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WATER BALANCE

Water BalanceLife on earth began in water. Water is the largest molecular constituent of the body. It makes up for about 60% of the total body weight in males and 55% in females. It provides a medium for metabolic functions in the body. Enzymatic reactions occur in aqueous media. It maintains the form of cells, tissues and organs, helps in digestion, evacuation of body wastes, maintenance of body temperature, lubrication in joints, prevention of infections and many more such functions. Water Distribution in the body Of the total body water, 2/3 is in the cells and 1/3 is extracellular. Of the extracellular water, 2/3 is outside the vascular system and 1/3 is in blood. Regulation of water balance The osmolality( a measure of solute concentration in water) is held in a very narrow limit in the human body. This typically is 280 to 295 mosm/kg. If the osmolality increases in the body fluids, a hormone called ADH is produced at the base of the brain. This hormone increases thirst and decreas…
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Kidney Biopsy

Kidney Biopsy is a procedure in which a very tiny piece of the kidney is removed for examination under a microscope for diagnosis of the kidney disease. It may also inform us about prognosis (future course ) of the disease, severity of disease and suggest ways of treatment. The information given below is relevant for cases of native kidney biopsy. Indications for kidney biopsy: When urine shows high levels of protein, RBCs or other abnormalities like casts. Unexplained acute kidney injury Some cases of chronic kidney disease renal transplant dysfunction The procedure of kidney biopsy: Patients consent is taken. Blood group is checked. Tests are done to see that the bleeding and clotting is normal Ultrasonography to confirm that both kidneys are present , normal or large, more or less symmetrical, there is no stone disease, tumour or cyst etc. The person is made to lie down on his abdomen with the back facing up. After cleaning the area with antiseptics, the site of biopsy is injected w…

Vitamin B Complex

Vitamin B6  Pyridoxine / Pyridoxal / PyridoxamineVit B 6 is referred as pyridoxine which is available from plant sources and Pyridoxal phosphate which is available from animal sources. The vitamin is found in legumes, wheat grain covering(bran), meat, nuts etc. Deficiency states are due to poor intake of the vitamin. It can also occur if the bran is removed from wheat and starvation states. Deficiency may occur if less than .2 mg is taken daily. If a person is put on antituberculosis drug Isoniazid, deficiency symptoms can occur. This drug interacts with pyridoxal phosphate and hence vitamin B 6 is given together with Isoniazid to TB patients. Symptoms of deficiency are burning and strange sensations in hands and feet (neuropathy), confusion, madness (psychosis), anemia, fits, depression, red tongue and seborrhea. Deficiency is treated by giving Vit B6 in a dose of 50 mg/day. Intake of > 100 mg/day may cause toxic side effects which can be severe. Vitamin B12  CyanocobalminVitamin B12  …

Riboflavin B2 Niacin B3

Riboflavin (Vitamin B 2) This is another Vitamin of the B group. It is water soluble. The rich sources of this vitamin are, eggs, meat, milk and other dairy products, fish, green vegetables, yeast etc. This vitamin works in the cells mainly in energy transport, dehydrogenation, oxidation and electron transport mechanisms. Deficiency of this vitamin is common in cases  where food intake is less starvation,after natural and man-made calamities,in anorexia nervosaand diseases of intestines where absorption is limited,
Deficiency suggests relatively recent problem as the vitamin is not stored for long in the body. The daily requirement is about 1.3 mg in men and 1.1 mg in women. Deficiency causes non-specific signs and symptoms. The common manifestations are Redness of throat, Sores at angles of the mouth, Redness of inner lining of cheeks, Dermatitis with excess sebum production, Anemia etc.
Treatment consists of replacement of the hormone. Niacin (Vitamin B 3) The symptoms of Niacin defici…

Water Soluble Vitamins

ThiamineBeriBeri was known to the Chinese 5000 years back. However the fact that it was due to Vitamin B1 deficiency was only known in 1926. This vitamin is found in nuts, legumes, yeast and rice (unpolished). It is not found in fruits, milk or vegetables. The meagre quantities found in these can be destroyed by cooking as well. This vitamin is required for the metabolism of carbohydrates and proteins in the body. It forms part of a chemical required for enzymatic activity. The requirement for man and woman is slightly more than 1 mg /day. A pregnant woman may require about one and half times of this. Severe deficiency of this vitamin can cause the following diseases: Infantile beriberi Adult beriberi Wernicke-Korsakoff syndrome Leigh disease Infantile beriberi occurs in infants less than 6 months fed exclusively on formula feeds not having thiamine. It is now rare. Adult Beriberi: Dry beriberi usually causes nervous system disorder. Wet beriberi causes swelling of feet, breathlessness…

