｌｉｖｅ　ａｔｔｅｎｕａｔｅｄ　ｖｉｒｕｓ　，　ｗｈｉｃｈ　ｍｅａｎｓ　ｉｔ　ｃｏｎｓｉｓｔｓ　ｏｆ　ｗｅａｋｅｎｅｄ　ｐｏｌｉｏ　ｖｉｒｕｓ　ｓｔｒａｉｎｓ　．
～　ｍｏｓｔ　ｏｆ　ｔｈｅ　ｔｉｍｅ　，　ｔｈｅ　ｃｈｉｌｄ　ｇｅｔｓ　ｉｎｆｅｃｔｅｄ　ｗｉｔｈｏｕｔ　ｓｙｍｐｔｏｍｓ（ｂｅｆｏｒｅ　１９５０ｓ　，ｎｅｖｅｒ　ｂｅｅｎ　ｖａｃｃｉｎａｔｅｄ．）
～　ｔｈｅ　ｐｏｌｉｏｖｉｒｕｓ　ｉｓ　ｔｒａｎｓｍｉｔｔｅｄ　ｔｈｒｏｕｇｈ　ｔｈｅ　ｏｒａｌ　ｒｏｕｔｅ　．
～　ｉｔ　ｒｅｐｌｉｃａｔｅｓ　ｉｎ　ｔｈｅ　ｎａｓｏｐｈａｒｙｎｘ　ａｎｄ　ｇａｓｔｒｏｉｎｔｅｓｔｉｎａｌ　ｔｒａｃｔ　，　ｔｈｅｎ　ｉｎｖａｄｅｓ　ｔｈｅ　ｂｌｏｏｄ　ｓｔｒｅａｍ　．
～　ｆｒｏｍ　ｔｈｅ　ｂｌｏｏｄ　，　ｉｔ　ｅｎｔｅｒｓ　ｔｈｅ　ｎｅｒｖｅｓ　，　ｌａｒｇｅｌｙ　，ｔｈｅ　ｍｏｔｏｒ　ｎｅｕｒｏｎｓ　ｉｎ　ｔｈｅ　ｓｐｉｎａｌ　ｃｏｒｄ　．
～　ｍｏｔｏｒ　ｎｅｕｒｏｎｓ　ａｒｅ　ｔｈｅ　ｏｎｅｓ　ｒｅｓｐｏｎｓｉｂｌｅ　ｆｏｒ　ｔｒａｎｓｍｉｔｔｉｎｇ　ｔｈｅ　ｂｒａｉｎ　ｍｅｓｓａｇｅｓ　ｆｏｒ　ｍｏｖｅｍｅｎｔｓ　ｉｎ　ｔｈｅ　ｌｉｍｂｓ　．
～　ｗｉｔｈ　ｔｈｅ　ｍｏｔｏｒ　ｎｅｕｒｏｎｓ　ｄｅｓｔｒｏｙｅｄ　，　ｔｈｅ　ｎｅｒｖｅ　ｉｍｐｕｌｓｅｓ　ｃａｎｎｏｔ　ｂｅ　ｒｅｌａｙｅｄ　ａｎｄ　ｇｅｔ　ｆｌａｃｃｉｄ　ｐａｒａｌｙｓｉｓ　．
～　ａｆｔｅｒ　ａ　ｆｅｗ　ｗｅｅｋｓ　ｏｆ　ｐｏｌｉｏ　ｐａｒａｌｙｓｉｓ　，　ｂｅｇｉｎ　ｔｏ　ｎｏｔｉｃｅ　ｍｕｓｃｌｅｓ　ｄｅｃｒｅａｓｉｎｇ　ｉｎ　ｓｉｚｅ　ａｎｄ　ｂｕｌｋ　（　ｃａｌｌｅｄ　ａｔｒｏｐｈｙ　）
～　ｍａｙ　ｒｅｃｏｖｅｒ　ｃｏｍｐｌｅｔｅｌｙ　，　ｏｒ　ｐａｒｔｉaｌｌｙ　ａｎｄ　ｓｏｍｅ　ｎｅｖｅｒ　ｒｅｃｏｖｅｒ　ａｔ　ａｌｌ　．
～　ｐｏｓｔ　ｐｏｌｉｏ　ｓｙｎｄｒｏｍｅ　ｔｙｐｉｃａｌｌｙ　ｄｅｖｅｌｏｐｓ　３０　－　４０　ｙｅａｒｓ　ａｆｔｅｒ　ｔｈｅ　ｉｎｉｔｉａｌ　ｐｏｌｉｏ　ｉｎｆｅｃｔｉｏｎ　．　（　ｈａｄ　ａ　ｈｉｓｔｏｒｙ　ｏｆ　ｐｏｌｉｏ　ｉｎ　ｔｈｅ　ｐａｓｔ　）
～　ｔｅｎｄ　ｔｏ　ｐｒｏｇｒｅｓｓ　ｓｌｏｗｌｙ　，　ｓｔａｂｉｌｉｓｉｎｇ　ｆｒｏｍ　ｔｉｍｅ　ｔｏ　ｔｉｍｅ　．
～　ｌｏｏｋ　ｏｕｔ　ｆｏｒ　：－

