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Part I Gastrointestinal Diseases-What it is and types of common structural GI diseases!

GERD, diarrhea and colorectal cancer are examples of gastrointestinal diseases. When examined, some diseases show nothing wrong with the GI tract, but there are still symptoms. Other diseases have symptoms, and there are also visible irregularities in the GI tract. Most gastrointestinal diseases can be prevented and/or treated.

What are gastrointestinal diseases?

Gastrointestinal diseases affect the gastrointestinal (GI) tract from the mouth to the anus. There are two types: functional and structural. Some examples include nausea/vomiting, food poisoning, lactose intolerance and diarrhea.

What are functional gastrointestinal diseases?

Functional diseases are those in which the GI tract looks normal when examined, but doesn’t move properly. They are the most common problems affecting the GI tract (including the colon and rectum). Constipation, irritable bowel syndrome (IBS), nausea, food poisoning, gas, bloating, GERD and diarrhea are common examples.

Many factors may upset your GI tract and its motility (ability to keep moving), including:

  • Eating a diet low in fiber.
  • Not getting enough exercise.
  • Traveling or other changes in routine.
  • Eating large amounts of dairy products.
  • Stress.
  • Resisting the urge to have a bowel movement, possibly because of hemorrhoids.
  • Overusing anti-diarrheal medications that, over time, weaken the bowel muscle movements called motility.
  • Taking antacid medicines containing calcium or aluminum.
  • Taking certain medicines (especially antidepressants, iron pills and strong pain medicines such as narcotics).
  • Pregnancy.

What are structural gastrointestinal diseases?

Structural gastrointestinal diseases are those where your bowel looks abnormal upon examination and also doesn’t work properly. Sometimes, the structural abnormality needs to be removed surgically. Common examples of structural GI diseases include strictures, stenosis, hemorrhoids, diverticular disease, colon polyps, colon cancer and inflammatory bowel disease.

Constipation

Constipation, which is a functional problem, makes it hard for you to have a bowel movement (or pass stools), the stools are infrequent (less than three times a week), or incomplete. Constipation is usually caused by inadequate “roughage” or fiber in your diet, or a disruption of your regular routine or diet.

Constipation causes you to strain during a bowel movement. It may cause small, hard stools and sometimes anal problems such as fissures and hemorrhoids. Constipation is rarely the sign that you have a more serious medical condition.

You can treat your constipation by:

  • Increasing the amount of fiber and water to your diet.
  • Exercising regularly and increasing the intensity of your exercises as tolerated.
  • Moving your bowels when you have the urge (resisting the urge causes constipation).

If these treatment methods don’t work, laxatives can be added. Note that you should make sure you are up to date with your colon cancer screening. Always follow the instructions on the laxative medicine, as well as the advice of your healthcare provider.

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (also called spastic colon, irritable colon, IBS, or nervous stomach) is a functional condition where your colon muscle contracts more or less often than “normal.” Certain foods, medicines and emotional stress are some factors that can trigger IBS.

Symptoms of IBS include:

  • Abdominal pain and cramps.
  • Excess gas.
  • Bloating.
  • Change in bowel habits such as harder, looser, or more urgent stools than normal.
  • Alternating constipation and diarrhea.

Treatment includes:

  • Avoiding excessive caffeine.
  • Increasing fiber in your diet.
  • Monitoring which foods trigger your IBS (and avoiding these foods).
  • Minimizing stress or learning different ways to cope with stress.
  • Taking medicines as prescribed by your healthcare provider.
  • Avoiding dehydration, and hydrating well throughout the day.
  • Getting high quality rest/sleep.

Hemorrhoids

Hemorrhoids are dilated veins in the anal canal, structural disease. They’re swollen blood vessels that line your anal opening. They are caused by chronic excess pressure from straining during a bowel movement, persistent diarrhea, or pregnancy. There are two types of hemorrhoids: internal and external.

Internal hemorrhoids

Internal hemorrhoids are blood vessels on the inside of your anal opening. When they fall down into the anus as a result of straining, they become irritated and start to bleed. Ultimately, internal hemorrhoids can fall down enough to prolapse (sink or stick) out of the anus.

Treatment includes:

  • Improving bowel habits (such as avoiding constipation, not straining during bowel movements and moving your bowels when you have the urge).
  • Your healthcare provider using ligating bands to eliminate the vessels.
  • Your healthcare provider removing them surgically. Surgery is needed only for a small number of people with very large, painful and persistent hemorrhoids.

External hemorrhoids

External hemorrhoids are veins that lie just under the skin on the outside of the anus. Sometimes, after straining, the external hemorrhoidal veins burst and a blood clots form under the skin. This very painful condition is called a “pile.”

Treatment includes removing the clot and vein under local anesthesia and/or removing the hemorrhoid itself.

Anal fissures

Anal fissures are also a structural disease. They are splits or cracks in the lining of your anal opening. The most common cause of an anal fissure is the passage of very hard or watery stools. The crack in the anal lining exposes the underlying muscles that control the passage of stool through the anus and out of the body. An anal fissure is one of the most painful problems because the exposed muscles become irritated from exposure to stool or air, and leads to intense burning pain, bleeding, or spasm after bowel movements.

Initial treatment for anal fissures includes pain medicine, dietary fiber to reduce the occurrence of large, bulky stools and sitz baths (sitting in a few inches of warm water). If these treatments don’t relieve your pain, surgery might be needed to repair the sphincter muscle.

