Pregnancy Symptoms Week by Week

Pregnancy symptoms week by week is one of the concerns of pregnant women because they want to know what is happening to their bodies as well as what is happening inside their womb. This article discusses the pregnancy symptoms week by week as well as the fetal development week by week. It shows the possible pregnancy symptoms week by week in order for expecting mothers to expect and prepare for the changes throughout pregnancy. The most important thing of knowing the changes throughout pregnancy is to maintain a healthy one with good pregnancy outcomes.

Pregnancy Symptoms week by week

Week 1

Maternal Changes – During this week, the body is getting ready for ovulation.

Fetal Development – There is still no fetus that is developing, but the ovaries are starting to develop a mature egg cell for ovulation.

Recommendations: Women planning to have pregnancy should start taking iron and folic acid supplements as soon as the last menstruation has ended in order for the body to prepare for possible pregnancy during the next cycle. It’s also nice to know the exact date of ovulation through menstrual calendars in order to determine the right time to conceive.

Week 2

Maternal Changes – The uterus has just developed the uterine lining in time that the egg cell will be fertilized by a sperm. During the time of ovulation, women may feel a sharp pain on side of the lower abdomen as a sign of egg cell rerelease known as mittleschmerz as a sign of pregnancy symptom week by week.

Fetal Development – The ovum is now released in the fallopian waiting for a sperm cell for fertilization.

Week 3

Maternal changes – Fertilization has just occurred after a successful sexual intercourse. There may be signs of implantation because the zygote or the fertilized egg implants at the lining of the uterus. Spotting during this time should not be mistaken as menstruation. Mothers should abstain from drinking alcohol and smoking because these may have effects on the growing embryo. Smoking during pregnancy may bring about problems in fetal development. The mother’s body also releases early pregnancy factor to prevent the body from attacking the embryo as a foreign body.

Fetal Development – The zygote divides rapidly as it travels along the fallopian tube into the uterus for implantation. The zygote usually travels to the uterus for 4 to 7 days. Cell division occurs until it becomes a blastocyst. On day 10, the blastocyst has successfully implanted. Once implantation has occurred, the zygote is now known as an embryo.

Week 4

Maternal Changes – During this time, a pregnancy test will usually yield a positive result due to increase in a hormone called HCG or Human Chorionic Gonadotropin. Women may also start feeling presumptive signs of pregnancy such as mood swings, frequent urination, tender breasts and feelings of tiredness.

Fetal Development – The first trimester is the most crucial stage for the fetus because organogenesis happens or the development of the organs. The 4th week of pregnancy reveals a yolk sac that acts as a placenta.

Week 5

Maternal Changes – Pregnant women may start feeling headaches, crampy uterus and morning sickness. This usually persists until the end of the first trimester.

Fetal Development – The heart of the bay begins to beat early during this week. This may be apparent in ultrasounds. The head and the tail of the baby are also distinguishable. The neural folds also begin to fuse to form the spine. The average length of the fetus is now 1.5 to 2.5 mm.

Week 6

Maternal Changes – The morning sickness may get intensified during this week because of continuous rise is maternal hormones. The areola will also start to appear darker and bigger. Avoid cleaning the cat litter to prevent toxoplasmosis that can result in fetal abnormalities.

Fetal Development – The larynx and the inner ear start to appear. The limbs also develop as buds. The heart begins to bulge and the circulation is well established. The placental lining is still forming. The primordial of the stomach, lungs, pancreas and liver may also be evident.

Week 7

Maternal Changes – Chloasma or melasma start to appear because of increasing pregnancy hormones.

Fetal Development – The baby is about 7 to 9 mm during this stage. The hand plates are present and the genital tubercle is also developing, but it is still hard to distinguish if the fetus is a boy or a girl.

Week 8

Maternal Changes – Regular prenatal check-ups start at this week. The maternal symptom such as morning sickness, feeling of tiredness and breast tenderness still persist.

Fetal Development – The length of the baby is 8 to 11 mm from crown to rump. The hind brain of the fetus is visible, the gonads will differentiate into either ovaries or testes and there is spontaneous movement, but the mother may still not feel it. Hardening of the bones also starts during this stage and elbows start to appear. The toes may also have developed by now.

Week 9

Maternal Changes – Mothers may begin feeling stuffy nose because of increased progesterone in the body. Nose bleeding and nasal congestion may be normal during this stage.

Fetal Development – The fetus already has distinct elbows by now. The length will be about 13 to 17 mm. The average weight will be also 1 gram. The gonads of the fetus have already developed.

Week 10

Maternal Changes – The abdomen may begin to enlarge a little as a pregnancy symptom week by week during this time. The waistline will slowly disappear and linea nigra, a black, thin line from the umbilicus to the symphysis pubis, may develop. This integumentary change may eventual disappear weeks after delivery.

Fetal Development – The embryo now becomes a fetus during the 10th week of pregnancy. It has grown to 25 to 35 mm in size and increases weight to 4 grams. There are already evident tiny toes. The eyes may be largely open; however, the eyelids may still begin to fuse. The genitals of the fetus may also start to differentiate, but still not distinguishable. The upper lip and the external ears also have formed. The tail of the fetus already has disappeared during this stage.

Week 11

Maternal Changes – Gaining weight starts to begin during this stage. The normal weight gain for pregnant women is 1 to 2 lbs a month. Healthy diet is a key to prevent excessive weight gaining.

Fetal Development – The head of the baby is actually 3 times larger than the body. The fingernails may appear during this week and the iris of the eyes is developing. The average weight of the fetus during this week is 7 grams.

Week 12

Maternal Changes – The early symptoms of pregnancy such as nausea and extreme tiredness usually fade away as the first trimester ends. The abdomen will also start to appear bigger. The placenta has been fully developed and it takes the place of the corpus luteum in producing maternal hormones. Risk for miscarriages is reduced at the end of the third trimester.

Fetal Development – The structure of the brain is now similar to the brain at birth. The liver starts to secrete bile during this week. The average weight doubles from the previous week to 14 grams. The length will now be 3.5 inches. The reflexes also appear. Doppler may be able to detect the heart beat of the fetus.

Week 13

Maternal Changes – This is the beginning of the second trimester. During this time, the mother feels stronger because of absence of morning sickness and other uncomfortable feelings. Pregnancy starts to become real for spouses.

Fetal Development – The complete set of baby teeth has developed, but still has not erupted until the 6th month of extrauterine life. The average weight is 28.3 grams. The placenta also continues to grow. The intestines begin to migrate into the abdominal cavity. Insulin has also stared to be secreted by the pancreas. The presence of diabetes in mothers may be detected by the pancreas of the fetus, which secretes more to cope with the maternal blood. The fetus’ stool or meconium also begins to develop on the intestines.

Week 14

Maternal Changes – Chloasma is starting to be more apparent during this time as estrogen and progesterone continues to increase. The linea nigra may be darker and more apparent as well as the areola also starts to become bigger.

Fetal Development – The size of the fetus is now 12.5 cm. The kidneys are actually producing urine. The urine may mix with the amniotic fluid. The fetus starts to ingest the amniotic fluid and eventually excretes it through the urine.

Week 15

Maternal Changes – The heart increases cardiac output to compensate with low hemoglobin levels and to supply the baby with blood through the placenta. There is also increasing weight and the usual clothes may not fit well anymore. Detecting fetal abnormalities through blood tests such as Alpha-fetoprotein determination can now be done.

Fetal Development – The skin of the fetus is very thin with visible blood vessels. The average weight is about 70 grams. The heart begins to pump more blood of about 25 quarts of blood in a day. The hair pattern on the scalp also develops.

pregnancy symptoms week by week image

Pregnancy symptoms week by week picture

fetal development week by week from 8 to 40

Fetal development week by week

Week 16

Maternal Changes – Women may have increased sexual drives because of very high maternal hormones. Modifications in positions may be necessary, but generally, sexual intercourse is not prohibited during pregnancy.

Fetal Development – The eyelashes and the eyesight of the fetus have already developed during this stage and the nails in the fingers and toes have started to grow.

Week 17

Maternal Changes – The fundus of the uterus is now between the navel and the symphysis pubis. The vaginal secretions, sweating and nasal congestion may increase normally.

Fetal Development – Brown fats are starting to develop at the skin. Brown fats help fetus maintain normal body temperature when they are born. The average weight is now 142 grams. Startling reflex may be apparent when the fetus hears loud noises on the outside world.

Week 18

Maternal Changes – Since the uterus may compress other organs when you lie down, women now start to sleep harder. Sleeping with more than one pillow usually relieve this feeling. Increased urination is also more intense as the growing uterus pushes into the bladder.

