The skin is the largest organ of the body, with a total area of about 1.86 m² (adult). The skin protects us from environmental aggression (physical, chemical, pathogens), helps regulate body temperature, and permits the sensations of touch, heat and cold.

Skin has three layers:

The epidermis, the outermost layer of skin, provides a waterproof barrier and creates our skin tone.

The dermis, beneath the epidermis, contains tough connective tissue, hair follicles, and sweat glands.

The deeper subcutaneous tissue (hypodermis) is made of fat and connective tissue.

The skin’s colour is created by special cells called melanocytes, which produce the pigment melanin. Melanocytes are located in the epidermis.

Dermatitis

Dermatitis is the general term for inflammation of the skin. Atopic dermatitis is the most common form.

Eczema

Skin inflammation (dermatitis) causing an itchy rash is named eczema. Most often, it’s due to an overactive immune system.

Dandruff

Dandruff is a scaly condition of the scalp that may be caused by seborrheic dermatitis, psoriasis, or eczema.

Rosacea

Tipically, this condition affects the skin face and is a chronic skin condition causing a red rash. Rosacea may look like acne and is poorly understood.

https://www.webmd.com/skin-problems-and-treatments/picture-of-the-skin#1

Androgenic alopecia

Androgenic alopecia is a genetic condition characterized by a receding hairline and gradual disappearance of hair from the crown and frontal scalp. This condition can affect both men and women. Men with this condition, called male pattern baldness, can begin suffering hair loss as early as their teens or early 20s. Women with this condition, called female pattern baldness, don't experience noticeable thinning until their 40s or later. Women experience a general thinning over the entire scalp, with the most extensive hair loss at the crown. 

https://www.webmd.com/skin-problems-and-treatments/hair-loss/understanding-hair-loss-basics#1

Acne

Acne, also known as acne vulgaris, is a long-term skin disease that occurs when dead skin cells and oil from the skin clog hair follicles. Typical features of the condition include blackheads or whiteheads, pimples, oily skin, and possible scarring. It primarily affects skin with a relatively high number of oil glands, including the face, upper part of the chest, and back. The resulting appearance can lead to anxiety, reduced self-esteem, and, in extreme cases, depression.

Aslam I, Fleischer A, Feldman S (March 2015). "Emerging drugs for the treatment of acne". Expert Opinion on Emerging Drugs (Review)

Psoriasis

Psoriasis is a chronic inflammatory skin disease with a strong genetic predisposition and autoimmune pathogenic traits. The dermatologic manifestations of psoriasis are varied; psoriasis vulgaris is also called plaque-type psoriasis and is the most prevalent type.

Psoriasis is a chronic relapsing disease, which often necessitates a long-term therapy. The choice of therapy for psoriasis is determined by disease severity, comorbidities and access to health care. Psoriatic patients are frequently categorized into two groups: mild or moderate to severe psoriasis, depending on the clinical severity of the lesions, the percentage of affected body surface area, and patient quality of life.

In the past years, an accelerated development in psoriasis therapies has resulted in advanced targeted biological drugs.

Adriana Rendon and Knut Schäkel, Psoriasis Pathogenesis and Treatment, Psoriasis Pathogenesis and Treatment; Published online 2019 Mar 23. doi: 10.3390/ijms20061475

For further details regarding this disease, please contact your specialist doctor

Breast cancer

Breast cancer occurs when some breast cells begin to grow abnormally. These cells divide more rapidly than healthy cells do and continue to accumulate, forming a lump or mass. Cells may spread (metastasize) through your breast to your lymph nodes or to other parts of your body.

Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular carcinoma) or in other cells or tissue within the breast.

https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470

Non-small cell lung carcinoma (NSCLC)

NSCLC is a type of cancer that starts in the lungs when some lung cells begin to grow out of control. Non-small-cell lung carcinoma (NSCLC) is any type of epithelial lung cancer other than small cell lung carcinoma (SCLC). NSCLC accounts for about 85% of all lung cancers. When possible, they are primarily treated by surgical resection with curative intent, although chemotherapy has been used increasingly both pre-operatively (neoadjuvant chemotherapy) and post-operatively (adjuvant chemotherapy).

https://www.cancer.org

For further details regarding this disease, please contact your specialist doctor

Cystitis

Cystitis is an inflammation of the bladder. Inflammation is where part of your body becomes irritated, red, or swollen. In most cases, the cause of cystitis is a urinary tract infection (UTI). A UTI happens when bacteria enter the bladder or urethra and begin to multiply. Other causes can be: radiation, medication, use of catheters, hygiene products. There are several types of cystitis: bacterial, drug induced, radiation induced, foreign body, chemical, associated to other conditions.

