Chloride (CSF) Tips

Salt is one of the essential ingredients in cooking. In its absence, food items do not taste good. The importance of salt can only be felt, when it is not present in any item. Different types of salts are sea salt, rock salt, black salt, etc. Not only do they all differ in taste and texture, there are also differences in mineral and sodium content.

Let us take a look at the benefits and side-effects of all the above-mentioned salts:

Regular Table Salt: Table salt is the one people have on regular basis and use to prepare dishes for taste. Production of table salt involves mining and use of vacuum pan evaporators required for extraction at very high temperature.

Benefits: Benefits of table salt come from its two major elements, sodium and chloride.

• Sodium: It plays a major role in maintaining the delicate balance of fluids and substances in and outside of cells. Hence, this mineral is fundamental to keep the bodies hydrated and helps in proper functioning of the nervous system.
• Chloride: Chloride and sodium along with other minerals like potassium, calcium and magnesium help to keep the physiological activities in check, by keeping them in right amounts.

Side-Effects:

• Overload of table salt can hamper the kidneys and interrupt in the functioning.
• Too much intake of table salt would lead to increase in blood pressure.
• Consuming too little salt can also result in electrolyte imbalance.

2. Sea Salt: Sea Salt is produced from sea water. Sea water is sun-dried and canalized in nature.

Benefits:

• Sea Salt helps to avoid dehydration
• Helps to get rid of rheumatoid arthritis
• Helps in the proper functioning of brain, nervous system and muscles

The only side-effect is that people who suffer from high blood pressure should avoid taking sea salt.

3. Black Salt: Black Salt, a kind of rock salt, which is salty and pungent in smell. It is mainly composed of sodium chloride along with various other components, which give the colour and smell to the salt.

Benefits:

• Helps in curing the problem of constipation and bloating
• Consuming black salt assists in treating joint problems
• Helps to lose weight
• Cures respiratory problems and heartburn

Side-Effects:

• Consuming large doses of black salt can lower down the digestive system
• Problem of hypertension may arise

4. Rock Salt or sendha namak: Rock salt is the purest form of salt - unprocessed and raw, devoid of environmental pollutants and chemical components. It contains 84 out of the 92 trace elements required by the body including potassium, iron, calcium, zinc, magnesium, copper and so on.

Benefits:

• It helps in balancing blood sugar
• Improves digestion
• Boosts metabolism
• Builds immunity
• Leads to increase in energy
• Provides pH balance
• Promotes sound sleep

Side-Effects:

• Makes a person lethargic
• Leads to dehydration
• Weakness creeps in
• Irritation

Now, when you know the pros and cons of all types of salts, you can decide which one suits the needs of your body and which one should you avoid consuming.

Cystic fibrosis is a genetic condition, which primarily affects the lungs and persistence of this condition might lead to severe breathing problems and loss of lung function. If you have inherited two copies of the defective gene from your parents, you are likely to suffer from this disease. Cystic Fibrosis causes a buildup of thick mucus in your lungs and affects other organs such as the kidneys, pancreas and the intestines in your body.

It isn't very uncommon as one out of fifty people in Asia is a carrier of this disease. The disease gets its name from the cysts formed in the pancreas of the sufferer. However, this disease can be detected by testing the quantity of salt present in your sweat. Prenatal testing for Fibrosis is another method to test if your newborn is likely to contract a lung infection.

Complications faced due to cystic fibrosis include:

1. Serious sinus infections
2. Serious damage in lungs due to inflammation and incessant infection
3. Malnutrition
4. Complication in breaking down protein
5. Respiratory tract contamination

If you observe one or more of the following symptoms, you might be suffering from Cystic Fibrosis:

1. Salty-tasting skin
2. Bowel obstruction caused due to meconium ileus (obstruction of the bowels)
3. Persistent coughing with phlegm discharge
4. Shortness of breath while engaging in a physical task
5. Stunted or measly growth despite healthy lifestyle habits
6. Infertility in males

If you're suffering from cystic fibrosis, there isn't any particular treatment which is recommended due to the varying degrees of it found in people. However, consultation with a medical practitioner and an individualised treatment plan can help you minimise the risks and lead a better life.

Diagnosis:

Diagnosis of Cystic fibrosis can be made by measuring the quality of salt i.e. the amount of chloride in your sweat (sweat chloride test). Genetic testing for CFTR gene mutation detection can also be done at specialized centres. 