Perianal abscesses

Perianal abscesses, also a structural disease, can occur when the tiny anal glands that open on the inside of your anus become blocked, and the bacteria always present in these glands causes an infection. When pus develops, an abscess forms. Treatment includes draining the abscess, usually under local anesthesia in the healthcare provider’s office.

Anal fistula

An anal fistula – again, a structural disease – often follows drainage of an abscess and is an abnormal tube-like passageway from the anal canal to a hole in the skin near the opening of your anus. Body wastes traveling through your anal canal are diverted through this tiny channel and out through the skin, causing itching and irritation. Fistulas also cause drainage, pain and bleeding. They rarely heal by themselves and usually need surgery to drain the abscess and “close off” the fistula.

Check out Part II tomorrow!

QUOTE FOR THURSDAY:

“What is the home Epley maneuver?

The home Epley maneuver is a type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV). You can do this exercise at home.

BPPV is caused by a problem in your inner ear. Your semicircular canals are found inside your ear. They detect motion and send this information to your brain. The utricle is a nearby part of the ear. It contains calcium crystals (canaliths) that help it detect movement.

Sometimes these crystals detach from the utricle and end up inside the semicircular canals. When these crystals move inside the canals, they may send incorrect signals to your brain about your position. This can make you feel like the world is spinning. This is called vertigo.

Dr. John Epley designed a series of movements to dislodge the crystals from the semicircular canals. These movements bring the crystals back to the utricle, where they belong. This treats the symptoms of vertigo.

The original Epley maneuver was designed to be done with a healthcare provider. The home Epley maneuver is similar. These are a series of movements that you can do without help, in your own home.”

John Hopkins Medicine (Home Epley Maneuver | Johns Hopkins Medicine)

Part 3 Benign Posterior Paroxsymal Vertigo – Surgeries for it and hospital with high ratings in this area.

 

Surgical Procedures for Vestibular Dysfunction When is surgery necessary? 

When medical treatment isn’t effective in controlling vertigo and other symptoms caused by vestibular system dysfunction, surgery may be considered. The type of surgery performed depends upon each individual’s diagnosis and physical condition. Surgical procedures for peripheral vestibular disorders are either corrective or destructive. The goal of corrective surgery is to repair or stabilize inner ear function. The goal of destructive surgery is to stop the production of sensory information or prevent its transmission from the inner ear to the brain.  The types of surgeries used if non-invasive treatments are not successful are possibly: 

Labyrinthectomy:

A labyrinthectomy is a destructive procedure used for Ménière’s disease. The balance end organs are removed so that the brain no longer receives signals from the parts of the inner ear that sense gravity and motion changes. The hearing organ (cochlea) is also sacrificed with this procedure.

Vestibular nerve section:

A vestibular nerve section is a destructive procedure used for Ménière’s disease. The vestibular branch of the vestibulo-cochlear nerve is cut in one ear to stop the flow of balance information from that ear to the brain. The brain can then compensate for the loss by using only the opposite ear to maintain balance.

Chemical labyrinthectomy:

A chemical labyrinthectomy is also known as transtympanic or intratympanic treatment or gentamicin infusion. This is a destructive procedure used for Ménière’s disease. An antibiotic called gentamicin is introduced into the middle ear and absorbed via the round window. The drug destroys the vestibular hair cells so that they cannot send signals to the brain.

Endolymphatic sac decompression:

Endolymphatic sac decompression is a stabilizing procedure sometimes used for Ménière’s disease or secondary endolymphatic hydrops to relieve endolymphatic pressure in the cochlea and vestibular system. A variety of techniques exist. One method involves allowing the sac to decompress by removing the mastoid bone surrounding it. Other methods involve inserting a shunt (a tube or strip) into the endolymphatic sac so that, theoretically, excess fluid can drain out into the mastoid cavity or other location. The effectiveness of decompression techniques in controlling vertigo remains in doubt.

Oval or round window plugging:

If the exercises described above are ineffective in controlling symptoms, symptoms have persisted for a year or longer,  and the diagnosis is very clear, a surgical procedure called “posterior canal plugging” may be recommended. Canal plugging blocks most of the posterior canal’s function without affecting the functions of the other canals or parts of the ear. This procedure poses a substantial risk to hearing — ranging from 3-20%, but is effective in about 85-90% of individuals who have had no response to any other treatment (Shaia et al, 2006; Ahmed et al, 2012). The risk of the surgery to hearing derives from inadvertent breaking into the endolymphatic compartment while attempting to open the bony labyrinth with a drill. Sensibly, canal plugging for BPPV (note the first letter stands for “benign”) is rarely undertaken these days due to the risk to hearing.

Alternatives to plugging:

Singular nerve section is the main alternative. Dr Gacek (Syracuse, New York) has written extensively about singular nerve section (Gacek et al, 1995). Interestingly, Dr. Gacek is the only surgeon who has published any results with this procedure post 1993 (Leveque et al, 2007). Singular nerve section is very difficult because it can be hard to find the nerve.

Dr. Anthony (Houston, Texas), advocates laser assisted posterior canal plugging.  It seems to us that these procedures, which require unusual amounts of surgical skill, have little advantage over a conventional canal plugging procedure.  Oval or round window plugging is a stabilizing procedure sometimes used for repair of perilymph fistulas. Openings in the oval and/or round windows are patched with tissue taken from the external ear or from behind the ear so that perilymph fluid does not leak through the fistulas.