(https://www.healthline.com/health/cystitis)

For further details regarding this disease, please contact your specialist doctor

Immunity is the capability of multicellular organisms to resist harmful microorganisms from entering it. Immunity involves both specific and nonspecific components. The nonspecific components act as barriers or eliminators of a wide range of pathogens irrespective of their antigenic make-up. An immune system may contain innate and adaptive components. The innate system in mammalians, for example, is composed of primitive bone marrow cells that are programmed to recognise foreign substances and to react. The adaptive system is composed of more advanced lymphatic cells that are programmed to recognise self-substances and not to react. The reaction to foreign substances is etymologically described as inflammation, meaning to set on fire. The non-reaction to self-substances is described as immunity, meaning to exempt or as immunotolerance. These two components of the immune system create a dynamic biological environment where "health" can be seen as a physical state where the self is immunologically spared, and what is foreign is inflammatorily and immunologically eliminated. "Disease" can arise when what is foreign cannot be eliminated or what is self is not spared.

( Janeway, Charles; Paul Travers; Mark Walport; Mark Shlomchik (2001). Immunobiology; Fifth Edition)

Iron Deficiency Anaemia

Iron-deficiency anemia is anemia caused by a lack of iron. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When onset is slow, symptoms are often vague such as feeling tired, weak, short of breath, or having decreased ability to exercise. Anemia that comes on quickly often has more severe symptoms, including: confusion, feeling like one is going to pass out or increased thirst. Anemia is typically significant before a person becomes noticeably pale. Children with iron deficiency anemia may have problems with growth and development. There may be additional symptoms depending on the underlying cause.

Iron-deficiency anemia is caused by blood loss, insufficient dietary intake, or poor absorption of iron from food. Sources of blood loss can include heavy periods, childbirth, uterine fibroids, stomach ulcers, colon cancer, and urinary tract bleeding. Poor absorption of iron from food may occur as a result of an intestinal disorder such as inflammatory bowel disease or celiac disease, or surgery such as a gastric bypass. In the developing world, parasitic worms, malaria, and HIV/AIDS increase the risk of iron deficiency anemia. Diagnosis is confirmed by blood tests.

(Janz TG, Johnson RL, Rubenstein SD (November 2013). "Anemia in the emergency department: evaluation and treatment". Emergency Medicine Practice)

Allergies

Allergies are one of the most common chronic diseases. A chronic disease lasts a long time or occurs often. An allergy occurs when the body’s immune system sees a substance as harmful and overreacts to it. The substances that cause allergic reactions are allergens. When someone has allergies, their immune system makes an antibody called immunoglobulin E (IgE). These antibodies respond to allergens. The symptoms that result are an allergic reaction.

Allergy treatment is based on the medical history and the severity of the symptoms. It can include three different treatment strategies: avoidance of allergens, medication options and/or immunotherapy (a treatment to train immune system not to overreact).

Asthma and Allergy Foundation of America; https://www.aafa.org/about-aafa.aspx

Throat infection

An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, or larynx. This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, and the common cold. Most infections are viral in nature, and in other instances, the cause is bacterial. URTIs can also be fungal or helminthic in origin, but these are less common.

In uncomplicated colds, coughing and nasal discharge may persist for 14 days or more even after other symptoms have resolved. Acute URTIs include rhinitis, pharyngitis/tonsillitis, and laryngitis often referred to as a common cold, and their complications: sinusitis, ear infection, and sometimes bronchitis (though bronchi are generally classified as part of the lower respiratory tract.) Symptoms of URTIs commonly include cough, sore throat, runny nose, nasal congestion, headache, low-grade fever, facial pressure, and sneezing.

( "Rhinitis Versus Sinusitis in Children" (PDF). Centers for Disease Control and Prevention. Archived (PDF) from the original on 16 February 2017.)