Some therapies you can opt for are:

• Airway clearance: This therapy helps sift the thick layer of mucus around your organs. Some people have also chosen to use the inflatable vest which vibrates around your chest, thereby, thinning and loosening the layer of mucus.
• Inhaled medicines: Another breakthrough in the field of respiratory medicine, this method requires the patient to sniff a liquid consisting of mist, which is inhaled with the aid of a nebuliser. This method is known to be beneficial for opening airways.
• Pancreatic enzyme supplements: Along with multivitamins, these specially designed supplements are known to cater to your pancreas with the much-needed nutrients and they need to be consumed with every meal.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Every organ is important for the human body to perform its functions normally. Kidneys too are vital and are responsible for removing the excess fluid and toxins from the body. If the kidney is not functioning properly, then the patient is advised to undergo dialysis treatment. In some cases, the patient is advised to undergo a transplant. However, in any case, the patient has to follow a healthy diet, for the treatment and the medicines to work positively.

Suitable diet during dialysis
Most of the patients are not aware of the diet prescribed for dialysis. Though it is always advised to consult a dietician before following any diet for the condition, it is also advisable to gain some knowledge about what the dietician might suggest, so that one is not clueless about the treatment. In a majority of the cases, food containing potassium, phosphorus, low-fat cholesterol, and sodium is included in the diet of these patients. However, these are prescribed in a limited amount and vary from patient to patient.

1. Sodium: The sodium level of the dialysis patients needs to be controlled; and this can be done by eating food items that have a low sodium content, not more than 2,000 mg. Hence, the quantity of snacks, pudding, and chips are to be reduced in the diet chart.
2. Potassium: The level of potassium also needs to be kept in check to avoid further deterioration of the kidney. Bread, certain vegetables, and grains contain a high amount of potassium. Moreover, various salt substitutes contain potassium chloride instead of sodium chloride. Large intake of these foods may affect the kidney permanently. Hence, these are majorly excluded from the diet. The patients are advised to include tomatoes and bananas in their diet, though not on a daily basis.
3. Phosphorus: The patient is advised to avoid foods with high phosphorus. This includes milk and dairy products and grains. However, while on dialysis, meat is important as it gives enough protein despite being high on phosphorus. But, an abundance of meat in the diet may affect adversely. Hence, this is advised, but kept in control.
4. Cholesterol: To keep cholesterol amount in check during dialysis, the patient needs to cut down on fruits and vegetables and specific fat diets, while eating a sufficient amount of fish.
5. Protein: High protein food is necessary for a patient with a kidney disease. Meat is an excellent source of protein. Along with that, poultry, fish, and eggs are important, as well. Hence, all this is included in the diet.
6. Fluids: Dialysis helps in removing the excessive waste fluids from the kidney. But, to keep the body hydrated, the patient is allowed liquid intake, but only up to a certain limit.

It is necessary to maintain a proper diet during dialysis, as it quickens the treatment as well as helps the patient recover quickly.

Traumatic brain injury (brain injury triggered by an external event such as a fall or a road accident) can be quite a harrowing experience for the patient and their loved ones. While most people recover from the injury, the duration and extent of recovery may vary from individual to individual.

Some patients may simply suffer from a temporary amnesia, while others may remain comatose for months. The recovery time and extent of neurological deficits in traumatic brain injury is determined by the severity and location of the brain injury. The traumatic brain injury can be

Open or closed

• Open injury: There is an opening up of the skin and other layers leading to direct contamination of the brain from external debris and the risk of brain infection is high in such a case.
• Closed injury: here, the brain is not contaminated, but the impact may cause various degrees of injury to parts of the brain.

Primary or secondary injury:

Primary injury: it is damage caused to the brain at the time of the injury. The damage can be

• A crack or fracture in the skull.
• Bleeding into the layers between skull and brain, like a EDH (Extra Dural Hematoma), SDH (Subdural Hematoma) or SAH (Sub-Arachnoid hemorrhage). These are potential emergencies, especially an EDH, where timely Neurosurgical intervention can decide between life and death.
• Due to violent shaking of the brain inside the skull cavity, there can be a damages to the entire brain including the axons and neurons without any visible hemorrhage on CT scans (Diffuse Axonal Injury). The outcome can be quiet unpredictable. It is dangerous if the brain starts swelling up excessively after a DAI.
• A person can also suffer from brain hemorrhages and contusions within the brain matter. Large contusions may need surgical evacuation to control brain pressure. Smaller ones are treated without surgery. Deep seated contusions towards the centre of the brain cause more morbidity even if small in size.