 Pneumatic equalization (PE) tubes:

Pneumatic equalization (PE) is a stabilizing procedure sometimes used for treating perilymph fistulas. A tube is inserted through the tympanic membrane (eardrum) with one end in the ear canal and the other in the middle ear, to equalize the air pressure on the two sides of the eardrum.

Canal partitioning (canal plugging):

Canal partitioning is a stabilizing procedure sometimes used for treating BPPV or superior semicircular canal dehiscence. The problematic semicircular canal is partitioned or plugged with small bone chips and human fibrinogen glue to stop the movement of endolymph and foreign particles within the canal so that it no longer sends false signals to the brain.

Microvascular decompression:

Microvascular decompression is performed to relieve abnormal pressure of the vascular loop (blood vessel) on the vestibulo-cochlear nerve.

Stapedectomy:

Stapedectomy is a stabilizing procedure sometimes used for otosclerosis. It is accomplished by replacing the stapes bone with a prosthesis.

Acoustic neuroma (vestibular schwannoma): 

This procedure involves the removal of a noncancerous tumor that grows from the tissue of the vestibular branch of the vestibulo-cochlear nerve.

Cholesteatoma removal:

This procedure involves the removal of a skin growth that starts in the middle ear and that can secrete enzymes that destroy bone and surrounding structures.

Ultrasound surgery:

Ultrasound is applied to the ear to destroy the balance end organs so that the brain no longer receives signals from the parts of the ear that sense gravity and motion changes. Cochlear dialysis Cochlear dialysis is a stabilizing procedure sometimes used to promote movement of excess fluid out of the inner ear by filling the scala tympani with a chemical solution.

Thanks to NYU Medical Hospital in Manhattan, NY you can Click here to download the “Surgery for Peripheral Vestibular Disorders” publication. – See more at: http://vestibular.org/understanding-vestibular-disorders/treatment/vestibular-surgery#sthash.GDeNWxjl.dpuf.

If you have this problem and need a great hospital than let us look at the ranking of hospitals:

Of all 180 hospitals in the New York, New York metropolitan area, the 53 listed below are the top-ranking. This metro area, also called NYC, includes Long Island, Westchester County, and northern New Jersey. I know if I had a problem that I could not get rid of immediately with a antibiotic simple cure I would next want to go to the best if my county’s hospital couldn’t remove the problem completely. So here through “US News and World Report” via the internet they show the following information on the best hospitals in NYC and Northern NJ: (Look below or to the next page)

These are their rankings on Columbia Presbyterian and NYU, NATIONALLY, in the following categories:

Starting with the best is Columbia Presbyterian in NY, for those in NY, as your #1 choice:

Adult Specialties

This hospital was among 144 facilities—roughly 3 percent of the 4,743 analyzed for the latest Best Hospitals rankings—to be ranked in even one of the 16 specialties 2024.

COLUMBIA PRESBYTERIAN RATINGS:

Nationally Ranked
High-Performing

 

NYU HOSPITAL RATINGS:

Gynecology

Rank in This Specialty #NA
Overall Score in This Specialty 66.8 / 100

For further checking of hospitals go to http://health.usnews.com/best-hospitals/area/ny/new-york-presbyterian-university-hospital-of-columbia-and-cornell-6210024 since hospitals do change yearly in their scores and this is the most recent.

QUOTE FOR WEDNESDAY:

“Benign paroxysmal positional vertigo (BPPV) is a common inner ear disorder. BPPV isn’t a sign of a serious problem, and it usually disappears on its own within a few days of the first episode. (It could take several weeks for some people.) However, the symptoms of BPPV can be very frightening and may be dangerous, especially in adults over the age of 65. The unsteadiness of BPPV can lead to falls, which are a leading cause of fractures.

Benign paroxysmal positional vertigo is the most common inner ear disorder. In fact, approximately 20% of people who are evaluated for dizziness are diagnosed with BPPV.  BPPV usually goes away on its own. However, until it’s successfully treated, it can come back. In some cases, months — or even years — go by before another episode occurs.  BPPV is almost always triggered by a change in your head’s position. Some people may notice symptoms when lying down or sitting up in bed. Others might notice symptoms when they tilt their head back or to the side. These symptoms often worsen with age due to normal wear and tear of the inner ear structures.”

Cleveland Clinic (Benign Paroxysmal Positional Vertigo (BPPV): Treatment, Symptoms & Causes)

 

Part 2 BPPV-Benign Paroxsymal Posterior Vertigo: Causes, Complications , Know what to expect to ask your doctor on the intial visit for Vertigo and Treatment that is non-evasive (not surgery).

Know The ear’s role with BPPV

Inside your ear is a tiny organ called the vestibular labyrinth. It includes three loop-shaped structures (semicircular canals) that contain fluid and fine, hair-like sensors that monitor the rotation of your head.

Other structures (otolith organs) in your ear monitor movements of your head — up and down, right and left, back and forth — and your head’s position related to gravity. These otolith organs — the utricle and saccule — contain crystals that make you sensitive to gravity.

For a variety of reasons, these crystals can become dislodged. When they become dislodged, they can move into one of the semicircular canals — especially while you’re lying down. This causes the semicircular canal to become sensitive to head position changes it would normally not respond to. As a result, you feel dizzy. Depending what section of the semicircular canal the problem is in will be a factor with the actual result on the crystals or rocks flowing freely or become stuck together causing a blockage in one of the canals. The other factor that determines this is the etiology for it occuring (ex. Dehydration or blow to the head).