Fungal infection 

Vaginal complaints are common. Vulvovaginitis, or inflammation of the vulva and vagina, is most commonly secondary to infectious agents in reproductive-aged women. Candidal vulvovaginitis is responsible for about one-third of cases. Candidal vulvovaginitis is caused by inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species, most commonly Candida albicans. Candida is part of the normal flora in many women and is often asymptomatic. Therefore, candidal vulvovaginitis requires both the presence of candida in the vagina/vulva as well as the symptoms of irritation, itching, dysuria, or inflammation. ¹ Since a local treatment is the first line of choice in cases of acute vaginal yeast infection, a variety of topical preparations are on the market, mainly containing azole fungistatic agents such as ketoconazole, miconazole, and clotrimazole (CLO).²

¹ https://www.ncbi.nlm.nih.gov/books/NBK459317/

² https://www.researchgate.net/publication/8068953_Topical_Therapy_for_Fungal_Infections

For further details regarding this disease, please contact your specialist doctor

Parkinson Disease

Parkinson's disease (PD) is a neurodegenerative disorder that affects predominately dopamine-producing (“dopaminergic”) neurons in a specific area of the brain called substantia nigra. Symptoms generally develop slowly over years. People with PD may experience tremor, mainly at rest and described as pill rolling tremor in hands. Other forms of tremor are possible: bradykinesia, limb rigidity and gait and balance problems. Monoamine oxidase inhibitors of which the best known is rasagiline are often used in treatment of mild early PD. They allow existing dopamine to work better because they block the enzyme which breaks it down. Levodopa sparing strategies are used as much as possible (especially in young onset PD) in order to delay the onset of dyskinesia, but these strategies have their own drawbacks. Carbidopa/levodopa and/or dopamine agonists may be useful. When wearing off occurs, it is best treated by augmenting or adjusting the anti-PD medications, for example, by increasing the frequency of dosing, or adding a “levodopa extender” such as entacapone.

¹ https://www.parkinson.org/understanding-parkinsons/what-is-parkinsons, page reviewed by Dr. Ahmad Elkouzi, Movement Disorders Fellow at the University of Florida, a Parkinson’s Foundation Center of Excellence.

² Introduction to Parkinson's Disease, © 2016 Dr. Robert Fekete, author

³ Parkinson’s disease - Patients Care Handbook. I. Tuite Paul, author

For further details regarding this disease, please contact your specialist doctor

Asthma is a heterogeneous lung disease, usually characterized by chronic airway inflammation.It is defined as history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and intensity, together with variable expiratory airflow limitation. GINA recommends treatment with daily low-dose ICS for most patients with asthma, or as-needed low dose ICS-formoterol for those with infrequent symptoms. ¹

The Global Initiative for Chronic Obstructive Lung Disease (GOLD), a project initiated by the National Heart, Lung, and Blood Institute (NHLBI) and the World Health Organization (WHO), defines COPD as follows: "COPD is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. The chronic airflow limitation that characterizes COPD is caused by a mixture of small airways disease (eg, obstructive bronchiolitis) and parenchymal destruction (emphysema), the relative contributions of which vary from person to person. Chronic inflammation causes structural changes, small airways narrowing, and destruction of lung parenchyma. A loss of small airways may contribute to airflow limitation and mucociliary dysfunction, a characteristic feature of the disease."²

¹ Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated 2019. http://www.ginasthma.org.

² COPD — The Global Initiative for Chronic Obstructive Lung Disease (GOLD), updated 2020. https://goldcopd.org/wp-content/uploads/2019/11/GOLD-2020-REPORT-ver1.0wms.pdf

For further details regarding this disease, please contact your specialist doctor

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology, principally affecting smaller synovial joints in a symmetrical fashion, leading, in most cases, to joint destruction. Extra-articular manifestations are common and a variety of immunological abnormalities that lead to disability are evident. A variety of disease-modifying antirheumatic drugs (DMARDs) are available to control the clinical activity of rheumatoid arthritis (RA).