• ｍｕｓｃｌｅｓ　ａｎｄ　ｊｏｉｎｔ　ｗｅａｋｎｅｓｓ　ａｎｄ　ｐａｉｎ　ｔｈａｔ　ｐｒｏｇｒｅｓｓｅｓ　ｇｒａｄｕａｌｌｙ．
• ｔｉｒｅｄｎｅｓｓ　ａｎｄ　ｐｒｏｆｏｕｎｄ　ｆａｔｉｇｕｅ　ｗｉｔｈ　ｊｕｓｔ　ｍｉｎｉｍａｌ　ａｃｔｉｖｉｔｙ　．
• ｍｕｓｃｌｅｓ　ｓｔａｒｔｉｎｇ　ｔｏ　ａｔｒｏｐｈｙ　．
• ｂｒｅａｔｈｉｎｇ　ａｎｄ　ｓｗａｌｌｏｗｉｎｇ　ｐｒｏｂｌｅｍ　．
• ｉｎａｂｉｌｉｔｙ　ｔｏ　ｔｏｌｅｒａｔｅ　ｃｏｌｄ　ｔｅｍｐｅｒａｔｕｒｅｓ　．　

～　ｉｔ　ｉｓ　ｂｅｌｉｅｖｅｄ　ｔｈａｔ　ｔｈｅ　ｉｎｉｔｉａｌ　ｐｏｌｉｏ　ｉｎｆｅｃｔｉｏｎ　ｄｅｓｔｒｏｙｓ　ｔｈｅ　ｍｏｔｏｒ　ｎｅｕｒｏｎｓ　ａｎｄ　ｂｅｎｄ　ｔｈｅｍ　ｏｕｔ　ｏｆ　ｓｈａｐｅ　．
～　ｔｈｅｎ　ｔｏ　ｃｏｍｐｅｎｓａｔｅ　ｆｏｒ　ｔｈｅ neuron shortage , the remaining motor neurons become enlarged and sprout new fibres .
~ this stresses the remaining neurons and over the years , they deteriorate too .
~ then begin to lose their corresponding action .
~ the more severe the initial polio infection , the higher the chance of getting post - polio syndrome .
~ the later the develop polio ( teenager or adult ) the higher the risk also .
~ the better recovery after polio , the higher chance of this syndrome too .
~ because it seems that a greater recovery paces more stress on the remaining motor as neurons .
~ exercise too much also higher the chance of this syndrome because exercise confers stress .
~ polio is a virus , none of the antivirals are effective .

Shingles

~ shingles in a skin rash caused by the virus that also causes chicken pox .
~ also called herpes zoster .
~ the virus is called varicella zoster .
~it belongs to herpes group .
~ shingles usually occurs years after getting chickenpox .
~ once you have had chickenpox , you are immune to get chickenpox again .
~ but the varicella virus may still remain in the body's nervous system - in particular , the nerves .
~ when the body's immune system is suppressed the virus can then be reactivated and cause shingles .
~and once you have suffered from shingles , you are more likely to get it again . ( recurrence )
~ commonly occur in people above age 60 .
~ shingles is contagious . it spread it to another person who has not had chickenpox . they catch chickenpox instead , and not shingles .
~ chickenpox - the rash appears over the body .
~ shingles - rash appear only in one patch of the skin .
~ before rash appears , you may feel a burning pain on a patch of the skin and it may become very sensitive .( go on for several days or up to a week ) during this time , you are actually not sure what you are getting .
~ then small blisters on a red patch begin to appear .
~ new blisters come up . ( 3 - 5 days )
~ the patch of skin involved is the patch serviced by a particular nerve , the same nerve that hosts the varicella virus that has lain dormant all these years in the body .
~ shingles is likely to affect the nerves of the body that service the patches / bands of skin on your trunk or back .
~ these bands are called dermatomes , so the blisters will only appear on the dermatome .
~ usually only one dermatome is involved .
~ like chickenpox , the blisters itch , pop , ooze out liquid , and then crust over as healing begin .
~ this whole process may last up to 4 weeks .
~ there is one variant of shingles where pain is present , but the blisters never appear .
~ usually no complications ( depend on where the shingles is affecting you )
~ when scratch too much and bleed , blisters can get infected with bacteria , then you can have cellulitis .
~ if shingles affect your face , particularly in the region of your forehead and nose , ( a dermatome serviced by fifth cranial nerve ) , eye can be affected .
~ antiviral medication for shingles ( Acyclovir ) should be taken early . ( within three days of the first appearance of the rash .)