Fetal Development – The fetus is growing rapidly during this stage. The bones still continue to harden. The fingerprints may be well developed and the pads of the toes and pads are developed.

Week 19
Maternal Changes
Heart burn and indigestion may be a special problem starting this week because of slowed intestinal motility and gastric emptying as a result of maternal hormones. Staying upright after eating is a remedy to prevent heart burn.
Fetal Development
The ovaries of female fetuses normally may have developed primitive egg cells during this time. Fine hair called lanugo also grows in the skin of the fetus. Lanugo normally lessens as the baby reaches term.

Week 20

Maternal Changes – This stage may make mothers excited because they are halfway over pregnancy. The navel may start to prop out because the growing uterus pushes out the belly button. There is also increasing difficulty of breathing as the uterus pushes against the diaphragm. During this time, the fetus may have quickening, meaning that it moves constantly inside the womb making the mother notice the movement. Mothers usually feel becoming a mother for the first time when life begins to be apparent inside the womb.

Fetal Development – A creamy, cheese-like substance on the skin called vernix caseosa begins to form. Vernix is more apparent in the creases in the body. This protects the baby from cold temperature at birth. The weight of the fetus may now be 283 grams with a length of 25 cm. The 20th week may be the best time to have an ultrasound to look at the gender of the baby.

Week 21

Maternal Changes – Stretch marks may start to appear as the skin starts to stretch to make way for the growing abdomen. Back pain also intensifies because of increased weight of the fetus and placental structures.

Fetal Development – There is no new formation during this stage. The fetus may weigh 369 grams.

Week 22

Maternal Changes – Libido may still be increased during this time because of increased blood flow into the clitoris and the vagina.

Fetal Development – The fetus continues to develop the eyebrows. The average size during this time is 27.5 cm with a weight of 425 grams.

Week 23

Maternal Changes – Swelling of the feet may be apparent because of pressure of the uterus to the major veins on the lower extremities. This may be normal, but swelling in the face and hands may mean more serious indications. Women may also feel slight discomforts from Braxton Hicks contractions or faint contraction of the uterus in preparation for childbirth.

Fetal Development – The lanugo usually darkens. The weight increases to 1 pound.

Week 24

Maternal Changes – The fundus of the uterus usually is in line just above the navel with increasing difficulty of breathing. During the second trimester, there may be lesser frequency of urination than the first trimester because the uterus usually ascends to the pelvic and abdominal cavity.

Fetal Development – Brown fat still continues to be deposited under the skin. The weight of the fetus may be 596 grams or 1.5 pounds. The fetus also grows to up to 12 inches in length.

Week 25

Maternal Changes – This is the beginning of the third trimester. At this point there is increased weight gaining of up to 1 pound per week because of continuous growth of the fetus.

Fetal Development – The bones still continue the hardening process or ossification. The fetus may weigh slightly heavier of 709 grams.

Week 26

Maternal Changes – Sleeping may be especially difficult for women because of the compression of the vena cava. Pregnant women are advised to sleep on their left side to prevent dizziness and hypotension as a result of compressing the vena cava.

Fetal Development – The fetus may start to hear the surroundings on the outside world. In this line, listening to music may help stimulate the baby. The fetus may also be able to see light and dark as light may pass through the skin into the uterus.

Week 27

Maternal Changes – The breast can weigh as much as 14 ounces because of engorgement in preparation for lactation. The amniotic fluid will also increase in amount as evidenced by increased weight.

Fetal Development – The skin of the fetus is usually wrinkled due to presence in amniotic fluid all the time. The wrinkles usually disappear days or weeks after birth. The baby may be as heavy as 900 grams.

Week 28

Maternal Changes – Increase prenatal check-ups are required to at least every two weeks. The breast may also start to produce colostrums, essential breast milk for babies that contain antibodies.

Fetal Development – Subcutaneous fats start to be deposited. Descent of testes among boys may also begin. The baby may weigh up to 1 kilogram and grow as large as 35 cm.

Week 29

Maternal Changes – Increasing discomforts on the back, legs and breathing is starting to get intensified. It is essential to get proper exercise, rest, nutrition as well as good posture to prevent musculoskeletal problems such as cramps, and back aches.

Fetal Development – The bone marrow is fully developed to produce the baby’s own red blood cells and other blood components. The kidneys may also produce up to half a liter of urine everyday.

Week 30

Maternal Changes – Same feelings may affect the mother such as back aches and leg pains. Exercise and good posture is a key to reduced symptoms.

Fetal Development – During this time, the fetus may grow up to 1.36 kilograms and may have length of 37.5 cm.

Week 31

Maternal Changes – The rib cage may be sore because of pressure of the growing fetus in the rib cage. The fetus may also fill up the space in the abdominal cavity displacing all organs inside.

Fetal Development – The iris and pupils of the fetus may now react to light. The skin of the fetus is usually pink. It now weighs up to 1.5 kg. The fingernails may also reach up to the end of the fingers or toes.

Week 32

Maternal Changes – Mothers may be especially concerned about labor as pregnancy comes to end. It is important to discuss fears and concerns to other people as well as to the doctor.

Fetal Development – There may be an increased amount of hair in the scalp. The average weight of the fetus may be 1.7 kg with a length of 16 inches.

Week 33

Maternal Changes – Small bumps may be felt on the abdomen while the baby moves inside the uterus.

Fetal Development – The lungs have already formed surfactant, which helps the baby breathe after birth. When a baby will be born during this stage, the chances of survival are higher than earlier weeks because of the presence of lung surfactant.

Week 34

Maternal Changes – There may be more frequent Braxton Hicks contractions, which help women, prepare for birth. There may be breast milk production as the hormones in the placenta stimulate breast milk production.

Fetal Development – The baby may reach 2 kg in weight and 16.8 inches in length. The baby may also urinate more in the amniotic fluid.

Week 35

Maternal Changes – Increase difficulty of breathing is felt during this time. There may be increased urination, but less often than what happens as you reach term.

Fetal Development – The baby may weigh at least 2.15 kg getting ready for birth. The length may reach 18 inches. The organs have been developed during the first trimester, but finishing touches occur during this time. The baby’s brain may also begin to double in size.

Week 36

Maternal Changes – Prenatal check-ups should be increased to once a week in order to prepare for childbirth. The mother may be relieved of difficulty of breathing as the fetus descends down the pelvis. However, increased urinary frequency is more intense as the fetus pushes more on the bladder.

Fetal Development – The baby may assume a head down position compatible for vaginal delivery. During this time, the fetus also descends into the pelvis ready for delivery. The baby may weigh 2.3 kilograms and has a length of 18 inches.

Week 37

Maternal Changes – The pregnant woman is considered to have reached term staring the 37th week of pregnancy. It is important to prepare the things for birth because the fetus is ready for birth anytime.

Fetal Development – The baby practices breathing by inhaling amniotic fluid in the lungs.

Week 38

Maternal Changes – The woman may feel tingling sensations in the vagina and the legs as the baby’s head settles into the pelvis for delivery as pregnancy symptoms week by week during this stage.

Fetal Development – The weight gain for the fetus during this time is one ounce in a day. There is a large growth happening in the fetus during this time.

Week 39

Maternal Changes – One week left and you’re going to give birth. Some women may have given birth at this time and it is considered term and safe. Lightening may be experienced as the fetus descends further into the true pelvis. Expecting others may present symptoms during this week or few hours prior to labor such as:

  • Bloody show in the vagina as a result of loss of mucous plug
  • Loose stools
  • Increase in appetite
  • Sudden increase in energy

Fetal Development – There are no developments happening on the fetus during this time because of imminent delivery. The meconium may reach the rectum ready to be released at birth or few hours after birth.

Week 40

Maternal Changes – The mother is now ready to give birth. The actual percentage of women giving birth on their due date is only 4%. Most of women give birth 2 weeks before or two weeks after expected date of delivery.

Fetal Development – Most of babies during this week have assumed a cephalic presentation for vaginal delivery. However, up to 4% may assume different presentations such as breech or shoulder that may need cesarean birth to prevent fetal distress.

These detailed pregnancy symptoms week by week provides knowledge to pregnant women. These pregnancy symptoms week by week should be observed in order to detect any abnormalities in the mother as well as the fetus. The pregnancy symptoms week by week should also be reported to the physician in order to provide managements for the discomforts.