Vitamin D

Vitamins are essential parts of nutrition, required in small quantities for normal metabolism. These are not produced in human bodies and their deficiency can cause diseases. Vitamin D however, is an exception as it can be produced in the human skin. Vitamin D : Rickets in children and osteomalacia in adults are bone diseases due to deficiency of Vitamin D. Rickets was 1st described in 1600 but the cause of the disease discovered later. Vit D is also called Calciferol. Vitamin D2 from plants is called ergosterol while the vitamin found in animal sources is Vitamin D3. Sources: Vitamin D is found in fatty fish, cod liver, eggs etc. Milk is, however, a poor source. Milk and vegetable oils in some countries may be fortified with Vitamin D. In human beings, Provitamin D in the skin is converted to Cholecalciferol. This then is converted 1st in the liver and then in the kidneys to its active form (1,25 OHD). Requirements of Vitamin D: About 600 units of Vit D are required from age 1 yr to 70 …

Benign Prostatic Hypertrophy

The prostate gland is located in the midline at the junction of the urinary bladder and urinary passage in the penis. It is present only in men and is about 20 gms in weight at 20 yrs of age, but increases in size to about 50 gms by the age of 80 yrs. It surrounds the urinary passage on all sides just below the bladder and this part of the urinary passage is called prostatic urethra. The prostate gland is a chemical factory. It produces secretions which act as lubricants, produces chemicals which can increase or decrease blood pressure. It also produces a substance called prostacyclin which reduces blood clotting by stopping platelets from adhering to each other. As the prostate enlarges over the age, in about 20% of men, it can produce symptoms or obstruction. The incidence of obstruction rises with advancing age. The symptoms of prostatic enlargement are often referred as LUTS (men) or lower urinary tract symptoms. SymptomsUrgency or inability to hold urine for adequately long timePr…

Tuberculosis (TB)

Part I (Lung TB)Tuberculosis is a worldwide disease. It was equally found in the western developed world until a century back. Better treatment, hygiene, case detection, prevention has decreased the incidence in the developed world. It is a common cause of prolonged illness and fatalities in the 3rd world. HIV had caused spread and increase in no of TB patients which are now declining. It is caused by a bacteria (Mycobacterium) which grows better in tissues with high Oxygen levels. Since oxygen levels are high in the upper portion of lungs, the commonest form of TB involves upper lungs. It is spread by droplet infection. Droplets are small drops of body fluid sent out of the body during coughing and sneezing. The TB bacteria are present in the phlegm of patients and is spread in patients vicinity when they cough. Once it is inhaled by susceptible people, the infection may occur. Susceptible persons are ones with decreased or low immunity. These include young children, elderly patients…

Our Kidneys

Our KidneysCommon QuestionsAre both my kidneys affected? Ans:  Most diseases involve both kidney diseases simultaneously. Exceptions are obstructions in one kidney or ureter, the tumor of one kidney, injury to one kidney or ureter, infections confined to one kidney etc. However, some people may be born with only one kidney! Have both my kidneys failed? Ans:      If the urea and creatinine are high, it means both kidneys are functioning less. If one kidney function is normal, urea and creatinine are usually not elevated. Will the kidney function recover with dialysis? Ans:     Dialysis does not improve kidney function. It is a substitute for some of the kidney functions. In acute kidney injuries, dialysis may buy time and allow the kidneys to start functioning again. In Chronic kidney disease, unless there are some reversible elements, the kidney function will not only not recover but the residual function will also decrease with time. Do kidney donors lead a normal life? Can they do heav…

Stone Disease of the Kidneys

Stone Disease of the KidneysStone formation in the kidneys is a common disease. About 1 in 8 men and 1 in 20 women suffer from the symptomatic stone disease. Stone formation without symptoms is even more common. About ¾ of the stones contain calcium and 10% have uric acid. Rest are due to combinations and rare diseases. Calcium Stones These contain calcium oxalate or calcium phosphate. Former is more common. The risk factors for stone formation are In Urine  Low volume, High calcium in urine, High acid concentration and Low citrate levels. In Diet Water and fluid intake is low, fruits are seldom eaten, food has high oxalate level or if calcium content of the diet is on the lower side. Other diseases with high risk for stone formation are overweight, gout, diabetes, recurrent urinary tract infection etc. Bariatric surgery is a very significant risk factor. If kidneys have certain diseases like the inability to excrete acid, a stone formation may occur. Symptoms: Stones if they are on the …