NAILS IN HEALTH AND DISEASE.

Introduction:

The nails are present at the end of each finger tip on the dorsal surface.The main function of nail is protection and it also helps for a firm grip for holding articles.It consists of a strong relatively flexible keratinous nail plate originating from the nail matrix. Under the nail plate there is a soft tissue called nail bed.Between the skin and nail plate there is a nail fold or cuticle.Normal healthy nail is slight pink in colour and the surface is convex from side to side.Finger nails grow 1 cm in three months and toe nails take 24 months for the same.

Importance of nails in disease diagnosis:

The colour ,appearance, shape and nature of the nails give some information about the general health and hygiene of a person . Nails are examined as a routine by all doctors to get some clues about underlying diseases.Just looking at nails we can makeout the hygiene of a person.The abnormal nail may be congenital or due to some diseases.The cause for changes in the nail extend from simple reasons to life threatening diseases.Hence the examination by a doctor is essential for diagnosis .Some abnormal findings with probable causes are discussed here for general awareness.

1) Hygiene:-

We can make out an unhygienic nail very easily .Deposition of dirt under the distal end of nail plate can make a chance for ingestion of pathogens while eating.If nail cutting is not done properly it can result in worm troubles in children.When the worms crawl in the anal orifice children will scratch which lodges the ova of worms under the nails and will be taken in while eating.Prominent nail can also complicate a skin disease by habitual scratching.Sharp nails in small kids cause small wounds when they do feet kicking or hand waving.

2) Colour of the nails:-

a) Nails become pale in anaemia.

b) Opaque white discolouration(leuconychia) is seen in chronic renal failure and nephrotic syndrome.

c) Whitening is also seen in hypoalbuminaemia as in cirrhosis and kidney disorders.

d) Drugs like sulpha group,anti malarial and antibiotics ect can produce discolouration in the nails.

e) Fungal infection causes black discolouration.

f) In pseudomonas infection nails become black or green.

g) Nail bed infarction occures in vasculitis especially in SLE and polyarteritis.

h) Red dots are seen in nails due to splinter haemorrhages in subacute bacterial endo carditis, rheumatoid arthritis, trauma, collagen vascular diseases.

i) Blunt injury produces haemorrhage and causes blue/black discolouration.

j) Nails become brown in kidney diseases and in decreased adrenal activity.

k) In wilsons disease blue colour in semicircle appears in the nail.

l) When the blood supply decreases nail become yellow .In jaundice and psoriasis also nail become yellowish.

m) In yellow nail syndrome all nails become yellowish with pleural effusion.

3) Shape of nails:-

a) Clubbing: Here tissues at the base of nails are thickened and the angle between the nail base and the skin is obliterated. The nail becomes more convex and the finger tip becomes bulbous and looks like an end of a drumstick. When the condition becomes worse the nail looks like a parrot beak.

Causes of clubbing:-

Congenital Injuries

Severe chronic cyanosis

Lung diseases like empyema,bronchiactesis,carcinoma of bronchus and pulmonary tuberculosis.

Abdominal diseases like crohn's disease,polyposis of colon,ulcerative colitis,liver cirrhosis ect...

Heart diseases like fallot's tetralogy,subacute bacterial endocarditis and ect..

b) Koilonychia:-

Here the nails become concave like a spoon.This condition is seen in iron deficiency anaemia.In this condition the nails become thin,soft and brittle.The normal convexity will be replaced by concavity.

c) Longitudinal ridging is seen in raynaud's disease.

d) Cuticle becomes ragged in dermatomyositis.

e) Nail fold telangiectasia is a sign in dermatomyositis ,systemic sclerosis and SLE.

4) Structure and consistancy:-

a) Fungal infection of nail causes discolouration,deformity,hypertrophy and abnormal brittleness.

b) Thimble pitting of nail is charecteristic of psoriasis ,acute eczema and alopecia aereata.

c) The inflamation of cuticle or nail fold is called paronychia.

d) Onycholysis is the seperation of nail bed seen in psoriasis,infection and after taking tetracyclines.

e) Destruction of nail is seen in lichen planus,epidermolysis bullosa.

f) Missing nail is seen in nail patella syndrome.It is a hereditary disease.

g) Nails become brittle in raynauds disease and gangrene.

h) Falling of nail is seen in fungal infection,psoriasis and thyroid diseases.

5) Growth:-

Reduction in blood supply affects the growth of nails. Nail growth is also affected in severe ilness. when the disease disappears the growth starts again resulting in formation of transverse ridges.These lines are called Beau's lines and are healpful to date the onset of illness.