Smoking During Pregnancy Risks, Effects to Mother and Baby

Smoking is one of the vices that have a negative impact on health. According to most obstetricians, smoking has been the leading cause of adverse effects to babies. Cigarette smoke contains more than enough chemicals that can produce harsh effects to the baby and the mother. It contains up to 4,000 harsh substances such as nicotine, tar, lead, cyanide and many more. It also contains up to 60 carcinogens that can travel through the blood stream and cross the placenta.

The most common chemical that produces harsh effects on the fetus and the mother are nicotine and carbon monoxide. Nicotine is a potent vasoconstrictor that reduces the perfusion to the placenta as well as the fetus. The effects of smoking are almost not managed by medications during pregnancy so its effects are imminent.

Smoking During Pregnancy

Causes of Smoking during Pregnancy

Smoking during pregnancy is caused by various factors. Women who smoke during pregnancy are most often a chain smoker most of her life, which makes it difficult to quit smoking even during pregnancy. Most often, women know that smoking during pregnancy is bad for their health, but just can’t stop smoking. Aside from being addicted to smoking, the vice during pregnancy may also be caused by certain factors such as:

  • They are still ambivalent about the pregnancy whether they want to keep it or not
  • Problems with their partner, which is released through smoking
  • Emotional and psychological imbalance, which makes them unable to decide for healthy choices

Associations of smoking during Pregnancy

Smoking during pregnancy is associated with a lot of factors. A lot of birth defects of babies are commonly associated with smoking. Cigarette smoke is also associated with most deaths in utero of fetuses because of its harsh effects. The nicotine found in smoking results in vasoconstriction of the blood vessels, which is generally harmful for the normal blood perfusion for the developing fetus. Smoking during pregnancy can also lead to stroke, heart diseases, cancer and others even after pregnancy.

Effects (risks) of smoking during Pregnancy

As discussed earlier, smoking during pregnancy results in various effects to the mother and baby. The main mechanism of the defects is associated with the constriction of the blood vessels that supplies blood to the placenta for the use of the developing fetus. It also results to problems in the mother.

Effects to the Mother

  • Vaginal bleeding. Pregnant mothers may experience vaginal bleeding as a result of too much pressure in the blood vessels in the uterus. Vaginal bleeding may also be a sign of ongoing problems in the fetus such as imminent abortion.
  • Pregnancy induced hypertension (PIH). PIH is the occurrence of hypertension during pregnancy. Smoking during pregnancy is a factor to its development because of marked vasoconstriction.
  • Abruptio placentaAbruptio placenta is the premature separation of the placenta from the uterus even though the fetus has not yet been delivered. This results from pregnancy induced hypertension as a result of vasoconstriction brought about by nicotine.
  • Placenta previa. Placenta previa is the low implantation of the placenta also as a result of harsh effects of smoking. Placenta previa prevents the fetus from being delivered first and may result to severe vaginal bleeding during labor because of its location.
  • Still birth. Mothers may also experience delivering a dead fetus because of hypoxia inside the uterus. Still birth may result in psychological and emotional problems to the mother.

After delivery, the mother is also predisposed to developing other conditions related to smoking such as lung, gastric and oral cancers, heart diseases, and cerobrovascular diseases.

Effects to the Baby

  • Premature birth. The limited blood supply in the uterus causes premature uterine contractions that may lead to premature delivery. The uterus needs an adequate blood supply in order to establish its integrity until the right time for delivery. However, when a mother smokes, the circulation is impaired, which stimulates early contraction of the uterus.
  • Small gestational age baby. The developing fetus relies on the placental perfusion for nutrition. The blood that is supplied by the placenta is the chief source of nutrition. When there is vasoconstriction, the fetus receives limited nutrition, which affects the growth leading to low birth weight baby.
  • Birth defects. Babies may also be born with cleft lift or palate because of poor intrauterine development. Heart defects may also result, which reduces the life expectancy of the baby.
  • Cerebral palsy. The developing brain of the fetus needs adequate oxygen. With poor perfusion, the brain of the baby also receives limited oxygen leading to the death of some brain cells, which eventually leads to cerebral palsy at birth.
  • Mental retardation and learning difficulties. Cerebral palsy and limited oxygenation of the brain during development may also lead to long-term effects such as mental retardation and difficulties in learning.
  • Intrauterine fetal demise or death. Severe fetal distress because of hypoxia inside the uterus may lead to fetal demise.
  • Risk for developing asthma and sudden infant death syndrome. The respiratory system is also affected, which may result in asthma during childhood. Sudden infant death syndrome or SIDS also results because of severe apnea during infancy. Other respiratory diseases may also include pneumonia, ear infections and bronchitis.

Reasons to quit smoking during Pregnancy

There are a lot of reasons to quit smoking. Quitting smoking improves pregnancy outcomes and ensures the health of your baby. Cutting off the number of sticks of cigarette per day will prevent more adverse outcomes, but quitting altogether provides the best benefit for the mother and the baby. Smoking is not a good thing, pregnant or not and you will never be healthier unless you quit. Quitting smoking is also beneficial because of these reasons:

  • Safer delivery
  • Healthier children
  • Prevents diseases such as heart disease and stroke
  • Fresher breath
  • Healthier teeth
  • Prevents wrinkles
  • Increased strength to care for your baby

How to quit Smoking during pregnancy?

It’s never too late to quit smoking during pregnancy as long as you have the discipline to stop. The primary step in quitting smoking is having the motivation to stop it. Lack of discipline and motivation are the most common reasons for failures in quitting.
Here are the tips on how to quit smoking:

  • Increase fluid intake to satisfy your oral fixation.
  • Indulge on candies and gums to replace the urge to smoke.
  • Make yourself busy by engaging in worthwhile activities such as exercise.
  • Avoid things, places and people who make you feel like smoking.

Finally, seek the help of your partner in quitting. Psychological and emotional support is very essential in quitting smoking during pregnancy.

Top 10 Healthy Fast Food Tips

Most people dine in fast food chains because it is convenient, cheap and offers well tasting foods. Fast foods also offer on the go meals that are beneficial to people with a fast-paced life. Children as well as adults become fanatics of fast foods because of combo meals that have one or more food choices, plus they come in very appetizing plating. The fall back of fast foods is that most of the foods they offer are not healthy.

Healthy Fast FoodEating just one meal can give sodium, fat and calories in excess and if you dine in fast foods regularly, you can have build-up of fats, calories and sodium which contributes to obesity. Fast foods also becomes a risk factor for certain heart diseases and diseases of the intestines. In fact, lawsuits have been made with certain fast food chains because of the incidence of obesity in children and adults. Children are also caught eating meals only that are served in fast foods, which increase obesity even at a young age.

Healthy Fast Food

Fast foods are very in demand and highly growing, we can just make healthy choices rather than eliminating them. But the question is how can we make fast foods healthy? Here are some of the tips to choose healthy fast food:

1. Eat in moderation

Eating in moderation becomes the solution. It is always okay to eat fast foods such as french fries from time to time, but eating every day becomes a problem. Try to dine in fast food chains only during holidays or weekends. Don’t make it as your kitchen eating your breakfast, lunch and supper there. Allow children to eat their favorites as reinforcement for their job well-done activities, but don’t allow them to eat only what they like for the rest of their lives. Teach children to eat foods prepared in the home, which is far healthier.

2. Learn to have healthier choices

Food choices in fast foods are not necessarily unhealthy. You can choose the ones which are healthier. Avoid fried, breaded, creamy, crispy and batter-dipped food choices. Go for vegetables and order lean meats.

3. Try to undress your meal

When ordering fried chicken for instance, remove the skin and don’t use the gravy. These components have high fat, cholesterol and calorie content, which makes you unhealthy. Instead of putting mayonnaise, you can ask for mustard or ketchup, which you can put on your own. In this way, you eat your favorite fast food, but less the unhealthy portions.

4. Go for water or iced teas, instead of soda

Thirty two (32) ounce of soda can yield 400 calories, which is mainly the composition of what supposed to be a healthy meal. Soda, which has 400 calories plus the food you ordered will double the calorie you take in one meal. So instead of ordering sodas for drinks, choose water or juices.

5. Don’t rush eating

When you’re rushing, it leads to eating your meal unmindful. Take time to eat so you can be mindful that you have eaten a lot. When you take time eating, the tendency is, you are already full even if you have not eaten most of your meal yet.

6. Choose the more simple foods

Complicated foods ted to have more food additives. You can order for a single patty burger instead of a double patty or large burger. In this way, you can cut down excessive fats and calories in your body.

7. Don’t super size your meal

A single order can have as much as 1000 calories and if you super size it, you can still double the unwanted calories in your body. Order the regular meal and have a salad as a side dish instead of ordering fries.

