List of Disease

Anaemia

Anaemia describes a group of conditions in which there is a lower-than-normal count of red blood cells (so less oxygen carrying pigment haemoglobin) in blood. The most common types of anaemia are haemolytic, macrocytic and microcytic and they share similar symptoms. Anaemia that is due to the lack of iron is called iron deficiency anaemia.
The three main causes of anaemia:

• Not enough red blood cells being made
• Red blood cells being destroyed faster than produced
• Red blood cells being lost from body at an unusual rate by slow, chronic bleeding in the form of heavy menstrual periods or gastrointestinal bleeding

Symptoms

• Tiredness
• Headaches
• Pale skin
• Short of breath
• Palpitations (anaemic patients often have high heart rates)

Testing

• Full blood count check
• Blood film test
• Test to check for low levels of vitamin B12 and folic acid
• Test to estimate the body’s stores of iron
• Reticulocyte count to measure how many young cells the bone marrow is producing

Treatment

• Iron tablets if suffering from iron deficiency anaemia
• Injections with the deficient vitamin is given that appropriate to the type of anaemia the patient is suffering from

Alzheimer’s disease

This is the most common cause of dementia. It is a progressive degenerative brain condition and is a result from the loss of nerve cells in the brain, a reduction in neurotransmitter levels and the development of ‘protein tangles’ around the nerve cells. The underlying cause is not known but studies have shown that it may be genetic.

Symptoms

• Loss of language and speaking skills
• Inability to learn new information or skills
• Limited memory
• Inability to perform complex muscular activity
• Rapid mood swings
• Personality changes
• Confusion

Testing

• Answering set questions
• Brain scan to distinguish Alzheimer’s disease from other possible causes of dementia

Treatment

There is no cure for Alzheimer’s disease, but medication can be provided to give relief from symptoms. Support from carers and families is what is mainly required from patients as their condition progressists. Psychological treatments (e.g. cognitive simulation therapy) may help to improve memory and language ability.

Arthritis

This condition is characterised by inflammation that causes pain and stiffness in one or more of the body’s joints. The condition may be chronic (a constant dull ache) or acute (typically sharp, severe and short-lived pain). There are several different types of arthritis and each type has its own characteristics. The two most prevalent are osteoarthritis and rheumatoid arthritis.

• Osteoarthritis

This is when the smooth cartilage lining of the joints is worn away. Once the cartilage starts to thin out, the tendons and ligament have to work harder which can cause swelling as well as the formation of bony spurs called osteophytes. Further, it may lead to bone rubbing on bone which can alter the shape of the joint and move bones out of the normal position. It often affects weight-bearing joints such as knees and hips and also the hands.

Symptoms of osteoarthritis

• Joint pain and stiffness
• Problems moving the joint
• Grating sound when moving affected joints

• Rheumatoid arthritis

This is when the synovial membrane (outer covering of the joint) becomes inflamed. The joints become swollen and stiff and ultimately deformed. People suffering with this condition may also develop problems with other tissues and organs in their body.

Symptoms of Rheumatoid arthritis

• Joint pain and stiffness
• Swelling
• Problems moving the joint
• Dry eyes: if eyes are affected
• Chest pain: if heart or lungs are affected
• Weight loss
• Tiredness and lack of energy

Testing for arthritis

• Physical examination to evaluate the presence of fluid around the joints and motion of them
• Blood test: to find out the presence of specific types of antibodies
• X- rays to determine the type of arthritis

Treatment

There is no current cure for the condition however treatments are available to reduce the amount of pain in the joints and to prevent any further damage. These include:

• Heating pads or ice packs
• Analgesics or other anti-inflammatory drugs
• Physical therapy and surgeries according to intensity of pain
• Low impact exercises (eg. yoga)
• Assistive devices such as walking with a cane or wearing braces

Asthma

Asthma is the result of swelling (inflammation) of breathing tubes that carry air in and out of the lungs. This condition affects the respiratory system with the main focus being the smaller airways (bronchi and bronchioles). These airways have an inner lining called the mucosa that’s surrounded by a layer of smooth muscle. In people who suffer from asthma, their airways are chronically inflamed (so they temporarily narrow) making them hyper-responsive to certain triggers. These triggers include pollen, tobacco smoke, dust, fragrances, exercise, environmental factors stress and the flu. When exposed to these triggers, an exacerbation or asthma attack (period attacks of wheezing, coughing and shortness of breath) can take place. During the attack, the muscles surrounding the airways tighten and narrow, thus the flow of air reduces, and the swelling of the airways increase. Furthermore, the flow of air is impeded as mucus is also produced when inflammation occurs.