The secondary brain injury may develop gradually (within few hours or days from the primary brain injury), further aggravating the brain tissues. This is brought about by inflammation, altered blood supply, high brain pressure, brain edema or swelling, and programmed cell death. Sometimes, even though the primary insult is small, patients may succumb due to secondary injuries which are highly unpredictable and difficult to treat.

Estimating the extent of the brain damage

The damage inflicted to the brain is assessed by the combined assessment of the following:

1. The mode of injury, especially velocity of impact.

2. How long the person has been unconscious.

3. How bad are the visible external injuries. Is it an open or closed injury?

4. Whether there was any convulsions, vomiting, ear or nose bleeding?

5. Assessment of eye opening, verbal response and movement. This is assessed and recorded by the GCS (Glasgow coma scale).A score of 15 implies the person is fully conscious, a score of 9 indicates the person is in a semi-alert state, while a score of 3 indicates a deep state of coma.

6. Brain imaging through CT or MRI. This gives a more direct information about the physical damages to the brain, and guides the decision about Neurosurgical intervention.

Treatment of traumatic brain injury:

• Medical : medicines are administered to control brain pressure and limit the secondary injuries. It also attempts to control events like convulsions and infections.
• Surgical: surgery becomes necessary when there are depressed fractures impinging into the brain, or large hematoma or brain swelling causing rise of brain pressure or a shift of the brain to one side. Other indications are uncontrolled CSF (cerebrospinal fluid) leakage from nose. Sometimes shunts need to be put to drain out CSF in hydrocephalus (accumulation of excess water in the brain ventricles). During surgery, parts of the skull may need to be removed (Craniectomy) temporarily to allow brain expansion and control brain pressure.
• Accessory surgeries: smaller procedures like a tracheostomy (bypass of the windpipe) or PEG (stomach tube) may need to be done for long term care in comatose patients.
• Rehabilitation: tireless care by nursing and physiotherapy are necessary to help patients recover faster and avoid complications like bed sore, deep vein thrombosis, spasticity and weakness of limbs.
• Recovery: Recovery from traumatic brain injury may be time taking (weeks, months to even years). In addition to the initial treatment and medications, patients may need Brain Injury Rehabilitation. The rehabilitation aims at enabling the person to lead a normal life as early as possible. There are medications, activities, and exercises to improve one's cognitive power.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Discharge from the ear is medically termed as otorrhea. This discharge can be white (clear), yellow, brown, bloody, or pus (purulent). Also, it can be offensive (smelly) or non-offensive. Discharge can be due to the pathologies of the ear canal, middle ear, or, rarely, from inside the skull. There are many causes of ear discharge, some are:

1. Earwax- Wax is a brown, sticky discharge from the ear. The wax formation is a normal process. It is a protective mechanism of the body. It protects the ear from dust, bacteria, viruses, or any foreign bodies entering inside. Sometimes excess of wax can be a problem. That’s why it should be removed regularly.
2. Infection- It is one of the most common reasons for discharge from the ear. It occurs when the middle ear is infected with bacteria or viruses. This causes fluid to build up in the ear, which leads to ear discharge. Generally, the discharge is yellowish due to pus and offensive because of the infection.
3. Swimmer’s ear- It is medically termed as otitis externa. It occurs when the ear canal is infected with bacteria or virus. Mostly, this condition is due to long hours of swimming; too much moisture in the ear can rupture the wall of the ear canal through which the infection enters in the ear canal. Also, this can be due to eczema or any foreign body in the ear which can rupture the wall.
4. Trauma- This can be due to the cotton swab while cleansing your ear if you insert or push it too deep. Also, this can be due to altitude changes such as seen in scuba diving or while flying in the aeroplane. This can cause rupture of the ear drum leading to ear discharge. Acoustic trauma- This type of trauma occurs due to loud noises which rupture the eardrum and can cause discharge from the ear.
5. Necrotizing or malignant otitis externa- This condition is very rare. This condition can occur as a complication of otitis externa, or in immunocompromised patients, or in those suffering from diabetes. This can cause damage to the cartilage and bones in the base of the skull which is responsible for the ear discharge. It can be clear fluid due to cerebrospinal fluid (CSF) which is present in the brain.
6. Cholesteatoma- It’s a noncancerous growth of skin cells in the middle ear leading to discharge from the ear.
7. Mastoiditis- It is due to infection of the mastoid bone which can cause discharge from the ear. Even this condition is very rarely seen.
8. Fracture of the skull- Fracture in any of the bones in the skull can lead to discharge from the ear.
9. Head injury- It’s an emergency. Bloody discharge from the ear can be present.