Chickenpox ( or Varicella )

~ is highly contagious disease.
~ caused by the varicella-zoster virus.
~ once the virus enters the body, it starts replicating in the respiratory region, ( its route of entry ) and the regional lymph nodes within 2-3 days.
~ then enters the bloodstream and further replicates in the liver, spleen and other organs.
~ symptoms starts 10- 21 days after exposure to virus.
~ fever, headache, sore throat, loss of appetite and tiredness, then pimple-like red bumps pop up all over the body, causing itching.
~ these bumps develop into blister, which burst and dry after a few days, then turn into brown scabs.
~ scratching predisposes to secondary bacterial infection and causes scarring.
~ 12 years above and adults suffer more severe form of chickenpox.
~ develop a lifetime immunity against chickenpox after the first infection.
~ the virus stays in the nerve cells near the spinal cord long after the illness remaining dormant.
~ it may reactivate later in life and move along the nerves to the surface of the skin causing shingles. ( herpes zoster )
~ shingles is a rash of painful blisters last for 2-3 weeks.
~ not dangerous but very painful and cause lingering nerve pain for months after the rash is gone.
~ 10-20% had chickenpox develop shingles ( age of 50 years ).
~ prevent chickenpox through varicella vaccination.
~ varicella vaccine contains weakened live varicella-zoster virus.
~ 95% effective in preventing the infection.
~ vaccinated people get milder form of the illness, with fewer blisters and symptoms.
~ 7-8% several small bumps may develop at the area where the shot was give.
~ vaccine not recommended for people with impaired immune systems, those allergic to gelatin or the antibiotic neomycin and pregnant women those taking steroids or aspirin should not be given the vaccine until after stopping the medicine, asthmatics and children recovering from kawasaki disease.
~ it spreads easily through direct contact with the infected person, through a sneeze or cough by touching the fluid from a chickenpox blister.
~ also spread indirectly through contact with contaiminated surfaces.
~ can also catch chickenpox from someone with shingles.
~ it is contagious 2 days before the rash appears up to the time when all the blisters have dried up.
~ Acyclovir, an antiviral agent is effective when given during the early stages of the infection.
~ never use aspirin to reduce pain or fever in patient with chickenpox.
~ chickenpox infection during early pregnancy leads to birth defects, low birth rate, or limb abnormalities in the foetus.
~ catch chickenpox one week before and after delivery can lead to severe chickenpox in the newborn baby who is not immunologically protected.
~ if the mother gets infected within 10 days after delivery, the newborn baby may suffer a life-threatening infection.
~ an immune mother can protect her baby from infection within baby's first few months of life, as her immunity can pass to the baby through the placenta and breast milk.

Pre-diabetes

~ is a problem where the blood glucose levels are higher than normal, but not high enough to be diagnosed as "diabetes"
~ pre-diabetes is reversible, but diabetes is incurable.
~ pre-diabetes is also known as borderline diabetes, this condition are in a "gray zone" between normal and diabetes.
~ no symptoms or signs.
~ the best way to combat diabetes is at the pre-diabetes stage.
~ a healthy diet ( low fat, low sugar & high fibre ) exercise and taking supplement can prevent or delay the onset of diabetes and reduce the risk of complications.
~ blood sugar levels in the body is regulated by insulin, a hormone produced in the pancreas.
~ insulin helps to transport glucose from the blood through the cell membranes and into the cells of the body.
~ in healthy individuals, the rate of insulin production the pancreas is automatically controled by the amount of glucose in the blood.
~ if the insulin produced is not enough or not used effectively, the cells cannot absorb the glucose.
~ there is then no fuel for the tissues to carry on the processes of life.
~ unsed sugar builds up in the blood ( diabetes ).
~ prolonged high levels of glucose in the blood would eventually lead to type 2 diabetes.
~ complications :- blindness, kidney diseases, gangrene ( require amputation ) heart attack, stroke and hypertension.
~ diabetic are susceptible to infections and delayed wound healing.
~ blood test - the glucose level in the body is measured after 8 hrs fast to determine if the body metabolises glucose correctly.