8. Share with your companion

Instead of ordering two large fries, you can order one and share. Most often, servings in fast food contain more than one serving so it’s always an excess if you eat them all. You can also take some portions home so you don’t have to eat them all in one sitting.

9. Have a special order

You can place a special order such as removing the dressing or some additives in your food. Instead of having a dip on your sundae, you can ask for a plain vanilla ice cream instead.

Conclusion

  • Fast foods are convenient and save time, but eating most of your life in fast foods can have physical as well as psychological effects.
  • It’s always better to choose healthy foods in order to prevent diseases such as obesity and heart problems.
  • Resisting fast foods and choosing the better option sometimes require discipline and proper understanding of healthy foods.
  • Fast foods include additional additives to make their food more appealing and tasty.
  • It’s up to you if you go for these meals or choose healthier ones.

How to Measure, Lose, and Prevent Body Fat

What is Body Fat?

Body fat, which is made up of fatty acids and glycerol, is an essential energy source for muscles.

The essential fat will regulate the temperature of your body, which also serves as insulator of the organs, acts as a cushion, and is a storage area for energy. It is known to be the essential component of the human body. This is what is measured when using those methods mentioned awhile ago.

How much normal body fat should be present?

The normal body fat percentage depends on the frame and height. Generally, the male’s average body fat should fall under 6-13%. Meanwhile, females should normally have to be in between 14-20% of the essential body fat weight to be considered healthy.

This will differ when it comes to athletes. The acceptable range in the body fat percentage is within 25-31% for females and 18-25% in males. More than that, they are considered to be in the obese range.

BMI classification of underweight, normal, overweight, obese for AsiansPicture 1 – WHO classification of BMI of underweight, normal, overweight, obese people (Asians only)

Normal Body Fat ranges for standard adults (Healthy, Obese, Over fat)Picture 2 – Normal Body Fat ranges for Underfat, Healthy, Obese, Over fat People

Image Source -Healthruby.com

Different methods to measure body fat percentage

With the many luscious and affordable dishes, it’s easier to get fat than get thin. Obesity is the number one problem of the people nowadays. However, there are ways to get the desirable healthy weight. There are products sold in the market that will help you lose excess fats. You can also opt to do some exercise to be able to shed off that weight. Whatever ways you plan to burn those extra pounds, experts says that you must be able to keep note of your weight and your body fat.

It is very much important that you also measure your body’s fat. There are numerous equipments that will help you this goal. You can use either of the following methods:

Body Fat Analyzer & scale for body weight & fat measurementPicture 3 – Body Fat Analyzer & scale for body weight & fat measurement

Image Source – wellpromo.com

1. Skin Fold Caliper

The skin fold caliper uses the body fat caliper to measure the body fat percentage of your body. It is called as the “pinch” test. When using it, you pinch a fatty are with the use of your fingers and let the caliper measure the thickness of the pinched area, either in your thighs, hips, arms and several other areas in the body.

It is measured in millimeters. After getting the millimeter measurement, you then will compare that with a specified chart. The results are reliable if the one who is getting the measurements is a trained person or has experienced in using this kind of equipment. Otherwise, the results will be capricious.

Skin Fold Calipers for measuring body fatPicture 4 – Skin Fold Calipers for measuring body fat

2. Anthropometric Measures

The anthropometric measure is one of the oldest tests that are widely known. This makes use of the circumference of the body with the use of a measuring tape or tape measures. It is the simplest way to measure your body fat.

3. Height or Weight Charts

This is merely done as checking the tables found in the chart and then getting the height versus weight plot equivalent. It has been used for many years, but experts say it’s not fiduciary.

4. BMI (Body Mass Index)

The BMI method is calculating your height and weight. It will use the formula height in meters divided by weight in kilograms. With this method, you are able to know if you are in the normal, overweight, or obese category. The advantage in using this method is that it is free and easily made available. However, not everyone can use this method. The short people or the people who are muscular will have much less accurate results.

5. BIA (Bioelectric Impedance Analysis)

Using the BIA method will impel impedance of electricity, or the opposite electrical flow of the current in your body. The muscle, having water content that is high and conductive, while the fat has lower content of water and isn’t that conductive. In a matter of seconds, it will calculate the body fat.

6. Hydrostatic Weighing

With this method, it is required that you need to be submerged in a special tank filled with water. Its idea is that the bones and muscle are denser than water; persons having large percent of fat free mass weigh more in water and thus, will eventually produce a low percent of body fat. It is considered as the “gold standard” measurement.

7. DEXA SCAN

DEXA scan or Dual Energy X-ray Absorptiometry is the newest breed of technology that measures your body fat. What happens here is that it divides the body into three parts: total body mineral, fat tissue mass and fat free soft mass. The advantage of using this method or equipment is that it is very accurate. However, the disadvantage of this is that it is very expensive.

8. Bod Pod

This is the newest equipment which relies on the displacement of air. This is contrary to the Hydrostatic Weighing. What you need to do is that you step inside the Bod Pod chamber, be very still and you must control your breathing. We don’t want the results to be affected. The hydration level before the test can also affect the results. There is little accuracy when one uses this method.

Excess Body Fat Problems

  1. Stroke
  2. Heart attack
  3. Heart Failure
  4. Arteriosclerosis (atherosclerosis)
  5. Kidney failure

Excess body fat problems

Picture 5 – Over body fat complications

Ten Steps to Lose Body Fat

To effectively reduce the excess body fat mass naturally, the individual needs to exercise to be able to extend energy. You need to spend energy more than what you are consuming. Burning calories shall be your goal. Once your goal is established, you need to discipline yourself in eating less and exercising more.

Experts suggest that you can ten important steps to consider when you want to decrease body fat through eating:

1. Don’t run away from cravings. You should not let the food that you are craving, stop you from eating it. We suggest that you eat that food so that it won’t bother you ever again.

2. Work with your hunger pains. When you feel that your stomach is rumbling, the best way to solve it is to eat. Don’t starve yourself, you are only slowing your metabolism and storing the food that you had consume, which should not be the case.

3. Acknowledge the fact that you have fat phobia. Avoiding the foods that you think that could cause you to gain fats, is not the solution to reducing body fats. You have to be wise enough not to give in for it will cause you grief and it will remove the aim of producing unwanted fats results.

4. Eat Veggies and Salads. These are good for you.

5. Drink lots of water. It will keep you refreshed and hydrated.

6. Enjoy your protein intake. Protein doesn’t only be found in meats and poultry. You can get protein from numerous protein drinks.

7. Schedule your calorie reduction cycle. Some decrease their calorie intake on the odd days and increase them on even days. In this way, you let your body do the guessing while you stimulate your metabolism.

8. Portion size eating. You have to eat by portion. You can either do this by gauging a portion size of a mobile phone, for instance, as the amount of food you are to consume. Not too little, not too much. In this way you will be able to watch what you are eating.

9. Add variety to you meals. To spice up and entice your taste buds. It is advised that you try on other country’s dish

10. Good friends and Good Food. There’s nothing more enjoyable when your eating out with your friends.

How to Prevent Excessive Body Fat?

Excess body fats are due to excess consumption of calories. Eating the wrong kind of food is the leading cause of why there are excess body fats. Understand and gaining knowledge on what food to avoid is necessary in preventing such accumulation of excess unwanted fats. Foods that you should avoid are foods high in sugar or sweeteners, fats, starches and processed carbohydrates.

Sugar should be avoided since sugars are known to convert to fats when not in used. Wrong kind of fats such as saturated ones will lead to excess storage of body fats. While the carbohydrate and starches, just like sugars, are easily converted to fats when not in used by the body.

Five suggested steps to prevent body fat

There are five suggested steps that one must follow in order to prevent body fat accumulation, such steps are:

Step 1: You do at least 150 minutes of moderate-intensity of exercise per week. You can either do brisk walking or engage in jogging activities.

Step 2: You need to watch what you eat. It is important to watch what you eat so that you are able to notice which food can cause you more body fats. We suggest you research of foods that have lower calories or consult a nutritional expert and ask help from them with regards to calorie counting procedures or methods. Experts, advised to eat at least 500 calories less per day than you burn.

Step 3: Next eat a cup of blueberries every day, as much as possible. According to studies, the polyphenols that is found in blueberries helps in preventing the growth of new fatty cells and promoting breakdown of fat cells.

Step 4: Eating grapefruits, that is fresh, after meals or during snacks. According to studies, it will help in effectively reducing body fats.