Jerzy OEwierkot, Jacek Szechiñski, Methotrexate in rheumatoid arthritis, Pharmacological Reports, Institute of Pharmacology Polish Academy of Science

Juvenile idiopathic arthritis

Juvenile idiopathic arthritis (JIA) is the most common form of juvenile arthritis and includes several types: oligoarthritis, polyarthritis, systemic, enthesitis-related, juvenile psoriatic arthritis and undifferentiated. Drugs that control disease activity include corticosteroids and disease-modifying antirheumatic drugs (DMARDs).

https://arthritis.org/diseases/juvenile-arthritis

For further details regarding this disease, please contact your specialist doctor

Vaginal complaints are common. Vulvovaginitis, or inflammation of the vulva and vagina, is most commonly secondary to infectious agents in reproductive-aged women. Candidal vulvovaginitis is responsible for about one-third of cases. Candidal vulvovaginitis is caused by inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species, most commonly Candida albicans. Candida is part of the normal flora in many women and is often asymptomatic. Therefore, candidal vulvovaginitis requires both the presence of candida in the vagina/vulva as well as the symptoms of irritation, itching, dysuria, or inflammation. ¹ Since a local treatment is the first line of choice in cases of acute vaginal yeast infection, a variety of topical preparations are on the market, mainly containing azole fungistatic agents such as ketoconazole, miconazole, and clotrimazole (CLO).²

¹ https://www.ncbi.nlm.nih.gov/books/NBK459317/

² https://www.researchgate.net/publication/8068953_Topical_Therapy_for_Fungal_Infections

For further details regarding this disease, please contact your specialist doctor

Glaucoma

Glaucoma is a leading cause of irreversible blindness worldwide and is associated with characteristic damage to the optic nerve and patterns of visual field loss due to retinal ganglion cell (RGC) degeneration. Intraocular pressure (IOP) is regarded as the major risk factor. There are estimated to be over 60 million people worldwide with glaucomatous optic neuropathy of which 8.4 million are blind. The global incidence of glaucoma is anticipated to increase to 76 million by 2020 and 111.8 million by 2040. Glaucoma is an umbrella term encompassing various subtypes of the condition, but the structural damage to the optic nerve is common throughout.

Glaucoma is a degenerative optic neuropathy characterized by retinal ganglion cell (RGC) loss and visual field defects. It is known that in some glaucoma patients, death of RGCs continues despite intraocular pressure (IOP) reduction. Neuroprotection in the field of glaucoma is defined as any treatment, independent of IOP reduction, which prevents RGC death.

¹ Benjamin Michael Davis, Laura Crawley, Milena Pahlitzsch, Fatimah Javaid, Maria Francesca Cordeiro, Glaucoma: the retina and beyond, Acta Neuropathol (2016) 132:807–826, DOI 10.1007/s00401-016-1609-2

² https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4926571/

Dry Eye

The refined TFOS DEWS II global dry eye definition, as follows: “Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”

Artificial tears may be safe and effective means for treating dry eye syndrome.

¹ https://www.tfosdewsreport.org/report-definition_and_classification/48_36/en/

² https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5045033/

For further details regarding this disease, please contact your specialist doctor

X-rays, used since 1895, were the first type of radiation to provide images of the interior of the body. Other imaging techniques have been developed using X-rays. In tomography, X-ray images of deep internal structures can be obtained by focusing the rays on a specific plane within the body. A more complex variation of this technique is computed tomography, known as a CT scan. A limiting factor in X-rays when used alone is the inability to distinguish between adjacent, differentiated soft tissues of roughly the same density. To obtain this contrast, a contrast medium is injected into the body.

MRI is a non-invasive imaging technology that produces three dimensional detailed anatomical images. It is often used for disease detection, diagnosis, and treatment monitoring. It is based on sophisticated technology that excites and detects the change in the direction of the rotational axis of protons found in the water that makes up living tissues. To obtain an MRI image, a patient is placed inside a large magnet and must remain very still during the imaging process in order not to blur the image. Contrast agents (often containing the element Gadolinium) may be given to a patient intravenously before or during the MRI to increase the speed at which protons realign with the magnetic field. The faster the protons realign, the brighter the image.

https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri

Contrast agents or contrast media are used to improve pictures of the inside of the body produced by x-rays, computed tomography (CT), magnetic resonance (MR) imaging, and ultrasound. Often, contrast materials allow the radiologist to distinguish normal from abnormal conditions. When introduced into the body prior to an imaging exam, contrast materials make certain structures or tissues in the body appear different on the images than they would if no contrast material had been administered. Contrast materials help distinguish or "contrast" selected areas of the body from surrounding tissue. By improving the visibility of specific organs, blood vessels or tissues, contrast materials help physicians diagnose medical conditions.

https://www.radiologyinfo.org/en/pdf/safety-contrast.pdf

For further details regarding this disease, please contact your specialist doctor

Allergies are one of the most common chronic diseases. A chronic disease lasts a long time or occurs often. An allergy occurs when the body’s immune system sees a substance as harmful and overreacts to it. The substances that cause allergic reactions are allergens. When someone has allergies, their immune system makes an antibody called immunoglobulin E (IgE). These antibodies respond to allergens. The symptoms that result are an allergic reaction.