Causes of BPPV;

Timothy C. Hain MD of dizziness and balance.com states The most common cause of BPPV in people under age 50 is head injury . The head injury need not be that direct – -even whiplash injuries have a substantial incidence of BPPV (Dispenza et al, 2011). There is also a strong association with migraine (Ishiyama et al, 2000). BPPV becomes much more common with advancing age (Froeling et al, 1991) and in older people, the most common cause is degeneration of the vestibular system of the inner ear. Viruses affecting the ear such as those causing vestibular neuritis and Meniere’s disease are significant causes(Batatsouras et al, 2012).

Occasionally BPPV follows surgery, including dental work, where the cause is felt to be a combination of a prolonged period of supine positioning, or ear trauma when the surgery is to the inner ear (Atacan et al 2001). While gentamicin toxicity is rarely encountered, BPPV is common in persons who have been treated with ototoxic medications such as gentamicin (Black et al, 2004). In half of all cases, BPPV is called “idiopathic,” which means it occurs for no known reason. Other causes of positional symptoms are discussed here.

Web MD points out tiny calcium “stones” inside your inner ear canals help you keep your balance. Normally when you move a certain way, such as when you stand up or turn your head, these stones move around. But things like infection or inflammation can stop the stones from moving as they should. This unfortunately sends a false message to your brain and causes the vertigo. About half the time, doctors can’t find a specific cause for BPPV.

When a cause can be determined, BPPV is often associated with a minor to severe blow to your head. Less common causes of BPPV include disorders that damage your inner ear or, rarely, damage that occurs during ear surgery or during prolonged positioning on your back. BPPV also has been associated with migraines. In many cases the doctors can’t figure out the cause.

Complications of BPPV:

Benign paroxysmal positional vertigo occurs most often in people age 60 and older, but can occur at any age. Aside from aging, there are no definite factors that may increase your risk of benign paroxysmal positional vertigo. However, a head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Although benign paroxysmal positional vertigo (BPPV) is uncomfortable, it rarely causes complications. In rare cases, if severe, persistent BPPV causes you to vomit frequently, you may be at risk of dehydration. The dizziness of BPPV can put you at greater risk of falling. It is more of a headache in going through the time to resolve the vertigo possibly affecting people in doing their regular activities of living for a week to several weeks. For some it never comes back but for many it does after several months depending on what the cause is.

TREATMENT

In all cases the doctor first has the patient (pt.) in their office and either through them or through physical therapy ordered by the M.D. after evaluating the pt with diagnosing the pt. with BPPV in treating the pt. using exercises which help in high percentages resolving the vertigo but continuing them when the vertigo is gone will do very little help unfortunately including it commonly comes back several weeks to months later and the exercises help more than. These exercises used are:

OFFICE TREATMENT OF BPPV are :

The Epley and Semont Maneuvers

There are two treatments of BPPV that are usually performed in the doctor’s office. Both treatments are very effective, with roughly an 80% cure rate, ( Herdman et al, 1993; Helminski et al, 2010). If your doctor is unfamiliar with these treatments, you can find a list of clinicians who have indicated that they are familiar with the maneuver from the Vestibular Disorders Association (VEDA) .

The maneuvers, named after their inventors, are both intended to move debris or “ear rocks” out of the sensitive part of the ear (posterior canal) to a less sensitive location. Each maneuver takes about 15 minutes to complete. The Semont maneuver (also called the “liberatory” maneuver) involves a procedure whereby the patient is rapidly moved from lying on one side to lying on the other (Levrat et al, 2003). It is a brisk maneuver that is not currently favored in the United States, but it is 90% effective after 4 treatment sessions. In our opinion, it is equivalent to the Epley maneuver as the head orientation with respect to gravity is very similar, omitting only ‘C’ from the figure to the right.

The Epley maneuver is also called the particle repositioning or canalith repositioning procedure. It was invented by Dr. John Epley, and is illustrated in figure 2. Click here for a low bandwidth animation. It involves sequential movement of the head into four positions, staying in each position for roughly 30 seconds. The recurrence rate for BPPV after these maneuvers is about 30 percent at one year, and in some instances a second treatment may be necessary.

When performing the Epley maneuver, caution is advised should neurological symptoms (for example, weakness, numbness, visual changes other than vertigo) occur. Occasionally such symptoms are caused by compression of the vertebral arteries (Sakaguchi et al, 2003), and if one persists for a long time, a stroke could occur. If the exercises are being performed without medical supervision, we advise stopping the exercises and consulting a physician. If the exercises are being supervised, given that the diagnosis of BPPV is well established, in most cases we modify the maneuver so that the positions are attained with body movements rather than head movements.

After either of these maneuvers, you should be prepared to follow the instructions of your doctor or physical therapist who should give you written instructions on them to take home with you, which are aimed at reducing the chance that debris might fall back into the sensitive back part of the ear. Not always the case.