Step 5: You have to stay hydrated. The suggested water intake per day is at least eight cups of water per day. Water is good for the body. It helps in intoxication and will keep the body system, such as digestive system and metabolic system, from functioning well.

Mycosis Fungoides

Mycosis fungoides is the most common example of cutaneous T cell lymphoma. This condition may usually affect adults who are over 50 years of age but cases of children being affected have been reported [1, 2].

What is Mycosis Fungoides?

The disease condition of mycosis fungoides is an example of a blood cancer called as cutaneous T-cell lymphoma. In this malignancy, the T-cells of the blood become cancerous and affects the skin. The result is the appearance of different types of skin lesion. Although the lesions are on the skin, the skin cells do not become malignant [3, 4]. Figure 1 shows an example of lesions associated with mycosis fungoides.

mycosis fungoides images

 

Figure 1- Mycosis fungoides

The prognosis of this condition depends on several factors such as the age of the patient and the progression of the condition. Those who were diagnosed at the early phase of mycosis fungoides have a 5-year survival rate of 100% while those in the last phase of the condition have a 5-year survival rate of 14% [5].

Phases

The condition have a slow progression and undergoes several distinct stages. It is important to note that not everyone will undergo through all of the stages [1, 2, 6].

Mycosis fungoides photo

Premycotic phase

Most patients will develop flat and scaly lesions that are reddish or pinkish. The malignant T-cells are present in these lesions. These do not cause any symptoms and may last for several months or even years [1, 2, 6].

Patch phase

Eczema-like patches will appear in the body. They are commonly found in upper thighs, lower abdomen, breasts and buttocks [1, 2, 6].

Plaque phase

The plaques are reddish or brownish raised lesions. These plaques may develop from the patches or they may develop on their own. There are patients who have patches and plaques at the same time [1, 2, 6].

Tumor phase

Tumors that are deeper and thicker than plaques may develop. As before, the tumors may develop from existing patches and plaques or they can form on their own. There are times that these tumors will have open sores which increases the risk for infection. The cancerous T-cells may spread to other organs such as the lungs, liver, spleen and lymph nodes [1, 2, 6].

Causes

The exact cause of mycosis fungoides is still unknown but the DNA of the cancerous cells have shown chromosomal abnormalities. Examples of chromosomal changes include addition or loss of genetic material. Other causes that are being considered are viral or bacterial infections and environmental exposure [1, 4].

Risk Factors

Factors that may increase the likelihood of an individual to develop mycosis fungoides include advanced age, cigarette smoking, elevated body mass index, familial history of multiple myeloma and the presence eczema [7].

Signs and Symptoms

The primary symptoms of mycosis fungoides is the appearance of skin lesions. These lesions may be in the form of rash, patch, plaque or tumor in the skin. It is through the lesions that the stage of the disease is identified. Other symptoms that may be present include lymphadenopathy, hypercalcemia and enlarging of some organs or organomegaly [4].

Diagnosis

Health history and physical examination

As part of the health history, the physician will note the patient’s health habits and past illnesses. The physician will take note of the quantity and quality of the skin lesions during the physical examination. Photos may be even be taken to monitor the progression. Other symptoms that may be present will be identified as well [2, 4].

Skin biopsy

A sample of the patient’s skin will be collected by the physician and will be sent to a pathologist for an examination. This will be viewed under a microscope to check for the presence of cancer. Several skin biopsies may be performed before the diagnosis of mycosis fungoides is established [2, 4].

T-cell receptor gene arrangement test

The T-cells that are present in a tissue sample will be analysed. This test will identify any changes in the genes of the T-cell [2, 4].

Treatment

There are different types of treatment regimen that are used for the management of mycosis fungoides. The treatment depends on factors such as the lesions that are present and the progression of the condition [1, 2, 4].

Photodynamic therapy

This therapy involves a laser light and a drug that is injected to the vein of the patient. The drug collects more in cancer cells and is not active until it is exposed to the light. The result is the elimination of cancer cells while the normal cells of the body are barely harmed [1, 2, 4].

Chemotherapy

Chemotherapy uses antineoplastic drugs that may eliminate the cancer cells or prohibit them from growing. The combination of the drugs that will be used and the method of administration would depend on the stage of the condition [1, 2, 4].

Biologic therapy

This mode of therapy utilizes the patient’s immune system to eliminate the cancer cells. It may be strengthen with the use of substances that are either produced by the body or synthesized in a laboratory. This regimen is also known as biotherapy or immunotherapy [1, 2, 4].

Symptom relief

The skin lesions can be managed with the use of a corticosteroid or retinoids. A corticosteroid cream may relieve the swelling or inflammation of the skin while the use of retinoid is known to slow down the growth of certain cancer cells [1, 2, 4].
References

  1. US National Library of Medicine. (2016, May 25). Mycosis Fungoides. Retrieved from Genetics Home Reference: https://ghr.nlm.nih.gov/condition/mycosis-fungoides
  2. National Cancer Institute. (2016, February 5). Mycosis Fungoides and the Sézary Syndrome Treatment (PDQ®)–Patient Version. Retrieved from National Cancer Institute: http://www.cancer.gov/types/lymphoma/patient/mycosis-fungoides-treatment-pdq
  3. American Osteopathic College of Dermatology. (2015). Mycosis Fungoides. Retrieved from American Osteopathic College of Dermatology: http://www.aocd.org/page/MycosisFungoides
  4. Pinter-Brown, L. (2016, January 15). Cutaneous T-Cell Lymphoma. Retrieved from Medscape: http://emedicine.medscape.com/article/2139720-overview
  5. Stanford Medicine Multidisciplinary Cutaneous Lymphoma Group. (2016). Mycosis Fungoides/Sèzary Syndrome. Retrieved from Stanford Medicine Multidisciplinary Cutaneous Lymphoma Group: http://cutaneouslymphoma.stanford.edu/community/mycosis_fungoides.html
  6. Aschebrook-Kilroy, B., Cocco, P., & La Vecchia, C. (2014): The InterLymph Non-Hodgkin Lymphoma Subtypes Project. JNCI Monographs, 98-105.
  7. Kim, Y., & Liu, H. (2003). Long-term Outcome of 525 Patients With Mycosis Fungoides and Sézary Syndrome. JAMA Dermatology, 857-866.

Agranulocytosis

What is Agranulocytosis?

It is otherwise known as granulopenia, granulocytopenia or agranulosis. It is sometimes interchanged with the medical term neutropenia. It is a medical condition or term, which is derived from a Greek word that means “without granulocyte”, that suggest a reduction in the production of granulocytes, which is a blood disorder, under this classification includes subtypes such as basophils, eosinophils and neutrophils.

Granulocytes are actually a kind of WBC or white blood cells. When a person has or is experiencing Agranulocytosis, he or she is at great risk to acquire infection as well as mucosal ulceration. Without these cells, the body is unable to fight off the infection.

agranulocytosis picture

Agranulocytosis Image

Image source: loroati.com

Agranulocytosis Symptoms

Persons that have Agranulocytosis will experience the following symptoms:

  • Weakness
  • Ulcers in the person’ s stomach, bowels or mouth
  • Chills
  • Fever
  • Rigors
  • Fatigue
  • headache
  • Sore throat
  • Opportunistic Infection to any organ such as the throat, rectum, mouth, vagina, or nose
  • Septicemia (in the long run or as the condition worsens)

Although the symptoms mentioned above are associated with Agranulocytosis, still some of the persons who reportedly suffer from this kind of condition reports to have no symptoms or are asymptomatic during the illness period.

Agranulocytosis Causes

The etiological reason or cause of why Agranulocytosis occurs may be due to the following reasons or causes:

  • Chemotherapy effect
  • Diseases that affects the bone marrow
  • Hereditary diseases
  • Radiation therapy side effects
  • Having autoimmune diseases
  • Taking in prescriptions which have a side effect of Agranulocytosis such drugs like antineoplastic, sulfonamides, psychotropic and chloramphenicol.