Allergy treatment is based on the medical history and the severity of the symptoms. It can include three different treatment strategies: avoidance of allergens, medication options and/or immunotherapy (a treatment to train immune system not to overreact).

Asthma and Allergy Foundation of America; https://www.aafa.org/about-aafa.aspx

For further details regarding this disease, please contact your specialist doctor

Infertility happens when a couple cannot conceive after having regular unprotected sex.

It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.

Types

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control

Secondary infertility is when they have previously conceived but are no longer able to.

Diagnosis

If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. Male fertility starts to fall after 40 years.

The doctor may ask about the couple’s sexual habits and make recommendations regarding these. Tests and trials are available, but testing does not always reveal a specific cause.

Risk factors and causes in men

Semen and sperm

The following problems are possible:

Low sperm count:

Low sperm mobility (motility):

Abnormal sperm:

If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult.

This can result from: a medical condition, overheated testicles, ejaculation disorders, hormonal imbalance, Age, Some diseases, Some medications, overweight or obesity

Risk factors and causes in woman

Infertility in women can also have a range of causes.

Age (The ability to conceive starts to fall around the age of 32 years), Smoking/ Alcohol, Diet, Medical conditions - Some medical conditions can affect fertility. Ovulation disorders appear to be the most common cause of infertility in women.

Treatment

Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

Fertility treatments for men

Treatment will depend on the underlying cause of the infertility. Erectile dysfunction or premature ejaculation, varicocele, blockage of the ejaculatory duct, retrograde ejaculation, surgery for epididymis

Fertility treatments for women

Fertility drugs might be prescribed to regulate or induce ovulation.

Surgical procedures for women

Assisted conception

https://www.medicalnewstoday.com/articles/165748

Menopause

Menopause is a transition into a new phase of life. It begins when the menstrual cycle finishes. Hormonal changes and other factors involved can cause discomfort.

Each person may experience menopause differently.

Menopause usually starts between the ages of 40 and 58 years in developed countries, where the average age is 51 years. For some, it will occur earlier due to a medical condition or treatment, such as the removal of the ovaries.

Causes

Most women experience natural menopause during midlife. However, surgery and other factors can cause menopause to start earlier.

If this happens before middle age, doctors may refer to it as “early menopause.”

Some treatments, such as chemotherapy and radiotherapy, can cause the ovaries to stop working either temporarily or permanently.

Doctors consider menopause to be “premature” if it develops before the age of 40 and “early” if it starts between the ages of 40 and 45.

The changes involved in menopause include:

Lower fertility, Irregular menstruation, Vaginal dryness and discomfort, Atrophic vaginitis, Hot flashes are common around the time of menopause. A hot flash can also cause: sleep disturbances, emotional changes, depression, anxiety, and low mood are common during menopause. It is not unusual to experience times of irritability and crying spells, trouble focusing and learning, physical changes, increased risk of some health conditions

Diagnosis

A doctor can often confirm the menopause by asking some questions.

They may also test hormone levels and perform other analyses of the blood and urine to rule out health issues. No tests, however, can conclusively indicate that menopause has begun.

Treatment

Hormone therapy

Other treatments - can help to reduce the occurrence of hot flashes and other menopause symptoms.

A person may find that the following can also help relieve symptoms:

over-the-counter gels and other products for vaginal dryness

prescription pills

low-dose hormonal birth control pills for hot flashes, vaginal dryness, and mood changes

low-dose antidepressants for hot flashes, even among people who do not have depression

https://www.medicalnewstoday.com/articles/155651#causes

For further details regarding this disease, please contact your specialist doctor

Obesity

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist–hip ratio and total cardiovascular risk factors. Obesity increases the likelihood of various diseases and conditions, particularly cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, certain types of cancer, osteoarthritis, and depression.