Tuberculosis is a lung related disease that is caused by bacteria known as Mycobacterium Tuberculosis. Tuberculosis spreads through the air and is a highly contagious disease that can be transmitted through coughing, sneezing and spitting. The symptoms of this condition include coughing, blood discharge while coughing, fever, extreme weight loss, and chills. Against general myths, this disease can be treated and is curable too. Effective, timely diagnosis and treatment with the correct methods and medication are required. Let us find out the various means for effective treatment of tuberculosis.

Diagnosis: The diagnosis of the infection at the earliest is helpful by detecting the presence of the bacteria in the body. The doctor will take a samples like sputum, CSF, Bronchial wash, blood, etc and conduct a series of lab tests in order to diagnose the condition. Also, the doctor will check the medical history of the patient to understand the complications the patient may be prone to. Diagnosis of Pulmonary TB is by sputum, BAL for AFB examination, culture, gene expert and some other blood test may also be required. 

Medication: Usually, the best way to treat this condition is with the help of a six month long course of antibiotics, which may also last for 12 months, depending on the prognosis. The patient needs to be in isolation at home or at hospital so that he or she does not end up spreading this disease to anyone else. A voluntary medical practitioner or trained health worker will help in care giving and medicine administration under the instructions of the doctor. The medication will usually consist of four antibiotics, which will act on the metabolism of the bacteria to ensure that the bacteria gets killed eventually. 

Control of Infection: The spread of the infection is such that a single sneeze or cough can infect up to ten to fifteen people who are near the patient without proper masks and other protective equipment to prevent the transmission. The patient needs to be taught about the cough manners to prevent the spread. Therefore, it is the job of the doctor or the hospital to ensure that proper infection control takes place.

One thing that the patient must remember about the treatment is that immediate and timely treatment with medication must be taken so that the patient is able to get cured. If the patient skips medicines or does not get treated on time, then the infection will come back again and again. The patient also gets resistance to the antibiotics given. In extra pulmonary TB infection, proper diagnosis and adequate treatment with antibiotics is needed. If you wish to discuss about any specific problem, you can consult a General Physician.

Discharge from the ear is medically termed as otorrhea. This discharge can be white (clear), yellow, brown, bloody, or with pus (purulent). Also, it can be offensive (smelly) or non-offensive. Discharge can be due to the pathologies of the ear canal, middle ear, or, rarely, from inside the skull. There are many causes of ear discharge, some are:

1. Earwax- Wax is a brown, sticky discharge from the ear. The wax formation is a normal process. It is a protective mechanism of the body. It protects the ear from dust, bacteria, viruses, or any foreign bodies entering inside. Sometimes excess of wax can be a problem. That’s why it should be removed regularly.
2. Infection- It is one of the most common reasons for discharge from the ear. It occurs when the middle ear is infected with bacteria or viruses. This causes fluid to build up in the ear, which leads to ear discharge. Generally, the discharge is yellowish due to pus and offensive because of the infection.
3. Swimmer’s ear- It is medically termed as otitis externa. It occurs when the ear canal is infected with bacteria or virus. Mostly, this condition is due to long hours of swimming; too much moisture in the ear can rupture the wall of the ear canal through which the infection enters in the ear canal.Also, this can be due to eczema or any foreign body in the ear which can rupture the wall.
4. Trauma- This can be due to the cotton swab while cleansing your ear if you insert or push it too deep. Also, this can be due to altitude changes such as seen in scuba diving or while flying in the airplane. This can cause rupture of the eardrum leading to ear discharge.Acoustic trauma- This type of trauma occurs due to loud noises which rupture the eardrum and can cause discharge from the ear.
5. Necrotizing or malignant otitis externa- This condition is very rare. This condition can occur as a complication of otitis externa, or in immunocompromised patients, or in those suffering from diabetes. This can cause damage to the cartilage and bones in the base of the skull which is responsible for the ear discharge. It can be clear fluid due to cerebrospinal fluid (CSF) which is present in the brain.
6. Cholesteatoma- It’s a noncancerous growth of skin cells in the middle ear leading to discharge from the ear.
7. Mastoiditis- It is due to infection of the mastoid bone which can cause discharge from the ear. Even this condition is very rarely seen.
8. Fracture of the skull- Fracture in any of the bones in the skull can lead to discharge from the ear.
9. Head injury- It’s an emergency. Bloody discharge from the ear can be present.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Often many patients who visit wash their eyes daily with water based on the practice followed by their ancestors or other family members and friends.

