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Here YOU CAN KNOW everything about shingles, gallbladder, gout
and its treatment .
Here you can go through the list of hospitals, list of best hospitals in U.S . for treatment of shingles, gallbladder, gout .
Gout: Condition characterized by abnormally elevated levels of uric acid in the blood, recurring attacks of joint inflammation (arthritis), deposits of hard lumps of uric acid in and around the joints, and decreased kidney function and kidney stones. Uric acid is a breakdown product of purines, that are part of many foods we eat. The tendency to develop gout and elevated blood uric acid level (hyperuricemia) is often inherited and can be promoted by obesity, weight gain, alcohol intake, high blood pressure, abnormal kidney function, and drugs. The most reliable diagnostic test for gout is the identification of crystals in joints, body fluids and tissues.
Here YOU CAN KNOW everything about shingles, gallbladder, gout
and its treatment .
Here you can go through the list of hospitals, list of best hospitals in U.S . for treatment of shingles, gallbladder, gout .
Top ranked hopspitals in US (year 2011-2012)
1. Johns Hopkins Hospital, Baltimore
2. Massachusetts General Hospital, Boston
3. Mayo Clinic, Rochester, Minn.
4. Cleveland Clinic
5. Ronald Reagan UCLA Medical Center, Los Angeles
6. New York-Presbyterian University Hospital of Columbia and Cornell, N.Y.
7. UCSF Medical Center, San Francisco
8. Brigham and Women’s Hospital, Boston
9. Duke University Medical Center, Durham, N.C.
10. Hospital of the University of Pennsylvania, Philadelphia
11. Barnes-Jewish Hospital/Washington University, St. Louis
12. UPMC-University of Pittsburgh Medical Center
13. University of Washington Medical Center, Seattle
14. University of Michigan Hospitals and Health Centers, Ann Arbor*
14. Vanderbilt University Medical Center, Nashville*
16. Mount Sinai Medical Center, New York
17. Stanford Hospital and Clinics, Stanford, Calif.
note : Two Honor Roll hospitals tied for 14th number
KNOW MORE ABOUT SOME DISEASES :
Shingles
Herpes zoster
Shingles (herpes zoster) is a painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox.
Causes, incidence, and risk factorsAfter you get chickenpox, the virus remains inactive (becomes dormant) in certain nerves in the body. Shingles occurs after the virus becomes active again in these nerves years later.
The reason the virus suddenly become active again is not clear. Often only one attack occurs.
Shingles may develop in any age group, but you are more likely to develop the condition if:
You are older than 60
You had chickenpox before age 1
Your immune system is weakened by medications or disease
If an adult or child has direct contact with the shingles rash on someone and has not had chickenpox as a child or a chickenpox vaccine, they can develop chickenpox, rather than shingles.
Symptoms
The first symptom is usually one-sided pain, tingling, or burning. The pain and burning may be severe and is usually present before any rash appears.
Red patches on the skin, followed by small blisters, form in most people.
The blisters break, forming small ulcers that begin to dry and form crusts. The crusts fall off in 2 to 3 weeks. Scarring is rare.
The rash usually involves a narrow area from the spine around to the front of the belly area or chest.
The rash may involve face, eyes, mouth, and ears.
Additional symptoms may include:
Abdominal pain
Chills
Difficulty moving some of the muscles in the face
Drooping eyelid (ptosis)
Fever and chills
General ill-feeling
Genital lesions
Headache
Hearing loss
Joint pain
Loss of eye motion
Swollen glands (lymph nodes)
Taste problems
Vision problems
You may also have pain, muscle weakness, and a rash involving different parts of your face if shingles affects a nerve in your face. See: Ramsay Hunt syndrome
Signs and tests
Your doctor can make the diagnosis by looking at your skin and asking questions about your medical history.
Tests are rarely needed, but may include taking a skin sample to see if the skin is infected with the virus that causes shingles.
Blood tests may show an increase in white blood cells and antibodies to the chickenpox virus but cannot confirm that the rash is due to shingles.
Treatment
Your doctor may prescribe a medicine that fights the virus, called an antiviral. The drug helps reduce pain and complications and shorten the course of the disease. Acyclovir, famciclovir, and valacyclovir may be used.
The medications should be started within 24 hours of feeling pain or burning, and preferably before the blisters appear. The drugs are usually given in pill form, in doses many times greater than those recommended for herpes simplex or genital herpes. Some people may need to receive the medicine through a vein (by IV).
Strong anti-inflammatory medicines called corticosteroids, such as prednisone, may be used to reduce swelling and the risk of continued pain. These drugs do not work in all patients.