What to expect from your doctor on your visit with vertigo:

A doctor who sees you for symptoms common to BPPV may ask a number of questions, such as:

  • What are your symptoms, and when did you first notice them?
  • Do your symptoms come and go? How often?
  • How long do your symptoms last?
  • Is one or both of your ears affected?
  • Does anything in particular seem to trigger your symptoms, such as certain types of movement or activity?
  • Do your symptoms include vision problems?
  • Do your symptoms include nausea or vomiting?
  • Do your symptoms include headache?
  • Have you lost any hearing?
  • Have you had any weakness, numbness or tingling in your arms or your legs?
  • Have you had any difficulty talking or walking?
  • Have you had chest pain?
  • Are you being treated for any other medical conditions?
  • What medications are you currently taking, including over-the-counter and prescription drugs as well as vitamins and supplements?

 

QUOTE FOR TUESDAY:

“Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you’re spinning or that the inside of your head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in your head’s position. This might occur when you tip your head up or down, when you lie down, or when you turn over or sit up in bed.

Although BPPV can be bothersome, it’s rarely serious except when it increases the chance of falls. You can receive effective treatment for BPPV depending on the intensity!”

MAYO CLINIC (Benign paroxysmal positional vertigo (BPPV) – Symptoms and causes – Mayo Clinic)

Part 1 BPPV – Benign Paroxysmal Positional Vertigo. What it is and its symptoms.

If one day you start the day going to work than come home feeling like a sinus infection that appears to be spreading to the ears and after going to bed several hours upon wakening I sat up on my bed finding yourself pulling to one side that you think the cause is an ear infection but it could be something else.  When I was getting up and feeling dizzy but made it downstairs to eat a meal but due to the dizziness I vomited causing dizziness to increase terribly (like if sea sick or even like too much alcohol followed with vomiting and now everything’s spinning to the point you can’t get up from the ground) and got my self safely to the ground and couldn’t get up.   This all happened to me one year and when going to the MD that night I was sent to the ER for being ruled out initially of a stroke or transient ischemic attack.  I was aggravated and went.  I than was finding out in the ERmit wasn’t a stroke or TIA, which is what I thought would be the result, but their still was a reason for it.  What might this be?  I was diagnosed with BPPV for severe dehydration and it took me a week through exercises and taking meclizine, also known as antivert, that took my dizziness away.

This could be an ear infection with BPPV or just BPPV itself; this abbreviation stands for BPPV-Benign Paroxsymal Posterior Vertigo (highly probable if its feeling clogged, no draining from the ear canal, no wax build up after checked with an otoscope by an ENT or Neurologist and the symptoms listed above present that I mentioned= Vertigo, Nausea; Possibly vision disturbance with lethargy) including a nystagmus (described below). This is how you feel after a concussion (with or without a nystagmus) in varying intensities depending on the impact after a blow to the head. How do these symptoms arise with no infection in the ear?

This involves the inner ear causing the brain to pick up miscommunication signals in detecting or reading what is happening going on giving the ending result of vertigo =dizziness, causing your balance to be off, which again I reenforce is due to the condition that is going on in the middle ear. It is the sensitivity detection by ear sensitivity hairs picking up what shouldn’t be there, which in turn is causing the symptoms. This can be due to inner ear particles clumped together in the ear or particles in the inner ear floating freely depending where the are located in the inner ear. We will discuss this more in detail shortly, just know these particles are called “rocks”.

If your having these symptoms this should be checked for BPPV and (I do recommend you go to MD to be evaluated first):

Benign paroxysmal positional vertigo (BPPV) is probably the most common cause of vertigo in the United States. It has been estimated that at least 20% of patients who present to the physician with vertigo have BPPV. However, because BPPV is frequently misdiagnosed, this figure may not be completely accurate and is probably an underestimation. Since BPPV can occur concomitantly with other inner ear diseases (for example, one patient may have both Ménière disease and BPPV at once), statistical analysis may be skewed toward lower numbers.

BPPV was first described by Barany in 1921. The characteristic nystagmus and vertigo associated with positioning changes were attributed at that time to the otolithic organs. In 1952, Dix and Hallpike performed the provocative positional testing named in their honor, shown below. They further defined classic nystagmus and went on to localize the pathology to the proper ear during provocation.

It deals with the inner ear.

The patient is placed in a sitting position with the head turned 45° towards the affected side and then reclined past the supine position.

BPPV is defined as an abnormal sensation of motion that is elicited by certain critical provocative positions. The provocative positions usually trigger specific eye movements (ie, nystagmus). The character and direction of the nystagmus are specific to the part of the inner ear affected and the pathophysiology.

BPPV is a complex disorder to define; because an evolution has occurred in the understanding of its pathophysiology, an evolution has also occurred in its definition. As more interest is focused on BPPV, new variations of positional vertigo have been discovered. What was previously grouped as BPPV is now subclassified by the offending semicircular canal (SCC; ie, posterior superior SCC vs lateral SCC) and, although controversial, further divided into canalithiasis and cupulolithiasis (depending on its pathophysiology).

Although some controversy exists regarding the 2 pathophysiologic mechanisms, canalithiasis and cupulolithiasis, agreement is growing that the entities actually coexist and account for different subspecies of BPPV. Canalithiasis (literally, “canal rocks”) is defined as the condition of particles residing in the canal portion of the SCCs (in contradistinction to the ampullary portion). These densities are considered to be free floating and mobile, causing vertigo by exerting a force. Conversely, cupulolithiasis (literally, “cupula rocks”) refers to densities adhered to the cupula of the crista ampullaris. Cupulolith particles reside in the ampulla of the SCCs and are not free floating.