Fatty Liver

~ medical terms "steatosis"
~ the most common problems affect the liver is fatty liver- the accumulation of fat in liver cells.
~ healthy liver consists of 2%-5% fat.
~ fat storage in the liver cells starts with tiny droplets being deposited inside the cells themselves.
~ initially, only a few liver cells are affected by small droplet deposits but over time, the droplets become larger, eventually the size of the stored fatty droplets increases until they fill the liver cells completely.
~ as a result, the liver cells become enlarged, their internal structures destroyed and functions impaired.
~ these fatty cells also have a higher disposition to developing necrosis or "die" under even mildly toxic condition which normal healthy cells would be able to withstand.
~ factors cause fatty liver:-
(1) Alcoholic Fatty Liver Disease :
- consume more than 60g of alcohol per day over a long period of time.
-fatty infiltration of liver cells or fatty livers are found in up to 90% at all alcohol abuse cases.
-no signs and symptoms which lead to many undiagnosed cases.
-if left to progress will develop into alcoholic hepatitis and in a worst, cirrhosis.
-liver cells will be swollen, inflamed and death of cells may occurs.
-in cirrhosis, normal liver tissue are replaced with scar tissues, a process which is irreversible and potentially life-threatening if allowed to continue.
-advanced cirrhosis with liver failure, liver transplantation is the only treatment option left.
(2) Non-alcoholic Fatty Liver Disease:
-is the development of fatty liver in the absence of significant alcohol consumption.
-it is a spectrum of liver diseases ranging from simple steatosis or accumulation of fat in the liver cells to non-alcoholic steato hepatitis which can then progress to cirrhosis and lead to cancer of the liver.
-non-alcoholic steato hepatitis is more severe form of non-alcoholic fatty liver disease, is differentiated from simple fatty liver by the presence of cell inflammation and damage.
-non-alcoholic fatty liver disease is associated with clinical conditions found in the metabolic syndrome. (obesity, high blood pressure, diabetes and abnormal levels of lipid )
-fatty changes in the liver cells make the cells more susceptible to toxin and impair the cells' regenerative capacity.

Stages of Liver Damage
(1)Fatty Liver:- deposits of fat cause liver enlargement.
(2)Liver fibrosis:- scar tissue forms, more liver cell injury occurs.
(3)Cirrhosis:- ( hardening of the liver ) excessive scarring of liver tissue causes hardening of the liver, the liver fails to perform properly.

Gout

~ a form of arthritis .
~ caused by a build up of uric acid in the blood .
~ when uric acid crystallises in the joints , it causes inflammation and pain .
~ recurrent swelling in the big toe as the surrounding tissue is packed with uric acid crystals.
~ at the beginning of the disease, patients usually experience intermittent gout attacks and remissions, followed by a chronic phase where painless but firm tophi start to form in one or more joints of the body.
~ starts when one reaches 40.
~ affect more men than women.
~ after 65 years old, affects both sexes equally.
~ older patients tend to develop tophi early in the course of the illness.
~ younger ones develop tophi after years of intermittent attacks.
~ become more common because of the obesity epidmic .
~ dietary choices also raise the risk of gout.
~ consuming a lot of meat, seafood, sugar and alcohol especially beer- can trigger attacks of gout.
~ soda drinkers are also at risk, there is evidence that fructose, the main sweetener in many sugared beverages, increases uric acid levels in the blood.
~ high blood pressure is another major risk factor, get complicated because diuretic taken to lower blood pressure can also increase uric acid levels.
~ lose weight, cut back on alcohol, meat, and seafood, and eat more fruit, vegetables and low-fat dairy foods.
~ patients have to take drug to lower uric acid levels for life.
~ treatment:- (1) to reduce the patient's blood uric acid levels.
- (2) to relieve the pain and inflammation during a gout attack.
~ for surgical removal is when a patient's tophus is infected or when it puts a lot of on pressure on surrounding structures (nerve).
~ reduce blood uric acid level below 0.36mmol/L or 6mg/dL, the uric acid that is deposited will dissolve by itself with time.
~ stay away food that rich in purine, a chemical compound that break down into uric acid in the body.