Other medicines may include:
Antihistamines to reduce itching (taken by mouth or applied to the skin)
Pain medicines
Zostrix, a cream containing capsaicin (an extract of pepper) that may reduce the risk of postherpetic neuralgia
Cool wet compresses can be used to reduce pain. Soothing baths and lotions, such as colloidal oatmeal bath, starch baths, or calamine lotion, may help to relieve itching and discomfort.
Resting in bed until the fever goes down is recommended.
The skin should be kept clean, and contaminated items should not be reused. Nondisposable items should be washed in boiling water or otherwise disinfected before reuse. The person may need to be isolated while lesions are oozing to prevent infecting other people who have never had chickenpox -- especially pregnant women.
Expectations (prognosis)
Herpes zoster usually clears in 2 to 3 weeks and rarely recurs. If the virus affects the nerves that control movement (the motor nerves), you may have temporary or permanent weakness or paralysis.
Sometimes, the pain in the area where the shingles occurred may last from months to years. See: Postherpetic neuralgia
Complications
Sometimes, the pain in the area where the shingles occurred may last for months or years. This pain is called postherpetic neuralgia. It occurs when the nerves have been damaged after an outbreak of shingles. Pain ranges from mild to very severe pain. It is more likely to occur in people over 60 years.
Other complications may include:
Another attack of shingles
Blindness (if shingles occurs in the eye)
Deafness
Infection, including encephalitis or sepsis (blood infection) in persons with weakened immune systems
Bacterial skin infections
Ramsay Hunt syndrome if shingles affected the nerves in the face
Calling your health care provider
Call your health care provider if you have symptoms of shingles, particularly if you have a weakened immune system or if your symptoms persist or worsen. Shingles that affects the eye may lead to permanent blindness if you do not receive emergency medical care.
Prevention
Avoid touching the rash and blisters of persons with shingles or chickenpox if you have never had chickenpox or the chickenpox vaccine.
A herpes zoster vaccine is available. It is different than the chickenpox vaccine. Older adults who receive the herpes zoster vaccine are less likely to have complications from shingles. Adults older than 60 should receive the herpes zoster vaccine as part of routine medical care.
Gout
Gout: Condition characterized by abnormally elevated levels of uric acid in the blood, recurring attacks of joint inflammation (arthritis), deposits of hard lumps of uric acid in and around the joints, and decreased kidney function and kidney stones. Uric acid is a breakdown product of purines, that are part of many foods we eat. The tendency to develop gout and elevated blood uric acid level (hyperuricemia) is often inherited and can be promoted by obesity, weight gain, alcohol intake, high blood pressure, abnormal kidney function, and drugs. The most reliable diagnostic test for gout is the identification of crystals in joints, body fluids and tissues.
Gout is a kind of arthritis that occurs when uric acid builds up in the joints.
Colchicine
Colchicine is used to prevent gout attacks (sudden, severe pain in one or more joints caused by abnormally high levels of a substance called uric acid in the blood) in adults, and to relieve the pain of gout attacks when they occur. Colchicine is also used to treat familial Mediterranean fever (FMF; an inborn condition that causes episodes of fever, pain, and swelling of the stomach area, lungs, and joints) in adults and children 4 years of age and older. Colchicine is not a pain reliever and cannot be used to treat pain that is not caused by gout or FMF. Colchicine is in a class of medications called anti-gout agents. It works by stopping the natural processes that cause swelling and other symptoms of gout and FMF.
Drugs and Supplements - Last revised: February 1, 2010
Febuxostat
Febuxostat is used to treat gout. Gout is a type of arthritis in which uric acid, a naturally occurring substance in the body, builds up in the joints and causes sudden attacks of redness, swelling, pain, and heat in one or more joints. Febuxostat is in a class of medications called xanthine oxidase inhibitors. It works by decreasing the amount of uric acid that is made in the body. Febuxostat is used to prevent gout attacks, but not to treat them once they occur.
Drugs and Supplements - Last revised: June 1, 2009
Allopurinol
Allopurinol is used to treat gout, high levels of uric acid in the body caused by certain cancer medications, and kidney stones. Allopurinol is in a class of medications called xanthine oxidase inhibitors. It works by reducing the production of uric acid in the body. High levels of uric acid may cause gout attacks or kidney stones. Allopurinol is used to prevent gout attacks, not to treat them once they occur.
Drugs and Supplements - Last reviewed: October 1, 2010
Uric acid - urine
Uric acid is a chemical created when the body breaks down substances called purines. Purines are found in some foods and drinks, such as liver, anchovies, mackerel, dried beans and peas, beer, and wine. Purines are also a part of normal body substances, such as DNA.
Von Gierke disease
Von Gierke disease is a condition in which the body cannot break down glycogen for energy. Gycogen is stored in the liver and muscles and is normally broken down into glucose when you do not eat.
