Constipation and hemorrhoids

Constipation and hemorrhoids
Large number of people in the world is suffer from hemorrhoids. And most of the people think constipation is a major risk factor for hemorrhoids. Today we will talk more about this subject. According to Baily and love’s “short practice of surgery-25th edition” when stools are harder it requires more straining and more time sitting on the lavatory with relaxed perineum. This causes the venous plexus around the anus to get engorged and it could also obstruct the venous return. From this we can expect to have some association between hemorrhoids and constipation. But it is also mentioned in the same paragraph the epidemiological pattern of constipation differs from that of the hemorrhoids. So it means no association between hemorrhoids and constipation. But the current view about the hemorrhoids is that hemorrhoids are caused by shearing forces acting on the anus due to variety of reasons. But the most important thing is if a patient is suffering even from 1st degree hemorrhoids relieving constipation in that patient is a must. If the patient is having both constipation and hemorrhoids, constipation can really aggravate the symptoms of hemorrhoids. Actually patients with hemorrhoids are always advised by doctors to take more dietary fiber to normalize their bowel habits. As far as I believe according to the current view association between Constipation and hemorrhoids is a yes and a no.

HbA1c Test

If you are a diabetic probably by now you should know something about the HbA1c test. This test actually measures the percentage of glycosylated hemoglobin(HbA1c) in the blood of a person. In any person since there is a normal blood sugar level glucose molecules get attached to hemoglobin molecules without the aid of an enzyme. This is called the non-enzymatic glycosylation of hemoglobin. This percentage is usually in a non-diabetic less than 5.5%. In a diabetic since the blood sugar levels are high this rate of glycosylation is high. So this HbA1c value is higher. HbA1c test measures this HbA1c value. Since this is a long term process and life cycle of red blood cell is nearly 120 days this Hba1c value gives an idea about the blood sugar control in past 2-3 months. And the other important thing is a single heavy meal doesn’t affect the HbA1c test value much. So If the HbA1c value is high it means that your blood sugar control has been bad during past 2-3 months. Doctors recommend keeping HbA1c value below 7% for the diabetics.

Troponin T test TnT test

As I previously mentioned about Troponin I test or the TnI test, Troponin T is also a cardiac specific bio-marker. So during a heart attack blood troponin T levels are also elevated and physician can measure this value to get an idea about the condition. Actually when we talk about the Troponin T test basically there are two types. Troponin T titre, where the laboratory provides the actual serum value of troponin T, and the plain troponin T test, Where laboratory gives the test result only as positive or negative. For the clinical management of the patient Troponin T titre has an added benefit over simple troponin T test. Same to troponin I Troponin T also takes some time to rise so it may be necessary to repeat the test.

Troponin I test TnI test

Troponin I test
When a patient comes to the emergency room with a chest pain doctors tend to request a Troponin I test. This test is also known as TnI test. So lest talk bit more about this Troponin I test. Troponin I is a highly specific cardiac marker which is released to the blood when cardiac myocytes suffer injury. In a heart attack heart muscle cell die and after that troponin I within the muscle cells are released to the blood. By doing a Troponin I test (TnI test) doctors can get an idea whether there is an underlying cardiac muscle damage. As you can already see any injury to cardiac myocytes can cause increased levels of Troponin I. So conditions like acute or chronic conditions such as myocarditis (heart inflammation), congestive heart failure Can give rise to a positive troponin I test. The other important thing is conditions which affect the other muscles does not give rise to a positive Troponin I test. TnI test sometimes performed with other test such as CPK test or myoglobin. The other important thing is blood Troponin I levels may remain elevated even for 1-2 weeks. So even after a one week of a myocardial infarction TnI test can be positive. This is very important in diagnosing a previous heart attack.

Elevated CPK Enzyme

Elevated CPK enzyme level is of great diagnostic value. CPK enzyme is a non functional plasma enzyme and in most of the times elevated levels indicates as underlying organic skeletal muscle disorder or a myocardial infarction. CPK enzyme has 3-isoforms.