Symptoms

• Wheezing (whistling sound when breathing)
• Breathlessness
• Tight chest
• Coughing

Testing

• Medical history of patient
• Observation of patient during a physical test
• Breathing tests

Treatment

Tablets are sometimes orally taken however, the primary treatment for asthma is an inhaler which is a small device that lets you breathe in medicines, transporting medication along the affected airways and they come in two forms.

• Reliever inhalers: these treat symptoms immediately and contain beta-agonists. Beta-agonists allows the airways to widen so more air can travel into and out of the lungs
• Preventer inhalers: these treat asthma symptoms over the long term and contain corticosteroids. Corticosteroids inhibit airway sensitivity and inflammation, so asthma can be kept under control. They are also crucial in preventing long term damage from chronic inflammation, which can cause scarring in airways.

Atherosclerosis

It is a condition when the arteries narrow due to a build-up of fatty plaques called atheroma. This restricts blood flow and oxygen supply to the body’s tissues which further increases the risk of blood clots that prevent blood flow to brain and heart. Atherosclerosis often has no symptoms and the first sign may be a heart attack or stroke, hence it is vital to minimise the risks. If left untreated, the condition lead to a number of serious other ones which include:

• Coronary heart disease
• Angina
• Heart attacks
• Strokes
• Transient ischaemic attacks
• Peripheral arterial disease
• Aneurysms

Chance factors (non- modifiable factors which increase your risk) include:

• Age: the older you are the greater the risk
• Ethnicity
• Genetics: heredity plays a part in the health of the cardiovascular health. Inherited conditions such as hyperlipidaemia which causes high levels of fat in the blood increase risk
• Diabetes: it is associated with high cholesterol levels and cause fatty plaque to form much faster

Choice factors (changeable factors to decrease your chance of getting the condition):

• Smoking
• High blood pressure/ hypertension
• High blood cholesterol levels
• Obesity
• Lack of physical activity

Testing

• Assessment of risk factors and changes to lifestyle
• Cholesterol test: blood sample is analysed where doctors will check you ‘lipid profile’ for values of HDL and LDL cholesterol (high- and low-density lipoproteins) where HDLs give some protection against the disease
• Regular health check ups

Treatment

• Statins: deal with high cholesterol
• Aspirin or clopidogrel to reduce risk of blood clots
• Medication to treat high blood pressure
• Dietary changes
• Procedure to widen or bypass an affected artery

Cardiovascular disease

This describes any condition affecting the heart or blood vessels. It is one of the leading causes of death all across the world and there are 4 main types.

• Coronary heart disease: It is caused by the growing plaque/ deposits of atheroma in the walls of the coronary arteries, limiting the blood flow to the heart’s muscle. This is one of the main reasons for a heart attack, angina, heart failure.
• Strokes and TIAs: A stroke is when blood supply is cut off to a part of the brain which can result in brain damage. A transient ischaemic attack (mini stroke) is similar but the disrupted blood flow is temporary.
• Peripheral arterial disease: This is when there is a blockage in the arteries to the limbs (often the legs)
• Aortic disease: A group of conditions which affects the aorta, which is the largest blood vessel in the body, pumping blood from the heart to rest of body. Aortic aneurysm (when the aorta become weakened and bulges outwards) is the most common form.

Symptoms

In the early stages of heart disease there may be no symptoms however later on, the first symptom is usually chest pain (angina) on physical exertion or a heart attack. Some people may also develop arrhythmias (this is when you have abnormal heart rhythms i.e. when the heart beats too quickly, too slowly or irregularly) and suffer from associated palpitations and dizziness.

Causes

• Gender: men under 65 are likely to suffer from CVD than women under 65; oestrogen offers women protection until menopause but then the risk rises to equal that of men
• Ethnicity: It is more common in people of south Asian and Affrican background as there is link with these backgrounds having risk factors such as high blood pressure or diabetes
• Age: more common with people over 50
• Diabetes: this can damage and narrow blood vessels
• Smoking: substances in smoke such as tobacco can damage and narrow blood vessels by increasing blockage
• High Blood Pressure: Hypertension (high blood pressure) can damage blood vessels
• High cholesterol levels: this fatty substance can increase growing plaque in arteries, resulting in narrowing vessels and risk of developing blood clots.
• Obesity: this increases your chance of developing diabetes and high blood pressure
• Inactivity: regular physical exercise can reduce one’s chance of developing high blood pressure, cholesterol levels and being overweight which are risk factors for CVD. 