Probenecid
Probenecid is used to treat chronic gout and gouty arthritis. It is used to prevent attacks related to gout, not treat them once they occur. It acts on the kidneys to help the body eliminate uric acid. Probenecid is also used to make certain antibiotics more effective by preventing the body from passing them in the urine. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Synovial biopsy
A synovial biopsy is the removal of a piece of tissue lining a joint. The tissue is called the synovial membrane.
Tests and Treatments - Last reviewed: July 28, 2010
Injury - kidney and ureter
Injury to the kidney and ureter is damage to these organs of the upper urinary tract.
Diseases and Conditions - Last reviewed: September 3, 2010
Uric acid - blood
Uric acid is a chemical created when the body breaks down substances called purines. Purines are found in some foods and drinks, such as liver, anchovies, mackerel, dried beans and peas, beer, and wine.
Wrist pain
Wrist pain is any pain or discomfort in the wrist.
Ankle pain involves any discomfort in one or both ankles.
Lesch-Nyhan syndrome
Lesch-Nyhan syndrome is an inheritable disorder that affects how the body builds and breaks down purines. Purines are a normal part of human tissue and help make up the body's genetic blueprint. They are also found in many different foods.
Hereditary fructose intolerance
Hereditary fructose intolerance is a disorder in which a person lacks the protein needed to break down fructose. Fructose is a fruit sugar that naturally occurs in the body. Man-made fructose is used as a sweetener in many foods, including baby food and drinks.
Soy
The soybean has been a part of the human diet for almost 5,000 years. Unlike most plant foods, the soybean is high in protein and is considered equivalent to animal foods in terms of the quality of the protein it contains.
Pseudogout
Pseudogout is a joint disease that can cause attacks of arthritis. Like gout, the condition involves the formation of crystals in the joints. But in pseudogout, the crystals are formed from a salt instead of uric acid.
Synovial fluid analysis
Synovial fluid analysis is a group of tests that examine joint (synovial) fluid. The tests help diagnose and treat joint-related problems.
Eisenmenger syndrome
Eisenmenger syndrome is a condition that affects blood flow from the heart to the lungs in some babies who have structural problems of the heart.
Sulfinpyrazone
Sulfinpyrazone is used to treat gouty arthritis. It works by lowering the amount of uric acid in your blood, preventing gout attacks. The drug helps prevent attacks but will not treat an attack once it has started. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Foot pain
Pain or discomfort can be felt anywhere in the foot, including the heel, toes, arch, instep, sole, or ankles
GALLBLADDER PROBLEMS
Gallstones
Gallstones are hard, pebble-like deposits that form inside the gallbladder. Gallstones may be as small as a grain of sand or as large as a golf ball.
Gallbladder disease
Introduction:
The gallbladder is a sac located under the liver. It stores and concentrates bile produced in the liver. Bile aids in the digestion of fats, and is released from the gallbladder into the upper small intestine (duodenum) in response to food, especially fats.
Types of gallbladder disease include:
Cholecystitis (inflammation of the gallbladder)
Cholelithiasis (gallstones)
You can have gallstones without any symptoms. However, if the stones are large, they can block the duct that leads from the gallbladder. This can cause pain and require treatment. At first they may block the duct and move away, causing only occasional pain. Continuous blockage of the duct, however, can be life threatening and requires surgical removal of the gallbladder.
Signs and Symptoms:
Pain, mostly on the upper right side of the abdomen
Pain following meals, intolerance of fatty foods
Nausea, vomiting
Loss of appetite
What Causes It?:
Inflammation causes a gallbladder attack. This usually happens because a stone is blocking a passageway in the gallbladder. Gallstones develop in the gallbladder when substances in bile form hard particles. They can be as small as a grain of sand or as large as a golf ball. Women are at higher risk of developing gallstones than men, and the risk increases the more children a woman has had. However, the increased risk associated with having children can be offset by breastfeeding. Women who use hormone replacement therapy are also at higher risk of developing gallstones. Being overweight and rapid weight loss followed by weight gain are other risk factors for gallstones.
What to Expect at Your Provider's Office:
If you are having a gallbladder attack, you will feel tenderness when the upper right side of your abdomen is touched. Jaundice (yellowing of the skin) occurs when the bile duct (a tube between the liver and gallbladder) is also blocked. If your health care provider thinks you have a gallstone, you will probably need an ultrasound. During an ultrasound, sound waves take pictures of your gallbladder. This test is painless and can be performed quickly, which is important if you are in a lot of pain.
Treatment Options:
Gallbladders that cause pain are usually removed. There are no known problems caused by living without a gallbladder. Today, most gallbladder surgeries are performed with a laparoscope. This instrument shows the surgeon pictures of your gallbladder as it is being removed. The minimally invasive procedure allows for a smaller incision and a shorter hospital stay than traditional surgery.