Agranulocytosis Diagnosis

In diagnosing the patient with Agranulocytosis, the person will undergo examinations such as:

  • Medical history
  • Physical examination
  • Complete blood count examination that includes differential which measures eosinophils, basophils and neutrophils
  • Genetic examination
  • Blood examinations may be done through bone marrow biopsy through the special procedure called FNAB or fine needle aspiration biopsy

The important and confirmative examination with regards to diagnosing the person disease is laboratory values. It is consider as the main indicative measure especially when person is experiencing Agranulocytosis. The laboratory values will depict a lower number of cell counts of the granulocytes, which is considered to be abnormal in nature and which are indicative of Agranulocytosis. The normal laboratory values will differ from one hospital to another it is advisable that the normal laboratory values in a particular hospital is to be followed to be accurate in diagnosing Agranulocytosis.

bone marrow biopsy

Bone Marrow Biopsy as a confirmative diagnosis for the presence of Agranulocytosis

Image source: drhowell.net

Agranulocytosis Treatment

In treating persons with Agranulocytosis, the causative or the reason must be established first and then the treatment will be based on the cause. If the cause is due to too much intake of medications which can lead to Agranulocytosis, thus, the treatment should be to change or to lessen the medications taken which will need consultation from the trusted physician. Other treatment includes:

  • Isolation precaution
  •  Antibiotics
  • Bone marrow transplant
  •  GMCSF or otherwise known as granulocyte colony stimulating factors
  •  Stem cell transfusion

With regards to bone marrow transplantation, which is the primary effective treatment for persons that have Agranulocytosis, the criteria must be met prior to undergoing the transplant. The criteria includes matched donor, good health before undergoing the transplant procedure, the age is 40 years old and under.

Agranulocytosis Side Effects & Complications

There are no such thing as perfect treatment, hence we could not forego that there could be complications and side effects that are associated whenever we treat persons with Agranulocytosis. Such side effects and complications include the following:

  • Allergic reaction
  • High risk for infection
  • Bleeding

Hence, by knowing such, we must be able to understand the risk of the treatment provided.

Cornelia de lange syndrome

Define Cornelia de Lange syndrome

Cornelia de Lange syndrome (CdLS) is a congenital rare syndrome appear due to genetic disorders. The primary characteristic of this syndrome is delayed physical development during fetal growth and continues to after birth. In other word, it can be described as a prenatal and postnatal growth retardation.

The signs and symptoms are associated with distinct physical appearance, including craniofacial (head and facial) abnormalities, defective upper limb (hands and arms) development; and mild to severe cognitive impairment due to mental retardation. The symptomatic variation seems with case to case. (1,2)

Cornelia de Lange Syndrome image

Sign and symptoms

The typical sign and symptoms of Cornelia de Lange syndrome is distinct, but some features are considered as secondary features. Therefore, the appeared signs and symptoms are divided into two categories, which include primary characteristics and secondary characteristics, though all the below mentioned sign and symptoms may not be prominent in every case.

Primary characteristics of CdLS

Depending upon the genetic differences, the primary characteristics occur, which include:

Overall growth of a infants

The infant born by CdLS usually has low birth weight, that approximately 5 lbs. or 1oz., but this is not a fixed for every case, and it varies within a range of 1 lb., 2 oz. to 10 lbs. The length of the child is also low and calculated mean birth length is around 18 inches. The provided value can help to indicate that CdLS cause growth retardation during  fetal development in the womb. The head size of the infant is also small, which is termed as microcephaly.

Cornelia de lange syndrome

Delayed mental development

The children with CdLS typically has delayed mental development and cause mild to severe intellectual incapacitance. The common features  include Learning disabilities, language delays, but some individual can have borderline of standard intelligence.

Gastro esophageal Reflux Disease (GERD)

Vast majority of the CdLS patient (almost 85%) complains discomfort after ingestion of food, like heartburn due to the high possibility of GERD. The unpleasant effect also has a negative impact on  behavior.

Behavioral Issues

Different types of annoying behaviors, which may cause self hurting issues like head-banging or  hand-biting are often associated. Repetitive compulsive behavior,  Obsessive Compulsive Disorder, Attention Deficit Hyperactivity Disorder, Anxiety and Attention Deficit Disorder are also noticeable with patients having  CdLS syndrome.

Secondary Characteristics of CdLS

Typical  facial appearance

Along with microcephaly, a peculiar vertically extended groove present between the upper lip and nose, a stumpy nasal bridge; upturned nostrils; and a obtrude upper jaw. In addition, distinctive facial defects may consist of skinny, downturned lips; ears are low-sited; vaulted, prominent eyebrows that raise jointly diagonally from the bottom of the nose; an oddly short hairline on the forehead and the backside of the neck; and atypical twisted, elongated eyelashes and cleft palate or high-arched palate.

Limb distinction

The typical distinction of limb is also associated with CdLS patients, for them, which include small sized hands and feet with curved little finger (clinodactyl), incompletely united the second and third toes,  abnormal positioning of the thumbs. Associated hand abnormalities may be single sided or both sided. Foot size is smaller than the normal size. Other than these, rarely missing of fingers, forearms  or hands are noticed.

Other System Abnormalities

Other included abnormal features include inflamed eyelid, drooping eyelids, myopia (nearsightedness), involuntary rapid eye movement etc. (2,3,4)

Cornelia De Lange Syndrome Causes

The Cornelia de Lange syndrome is a genetic disorder. The responsible genes associated with CdLS are NIPBL gene on chromosome 5 and the SMC1L1 gene on the X chromosome. In most of the cases, almost half of the incidence is related to the abnormal mutation NIPBL gene, though a very few cases are associated with the abnormal mutation of SMC1L1 gene. Other involved gene yet to discover.

The mutagenic abnormality of the involved gene may carry forward from either of the parental source or new genetic alteration also cause the onset of CdLS. (2)

Diagnosis

An ultrasound imaging system may help to assume the presence of Cornelia de Lange syndrome (CdLS) during fetal growth. The waves of the ultrasounds form an image, which can detect growth retardation, deformities of limb, facial abnormalities and/or defective organ formation.

The confirmation can be notable about the presence CdLS is possible after the birth of the infant by performing a thorough clinical evaluation and detection of typical physical features. The different scientific literature described that a confirmed diagnosis of the presence of Cornelia de Lange syndrome can be reported  after receiving the distinct facial features with the association of  limb abnormalities, before and after birth growth retardation, and intellectual retardation. Mild symptomatic features can cause confusion of the CdLS diagnosis and often difficult to provide conclusive result.

In confirmatory test, molecular genetic testing is performed in the NIPBL and SMC1L1 and finding of abnormal genetic mutations validate the detected physical abnormality is related to CdLS. This test usually recommended for mild characteristic features.

If a precise NIPBL or SMC1L1 gene mutation has been detected, then in the prenatal stage diagnosis of CdLs is possible. (2,4)

Treatment

Depending upon the notable symptomatic approach, a treatment plan is prepared by the clinical experts. In the Cornelia de Lange syndrome, multiple organ deformity is involved, therefore a team of expert clinicians needs to provide a proper therapeutic approach to the affected child. The included specialists are pediatricians; surgeons; geneticists; orthopedists; orthopedic surgeons; plastic surgeon; gastroenterologists, urologists, otolaryngologists (specialist of the ears, nose, and throat); pediatric cardiologists; dentist; speech pathologists; audiologists (specialists who assess and treat hearing problems); eye specialists; physical and occupational therapists; and/or other health care givers.

Any involvement of cardiac problems, GI tract defect, audibility complications, and/or propensity towards respiratory infections need early detection and prompt medical care to reduce the complications. The interventions include pharmacological, surgical depending upon the site and type of abnormality. For example, child susceptible towards respiratory infection can need to treat with antibiotic therapy, episodes of convulsion can be controlled by anticonvulsive therapy, whereas abnormality in heart or limb abnormality may rectify by surgical intervention.

Other supportive therapeutic approaches like hearing aids may recommend and provide a beneficial effect for  hearing impairment. Remedial education, speech therapy, vocational training,  and/or other medical and/or social services also provide positive outcomes for CdLS.

Genetic counseling is suggested for affected persons and their family members. (2)

References

  1. Cornelia de Lange syndrome, (2016); Genetic Home References; Retrieve from: https://ghr.nlm.nih.gov/condition/cornelia-de-lange-syndrome
  2. Cornelia de Lange Syndrome; National Organization for rare diseases; http://rarediseases.org/rare-diseases/cornelia-de-lange-syndrome/
  3. Characteristics of CdLS; CdLS foundation; http://www.cdlsusa.org/what-is-cdls/characteristics-of-cdls.htm
  4. Matthew A Deardorff, Sarah E Noon, andIan D Krantz, (2016); Cornelia de Lange Syndrome; http://www.ncbi.nlm.nih.gov/books/NBK1104/

Adrenal Glands

What is the Adrenal gland?

The adrenal gland or the suprarenal gland is a part of the endocrine system responsible for secreting hormones for stress and other body functions. The adrenal glands have different shapes. The left adrenal gland is semilunar in shape while the right adrenal gland is triangular shaped. The adrenal gland is a small gland one-third the size of a normal kidney.