Though chance factors such as genetics, gender, ethnicity and age are non-modifiable, having a healthy lifestyle compromising of a balanced diet and regular physical activity can reduce the risk of CVD by a significant amount.

Cataracts

This is a condition when a lens become cloudy or opaque, causing blurred vision. The most common cause is aging, as fibres that make up the lens deteriorate naturally over time. Other causes also include diabetes, rubella, eye injury, prolonged exposure to sunlight, ionising radiation, long term steroid therapy and smoking.

Symptoms

• Blurring and gradual loss of vision
• Deterioration in colour vision
• If wearing glasses, prescription might change
• Find lights too bright

Testing

If it appears in only one eye the sufferers will be more aware of a difference in vision

• Ophthalmoscope to examine eyes
• Slit lamp microscope and dilate pupils with eye drops to allow for thorough
• Visual acuity exam: measure how well you see at various distances

Treatment

• If cataracts cause mild problems, stronger glasses and brighter reading lights may help for some time.
•  If symptoms worse over time, surgery might be an option to remove the affected lens and replace it with an artificial one.
• Phako-emulsification: a small incision made in the cornea and lens sac. Using an ultrasound probe, lens is broken up and sucked out. A replacement soft lens is positioned within the lens sac (procedure performed under local anaesthetic)

Conjunctivitis

This is an eye condition which is due to the inflammation of the conjunctiva (the thin layer of cells that lines the front of the eye and the inside of the eyelids. It is also known as red or pink eye and often looks worse than it actually is. It is usually caused by infection, allergies such as hay fever or irritants in products such as make up.

Symptoms

• Stinging, itchy or watering eyes
• Whites of the eyes become red and inflamed
• Produce pus that sticks to lashes

Testing

• If infection is suspected, antibiotic ointment or eye drop are prescribed
• If the cause is an allergy, anti-allergy eye drop will be provided

Treatment

An infection such as conjunctivitis is easily spread from hand to eye so close attention should be pain to hygiene. To ease symptoms:

• Use clean cotton wool, boil water and then cool. After gently rub eyelashes to clean off pus and hold a cold flannel on your eyes to help soothe. The infection should likely clear up in 5 to 7 days.

Dementia

It refers to the deterioration in mental ability due to a disorder of the brain. It occurs because of damage in the nerve cells and where this damage takes place determines the symptoms. Dementia indicates a group of symptoms – memory loss, confusion and intellectual decline and it is becoming increasingly common as an ageing population develops, affecting those over 70 generally. The most common cause of dementia are Alzheimer’s disease and multi-infract dementia. Other causes can include vitamin deficiency, anaemia and adverse reactions to certain drugs.

Symptoms

• Impaired memory
• Noticeably reduced verbal and conversational skills
• Loss of the ability to think
• Inability to learn new skills
• Loss of emotional control
• Depression and/or anxiety
• Behavioural difficulties
• Increasing restlessness
• Tendency to wander

Testing

• Blood sample to determine the possibility of a vitamin deficiency
• Brain scanning
• Carrying out a detailed questioning session aimed at assessing mental ability

Treatment

There is no cure for dementia and symptoms progressively worsen with time. For improvement of symptoms in the short term, new drugs have become available but long term no specific treatment is available. Caring for the dependent patient is the most important with most sufferers requiring full – time supervision and nursing care for the remainder of their life.

Vascular dementia

This condition is also known as multi-infract dementia and it is the most common form after Alzheimer’s disease. It occurs as the result of small ischaemic episodes, meaning there is a lack of blood supply reaching a part of the body. This reduced blood flow results in being deprived of oxygen around the areas of the brain, causing progressive death of nerve cells and thus control. The underlying cause is often atherosclerosis (narrowing of arteries), which is usually the consequence of factors such as a high-fat diet, lack of exercise, smoking and high blood pressure.

Symptoms

• Loss of language and speaking skills
• Inability to learn new information or skills
• Limited memory
• Inability to perform complex muscular activity
• Rapid mood swings
• Personality changes
• Confusion

Some may also deal with symptoms of Alzheimer’s disease as it is possible to suffer from both.