Classic BPPV is the most common variety of BPPV. It involves the posterior SCC and is characterized by the following symptoms:

  • Geotropic nystagmus with the problem ear down
  • Predominantly rotatory fast phase toward undermost ear
  • Latency (a few seconds)
  • Limited duration (< 20 s)
  • Reversal upon return to upright position
  • Response decline upon repetitive provocation. The purpose for this appears to be the brain acquires a response in getting used to this vertigo as normal by picking up wrong messages from that affected ear due to improper messaging by the pick up of how the rocks in the inner ear canal are situated (free floating or residing in a canal portion with how the ear hairs are picking up by sensitivity their presence giving wrong messages to the brain causing vertigo, nystagmus, with or without vomiting.
  • Because the type of BPPV is defined by the distinguishing type of nystagmus, defining and explaining the characterizing nystagmus are also important.
  • Nystagmus is defined as involuntary eye movements usually triggered by inner ear stimulation. It usually begins as a slow pursuit movement followed by a fast, rapid resetting phase. Nystagmus is named by the direction of the fast phase. Thus, nystagmus may be termed right beating, left beating, up-beating (collectively horizontal), down-beating (vertical), or direction changing.
  • If the movements are not purely horizontal or vertical, the nystagmus may be deemed rotational. In rotational nystagmus, the terminology becomes a bit more loose or unconventional. Terms such as clockwise and counterclockwise seem useful until discrepancies regarding point of view arise: clockwise to the patient is counterclockwise to the observer. Right versus left terminology is poorly descriptive because as the top half of the eye rotates right, the bottom half moves left.
  • Rotational nystagmus also can be described as geotropic and ageotropic. Geotropic means “toward earth” and refers to the upper half of the eye. Ageotropic refers to the opposite movement. If the head is turned to the right, and the eye rotation is clockwise from the patient’s point of view (top half turns to the right and toward the ground), then the nystagmus is geotropic. If the head is turned toward the left, then geotropic nystagmus is a counterclockwise rotation. This term is particularly useful in describing BPPV nystagmus because the word geotropic remains appropriate whether the right or the left side is involved.
  • These 2 terms are useful only when the head is turned. If the patient is supine and looking straight up, these terms cannot be used. Fortunately, the nystagmus associated with BPPV usually is provoked with the head turned to one side. The most accurate way to define nystagmus is by terming it clockwise or counterclockwise from the patient’s point of view.

The tympanic membrane where no doctor can open that and further the problem is in your semi-circular canal and if not resolving the problem it will damage the ear.

QUOTE FOR MONDAY:

“Many people enjoy living and working in cultivated greenspaces, and most like having beautiful plants around. But is there more to it? Here are seven benefits science says indoor plants may provide.

1. Indoor plants may help reduce stress levels

A studyTrusted Source published in the Journal of Physiological Anthropology found that plants in your home or office can make you feel more comfortable, soothed, and natural.

In the study, participants were given two different tasks: repotting a houseplant or completing a short computer-based task. After each task, researchers measured the biological factors associated with stress, including heart rate and blood pressure.

They found that the indoor gardening task lowered the stress response in participants. The computer task, on the other hand, caused a spike in heart rate and blood pressure, even though the study participants were young men well-accustomed to computerized work.

Researchers concluded that working with plants could reduce both physiological and psychological stress.

2. Real plants may sharpen your attention

Sorry, plastic plants won’t help you pass your exams. In a small study involving 23 participants, researchers put students in a classroom with either a fake plant, a real one, a photograph of a plant, or no plant at all.

Brain scans of the participants showed that the students who studied with real, live plants in the classroom were more attentive and better able to concentrate than students in the other groups.

3. Working with plants can be therapeutic

For people experiencing the symptoms of mental illness, indoor gardening can be helpful.

ResearchersTrusted Source have used horticultural therapy to increase feelings of well-being among people with depression, anxiety, dementia, and other conditions.

Although horticultural therapy has been around for centuries, it has found a modern expression: Medical clinics in Manchester, England are now “prescribing” potted plants to patients with depression or anxiety symptoms.

4. Plants may help you recover from illness faster

Being able to look at plants and flowers may speed your recovery from an illness, injury, or surgery.

A 2002 review of the research revealed that people recuperating from several kinds of surgery needed less pain medication and had shorter hospital stays than people who weren’t looking at greenery during their recovery periods.

It’s important to note that most research focuses on plants and natural scenery in hospital settings rather than at home.

5. Plants may boost your productivity

A bromeliad may turn out to be the best cubicle-mate you’ve ever had.

Multiple studies have found that plants in the workspace increase both productivity and creativity. One frequently cited study from 1996 found that students in a campus computer lab worked 12 percent faster and were less stressed when plants were placed nearby.

In a 2004 studyTrusted Source, researchers challenged people to make creative word associations. They performed better when a plant was in the room with them.

And a 2007 study showed that people with more plants in their workspace took fewer sick days and were more productive on the job.

6. Plants may improve your whole outlook on work

A view of the city park might improve anyone’s job satisfaction — but it might surprise you to learn that a potted plant could have a similar effect.

ResearchersTrusted Source interviewed over 440 Amazon employees in India and the United States. They found that those whose office environment included natural elements like indoor plants felt greater job satisfaction and more commitment to the organization than those who didn’t work around natural elements.

Researchers said the natural elements helped to buffer the effects of job stress and anxiety.

7. Plants may improve the quality of indoor air

Scientific support for phytoremediation — that’s the word for plants scrubbing contaminants from the air — usually begins with a NASA study conducted in the 1980s.