Vitamins And Your Health

These days, we all know that taking vitamins is an easy way to start pursuing a healthy and disease free way of life. In the past, vitamins were used with diets, although they weren’t near as sophisticated as they are today. The vitamins of today are far more sophisticated and geared towards certain aspects of your body and your health.

Even though some people may not realize it, food doesn’t give you all of the vitamins and nutrients your body needs. Although you may be following a healthy diet, you won’t receive everything your body needs to carry out daily functions. You can buy high quality food if you wish, although it isn’t the preferred way to fix this type of situation. No matter what you choose to eat, you still won’t get the vitamins and nutrients you need.

If you have any type of restrictions with your diet, it can be even more difficult to get the vitamins and nutrients you need. Those who suffer from food allergies especially, find it even harder to get the right amount of vitamins. Even if you have a small appetite, you can be at a major disadvantage to getting everything your body needs. Smaller appetites get full a lot quicker, making it harder to eat the foods you need on a daily basis.

No matter how you look at it, you won’t get everything your body needs from food. To get the vitamins, minerals, and nutrients you need, you’ll need to use supplements and vitamins. Vitamin supplements are the easiest way to give your body what it needs. You can use vitamins and supplements in your normal diet, although you’ll need to choose them accordingly with what you need and what your diet consists of.

Even though there are many vitamins that you can benefit from, one of the most important is B12, which can raise your energy levels and help with your immune system. Some other vitamins you’ll need to include in your normal diet are vitamin A, C, D, and E. These vitamins are very important to your body, as they help with many different functions. Vitamins C and E are among the most important, as they help with your skin, hair growth, and the way your body functions.

To ensure that your body remains at it’s best, you should make sure that you get the right amount of vitamins with your diet. You can find vitamin supplements locally or on the Internet, with hundreds to choose from. You should also include selenium and colostrum in your daily diet as well, as these two vitamins will help you with your health. If you take the right vitamins with your diet - you’ll find that your health and energy will always will remain at their top levels of performance.

Vegetables in Childhood May Benefit Breast Health

Girls who ate the most fruits and vegetables rich in carotenoids were less likely to get benign breast disease, a new study suggests.

Carotenoids are a group of pigments that typically produce an orange, red or dark green color. They are believed to have antioxidant properties that may guard against disease.

Benign breast disease describes a variety of noncancerous conditions of the breast; some forms raise the risk of breast cancer.

"There have been a number of studies about carotenoids and breast cancer," said lead researcher Caroline Boeke, a postdoctoral fellow at Channing Division of Network Medicine at Brigham and Women's Hospital and Harvard School of Public Health, in Boston.

While the studies have produced mixed results, she said, overall they suggest a protective effect of the carotenoids. So her team decided to analyze the intake of these vegetables by girls enrolled in an ongoing study that began in 1996.

For her study, Boeke and her colleagues looked at food reports from 1996 through 1998 and then evaluated reports in 2005, 2007 and 2010 from girls who got a diagnosis of benign breast disease from a doctor after having a biopsy.

In all, Boeke studied nearly 6,600 girls, and 122 reported a diagnosis of benign breast disease.

When she looked at carotenoid intake, she found high intakes were protective. "The odds of benign breast disease in those who consumed the most beta carotene were about half that of those who consumed the least," she said.

Girls in the highest intake group ate two to three servings of carotenoid-rich foods weekly, she said.

The study is published in the May issue of Pediatrics.

"It's an observational study, so we can't say for sure the carotenoids cause the lower risk," Boeke noted. "We can only say there's an association."

She did take into account other factors that might affect the risk of benign breast disease, such as alcohol intake, physical activity, family history and body mass index (a measure of body fat using height and weight).

Why might the fruits and vegetables help? It's not known for sure, but Boeke said it may be due partly to their antioxidant properties. Carotenoids absorb harmful substances known as free radicals which can harm cells.

The study looked only at food intake, not supplements, and Boeke said she would not recommend supplements since other research has found some harmful effects with supplement use.

Other foods that are rich in carotenoids include yams, melons, spinach and kale.

The most common kind of benign breast disease in teens and young women is a noncancerous tumor known as a fibroadenoma, according to Boeke.

The period of time between the start of a girl's period and the first birth is a sensitive one for the breasts, as they are very vulnerable to environmental exposures, according to background information in the study.

Not many lifestyle habits have been shown to protect against benign breast disease, said Dr. Joanne Mortimer, director of women's cancer programs and co-director of the breast cancer program at the City of Hope Comprehensive Cancer Center, in Duarte, Calif.

The study has limitations, she said, including the self-report by the girls of a benign breast disease diagnosis by a doctor and the food questionnaires, which are always subject to error since it's difficult to remember exactly what was eaten.

