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Sometimes in patients who have undergone removal of the stomach (most probably from severe peptic ulceration) a similar situation can occur. However, as the liver can store vitamin B12 with amounts that may last up to five years, it may be several years after surgery that the symptoms will commence. In other patients who have bowel disorders, there may be interference in folic acid absorption. A condition called Crohn’s disease may be present, or there may have been surgical removal of part of the bowel, coeliac disease, sprue and certain other disorders.

During pregnancy there is a large increase in the body’s need for folic acid. For this reason, folic acid is now given routinely together with iron to all women during pregnancy.

Some patients on drug medication for other conditions have their folic-acid supplies adversely affected. This ma y include drugs taken for epilepsy, and certain sulfa drugs, to name some of the more common ones implicated.

Apart from affecting the red cells. these deficiencies may also adversely affect the production of the white cells and platelets, both of which may be reduced in numbers. This in turn may produce serious symptoms and conditions attributed to this.

Vitamin B12 Deficiency Symptoms

The symptoms will be a combination of the usual symptoms of anaemia, plus symptoms of the underlying cause. A glossitis (sore, red tongue) usually occurs as well. The blood picture shows abnormal cells, and there is a reduced number of white cells and platelets.

Inadequate vitamin B12 may also react adversely on the nervous system, producing a serious condition called subacute combined degeneration of the spinal cord. This also produces symptoms that are described under the nervous system. It is essential that this condition be treated early, for damage to the cord may be rectified with prompt early treatment.

But if left, these changes may be permanent, much to the discomfort of the patient. Tests are available that directly measure the blood levels of folic acid and vitamin B12. (Refer to the section on vitamins for a list of foods rich in these substances.)

Vitamin B12 Deficiency Treatment

Therapy is very satisfactory, and the results relatively prompt. Once the diagnosis has been established, the doctor will most likely order folic acid in tablet form, commonly giving 5 mg three times a day.

Vitamin B12 is usually given in the form of an injection. Over the years the exact chemical formulation has changed. It used to be cyanocobalamin. often injected weekly by the doctor or district nurse. However. this has now changed to a related product called hydroxocobalamin 1000 (equals 1 000 micrograms/ ml) that is claimed to offer adequate protection if given once each three months by injection. This is now the routine in Australia and New Zealand for pernicious anaemia patients. Nevertheless, many older patients claimed they felt better on their monthly or bimonthly shots of B12 in the older form.

The injections may he necessary for the rest of the patient’s life. They are painless and adverse side effects are extremely uncommon. It is a small price to pay for a supplement that yields such dramatic and beneficial results.

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Vitamin B12 Deficiency Symptoms

The nasal cavity is the usual starting point for the flu. This is produced by viral invasion of the nasal lining, successfully attacking it when local resistance is reduced. This is common following or during chills, being in crowded surroundings with others soughing and sneezing germs about in profusion. A slight burning or itching is soon followed by a thin watery discharge, which generally becomes infected with secondary invaders to produce the typical thick, yellowish nasal discharge.

As toxins spread to other parts of the body, general feelings of malaise, elevated temperatures, aches and pains take place. The virus rapidly becomes established in other parts of the respiratory tract, and advances quickly to the pharynx (throat), larynx, bronchi and lungs. It can also travel into the sinuses on either side of the nasal passageways, and along the Eustachian tubes into the idle ear, setting up infections in each cc, together with a further set of symptoms.

The flu is the most common of all infectious disorders, and can account for the discomfort and disability, as well as tune loss in industry.

Chronic rhinitis sometimes will not completely disappear, and a long-standing chronic swelling of the nasal linings will occur. Also obstruction to the airways, due to mechanical blockage, or due to injury or allergy, may develop. There may be a chronic sinus infection, and the nasal passages may swell along with this. Fumes, dust, the ubiquitous house-dust mite, and an unsuitable climate have all been incriminated.

Flu Symptoms

There is swelling and redness of the mucosal lining of the nasal passages, and often respiratory difficulty. In the early stages it may be intermittent, or only on one side, but this may become more persistent, sometimes affecting both nostrils. There may be a thick, sticky discharge, with much hawking and nose blowing to gain freedom.

If the Eustachian tubes become blocked, hearing reduction may occur. Often there is a headache, with a feeling of fullness in the head, the voice becomes nasal, and mouth breathing and snoring may occur. The patient probably uses nasal drops to excess, and in due course this may aggravate the condition.

These are usually those of nasal obstruction, generally in a person prone to hay fever or other systemic allergies. Generally it affects both sides and there is some discharge. It may be colorless and mucoid in nature. If infections occur, this will become JW, will contain pus and probably be A. Often there are few other symptoms; headaches are unusual. Frequently the most troublesome symptoms are from the allergies that produced polyps in the first place, for these can persist.

Most patients tend to overuse nasal drops, but these give little if any relief, for usual polyp is far too large to be reduced by drops aimed at causing blood vessel walls to contract.

Sometimes the polyps can be seen when inspecting the internal part of the nose from the outside.

Flu Treatment

This consists of finding a possible underlying cause, such as foreign bodies, infections, septal deviations, environmental factors etc, and rectifying these where possible. Ceasing smoking, stopping the overuse of nasal decongestants, and getting out in the fresh air may help.

Antihistamines and the corticosteroid inhalants (such as beclamethasone dipropionate inhalant for nasal use) may give relief if there is an allergy basis. If these simple measures are unsuccessful, the ENT doctor may resort to submucosal diathermy. When this heals, the surface tissues will contract and reduce the swelling. In severe cases, resort to surgery may be necessary.