Haslam DW, James WP (October 2005). "Obesity". Lancet(Review). 366 (9492): 1197–209

Iron deficiency anemia

Iron-deficiency anemia is anemia caused by a lack of iron. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When onset is slow, symptoms are often vague such as feeling tired, weak, short of breath, or having decreased ability to exercise. Anemia that comes on quickly often has more severe symptoms, including confusion, feeling like one is going to pass out or increased thirst. Anemia is typically significant before a person becomes noticeably pale. Children with iron deficiency anemia may have problems with growth and development. There may be additional symptoms depending on the underlying cause.

Iron-deficiency anemia is caused by blood loss, insufficient dietary intake, or poor absorption of iron from food. Sources of blood loss can include heavy periods, childbirth, uterine fibroids, stomach ulcers, colon cancer, and urinary tract bleeding. Poor absorption of iron from food may occur as a result of an intestinal disorder such as inflammatory bowel disease or celiac disease, or surgery such as a gastric bypass. In the developing world, parasitic worms, malaria, and HIV/AIDS increase the risk of iron deficiency anemia. Diagnosis is confirmed by blood tests.

Janz TG, Johnson RL, Rubenstein SD (November 2013). "Anemia in the emergency department: evaluation and treatment". Emergency Medicine Practice

Vitamin D deficiency

Vitamin D is a fat-soluble vitamin used by the body for normal bone development and maintenance by increasing the absorption of calcium, magnesium, and phosphate. A circulating level of 25-hydroxyvitamin D greater than 30 ng/mL is required to maintain a healthy level of vitamin D. About 1 billion people worldwide have vitamin D deficiency. Vitamin D deficiency can lead to an array of problems, most notably rickets in children and osteoporosis in adults. The fortification of milk with vitamin D in the 1930s was effective in eradicating rickets in the world. However, vitamin D deficiency is now more prevalent than ever and should be screened in high-risk populations. Many conflicting studies are now showing an association between vitamin D deficiency and cancer, cardiovascular disease, diabetes, autoimmune diseases, and depression.

Vitamin D deficiency arises from multiple causes including inadequate dietary intake and inadequate exposure to sunlight. About 50% to 90% of vitamin D is absorbed through the skin via sunlight while the rest comes from the diet. Twenty minutes of sunshine daily with over 40% of skin exposed is required to prevent vitamin D deficiency. Certain malabsorption syndromes such as celiac disease, short bowel syndrome, gastric bypass, and cystic fibrosis may also lead to vitamin D deficiency. Moreover, some medicines speed up the degradation of vitamin D. Lastly, people with chronic liver disease and chronic kidney disease are at high risk for vitamin D deficiency. 

¹Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J Pharmacol Pharmacother. 2012 Apr;3(2):118-26. [PMC free article] [PubMed]

²Holick MF. Vitamin D: important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South. Med. J. 2005 Oct;98(10):1024-7. [PubMed]

³Naeem Z. Vitamin d deficiency- an ignored epidemic. Int J Health Sci (Qassim). 2010 Jan;4(1):V-VI. [PMC free article] [PubMed]

⁴Gröber U, Kisters K. Influence of drugs on vitamin D and calcium metabolism. Dermatoendocrinol. 2012 Apr 01;4(2):158-66. [PMC free article] [PubMed]

For further details regarding this disease, please contact your specialist doctor

Neuronal ceroid lipofuscinosis type 2 (CLN2) [ tripeptidyl peptidase 1 (TPP1) deficiency]

CLN2 is a type of neuronal ceroid lipofuscinosis, a group of severe diseases that affect the nervous system. Symptoms of the CLN2 generally develop between ages two and four years, although later onset cases have been reported. Children with CLN2 may experience speech delay, seizures that do not respond to medications, loss of muscle coordination (ataxia), muscle twitches (myoclonus), loss of vision, developmental delay, and intellectual disability. Symptoms of CLN2 worsen as the child gets older (progressive).
CLN2 is caused by changes (pathogenic variations) in the TPP1 gene and is inherited in an autosomal recessive manner. Although there is no medication that can currently cure CLN2, in the spring of 2017 both the United States Food and Drug Administration (FDA) and the European Commission approved the use of a medicine for children with CLN2. In clinical studies, this medicine was shown to slow down the progression of the disease.