The adrenal gland is supplied by blood by the superior, middle and inferior renal arteries. The venous blood is drained into the right and left suprarenal veins. The adrenal glands together with the thyroid gland are the top two organs that receive the most blood per gram of tissue.

adrenal glands image

Adrenal Glands is located at the top of kidenys

Image source: riversideonline.com

 

 Adrenal gland Location

The adrenal glands are located on the top of each kidney in the retroperitoneum. It is termed as suprarenal gland because it is situated on the top of each kidney. In humans, the adrenal glands are surrounded by the renal fascia and adipose tissues. The adrenal glands are found on the level of the 12th thoracic vertebrae.

The adrenal glands are divided into parts: the adrenal medulla and the adrenal cortex. Both structures in the adrenal gland have definite functions and hormones to produce.

Adrenal Gland Hormones and Functions

The adrenal gland secretes various hormones needed in the body such as:
Hormones secreted by the adrenal cortex

Glucocorticoid

The adrenal cortex secretes cortisol, corticosterone, and deoxycorticosterone responsible for the utilization of fats, proteins and carbohydrates in the body. It is also responsible for anti-inflammatory effects in the body.

Mineralocorticoid

Mineralocorticoid is secreted in the form of aldosterone. Aldosterone serves as a regulator in the body because it regulates salt and water in the kidneys. When aldosterone is increased, there is more sodium and water retention in the body. Because of sodium and water control, aldosterone is directly responsible for the regulation of blood pressure.

Androgens

The adrenal cortex also secretes androstenedione and dehydroepiandrosterone, which are precursors for the production of sex hormones especially testosterone.

Hormones secreted by the adrenal medulla

Epinephrine

Epinephrine or adrenaline is responsible for the fight and flight response of the body. It is responsible for adapting to stress. Epinephrine is responsible for the increase in the heart rate, respirations, metabolic rate and muscle contraction during stress. It also delays muscle fatigue to enable to face the stressor. When people are under stress, the bladder and the colon are less stimulated leading to urinary retention and constipation.

Norepinephrine

Norepinephrine or noradrenaline is also similar to epinephrine in action. It causes constriction of the blood vessels leading to an increase in blood pressure. It also increases the heart rate and improves coronary blood flow.

Adrenal Gland Disorders

Deficiency and overproduction in the hormones secreted by the adrenal gland lead to problems in the body. Certain disorders in the adrenal gland may include:

Cushing’s syndrome

Cushing’s syndrome is a condition wherein there is an increase in the production of cortisol. Because of this, there is an excessive cortisol that the body doesn’t need leading to problems such as hypertension, edema, abnormal fat distribution, increased susceptibility to infection, poor wound healing, and decreased resistance to stress because of too much cortisol in the body. Cushing’s disease often results from adrenal hyperplasia, adrenal tumor or exogenous administration of steroids leading to increased in amounts in the body.

cushing syndrome  pictures

Cushing Syndrome as one of the disorders of adrenal glands

Adrenal gland tumors

Adrenal gland tumors may also arise as a result of primary or secondary malignancy. Primary tumors initially arise in the adrenal gland while secondary tumors may arise from metastasis from other areas in the body such as the lungs. The presence of adrenal tumors leads to hyperfunctioning similar to Cushing’s disease.

Adrenal Gland Failure

Adrenal gland failure is also termed as Addison’s disease. This leads to the hypofunctioning of the adrenal cortex. Because of this, there is limited secretion of mineralocorticoids, glucocorticoids and androgens. Addison’s disease is considered idiopathic or there is no known cause. Deficiency in the mineralocorticoids leads to poor regulation of salt and water leading to increase in water excretion. Glucocorticoid deficiency leads to decreased gluconeogenesis and increased in the production of melanocyte stimulating hormone by the pituitary gland.

Adrenal Failure Symptoms

Symptoms of adrenal failure result from the reduction in the secretion of the steroids in the body. These include:

  • Fatigue – A reduction in the production of steroids may also affect the production of epinephrine. The reduced reaction to stress leads to fatigue.
  • Weight loss – Low levels of aldosterone also promote water loss from the body leading to rapid weight loss.
  • Hypoglycemia – Cortisol is responsible for gluconeogenesis. When the levels are low, it leads to poor metabolism of carbohydrates, fats and proteins that further leads to low blood sugar levels.
  • Dehydration – As a result of water loss from the body, the extracellular volume is depleted leading to dehydration.
  • Hyperkalemia – The potassium level also increases because of a decrease in the sodium levels in the body. Hyperkalemia further leads to cardiac arrhythmias.
  • Postural hypotension – The volume depletion reduces the vascular tone leading to low blood pressure.
  • Bronzed skin – The low levels of cortisol also fail to inhibit the adrenocorticotropic hormone produced by the pituitary gland, which increases the melanocyte stimulating hormone. As a result, there is increased production of melanin.
  • Decreased resistance to stress – There will also be decreased resistance to stress because of reduced epinephrine and norepinephrine production.

Causes of Adrenal Failure

The exact cause of adrenal failure is unknown, but the presence of congenital hypoplasia of the adrenal gland, pituitary tumors and management of Cushing’s syndrome may cause the condition.

Treatment of Adrenal Failure

The main treatment of adrenal insufficiency is to replace the adrenal hormones that are lacking. Treatments include:

Corticosteroid Therapy

Exogenous corticosteroids are usually given to provide the body with the lacking cortisol in the body and reverse the symptoms. However, corticosteroid therapy should be carefully tapered to prevent life-threatening crisis when the treatment is stopped.

Intravenous Glucose Administration

Hypoglycemia may be treated with intravenous glucose therapy to prevent severe hypoxia of the brain cells.

Intravenous Infusions

Intravenous fluid infusions are also given to maintain vascular integrity and prevent severe dehydration. Increasing the fluids also reverses hypotension as a result of loss of intravascular volume.

Vasovagal Syncope

What is Vasovagal Syncope?

It is a layman’s termed as fainting which can be experienced by anyone. It occurs due to various factors which may be discussed as we go along. When triggering factors are present, the patient will experience this kind of disease condition. It also activates the autonomic system before or after each attack. It may be otherwise known as neurocardiogenic kind of syncope or neutrally mediated hypotension or vasodepressor syncope. It can happen to anybody at anytime.

Aside from that, the most common etiological factor is a history of brief and acute episodes of losing consciousness that is sometimes happens momentarily. There are really no other  abnormalities associated to person’s both neurologic and cardiac aspects. Hence, it is totally harmless and does not really require treatment at all.

It deals with the vagus nerve, the nerve which crosses in the person’s larynx and throat and is responsible for heart rate as well as it supply the nerves of parasympathetic system such as esophagus, stomach or lungs and other organs in the abdominal region. When discussing about parasympathetic, it means that the system which controls the involuntary system of the person such as the lungs and heart and many other organs.

Vasovagal Syncope Symptoms

When a person undergoes vasovagal syncope, he or she will experience the following symptoms:

  • Lightheadedness
  • Tunnel vision
  • Cold sweat
  • Ringing in the ears
  • Physical weakness
  • Clammy sweat
  • Nausea
  • Diaphoresis or excessive sweating
  • Dizziness
  • Palpitations
  • Paresthesia
  • Chest pain
  • Dyspnea
  • Feeling of warmth or hot
  • Pallor

Many of those who experienced Vasovagal syncope commonly reports that prior on experiencing attacks, they usually felt an aura such as being nervous without reason or perhaps having visual disturbances before the Vasovagal syncope.

Vasovagal Syncope Causes

There are a lots of factors that may trigger attacks of vasovagal syncope such as:

  • Low blood pressure
  • Blood flow towards the brain is reduced
  • Emotional stress
  • Undergone a shocking incident or accident
  • Painful experience
  • Anemia
  • Fever
  • Fasting episodes
  • Prolonged bed rest
  • Having organic heart disease
  • Heat exposure
  • Standing for long hours
  • Having their blood drawn out
  • At the sight of human blood or any blood for that matter
  • Straining like during bowel movement
  • The fear or anxiety upon injury of the body

These are just some of the common factors reportedly associated with vasovagal syncope.

Vasovagal Syncope Pathophysiology

The Vasovagal syncope occurs because of two factors: triggering factors and the activation of autonomic.

With regards to the triggering factor, there are actually two kinds: the central and the peripheral. The central triggers are those that deal with instrumentation, pain and emotion. Meanwhile, the peripheral triggers deals with being in a hot environment, dehydration, illness, exercise or perhaps excessive consumption of alcohol.