SOURCES: Caroline Boeke, Sc.D., postdoctoral fellow, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard School of Public Health, Boston; Joanne Mortimer, M.D., director, women's cancer programs, and co-director, breast cancer program, City of Hope Comprehensive Cancer Center, Duarte, Calif.; May 2014 Pediatrics

Health Care Workers Wash Hands More When Patients Watching

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AppId is over the quota

TUESDAY, April 8, 2014 (HealthDay News) -- Next time you're in the hospital, keep an eye out for hygiene practices: Health care workers are more likely to wash their hands if patients are asked to monitor them, according to a new study.

It details an 11-month pilot project at the Family Practice Health Center at Women's College Hospital in Toronto. Patients were asked to observe and record the hand hygiene habits of their health care providers, who were aware that they were being watched.

During the project, nearly 97 percent of the health care workers washed their hands before direct contact with their patients, according to the study in the April issue of the American Journal of Infection Control.

The researchers also found that 58 percent of health care providers said they changed their hand hygiene practices, 88 percent said they were more motivated to wash their hands and 33 percent said they had more conversations with patients about infection prevention and control.

"Involving patients as the monitors of their health care providers' hand hygiene seems like an obvious, simple choice, and yet most hospitals in Canada don't use this method -- many opt for the often costly and time-consuming alternatives such as having their colleagues monitor and audit," study co-lead author Jessica Ng, manager of infection prevention and control at Women's College Hospital, said in a hospital news release.

The pilot project -- adapted from an approach used at Johns Hopkins Hospital in Baltimore -- was so successful that it is being implemented in other areas of the hospital, which is believed to be the first Canadian hospital with this type of program.

"The patient-as-observer approach is a practical, accurate and cost-saving alternative to the time- and resource-intensive direct observations by a paid hospital employee," study senior author Dr. Michael Gardam, the hospital's director of infection prevention and control, said in the news release.

"It's a promising tool for championing patient safety and quality improvement, because it supports education, engagement and empowerment of patients to play a more active role in their own health care," he added.

-- Robert Preidt
Copyright © 2014 HealthDay. All rights reserved. SOURCE: Women's College Hospital, news release, March 31, 2014

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Sitting Too Much May Harm Health

Excess Sitting Has Been Linked to a Host of Health Problems. Here's How to Reduce Your Sitting Time.

The studies just keep coming. Sitting our life away, it seems, may be very bad for our health and even our life expectancy.

Just since January, researchers have reported that sitting for long hours is linked to:

Worse mental healthA higher risk of death from heart disease and other causesA higher risk of being disabled

The new studies add even more weight to earlier research suggesting that too much sitting is bad -- even if you get regular exercise.

Experts say they still don't know for sure which comes first. Does too much sitting trigger poor health, or is it the other way around?

They also say we may need to think about sitting and exercise as two separate behaviors, each contributing on its own to our health. So while that 1-hour jog is great for you, it may not undo the 8 hours sitting at your desk.

WebMD asked three experts to weigh in on what we know about sitting and how we can reduce our sitting time.

''It has been linked to cardiovascular events like heart attack, heart disease death, overall death, and death from cancer," says Andrea LaCroix, PhD, director of the Women's Health Center of Excellence at the University of California, San Diego.

In her recent study, she found that older women who reported the most sitting time were more likely to die during the 12-year follow up. Those sitting more than 11 hours daily were at the highest risk, she reported in the American Journal of Preventive Medicine.

Sitting time has also been linked with high blood pressure, obesity, bad cholesterol, and too much belly fat.

The dangers of excess sitting have been discussed for decades, but research has picked up steam in the last 5 years, says Jacqueline Kerr, PhD, associate professor of family and preventive medicine at UC San Diego. She studies how to help people sit less.

Scientists can't explain it. And they emphasize that a link doesn’t prove that too much sitting causes these diseases.

One possibility: Sitting for a long time causes muscles to burn less fat and blood to flow more sluggishly. Both can increase the risk of heart disease, high blood pressure, and other problems.

In some cases, it's still unclear which way the link goes, says Barry Braun, PhD, director of the Energy Metabolism Laboratory at the University of Massachusetts in Amherst. "People who sit the most are more likely to be obese,'' he says. “Are people obese because they sit too much, or do they sit too much because they are obese?”

You might think that sitting would make you less hungry. Braun's research has found it is not true.

His team assigned people to sit a lot one day and to stand a lot on another day. Each time, the researchers studied how it affected their appetite. ''Going from active to sitting doesn't lower your appetite or your energy intake," he says. Prolonged sitting, he says, may trigger us to eat more than we should, leading to weight gain. 

Study shows Teens' Screen Time May Affect Their Bone Health

Spending too much time sitting in front of screens may be linked to poorer bone health in teen boys, according to a new study from Norway.