The Role of Self Esteem in Developing Social Anxiety

Nowadays, anxiety is a growing phenomenon because people come across more and more stressful situations. Therefore, among its different forms of manifestation, there is social anxiety. This type of anxiety generally starts in adolescence, when personality is still shaping up and when teenagers are more and more interested in getting confirmation from others. When he is analyzed by others, a teenager fears failure and being ashamed when things are not the way they should, he fears being judged by others for possible small mistakes and, thus, anxiety appears. In other words, persons with low self-confidence and lacking confidence in their abilities have low self-esteem and can easily develop a form of anxiety. As we have already mentioned, social anxiety is caused by the fear of being criticized by others, by the fear of being improperly evaluated, by the feeling of being ashamed, of being in the presence of unknown persons, etc. All these social contexts are backgrounds for individuals’ unexplainable restlessness that can lead to physical symptoms such as excessive perspiration, trembling, palpitations, blushing etc. Self-esteem is very important here as it is very important how the subject sees himself or herself in the social situation. Thus, if a person feels unable to deal with situations considered difficult and if there is lack of confidence in her/his own abilities, meaning he/she has low self-esteem, it is highly possible that this behaviour lead to the debut of social anxiety. Therapy sessions help reduce and even eliminate this disturbance. There are certain techniques consisting of facing the problems up to the moment where the subject begins feeling comfortable with normal life aspects which used to be considered anxiety episodes.

Serotonin Syndrome Developing Immediately after the Initiation of Low-Dose Methadone Therapy: A Case Report

We present a case in which serotonin syndrome developed immediately after the initiation of low-dose methadone following an increase in oxycodone dose and the initiation of duloxetine. The symptoms of serotonin syndrome were alleviated and later disappeared upon cessation of methadone alone. The case was a 47-year-old woman with a desmoid tumor. The administration of duloxetine (20 mg/day) was initiated while the patient took oxycodone sustained-release tablets (40 mg/day). The following day, excessive perspiration, chills, and tremors appeared after the initiation of 15 mg/day methadone. Discontinuation of methadone led to an alleviation of the symptoms which completely disappeared 3 days later. The results suggest that low-dose methadone can trigger serotonin syndrome as early as after the first dose. Thus, it is important to be aware of the risks and to immediately take action if symptoms appear.

Transthoracic endoscopic sympathectomy for upper limb hyperhidrosis

Background: Hyperhidrosis is a disabling troublesome characterized by excessive perspiration that produces a social and professional deficit for patients. Thorasoscopic sympathectomy represents the best approach for this disorder. There are several methods for treatment of extensive hyperhydrosis which includes: Antiperispirant, anticholenergic, ionophoresis, psychotherapy, botulinum toxins injection and surgery. Endoscopic Thorasoscopic Sympathectomy (ETS) which is most safety, which require excision and electrocoagulation by cautery or ultrasonic shear which is used in this study, and by Clips application on the thoracic sympathetic ganglia between T2 to T4 or T5. ETS is minimally invasive procedure that increased the interest in this modality of treatment.Methods: This prospective study include 78 cases admitted to IBN Sina Hospital, Sana’a, Yemen during the period of November 2013 and August 2017, 66 were male (84.6%) and, 12(15.4) are female. The procedure based on Endoscopic Thorasoscopic Sympathectomy.Results: Seventy-eight patients underwent bilateral thorasoscopic, palmer hydrosis in 55 (70.5%) patients, 14 (17.9%) combined axillary, palmar and planter and 9 (11.6%) combined with planter and axillary hyperhidrosis. Complications included partial right pneumothorax requiring chest drain one case (1.28%), chronic wound pain five to seven months two cases (2.56%) and compensatory sweating twenty -three cases (29.5%). There was one (1.25%) exploratory rethoracoscopy for bleeding at the end of the procedure which was the third intercostal artery at the vertebra-costal junction and controlled by ultrasonic shear cauterization. No cases of Horner's syndrome were identified. There was no mortality.Conclusions: Thorasoscopic sympathectomy is a safe and effective procedure for treatment of hyperhidrosis. Hospital stay is very short, lower post-operative rates of complication or infection and early wound healing. Patient more satisfied with the immediate treatment effects on the preoperative symptoms of hyperhidrosis.

Ayurvedic Panchkarma Management of Sthaulya (Obesity): A Case Report

Obesity is burning health problem for society nowadays. In Charak Samhita, Sthaulya is described widely and with deep interpretation. Also in sutrasthana which is most important part of Charak Samhita, in different adhyaya (eg. Astauninditiya, Langhanabrumhaniya, Santarpaniya) causes, symptoms and treatment are described. As an alternative approach, Ayurvedic treatment may serve as promising modality.A 27 years old male patient came in P.D. Patel Ayurveda Hospital at 5th June 2015. Patient measured weight was 98.1 kg and BMI was 33.94 which is fairly included in obesity category according to NHI guidelines. He also had some associated complaints like exertional dyspnoea, increased appetite, excessive perspiration. He was admitted in hospital and was treated with Snehana ( Aabhyantara and Bahya ), Swedana,Vamana, Virechana, Niruha Basti, Udavrtana along with oral medicines like Varunaadi Kwatha, Arogyavardhini Vati, Triphala Guggulu, Kaishor Guggulu and Navayasa Lauha. Also patient was advised to follow prescribed dietary regimes and life style strictly. The patient responded very well. He lost about 10.2 kg of weight, which was 87.9 kgs and BMI was 30.41 only in 26 days without any complications and any signs and symptoms of malnutrition. So with the help of Ayurvedic management patient got weight loss significantly