Some drugs can dissolve stones, eliminating the need for surgery. However, it can take 2 years for a stone to dissolve, and gallstones often recur later.
An oral bile acid, ursodeoxycholic acid (Ursodiol), can dissolve cholesterol stones that are quite small (less than 15 mm in diameter). The drug is successful in about 40% of patients.
Methyl tert-butyl ether and monooctanoin (Moctanin) are solvents that are infused directly into the bile duct or the gallbladder to dissolve stones.
Doctors may use shock wave therapy (lithotripsy) to break up stones.
Complementary and Alternative Therapies
You should see your provider for tests before you start any alternative treatment. This will help determine the remedies that are right for the size of your stone and your condition. Do not attempt complementary and alternative therapies on your own; work with an experienced provider. Keep all of your physicians informed regarding complementary and alternative therapies, as some therapies may interfere with conventional medical treatments. Work with a provider who is knowledgeable in complementary medicine to find the right mix of treatments for you.
Nutrition and Supplements
These nutritional tips may help reduce symptoms:
Eliminate suspected food allergens, such as dairy (milk, cheese, and ice cream), wheat (gluten), soy, corn, preservatives and chemical food additives. Eggs, especially, may irritate the gallbladder (as well as being high in cholesterol). Your health care provider may test you for food allergies.
Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell peppers).
Avoid refined foods, such as white breads, pastas, and sugar.
Eat fewer red meats and more lean meats, cold water fish, tofu (soy, if no allergy) or beans for protein.
Eat more fiber. Consider fiber supplements, such as flaxmeal (1 tsp. 1 - 3 times per day). Combine 1 heaping tsp. of flaxmeal in 8 oz. of apple juice for a drink high in fiber and pectin.
Use healthy cooking oils, such as olive oil or vegetable oil.
Reduce or eliminate trans fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
Avoid alcohol, and tobacco. Some evidence suggests that people who drink caffeinated coffee have a lower risk of gallstones, though study results are mixed. Talk to your doctor before increasing your caffeine intake, as caffeine can affect several conditions and interact with medications.
If possible, exercise lightly 5 days a week.
You may address nutritional deficiencies with the following supplements:
A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc, and selenium.
Vitamin C, 500 - 1,000 mg daily, as an antioxidant and for immune support.
Phosphatidylcholine, 300 - 2,000 mg daily, may help dissolve gallstones.
Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
Magnesium, 400 - 600 mg daily, for nutrient support.
Taurine, 1.5 - 3 gm daily, for nutrient support.
Herbs
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting any treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). People with a history of alcoholism should not take tinctures. Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures singly or in combination as noted. If you are pregnant or nursing, speak to your provider before using any herbal products.
A gallbladder attack can be a medical emergency. Do not use herbs to treat gallbladder disease on your own; work with a trained herbal practitioner under the supervision of your physicians. The following herbs are sometimes used to treat gallbladder disease:
Green tea (Camelia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant effects. You may also prepare teas from the leaf of this herb. Note: green tea extracts may contain caffeine. Look for decaffeinated products.
Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg 2 - 3 times daily, for liver and galbladder detoxification support.
Globe artichoke (Cynara scolymus) standardized extract, 250 - 500 mg 2 - 3 times daily, for support of galbladder and liver function.
Turmeric (Curcuma longa) standardized extract, 300 mg 3 times daily for support of liver function. High doses of turmeric can have blood thinning effects. Care should be taken if you are on other blood thinning medications.
Homeopathy
Few clinical studies have examined the effectiveness of specific homeopathic remedies. However, a professional homeopath may recommend one or more of the following treatments for menstrual pain based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
Some of the most common remedies are listed below. A common dose is 3 - 5 pellets of a 12X to 30C remedy every 1 - 4 hours until your symptoms improve.
Colocynthis for colicky abdominal pains that are lessened by pressure or bending double
Chelidonium for abdominal pain that moves to the right shoulder area
Lycopodium for abdominal pain that is worse with deep breaths
Physical Medicine
Castor oil pack. Apply oil to a clean, soft cloth and place on abdomen. Cover with plastic wrap, place a heat source (hot water bottle or heating pad) over the pack, and let sit for 30 - 60 minutes. For best results, use for 3 consecutive days. Apply to abdomen, especially the gallbladder area, to help reduce swelling.
Acupuncture
Acupuncture may be especially helpful in pain relief, reducing spasm, and easing bile flow and proper liver and gallbladder function.
Following Up:
Early surgery usually ends symptoms and recurrence. Stones may appear again in the bile duct, however.
Special Considerations:
If you have diabetes or are pregnant, you have a higher risk of complications from gallbladder attacks. If you are pregnant, use choleretic herbs with caution. Milk thistle and dandelion root are safe in pregnancy. Talk with your health care provider before you take any medication or supplement.
Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