Testing

• Assessment of symptoms
• Full medical history which includes asking about related conditions such as strokes or high blood pressure
• Assessment of mental abilities
• Brain scan such as an MRI scan or CT scan: to look for any changes in brain function

Treatment

Similar to many other forms of dementia, there is no cure as there is no possible way to reverse any loss of brain cells or repair multiple infarcts. Treatment is therefore focused on slowing down the progressive condition and most importantly the risk of a potentially fatal major stroke.

• Quit smoking and reduce alcohol consumption
• Physical activity
• Healthy, balanced diet
• Prescribed drugs to reduce blood pressure, lower cholesterol
• Regular doses of aspirin to reduce the chance of the formation of blood clots
• Therapies such as physiotherapy, occupational therapy and psychological therapy

Diabetes

Glucose (sugar) is your body’s principal source of energy and it is obtained from your diet. Insulin, which is a hormone, helps the glucose into the cells to provide energy. Diabetes is a condition that causes your blood glucose (sugar) levels to become too high. Having elevated glucose levels can cause a number of health problems such as heart disease, kidney damage and eye damage. Diabetes comes in two forms: type 1 diabetes and type 2 diabetes. With type 1 diabetes, your body’s immune system destroys the cells in our pancreas, meaning you can’t produce enough insulin (a hormone which controls blood glucose). With type 2 diabetes, either your body doesn’t utilise insulin well or the pancreas makes some insulin but not enough to carry sufficient glucose into your cells. Both forms of diabetes results in your glucose (sugar) levels in your blood to become too high.

Type 1 Diabetes

Type 1 diabetes is a condition where your body is unable to make insulin (hormone which controls blood glucose) resulting in blood glucose levels becoming too high. This form of diabetes is not controlled by factors such as age or being overweight. It is currently still not clear of the definite cause of type 1 diabetes, genetics and environmental factors has appeared to play a crucial role in its development.

Type 2 Diabetes

Type 2 diabetes is a condition where your body doesn’t utilise insulin (hormone which controls blood glucose) well or the pancreas makes some insulin but not enough to carry sufficient glucose into your cells, resulting in high blood glucose levels. This condition is also known as insulin resistance. It is caused by diet, age, being overweight as well as genetics.

Symptoms

• Feeling thirsty
• Fatigue and weakness
• Losing weight unintentionally
• Injuries which are not healing
• Frequent urination
• Blurred vision
• Mood changes
• High blood pressure and high cholesterol

Testing

• Blood glucose test (performed at a random time)
• A fasting blood glucose test (before or after meals)

Glycated haemoglobin (A1C) test (indicates one’s glucose levels 2 to 3 months prior to the test)

Treatment

Despite decades of research, there is still no permanent solution for this condition. However, it can be dealt with abstention and treatments. It involves a meticulously calculated diet, certain forms of physical activity, and blood glucose testing. With type 1 diabetes, a number of daily insulin injections are also performed. Prescribed medicines such as metformin is also given to those with type 2 diabetes.

Eczema/ dermatitis

This refers to a family of conditions which involve skin inflammation making it dry and itchy, with small blisters sometimes occurring. Its exact causation is still ambiguous, but an allergy may have an effect. Eczema can affect any part of the body but it is most commonly found on the hands, legs and feet. There are several different types of eczema:

• Atopic eczema (related to other diseases such as hay fever and asthma)
• Irritant induced eczema (contact with certain allergen such as detergents, soaps, oils)
• Allergic contact eczema (contact with foreign substance such as nickel, chromium, lanolin)
• Seborrheic eczema (affects areas of skin rich in sebaceous glands such as face, scalp and joint creases)
• Stasis dermatitis (related to circulatory problems causing skin irritation on lower legs)
• Neurodermatitis (scaly and itchy patches on lower legs, wrists, forearms and hands)

Symptoms

• Dry, scaly and cracked skin
• Red and inflamed skin
• Itchiness and irritation

Testing

• Patch testing: to determine what has triggered reaction such as possible allergies
• Blood test to test for eosinophils levels + IgE antibody
• Skin biopsy to confirm it is not another disease such as  low-grade skin cancer or psoriasis
• Buccal swabs to trace mutations in the filaggrin gene which is one of the main causes

Treatment

• Emollients: keeps moisture locked into the skin
• Corticosteroid creams: reducing inflammation
• Steroid ointments: moisture retaining, water repelling ointments
• Antibiotic creams: helpful where there is evidence of infections
• Steroid drugs: only required in severe cases of eczema

Epilepsy

This is a common neurological condition (affects the brain) and cause epileptic seizures/fits to occur. Seizures occur when part or all of the brain’s nerve cells create electrical signals in an uncontrolled manner and can result in a wide range of symptoms. Though this condition can affect a person at any age, it often commences either in early childhood or in people over 60. There is still no obvious case for most people but there are certain links to hereditary. Some other causes of seizures include brain trauma or surgery, brain tumour, drugs and alcohol and Alzheimer’s disease.