Researchers then were looking for ways to improve the air quality in a sealed spacecraft, and they concluded that the roots and soil of houseplants reduced airborne volatile organic compounds (VOCs) significantly.

Since those early studies, researchers have both confirmed those findings and called them into questionTrusted Source.

Recent findings suggest that you’d have to shelter a large number of plants to equal the air purifying efficiency of modern biofilters and other technologies.

If you do decide to purchase houseplants to freshen the air naturally, these are several of the species shownTrusted Source to be most effective:

  • areca, lady, dwarf date, and bamboo palms
  • Boston fern
  • rubber tree
  • spider plant
  • Ficus tree”

Healthline (7 Science-Backed Benefits of Indoor Plants)

Part II Learn types of Plants & how they can enhance our lives both physically and mentally!

plants enhance our lives (Arab.Thaliana) Part II  plants can enhance our lives (Arab.Thaliana Part II)

Part II

Look at medical proof, going back as far July 2011 by online publication of Nature, investigated why Arabidopsis does its major stem-growing in the dark—a pattern common to most plants. Biologist Steve Kay and colleagues at the University of California, San Diego, report that a specific trio of proteins regulates the rhythm in Arabidopsis stems. Arabidopsis thaliana helped scientists not very long ago too unearth new clues about the daily cycles of many organisms, including humans. This is the latest in a long line of research, much of it supported by the National Institutes of Health, that uses plants to solve puzzles in human health. While other model organisms may seem to have more in common with us, greens like Arabidopsis provide an important view into genetics, cell division and especially light sensing, which drives 24-hour behavioral cycles called circadian rhythms.

Some human cells, including cancer cells, divide with a 24-hour rhythm. One of the main human circadian rhythm genes, cryptochrome, has been associated with diabetes and depression. Both of these discoveries grew from work with plants.

  plants enhance our lives.png1 (Arabidopsis Thaliana) Part II                                                                                                                                         The Arabidopsis Thaliana Plant

Arabidopsis (rockcress) is a genus in the family Brassicaceae. They are small flowering plants related to cabbage and mustard, and can be used similarly to other mustard greens, in salads or sautéed, but its use as an edible spring green is not widely noted. Arabidopsis thaliana is a small dicotyledonous species being a member of the Brassicaceae or mustard family. Although closely related to such economically important crop plants as turnip, cabbage, broccoli, and canola, Arabidopsis is not an economically important plant. Despite this, it has been the focus of intense genetic, biochemical and physiological study for over 40 years because of several traits that make it very desirable for laboratory study. As a photosynthetic organism, Arabidopsis requires only light, air, water and a few minerals to complete its life cycle. It has a fast life cycle, produces numerous self progeny, has very limited space requirements, and is easily grown in a greenhouse or indoor growth chamber. It possesses a relatively small, genetically tractable genome that can be manipulated through genetic engineering more easily and rapidly than any other plant genome.

T group of proteins, called the evening complex, interacts in the early evening to silence two genes that usually promote plant growth. When the evening complex’s activity trails off a few hours before dawn, proteins release the brakes on growth and plants enter their nightly phase of rapid stem elongation.

The plant has been mutated in the three genes that code for the evening complex, they noticed that this made the Arabidopsis biological clock run out of sync—stems grew unusually long and flowered early.

Scientists aren’t yet certain why night is the best time for stems to grow, it has to do with using resources efficiently. Plants pick up carbon and nitrogen during the day, then store these essential nutrients as starch and proteins. In the later night, they can release these resources in a coordinated fashion to provide the building blocks for stem growth it has been said.

Our understanding of human health and the role of clocks in health and disease can greatly benefit from studying how clocks work in plants.

Scientists are interested in answering basic biological questions, but others who work with plants have their eyes on future disease therapies. Plant-based molecules, for instance, are being used to target reservoirs of HIV that hide out in their hosts. At the University of California, Berkeley, chemist Jay Keasling has been looking over the years for simple ways to get microbes to produce greater quantities of these plant-based molecules at lower cost.

How plants like Arabidopsis suppress harmful genes may also help improve HIV therapies. A team of biologists that had been led by Craig Pikaard at Washington University in St. Louis is investigating RNA polymerases, chemicals important in determining which genes get switched on, to learn how plants silence harmful virus-derived genes. Similar silencing pathways could be harnessed for HIV therapies.

More generally, scientists are looking toward plants as a medicinal source. Chemist Sarah O’Connor at MIT has genetically engineered periwinkle plants, the natural source of the anticancer drug vinblastine, to produce variations of the drug with halogens attached. Halogens make some medicines last longer in the body, meaning that probing periwinkle’s capabilities could make cancer treatments more effective.

Plant compounds present in carrots and parsley may one day support more effective delivery of chemotherapy treatments, new research has found. Specific plant compounds are able to inhibit transport mechanisms in the body that select what compounds are absorbed into the body, and eventually into cells. These same transport mechanisms are known to interfere with cancer chemotherapy treatment.