Is this necessary? Let’s understand.

The idea behind washing eyes with water appears to be to clean the eyes and remove dust/dirt, feel fresh and cool in hot weather etc.

The fact is, eyes clean themselves every minute through tear exchange during blinking which happens about 12-16 times per minute and so there is no need for additional cleaning. To feel cool in hot weather, one can always clean face with their eyes closed

Is there any harm in washing?

Yes. The tear fluid has a special composition friendly for the eye surface. Its pH, osmolarity, antimicrobial property, etc. gets disturbed by putting water or drops in the eyes. Water coming down from the overhead tank into tap or wash basin may be containing bacteria, fungus, parasites, etc. of serious nature. It can also contain other impurities. So there can be a risk of infections or irritation of the eye.

So eyes should never be washed?

The only situation when eye should be profusely washed with water or any sterile liquid like sodium chloride bottle is when some chemical falls in the eye. Do not wait for anything and wash the affected eye with lot of water even before contacting a doctor. In case you have a concern or query you can always consult an expert & get answers to your questions!

Cystic Fibrosis is a genetic disorder that is known to affect some of the vital organs of the body including the lungs, digestive system to name a few. For long it was believed that cystic fibrosis affects a person in their childhood. However, various research and studies suggest that adults are also susceptible to this inheritable disorder. In this article, we will discuss the cause and symptoms associated with cystic fibrosis.

Cause
The epithelial cells that line the stomach, nasal cavity and lungs, are responsible for the production of the digestive fluids, sweat, tears, mucus. The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene codes for a protein called the CFTR protein. The CFTR protein, a membrane protein plays a pivotal role in transporting the chloride ions of the epithelial cells inside and out of the cell. This regulation of the chloride ions goes a long way in ensuring that the mucus produced is free-flowing and thin.

In the case of Cystic Fibrosis, the CFTR gene that codes for the protein undergoes a mutation. With the CFTR protein unable to perform its function, sticky and thick mucus builds up and clogs some of the major systems of the body including the digestive system, reproductive, and respiratory system. There is also a higher salt content in the sweat of the affected person.

For a person to be affected by cystic fibrosis, he/she must inherit a copy of the mutated CFTR gene from both the parents ( Autosomal Recessive Disorder) at birth.

Symptoms
The symptoms associated with cystic fibrosis depends on the organs and systems affected.

1. The thick mucus formed can clog the digestive tract resulting in incomplete absorption of the essential nutrients from the food. This may have an impact on the overall growth and development of the body.
   • - There may be stunted growth or no weight gain.
   • - The stool may appear greasy and foul smelling. Some may also suffer from constipation.
   • - Newborns and infants may suffer from an intestinal blockage.
2. Cystic fibrosis, left unattended can lead to diabetes, intestinal blockage or obstruction.
   • - The mucus can also block the bile duct triggering a host of problems including liver disorders.
   • - At times, the obstruction or blockage can occur at the junction where the large and the small intestine meets (Distal intestinal obstruction syndrome).
3. The thick mucus can also affect the lungs and the respiratory system by blocking the tubes that act as a passage carrying the air inside and out of the lungs. As a result,
   • - A person may suffer from lung infections frequently.
   • - There may be difficulty in breathing, stuffy and blocked nose, or wheezing.
   • - Some people may also suffer from a chronic cough with a thick sputum.

Left untreated the complications can worsen resulting in

Nasal polyps, Chronic infections, Hemoptysis (there is blood while coughing), and Pneumothorax (air fills up in the space bifurcates the chest wall from the lungs).

In severe cases, there may be a respiratory failure.

Cystic fibrosis can also trigger fertility problems (both in males and females).