Symptoms of a seizure

• Collapsing/ becoming unconscious
• Loss of awareness
• Uncontrollable jerking and shaking
• Unusual sensations and tingles

Testing

• EEG (electroencephalogram): this trace the electrical activity of the brain
• Brain scanning: to shed light on any physical defects that could be causing the epilepsy, such as brain tumours

Treatment

• Anti-epileptic drugs: the main treatments
• Adhering to a ketogenic diet to help control seizures
• Resective: Surgery to remove a part of the brain that causes seizures

Fibroids

These are non-cancerous growths that develop within the wall of the uterus (womb). They occur most frequently in women aged 35 and 55 during their childbearing years and when oestrogen levels are at their highest. Some fibroids are very small and can cause no symptoms but when they occur in multiples or grow to the size of a grapefruit, they can cause heavy periods and pain. In some cases, infertility or miscarriage may occur.

Symptoms

• Prolonged and heavy menstrual bleeding
• Severe abdominal pain
• Infertility or increased risk of miscarriage
• Constipation
• Frequent need to urinate

Testing

• Pelvic examination
• Pelvic ultrasound scan

Treatment

Small fibroids causing no pain can be left untreated. For larger growths, drugs may be used to reduce size or may need to be removed which can be done in a number of ways:

• Hysteroscopy: small fibroids growing on the inner uterine wall
• Abdominal surgery: larger fibroids
• Hysterectomy: if fibroids are causing a number of serious problems and their size and location means they are difficult to remove

Flu

Flu (also referred to as the common cold) is a viral infection of the upper respiratory tract and are among the most common reasons for people to visit their doctors. It is caused by the influenza virus, with type A and B being the most common. These are spread by airborne droplets of mucus, expelled when an infected person coughs, sneezes or breathes into the air and also can be passed on by physical contact. Approximately half the population catches a cold once a year, most often in colder months of autumn and winter.

Symptoms

• Sneezing
• Coughing
• Fever/ high temperature (38 degrees or above)
• Headache
• Nausea
• Sore throat
• Dizziness
• Aching body
• Tired or exhausted

Testing

An appointment is advised if you have an infection that seems to be lasting longer than usual or if symptoms severely worsen. If you are in the at-risk groups which include the elderly, new-born babies, asthmatics, people with weakened immune systems due to diabetes or AIDS etc. or people with poor nutrition, it is important to see a doctor.

Treatment

With proper medication and care, recovery from a flu can be attained within 1 or 2 weeks. There are number of ways you can bring relief and soothe the symptoms yourself:

• Drinking plenty of water
• Keeping warm and having plenty of rest
• Taking decongestants to clear a stuffy nose
• Avoid alcohol and smoking
• Make sure rooms are well ventilated
• Cough medicines/ syrups or hot honey and lemon drinks
• Taking paracetamol or ibuprofen

Annual flus can also be prevented with flu jabs. The immunisation is different each year because it targets the strains predicted to be most widespread that particular season and those who in the at-risk group are recommended to have them.

Haemophilia

This is a rare condition where you lack an essential clotting factor in their blood. When exposed to an injury, clotting factor mix interact with platelets to make your blood sticky and form a clot, which eventually halts the bleeding. Thus, without the clotting factor VIII, severe bleeding can occur after injury or surgery or maybe even spontaneous.

Symptoms

• Nosebleeds that take a significant time to stop
• High susceptibility to bruising
• Painful swelling of muscles and joints due to internal bleeding
• Blood in urine
• Bleeding wounds that lost a long time

Testing

• A sample of blood to perform full blood count, blood film and blood clotting tests

Treatment

• Injections of factor VIII: obtained from donated blood plasma but not produced using genetically modified yeasts known as recombinant factor VIII
• Mild haemophilia sufferers can have levels of their own factor VIII boosted using a drug called DDAVP
•  

Kidney stones

These are crystalline and stone-like deposits in the kidneys which are formed if the urine becomes saturated with waste chemicals. They come in various sizes: small ones may travel down the urinary tract and simply pass out in the urine; larger stones tend to stay within the kidney but can move into the ureter, where they can cause severe pain. People living in a hot climate have a higher chance of developing them if they don’t drink enough fluid to replace that is lost through sweating. Some may inherit a predisposition towards the condition as well.