Some further examples of good compounds coming from plants for human lives are:

Flavonoids are one class of secondary plant metabolites that are also known as Vitamin P or citrin. These metabolites are mostly used in plants to produce yellow and other pigments which play a big role in coloring the plants. In addition, Flavonoids are readily ingested by humans and they seem to display important anti-inflammatory, anti-allergic and anti-cancer activities. Flavonoids are also found to be powerful anti-oxidants and researchers are looking into their ability to prevent cancer and cardiovascular diseases. Flavonoids help prevent cancer by inducing certain mechanisms that may help to kill cancer cells, and researches believe that when the body processes extra flavonoid compounds, it triggers specific enzymes that fight carcinogens. Good dietary sources of Flavonoids are all citrus fruits, which contain the specific flavanoids hesperidins, quercitrin, rutin, berries, tea, dark chocolate and red wine that includes many of the health benefits attributed to these foods come from the Flavonoids they contain.

Phytic acid is the main method of phosphorus storage in plant seeds, but is not readily absorbed by many animals (only absorbed by ruminant animals). Not only is phytic acid a phosphorus storage unit, but it also is a source of energy and cations, a natural antioxidant for plants, and can be a source of mycoinositol which is one of the preliminary pieces for cell walls.

Phytic acid is also known to bond with many different minerals, and by doing so prevents those minerals from being absorbed; making phytic acid an anti-nutrient. There is a lot of concern with phytic acids in nuts and seeds because of its anti-nutrient characteristics. In preparing foods with high phytic acid concentrations, it is recommended they be soaked in after being ground to increase the surface area. Soaking allows the seed to undergo germination which increases the availability of vitamins and nutrient, while reducing phytic acid and protease inhibitors ultimately increasing the nutritional value. Cooking can also reduce the amount of phytic acid in food but soaking is much more effective.

Phytic acid is an antioxidant found in plant cells that most likely serves the purpose of preservation. This preservation is removed when soaked, reducing the phytic acid and allowing the germination and growth of the seed.

Atropine is a type of secondary metabolite called a tropane alkaloid.

Alkaloids contain nitrogens, frequently in a ring structure, and are derived from amino acids. Tropane is an organic compound containing nitrogen and it is from tropane that atropine is derived from. Atropine is synthesized by a reaction between tropine and tropate, catalyzed by atropinase. Within Atropa belladonna atropine synthesis has been found to take place primarily in the root of the plant. The concentration of synthetic sites within the plant is indicative of the nature of secondary metabolites.

Gossypol has a yellow pigment and is found in cotton plants. It occurs mainly in the root and/or seeds of different species of cotton plants.  Gossypol can have various chemical structures. It can exist in three forms: gossypol, gossypol acetic acid, and gossypol formic acid. All of these forms have very similar biological properties. Gossypol is a type of aldehyde, meaning that it has a formyl group. The formation of gossypol occurs through an isoprenoid pathway. Isoprenoid pathways are common among secondary metabolites.  3Gossypol’s main function in the cotton plant is to act as an enzyme inhibitor. An example of gossypol’s enzyme inhibition is its ability to inhibit nicotinamide adenine dinucleotide-linked enzymes of Trypanosoma cruzi. Trypanosoma cruzi is a parasite which causes Chaga’s disease.

For some time it was believed that gossypol was merely a waste product produced during the processing of cottonseed products. Extensive studies have shown that gossypol has other functions. Many of the more popular studies on gossypol discuss how it can act as a male contraceptive. Gossypol has also been linked to causing hypokalemic paralysis. Hypokalemic paralysis is a disease characterized by muscle weakness or paralysis with a matching fall in potassium levels in the blood. Hypokalemic paralysis associated with gossypol in-take usually occurs in March, when vegetables are in short supply, and in September, when people are sweating a lot. This side effect of gossypol in-take is very rare however. Gossypol induced hypokalemic paralysis is easily treatable with potassium repletion.

Believe or not, plants enhanced our lives.

QUOTE FOR THE WEEKEND:

“Specifically, the researchers found that people who surround themselves with plant life and other forms of natural beauty, indoors and out, experience emotional and mental health benefits that have a positive impact on their social, psychological, physical, cognitive, environmental, and spiritual well-being, These benefits include:

1. Stress reduction. Spending time in natural settings helps speed up recovery from mental fatigue, slow down heart rate, reduce high blood pressure, and lower anxiety.

2. Reduced symptoms of depression. Researchers repeatedly report increases in subjects’ mood, fewer incidents of depressive symptoms, as well as increased memory span and decreased symptoms of anxiety after a walk in nature, as compared to a walk through an urban environment. One Korean study of patients diagnosed with moderate to severe depression compared the effects of cognitive-behavioral therapy (CBT) performed in a hospital to CBT performed in an arboretum with a forest-like setting. Symptoms of depression were most significantly reduced in the arboretum group, who also experienced 20% to 30% higher rates of complete remission when compared to a typically medicated group.

3. Stronger memory retention. Compared to those who walked through a well-trafficked urban area, participants in several studies who walked through a green space or a natural environment, such as an arboretum, were better able to focus and concentrate on a test of their working memory.

4. Fewer symptoms of post-traumatic stress. Studies of both veterans and victims of natural disasters who participated in horticultural therapies or nature-based rehabilitation programs found that both groups were better able to control symptoms of PTSD and developed more positive states of mind.

5. Improved symptoms of attention-deficient disorders (ADD/ADHD). In one study, school children diagnosed with ADHD were better able to concentrate after a walk in a park than their peers who went for a walk in a downtown neighborhood. Similar studies found that even short nature breaks are restorative and can improve attention span, working memory and cognitive functioning in children with ADD/ADHD.”

Psychology Today (11 Ways Plants Enhance Your Mental and Emotional Health | Psychology Today)