On the other hand, the activation of autonomic system will bring about the symptoms such as pallor, nausea and sweating, which are the most common symptoms.

Pathophysiologically speaking, what happens inside the person’s body during vasovagal syncope is that there is decrease venous return brought about by decrease blood flow which will in return result to decrease in the left ventricular filling and will then result to an increase in the person’s sympathetic tone as seen by the symptoms experienced such as palpitation and the like. When this happens, there will be vigorous ventricular contraction especially in the underfilled chamber which will trigger the increase in mechanoreceptor discharge which will eventually lead to the trigger of the central nervous system which results to vasodilation and bradycardia and hence the condition called as vasovagal syncope.

How to Treat Vasovagal Syncope?

Treating vasovagal syncope, in most cases, is not necessary. The condition will be gone in minutes even without treatment. If for instance you will encounter vasovagal syncope to the point that it interferes with your day to day activities, then you need to consult your physician so that you will be given diagnostic examination to know the condition that triggers you to have such condition. The physician may also recommend you the following treatment for such condition, such as:

Pharmacological treatment

The medications that are often prescribed to persons who encounter vasovagal syncope are as follows:

  • Antidepressants

Antidepressants under the classification of SSRI or otherwise termed as selective serotonin reuptake inhibitors are good medications which will prevent the occurrence of Vasovagal syncope.

  • Blood pressure medications

Drugs like metoprolol which treats persons with high blood pressure. This is given to patient who experiences vasovagal syncope because they act to block the signal which may lead to the said condition.

  • Constriction for blood vessel

Medications for the treatment of asthma and low blood pressure helps in the prevention of vasovagal syncope.

Therapeutic Management Treatment

Therapeutic regimen such as the wearing of elastic stockings, increasing salt in diet which is done for patients who are not contraindicated or who have no heart problems, tensing your muscles of the leg especially during standing, foot exercises, and leg elevation during the syncope episodes are recommended. Aside from that, it is advisable that you avoid hot and crowded places and prolonged standing. You also need to combat dehydration by drinking lots of fluids particularly water.

Surgical treatment

Last and the certainly the least, some physician would suggest, especially to persons who have heart problems, that the patient undergoes surgery for the insertion of the pacemaker or electrical pacemaker for that matter which will help in the regulation of the blood, heartbeat and persons who encounter Vasovagal syncope.

The treatment for vasovagal syncope varies from one person to another. Prior to undergoing the treatment recommended, the patient should undergo series of diagnostic tests to rule out any possible health problems associated with this condition.

Bartholin Cyst

What is Bartholin Cyst?

Bartholin cyst is the growth of a small tumor-like tissue on the Bartholin’s gland. The Bartholin’s gland is a pea-sized gland located on the side of the vaginal opening. The Bartholin’s gland is usually small and non-palpable, but the occurrence of a cyst makes it swell or enlarge.

These glands, also termed as vestibular glands are located underneath the skin in the vaginal orifice. The Bartholin’s glands in females are very important during sexual intercourse. These glands are responsible for secreting mucus, which serves as lubrication for the vagina during sexual intercourse.

Any obstruction in the duct causes the fluids to accumulate inside it. As a result, there is inability to release the fluid for use. When significant accumulation happens, it usually forms a cyst on the area.

Bartholin cyst is commonly the size of a pea or a marble. However, when it becomes infected, it can grow bigger with resulting abscess formation. The cyst is usually painless and cyst in only one duct is more common.
The presence of infection and abscess formation causes the cyst to become very uncomfortable. However, the cyst is usually benign. Tumors, cancers or hyperplasia in the glands are not common.

 

bartholin cyst image

Left Bartholin Cyst Abcess

Image source: brooksidepress.org

Bartholin Cyst Symptoms

Bartholin cysts have different symptom for infected and uninfected lesions. Uninfected cysts usually result to the following manifestations:

  • Presence of small lump in the vulva
  • Usually painless
  • Redness in the area
  • Swelling of the vaginal orifice
  • Cysts are a quarter to one inch in size
  • Enlarges during sexual intercourse because of more fluid accumulation
  • Pain during intercourse or dyspareunia as a result of lack of lubrication from the obstructed duct
  • Infected Bartholin cysts lead to the following symptoms:
  • Severe pain on the cyst
  • Difficulty sitting or walking because of pressure and pain on the area
  • Tenderness in the surrounding tissues
  • Formation of abscess, which may be foul smelling
  • Fever as a sign of severe infection
  • Vaginal discharges may be present as a sign of underlying sexually transmitted disease

Bartholin Cyst Causes

The primary cause of Bartholin cysts is the presence of accumulation in the Bartholin duct. This is caused by various factors such as:

Poor Personal Hygiene

Poor perineal care after sexual intercourse leads to obstruction of the duct by various materials. Poor hygiene may also cause infection in the area leading to Bartholin cysts.

Infection

Presence of sexually transmitted diseases is a common cause of Bartholin cyst. STDs lead to vaginal discharges that when lodges on the Bartholin’s ducts, it may cause obstruction and Bartholin cyst. Bacteria from the colon, which is Escherichia coli, can also go to the Bartholin’s duct and cause cyst formation.

Use of restrictive undergarments and pants

Young women suffering from Bartholin cyst usually develop it because of wearing of ill-fitting clothes. These clothes limit air circulation in the area and also restrict blood circulation. The Bartholin’s gland secretions may also not effectively escape the duct because of restriction and further leads to accumulation and blockage.

Bartholin Cyst Diagnosis

The primary diagnosis of Bartholin cyst involves physical examination of the vulva showing palpable mass on the vaginal orifice. Gynecologists usually do not perform other diagnostic tests when the cysts are not infected or uncomplicated.
However, when infection is observed such as the occurrence of abscess and vaginal discharges, the physician usually does other tests to identify the causative organism and the appropriate antibiotic therapy. Specific tests include:

Culture and Sensitivity Testing

This test involves the collection of pus on the area and subjecting it to culture to determine the specific bacteria. Next, sensitivity testing is done by subjecting the cultures to various antibiotics. The antibiotic to which the bacteria are most sensitive will be the drug of choice for the patient.

Smears

Smearing of the vagina and the cervix is also done to identify possible sexually transmitted disease in sexually active women. Gonorrhea and Chlamydia are the most common STDs that may cause Bartholin cyst.

Bartholin Cyst Treatment

Other patients may recover from Bartholin’s cyst without treatment because the cysts sometimes disappear on their own. However, most women seek treatment because of occurrence of pain, significant size of the cysts and difficulty in walking or sitting. Infected cysts become severely painful, which prompts patients for consult. The treatment of Bartholin cyst usually involves medications, surgery, as well as home treatments. These include:

Home Treatments

  • Hot sitz bath

Hot sitz bath is done to promote blood, circulation, drainage and healing of the cyst. Hot sitz bath involves exposing the vulva to hot steam because a hot temperature dilates the blood vessels as well as the duct. This is done at home by sitting in a tub of warm water three times a day for 15 minutes. It can also be done by sitting in a pail of water in order to prevent the water from touching the skin and allowing only the steam to reach the vulva. This technique may also help mature the cyst for easier surgical removal.

  • Proper perineal care

Washing the perineum with lukewarm water prevents the development of infection. It also hastens the healing of the Bartholin’s duct.

Medications

  • Analgesics
  • Analgesics are taken to reduce the pain especially for infected Bartholin’s cyst. Common analgesics include ibuprofen and acetaminophen.
  • Antibiotic therapy
  • Oral antibiotics are also taken for infected cysts. These should be taken for a course of days to allow the microorganism to be completely eradicated.

Surgical Excision

Excision involves the removal of the cyst by the use of instruments. This is done in an outpatient basis. Excision is the treatment of choice for uninfected cyst in order to prevent reoccurrence of the growth. It is performed under a local anesthesia.

Marsupialization

Marsupialization is also a surgical procedure involving the drainage of the abscess along with the removal of the cyst in infected Bartholin’s cysts. This is also done in an out-patient unit and performed under local anesthesia. However, it may still cause significant discomfort because local anesthetics do not act fully in infected Bartholin’s cyst. Sedation may be employed depending on the physician.

The procedure is started by making a small incision to drain the abscess. After which, the cyst is excised and the cyst wall is sutured to prevent re-growth or reoccurrence of the cyst.

 

bartholin cyst drainage

Marsupialization to drain and remove bartholin cyst and abcess

Complications of Bartholin Cyst

The primary complication of Bartholin cysts is infection. For cysts that are not surgically removed, it may disappear and reoccur from time to time. Presence of malignancies is usually uncommon for Bartholin cyst.