Symptoms

• Intense pain that radiates from the back to the groin
• Frequent, painful urination
• Blood in the urine
• Nausea and vomiting

Testing

• Plain X-ray
• Intravenous urography: identify presence and location of stones
• Ultrasounds

Treatment

The treatment for this condition is dependent on the size of stones

• Small stones may pass with rest, plenty of fluids. If these stones are lodged in the ureter, they can be removed during examination with a cystoscope
• Larger stones cause more complications as they are more likely to be lodged in the kidney. They are often treated with lithotripsy which is a method using high energy shock waves to break the stones down into a powder which will then pass out with urine.
• Stones can also be removed surgically in rare cases

Meningitis

This condition describes the inflammation of the membranes surrounding the brain (the meninges) and is usually a result of an infection. It can become life threatening if not treated quickly by causing septicaemia (blood poisoning) and result in permanent damage to brain or nerves. The condition can be classified into three types: bacterial, viral or fungal. Viral meningitis is the most common and least dangerous form, generally affecting young adults. Bacterial meningitis is the most serious that mainly affects children. Although most people make a full recovery from meningitis when treated, some are left with long-term problems following it, especially bacterial meningitis, which include hearing loss and impaired memory.

Symptoms

• Fever (above 38 degrees)
• Headache
• Neck stiffness
• Photophobia: dislike of bright lights
• Development of rashes (not always)
• Drowsiness
• Seizures

Testing

• Blood culture reports
• Computerised tomography (CT scan)
• Magnetic resonance imaging (MRI)
• Complete blood count
• Chest X RAYS
• Spinal tap or lumbar puncture to obtain cerebrospinal fluid

Treatments

Viral meningitis generally requires no specific treatment beyond analgesics to provide pain relief and reduce fever. With bacterial meningitis, prompt administration of intravenous antibiotics is essential. Corticosteroids may also be given to reduce inflammation. However, certain issues of meningitis can be prevented with vaccinations. These include:

• MMR vaccine
• Meningitis B vaccine
• 6-in-1 vaccine
• Pneumococcal vaccine
• Hib/MenC vaccine
• Meningitis ACWY vaccine

Multiple Sclerosis (MS)

This is an autoimmune condition which affects the central nervous system which consists of the spinal cord and the brain. Due to an abnormal activity of the immune system, damage is caused to myelin sheaths (a fatty substance that insulates the nerve cells and speeds signals along the nerves). This results in the nerve cells not functioning properly and therefore problems in communication between the brain and the rest of the body occur.  It’s a lifelong disease that can cause serious disability but can be occasionally mild, with most experts thinking a combination of genetic and environmental factors play a part.

There are four main types of MS:

• Clinically isolated syndrome (CIS)
• Relapsing remitting MS (RRMS): relapses occur as well as period of remission
• Primary progressive MS (PPMS): relapses occur but no period of remission
• Secondary progressive MS (SPMS)

Symptoms

• Weakness and/or numbness of limbs
• Loss of coordination
• Urinary frequency
• Blurred vision
• Fatigue
• Muscle stiffness or spasms
• Difficulty walking

Testing

• MRI brain scan: this will show areas of damage within the brain
• Taking a sample of the fluid from the spinal cord

Treatments

There is no long-term cure for this condition, but a number of treatments can help control it. These treatments will depend on the specific symptoms and difficulties.

• Steroids to treat relapses
• Disease- modifying therapies (such as beta-interferon) to help inhibit the exacerbation of disability in people with relapsing remitting MS as well as reducing the severity and length of relapses in people with secondary progressive MS

Osteoporosis

This is a common condition in which the bone tissue loses calcium meaning the bones become brittle and increasingly liable to fracture. Many people are unaware that they have the condition until they have a fall that results in a fracture, often in the wrist or hip. Other osteoporotic fractures include spine and femur (thigh bone) fractures, which can result in disability in elderly. The stage before osteoporosis is called osteopenia in which you have a lower bone density than the average for your age. Osteopenia does not always lead to osteoporosis and a number of steps can be taken to reduce your risk of developing it such as ensuring you take sufficient calcium and vitamin D in your diet along with exercise.