Mole SE, Williams RE. Neuronal Ceroid-Lipofuscinoses. GeneReviews. August 1, 2013

For further details regarding this disease, please contact your specialist doctor

Infantile hemangioma

Infantile hemangiomas are the most common benign tumor found in children. They are made up of blood vessels, often called strawberry marks, and are more common in girls than in boys. They usually appear on the skin of infants who are 4-6 weeks old. They tend to either grow quickly for up to a few months, and then shrink or involute without further problem, however some can ulcerate and form scabs which can be painful. Depending on their location and size, they may also be disfiguring or may impact the functionality.

Rarely, they may be related to disorders of the central nervous system or spine. They may also occur in the internal organs of the body, such as the liver, airway, or brain.

The color of the hemangioma depends on how deep it is in the skin: Superficial (near the skin's surface) hemangiomas tend to be bright red; deep (furthest from the skin's surface) hemangiomas are often blue or purple; mixed hemangiomas may have colors of both superficial and deep.

Drolet BA, Esterly NB, Frieden IJ. Hemangiomas in children. N Engl J Med. 1999 

Chronic venous insufficiency 

Chronic venous insufficiency (CVI) is a medical condition in which blood pools in the veins, straining the walls of the vein. The most common cause of CVI is superficial venous reflux which is a treatable condition. As functional venous valves are required to provide for efficient blood return from the lower extremities, this condition typically affects the legs. If the impaired vein function causes significant symptoms, such as swelling and ulcer formation, it is referred to as chronic venous disease. It is sometimes called chronic peripheral venous insufficiency and should not be confused with post-thrombotic syndrome in which the deep veins have been damaged by previous deep vein thrombosis.

Most cases of CVI can be improved with treatments to the superficial venous system or stenting the deep system. Varicose veins for example can now be treated by local aesthetic endogenous surgery.

Prevalence of varicose veins and chronic venous insufficiency in men and women in the general population: Edinburgh Vein Study.J Epidemiol Community Health. 1999 

For further details regarding this disease, please contact your specialist doctor

Cystitis

Cystitis is an inflammation of the bladder. In most cases, the cause of cystitis is a urinary tract infection (UTI). A UTI happens when bacteria enter the bladder or urethra and begin to multiply. Other causes can be radiation, medication, use of catheters, hygiene products. There are several types of cystitis: bacterial, drug induced, radiation induced, foreign body, chemical, associated to other conditions.

https://www.healthline.com/health/cystitis

Fungal infection 

Genital discomfort is quite common. Vulvovaginitis, or inflammation of the vulva and vagina, is most commonly secondary to infectious agents in reproductive-aged women. Candida vulvovaginitis is responsible for about one-third of cases. Candida vulvovaginitis is caused by inflammatory changes in the vaginal and vulvar epithelium secondary to infection with Candida species, most commonly Candida albicans. Candida is part of the normal flora in many women and is often asymptomatic. Therefore, candida vulvovaginitis requires both the presence of candida in the vagina/vulva as well as the symptoms of irritation, itching, dysuria, or inflammation.  Since a local treatment is the first line of choice in cases of acute vaginal yeast infection, a variety of topical preparations are on the market, mainly containing azole fungistatic agents such as ketoconazole, miconazole, and clotrimazole.

¹ https://www.ncbi.nlm.nih.gov/books/NBK459317/

² https://www.researchgate.net/publication/8068953_Topical_Therapy_for_Fungal_Infections

Infertility in men and women

Infertility happens when a couple cannot conceive after having regular unprotected sex.

It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.

Types

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control.

Secondary infertility is when they have previously conceived but are no longer able to.

Diagnosis

If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s. Male fertility starts to fall after 40 years.

The doctor may ask about the couple’s sexual habits and make recommendations regarding these. Tests and trials are available, but testing does not always reveal a specific cause.

Risk factors and causes in men

The following problems are possible:

· Low sperm count:

· Low sperm mobility (motility):

· Abnormal sperm:

If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult.

· This can result from: a medical condition, overheated testicles, ejaculation disorders, hormonal imbalance, age, some diseases, some medications, overweight or obesity

Risk factors and causes in woman

Infertility in women can also have a range of causes.

· Age, smoking, alcohol, disbalanced diet, medical conditions could be mentioned among infertility causes in women. Ovulation disorders appear to be the most common cause of infertility in women.

Treatment

Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

Fertility treatments for men

Treatment will depend on the underlying cause of the infertility. Erectile dysfunction or premature ejaculation, varicocele, blockage of the ejaculatory duct, retrograde ejaculation, surgery for epididymis

Fertility treatments for women

Fertility drugs might be prescribed to regulate or induce ovulation.