Ayurvedic Management of Sthaulya (Obesity): A Case Report

Obesity is burning health issue for society nowadays. In Sutrasthana of Charaka Samhita, in different Adhyaya (eg. Astauninditiya, Langhanabrumhaniya, Santarpaniya) causes, symptoms and treatment of Sthaulya are described. As an alternative approach, Ayurvedic treatment may serve as promising modality. A 17 years old male patient came in P.D. Patel Ayurveda Hospital on 22th May 2017. Patients weight was 114.8 kg and BMI was 37.51 which fairly included in obesity category according to NHI guidelines. He also had some associated complaints like exertional dyspnoea, increased appetite, excessive perspiration. He was treated with Snehana (Aabhyantara and Bahya), Swedana, Vamana, Virechana, Niruha Basti, Udvartana along with oral medicines like Varunaadi Kwatha, Arogyavardhini Vati, Triphala Guggulu, and Navayasa Lauha along with prescribed dietary regimes and life style modification. He lost about 9.7 kg of weight, which was 105.1 kgs and BMI was 34.34 only in 26 days without any complications.

Moisture Transport for Reaction Enhancement in Fabrics

The role of water in protective fabrics is critical to comfort and material performance. Excessive perspiration in clothing causes discomfort, and bound water can adversely affect the ability of carbon to adsorb chemicals. Yet the presence of water can also improve the moisture vapor transport of protective polymer films, and is essential for the hydrolytic destruction of nerve agents. Reported here are the findings of wicking and drying experiments conducted on various hydrophilic and hydrophobic cover fabrics that demonstrate the influence of wetting on permeation through fabrics. The influence of water content on reactive polymers capable of degrading nerve agent simulant is also discussed, and the importance of a novel “delivery system” for water to the reactive components through the use of a wicking fabric is introduced.

Mad Honey Intoxication: A Case Series of 21 Patients

Background. The “grayanotoxin (mad honey)” poisoning is not known commonly, there are some case series and case reports in the medical literature about it, especially in Turkey. The aim of this study was to describe the presentation of 21 natural honey intoxication cases and to review the literature. Material and Method. This study is retrospective analysis of twenty one patients who were admitted to the emergency department due to honey poisoning. Results. Median age of 21 patients was 55. The mean length of delay after consumption is 3.4 hrs. Dizziness, weakness, excessive perspiration, nausea-vomiting, and low blood pressure were the most observed symptoms. Mean pulse rate was 56/min. Mean systolic blood pressure was 102 mmHg. The mean length of hospital stay is 14.7 hrs. Patient rhytms on arrival were as follows: 10 patients were in normal sinus rhytm, 7 sinus bradycardia, 3 nodal rhytm, 1 atrial fibrillation. Atropine was given to 18 patients. None of our patients died and all were discharged home without any complication. Discussion. In the emergency setting, poisoning is a clinical state which is very hard to identify. We have to keep in mind that drugs and toxins may cause lethal dysrhythmias.

Literature review of the possible advantages of silicon liner socket use in trans-tibial prostheses

The silicon liner socket has been used in the trans-tibial prosthesis since the 1980s. Silicon liner sockets are sleeves of silicon material that are rolled onto the stump and fix the prosthesis to it. The producers of the liners propagate many advantages in their use i.e. better suspension of the prosthesis, protection of the stump skin and improved cosmetic appearance. This review was performed to find objective documentation in the literature in support of the advantages in prosthetic fitting and use of silicon liners. A medline search was performed with the key words: “silicon liner socket, Icelandic Roll On Silicon Socket (ICEROSS), trans-tibial prosthesis, lower leg prosthesis and stump sockets”. Six articles remained after application of the selection criteria. In two studies clinical examination was done while in the rest questionnaires were used to collect data. The indication for amputation varied from vascular insufficiency, diabetes mellitus and infection to trauma. Most studies mentioned improved prosthetic suspension compared to the conventional supracondylar fitting. Also the walking performance improved with less use of walking aids. There were reports of positive but also negative effects on the skin such as excessive perspiration and itching. Patients had a general preference in prosthetic appearance in favour of the prosthesis with a silicon liner. Further research is needed with the use of objective clinical parameters and a homogenous study group objectively to find advantages in the use of the silicon liner socket in the trans-tibial prosthesis.

Feasibility study of a novel approach to sore prevention in patients with spinal cord lesions: the computerized dynamic control Matrix 200 system

Objective: To evaluate the feasibility of a computerized mattress system based on a novel concept in sore prevention: continuous monitoring and adjustment of the interface pressure in small segments of contact between the skin and the supporting surface. Design: A preliminary observational study. Setting: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. Subjects: Twelve patients with spinal cord lesions. Interventions: Patients were examined for signs of impending sores after lying on the mattress for up to 4 successive hours. The pressure within each of the mattress's air cells was continuously measured and adjusted. Results: No evidence of redness or excessive perspiration was found in any of the areas considered to be high risk for bed sores. Maximal interface pressure was 22-30 mmHg in most of the examinations. Most of the patients felt comfortable on the mattress and the staff adapted easily to its operation. Conclusions: The system is apparently safe, and at least as efficient as other existing means for preventing sores. In addition, it may allow for increased intervals between bed positionings. We conclude that this approach of pressure control has the potential to improve bed sore prevention in a rehabilitation hospital setting.