Factors which increase your risk of developing osteoporosis:

• Low body weight
• Smoking
• Excess alcohol consumption
• Taking high dose steroid tablets for more than 3 months
• Family history
• Lack of exercise
• Overactive thyroid
• Rheumatoid arthritis
• Chronic kidney failure

Testing

• X-ray
• Bone mineral density (BMD): the level of bone density is measured in the demur and wrist to confirm the diagnosis
•  

Treatment

• Referred to a physiotherapist for bone-building exercises
• HRT (hormone replacement therapy)
• Calcium tablets
• Vitamin D supplements

Ovarian cysts

These are fluid-filled sacs that develop within the ovary and are very common during a woman’s reproductive years. There may be just one or several (which is known as polycystic ovary syndrome). They are usually non-cancerous, but some do have potential. Sometimes the symptoms either come and go or not at all present thus may be difficult to diagnose.

Symptoms (generally occurs with larger, persistent cysts)

• Abdominal pain normally felt on the affected side of the ovary
• Pelvic pain
• Bloating
• Deep pain during sexual intercourse
• Menstrual irregularities
• Feeling very full after eating little

Polycystic ovary syndrome (POS)

This is characterised by multiple fluid-filled ovarian cysts. It is caused by a relative excess of luteinising hormone and testosterone, and those suffering from this condition are at increased risk of developing diabetes, high blood pressure and suffering ovulatory failure. The condition may result in infertility if untreated.

Symptoms of POS

• Irregular or absent periods
• Excess body hair
• Ovulatory failure

Testing

• Ultrasound examination
• Blood test to check for the presence of tumour markers, which are proteins produced by tumours that can be measured in the blood

Treatment

• Large cysts require draining or removal
• If there are cancerous changes, it can be removed surgically while conserving as much of the ovary as possible
• If suffering from POS, fertility drugs may be given to stimulate ovulation and/or a contraceptive pill may be given to control irregular menstrual patterns

Pneumonia

This is a serious chest infection that causes inflammation in the air sacs (alveoli) in the lungs. This could potentially be a life-threatening condition especially if both lungs are affected as oxygen is required to pass through the walls of the alveoli in order to reach the bloodstream. It occurs most frequently among the very young and the elderly. Certain factors such as smoking, being malnourished, diabetes or AIDS sufferers can make a person more likely to develop pneumonia. In most cases, effective treatment with antibiotics (bacterial infections being the most common cause of pneumonia) leads to a full recovery with no lasting effects. The many types include:

• Bacterial infection
• Viral pneumonia
• Aspiration pneumonia
• Fungal pneumonia
• Hospital-acquired pneumonia

Symptoms

If the cause is viral, symptoms may develop gradually but rapidly development (over the course of several hours) can happen with bacterial pneumonia.

• Cough with mucus, may include blood
• High fever
• Breathlessness even when at rest
• Chest pain when breathing
• Delirium and/ or confusion
• Collapse or faint

Testing

• Looking over medical history
• Chest X-ray
• Blood test
• Sputum (phlegm) sample

Treatment

• Course of antibiotics
• Painkillers help to lower fever and control pain
• Plenty fluids
• Resting

More vulnerable people who rapidly become seriously ill can receive intravenous fluids and antibiotics, also may be provided oxygen via an oxygen mask. A ventilator may also be required to maintain adequate levels of oxygen until they recover

Psoriasis

This is a common skin condition which produces areas of red, thickened skin known as plaques which may have a covering of silvery scales which are often itchy and painful. They can be found anywhere but often appear on backs of the elbow, knees and in the scalp. The cause of this skin problem is unknown but stress, physical injury, infection and some drugs such as lithium and beta blockers can trigger psoriasis. It’s also thought to be related to a problem with the immune system as people psoriasis sufferer’s immune system attacks healthy skin cells by mistakes. In some cases, the condition can be associated with an arthritis known as psoriatic arthritis which is similar to rheumatoid arthritis.

Symptoms

• Areas of red, inflamed, thickened skin
• Flaky skin – often silvery in colour
• Pitted or discoloured nails
• Pain in joints

Testing

• Referred to a dermatologist often who often can diagnose based on appearance
• Skin biopsy: this in rare cases but it is to determine the exact type and rule out other disorders such as lichen planus and pityriasis rosea or seborrheic dermatitis
• Blood tests to rule out other conditions

Treatments

There is no cure for the condition, but a range of treatments are aimed at improving symptoms and appearance of skin patches.