CK-BB (Mainly found in the brain tissue)
CK-MB (Mainly found in the myocardial tissue)
CK-MM (Mainly found in the skeletal muscle issue)
Myocardial tissue is the only tissue that contains more than 5% of the total CK-MB activity. So elevated plasma levels of CK-MB isoform of CPK-enzyme suggest a myocardial infarction. But however this should be used along with another cardiac marker like Troponin I ot Troponin T since cpk enzymes coming from the other sources such as skeletal muscle can interfere with the interpretation of the results.




In the case of a myocardial infarction CPK enzyme levels start to rise to rise 4 to 8 hours after the onset of the chest pain and plasma CPK enzyme level reaches the peak in 24 hours.
Serum CPK enzyme is greatly elevated in many muscle disorders including Duchenne dystrophy and polymyositis.But the CPK enzyme level is not elevated in myasthenia gravis and LEMS. In muscle trauma plasma level of myoglobin is also elevated.

Enzyme test or a CPK test : What is it ?

When you go to the hospital after a chest pain your doctor might request an enzyme test or a CPK test. But what is this? Did you ever think about it?

OK now I am going to tell you more about it. You don't need to have huge medical knowledge to understand this article. So don't worry. All these are enzyme based diagnostic tests designed to identify a certain disease condition. As you know the human body is made up of billions of cells. Each and every cell is a fluid filled bag. Plasma membrane serves as the boundary of this bag. As long as it is healthy it keeps everything with inside the cell without allowing escaping. With in these cells there are enzymes. Enzymes are proteins which catalyze various biochemical reactions. But when the cell is injured these enzymes come out. Then these enzymes diffuse through the extra cellular space and contaminate the blood. So when a blood sample is taken this elevated cellular enzyme levels can be detected. As certain enzymes are specific for certain organs the doctors can detect the affected organ. Eg: The heart. Now you can understand. When you have a chest pain they suspect a heart attack. To diagnose whether it is a heart attack or some other condition they request a CPK test. If it is a heart attack CPK test is life saving. Remember CPK is a very important cardiac enzyme in diagnosing.

E.g.: C.P.K- Heart muscle

Can eggs cause acne?

Can eggs cause acne? This is a very interesting question. Many seek for answers. We have discussed previously about this also. So today we'll discuss about eggs and acne with more scientific evidence. A study in Jordan studied 166 patients and studied their patterns of acne. They were aged from 13 to 42. In this study they actually assessed the patient's perception about acne. 66% thought family history is positively related with acne. Most of the patients thought emotional stress, hot weather and sweating has an association with acne. Many also believed certain dietary factors such as Nuts, fatty food, fried food, chocolate, cakes as the triggering factors for acne. Many assume that the extra fat in eggs cause acne. But it is not. Even though you're not aware you can have some kind of a allergic reaction to eggs. Since acne is also caused by a complex abnormal immune response, eggs can trigger this abnormal immune response. So in some people eggs can cause acne in the others it may not cause acne at all. So to learn whether eggs are a cause of acne in you you may change your food habits. In most of the sensitive people simple reduction of the consumption of eggs may cause marked reduction in acne. Sometimes it is not the egg which causes acne, it is the way you cook it. So you may want to try changing the way you cook it. Again when we go back to the research I mentioned about you can clearly see most of the foods mentioned above have egg proteins. So probably the other things in those foods can also trigger acne. But try to understand the pathogenesis of acne is not a simple process. Even though you are sensitive to eggs, and you are avoiding eggs, but still the other factors can trigger acne.

Does stress cause acne?

Does stress cause acne? With modern theories and people are thinking more and more about stress and more the young people become concerned about their external appearance still one has not given a straightforward answer to the above questions. But during periods of stress such as during examination periods students tend to get more and more acne. With stress many of the body hormone levels are altered corticosteroid levels are increased, adrenaline levels are increased, also as a claim that body androgen levels are also increased during periods of stress. All these hormones alter the inflammatory status of the body. Each has a direct association with acne. So if stress causes acne one should know how to reduce the stress. Try to have a routine exercise schedule. Learn relaxation methods and breathing exercises. Try to organise your day. Meditation can also help you. But even though these things can help you if acne is reducing your self-confidence it is a good idea to meet a dermatologist and take advice. And if the stress is a big problem for you probably you can talk to a psychologist or psychiatrist. I hope I have told you something about stress and acne.