Other options might be surgical procedures for women or assisted conception

https://www.medicalnewstoday.com/articles/165748

Menopause

Menopause is a transition into a new phase of life. It begins when the menstrual cycle finishes. Hormonal changes and other factors involved can cause discomfort.

Each person may experience menopause differently.

Menopause usually starts between the ages of 40 and 58 years in developed countries, where the average age is 51 years. For some, it will occur earlier due to a medical condition or treatment.

Causes

Most women experience natural menopause during midlife. However, surgery and other factors can cause menopause to start earlier.

If this happens before middle age, doctors may refer to it as “early menopause.”

Some treatments, such as chemotherapy and radiotherapy, can cause the ovaries to stop working either temporarily or permanently.

Doctors consider menopause to be “premature” if it develops before the age of 40 and “early” if it starts between the ages of 40 and 45.

The changes involved in menopause include:

Lower fertility, Irregular menstruation, vaginal dryness and discomfort, atrophic vaginitis, hot flashes are common around the time of menopause. A hot flash can also cause: sleep disturbances, emotional changes, depression, anxiety, and low mood are common during menopause. It is not unusual to experience times of irritability and crying spells, trouble focusing and learning, physical changes, increased risk of some health conditions.

Diagnosis

A doctor can often confirm the menopause by asking some questions.

They may also test hormone levels and perform other analyses of the blood and urine to rule out health issues. No tests, however, can conclusively indicate that menopause has begun.

Treatment

· Hormone therapy

· Other treatments - can help to reduce the occurrence of hot flashes and other menopause symptoms.

A person may find that the following can also help relieve symptoms:

· over-the-counter gels and other products for vaginal dryness

· prescription pills

· low-dose hormonal birth control pills for hot flashes, vaginal dryness, and mood changes

· low-dose antidepressants for hot flashes, even among people who do not have depression

https://www.medicalnewstoday.com/articles/155651#causes

For further details regarding this disease, please contact your specialist doctor

Asthma 

Asthma is a heterogeneous lung disease, usually characterized by chronic airway inflammation. It is defined as history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and intensity, together with variable expiratory airflow limitation. Global Initiative for Asthma (GINA) recommends treatment with daily low-dose inhalator corticosteroids (ICS) for most patients with asthma, or as-needed low dose ICS-formoterol for those with infrequent symptoms.

Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Updated 2019. http://www.ginasthma.org.

Chronic obstructive pulmonary disease (COPD)

The Global Initiative for Chronic Obstructive Lung Disease (GOLD), a project initiated by the National Heart, Lung, and Blood Institute (NHLBI) and the World Health Organization (WHO), defines COPD as follows: "COPD is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases. The chronic airflow limitation that characterizes COPD is caused by a mixture of small airways disease (eg, obstructive bronchiolitis) and parenchymal destruction (emphysema), the relative contributions of which vary from person to person. Chronic inflammation causes structural changes, small airways narrowing, and destruction of lung parenchyma. A loss of small airways may contribute to airflow limitation and mucociliary dysfunction, a characteristic feature of the disease."

COPD — The Global Initiative for Chronic Obstructive Lung Disease (GOLD), updated 2020. https://goldcopd.org/wp-content/uploads/2019/11/GOLD-2020-REPORT-ver1.0wms.pdf

For further details regarding this disease, please contact your specialist doctor

Throat infection

An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, or larynx. This commonly includes nasal obstruction, sore throat, tonsillitis, pharyngitis, laryngitis, sinusitis, otitis media, fever, sneezing. Most infections are viral in nature, and in other instances, the cause is bacterial. URTIs can also be fungal or helminthic in origin, but these are less common.

In uncomplicated colds, coughing and nasal discharge may persist for 14 days or more even after other symptoms have resolved. Acute URTIs include rhinitis, pharyngitis/tonsillitis, and laryngitis often referred to as a common cold, and their complications: sinusitis, ear infection, and sometimes bronchitis (though bronchi are generally classified as part of the lower respiratory tract.)

"Rhinitis Versus Sinusitis in Children" (PDF). Centers for Disease Control and Prevention. Archived (PDF) from the original on 16 February 2017.

For further details regarding this disease, please contact your specialist doctor