• Topical corticosteroids
• Coal tar preparations and dithranol
• Vitamin D analogues
• Ultraviolet (UV) light treatment

Parkinson’s disease

This is common neurological condition in mainly the elderly and is characterised as the degeneration of nerve cells in a part of the brain (substantia nigra) that controls movement. This leads to a reduction in a chemical neurotransmitter called dopamine which plays a vital role in regulating the movement of the body. The underlying cause is unknown, but many believe family history plays a part and that men are more likely to develop the condition. The symptoms of Parkinson’s disease is somewhat similar to that of Parkinsonism, which is a condition that is due to identifiable factors such as certain drugs or by head injuries.

Symptoms

• Tremor of a hand, arm or leg
• Stiff and inflexible muscles
• A stopped, shuffling walk
• Expressionless
• Slurred speech
• Difficulty in initiating movement/ slow movement
• Depression

Testing

• Long term observation of muscle activity
• Blood tests to eliminate other condition
• Brain scans to establish if symptoms are caused by stroke or brain tumour instead

Treatment

There is no cure for the condition, but treatments are available to help relieve the symptoms.

• Levodopa (drug) which is converted to dopamine in the brain
• Anti-cholinergic drugs which help balance acetylcholine levels with reduced levels of dopamine
• Surgery for some (young person): to destroy tissue in the area of the brain that causes the tremor
• Supportive therapies such as physiotherapy: to perform stretching exercises to help with mobility problems. (the exercises have to be gentle otherwise excessive tiredness can worsen symptoms)
• Therapist to help with signs of depression

Sinusitis

This is the inflammation/ swelling of the sinuses (air-filled cavities around the eyes and nose, within the bones of the skull). It is often associated with an infection in the upper respiratory tract, such as a cold or hay fever. It is a common condition and usually clears up on its own within 2 to 3 weeks and can go away quicker with the aid of medications. You should seek medical advice if symptoms recur again with increased pain and fever. This ‘secondary sickening’ is due to an infection by bacteria.

Symptoms

• Headache
• Fever
• Blocked nose
• Pain and tenderness over the affected sinus
• Redness around the eyes
• Reduce sense of smell
• Bad breath

Testing

• The doctor will press on your cheeks and forehead to check for tenderness and may shine a light through skin to see if sinuses are clear.
• If secondary bacterial infection is likely, a short course of antibiotics may be prescribed
• If chronic sinusitis (short – lived infections occurring frequently in the sinuses) is suspected, an X-ray may be performed

Treatment

• Plenty of rest
• Decongestant tablets
• Avoid prolonged exposure to dust and irritants
• Painkillers such as paracetamol or ibuprofen
• Drink plenty of fluids
• Cleaning nose with a saltwater solution to ease congestion

Styes

These occur often in people and are pus filled swellings of the eyelash hair follicles. They can cause the eyelid to become inflamed and painful. A stye can be a small, painful lump on or inside the eyelid or the skin may be red/ swollen and filled with yellow pus like a pimple. Most styes are caused by infection with staphylococcus aureus bacteria and can be prevented with improved adequate hygiene.

Symptoms

• Red lump on the edge or around eyelid
• Painful when touching eye
• Red and watery eyes

If no lump is present, the condition is more likely to be conjunctivitis or blepharitis.

Treatment

To ease the discomfort and speed up recovery, these measures can be taken;

• Clean warm damp washcloth on eye and leave for about 10 minutes and repeat these 3 to 4 times a day
• Avoid wearing contact lenses and eye makeup until stye has healed.

It is also crucial not to intentionally burst a stye has this can spread infection.

Tonsillitis

This is an infection that is confined to the tonsils and it is a common condition in children (their tonsils are larger than adults so are more prone to infections). The tonsils are large lymph nodes that are situated either side of the back of the tongue and serves to intercept any invading viruses or bacteria.

Symptoms

• Sore throat
• Difficulty swallowing
• High temperature
• Swollen lymph nodes in the neck
• Pain and inflammation in the throat

Testing

They are usually easy to spot as the tonsils become red and inflamed with a white coating. A swab test may be further taken if the doctor suspects it is a bacterial sore throat (white pus filled spots on the tonsils may be seen with this) rather than the viral one.

Treatment

In the past, many removed the tonsils surgically (tonsillectomy) to prevent recurrent infections. Nowadays, doctors are more reluctant as the tonsils play a useful function as part of the body’s defences as well as the procedure having possible complications. Mild tonsillitis can be treated yourself and you can ease the symptoms in these ways:

• Plenty of rest
• Painkiller such as paracetamol and ibuprofen
• Drink cool drinks to soothe the throat
• Gargle with warm salty water