Nasal allergy. This is common, especially in young adults and children, although anybody may be affected. It simply means the body is allergic to various substances (called antigens) it contacts. An immediate reaction may occur, producing the typical set of symptoms.

The condition is more common in spring and early summer, when pollens from flowering grasses arc about in profusion. But many other allergens arc around. Each person will have a well-defined series of items to which he is allergic. These may include inhalants, items that are eaten or contacted. Moulds, feathers, pollens, house-dust (or more accurately the house-dust mite), some foods, most notably fish, milk and egg products, and certain drugs are well-established for causing trouble with many patients. Once sensitized to a substance, this tendency will remain. Symptoms are frequently widespread through the body.

There may be sneezing, with an itchy, watering nose that often blocks up. In severe cases, the allergic response may extend to the lungs, causing mild breathing difficulties and even a wheeze. This condition is widespread and important, and in recent times a significant advance has been made in treatment. It is now possible to gain very satisfactory results, even in cases that were once severe and sustained considerable degrees of disability.

Nasal polyps. Nasal polyps are grayish masses of tissue that can occur anywhere in the nasal passageways. They resemble a tiny bunch of grapes, having narrow stalks by which they are attached to the walls of the nasal passages. Almost always they are due to swelling of the nasal canal linings. In sonic areas the lining becomes waterlogged (oedematous) and as the tissue may be loose, it tends to sag. Constant nasal blowing, the addition of more fluid from infections, or more commonly allergies, produces further swelling. Gravity helps the downward movement, and finally a polyp is born.

This is usually carried out by the ENT surgeon. Diagnosis is made by a thorough inspection of the nasal passages, both from the front as well as from behind. Mirrors are used that give a good of the back parts of the nasal canals, and often large polyps are seen there.

Surgical removal of the polyps gives the best results, and this is carried out with a flu wire “snare” that grasps the polyp at its stalk and severs it. Results are A, and immediate normal nasal airway function is again possible. However, it is essential that any basic underlying cause is treated at the same time, otherwise recurrences are almost inevitable. Allergies, sinus infections and septal deformities should all be attended to, for unless this occurs, the operation may be redundant as the polyps make reappearance later on, producing identical symptoms.

What is Ulcer?

Ulcers may commonly occur in the oral cavity. They may come on suddenly, probably preceded by a small watery blister that erupts, leaving a shallow ulcer with a grey or yellow base. They are sometimes painful, and often take some time to heal. Various types of oral ulcers are described. Aphthous ulcers (also known as canker sore or dyspeptic ulcers of the mouth) are thought to be due to certain foods, and allergy may play a part. The advice is often put forward that, by leaving off possible irritating foods such as citrus fruits, nuts and chocolates, the risk of recurrence may be lessened.

Vincent’s angina is another form of painful throat that is often accompanied with ulceration of the oral cavity. It is thought to be due to infecting organisms, and sometimes follows dental work. It appears to be more common in people whose general level of health is poor. Symptoms. These forms of ulceration often come on abruptly. They may be accompanied with constitutional symptoms, such as mild fever and general malaise. The ulcers are usually painful, and may occur on the gums. the inner sides of the lips, tongue or throat. There may be general inflammation around them, and the lymph glands under the jaw and in the neck on the affected side may be swollen and quite painful to touch. Eating food is often painful, and salty food produces considerable discomfort in the ulcer itself.

Ulcer Treatment

Bland mouthwashes often help to remove debris from the ulcers. Adding half a teaspoon of common salt to a glass of hot water and rinsing every few hours stings. but can afford some relief. Avoiding products that are known to aggravate might prevent recurrences. In some ulcers, antibiotics will be effective, but usually this is not so. Your doctor may prescribe such medication as figures regularly testify. Regular care by the dentist will help prevent caries and gum problems. Prevention in this area is the best line.

The electronic computer used universally in business offices is a relatively modern invention. Each year they are becoming smaller, cheaper, more efficient, and requiring less sophisticated electronics. Indeed, today hardly a school student is without a computer at school (or at home, for that matter), and they have long since become as much a part of the daily human scene as transistor radios and television sets. However, the idea of the computer is nothing new. Indeed, the basic ingredients have been around for as long as the human race.

In fact, every human possesses one of the world’s finest computers. It is quick, reliable, requires minimum servicing, and flashes out the answers in record time. We refer, of course, to the human brain, and the intricate apparatus known as the central nervous system.

This is basically a complex communications network and, fortunately for the human race, because it is so specialized and so efficient, it makes living a relatively easy pastime.

Housed in the protective bony vault of the cranium is the nerve centre of this computer system. From here, branches radiate. Some nerves go directly to certain specialized areas providing specific functions—such as the optic nerve caring for vision that goes to the eye, and the auditory nerve attached to the ear structure that cares for the sense of hearing.

There are 12 so-called “cranial nerves” leading directly from the brain itself. A massive ropelike structure of nervous material then leaves the brain via the stem, and courses through a canal made up of a central hole in the vertebral bones of the spine.
Depending on their location, the vertebrae have been given different names, purely for descriptive purposes. Those in the neck are referred to as the cervical vertebrae. Those in the chest region are the dorsal or thoracic vertebrae. In the lower part of the trunk, they arc large, having to support the body, and these are the big lumbar vertebrae. Then comes a series of fused vertebrae located in the pelvic region, called the sacrum. Finally, at the very tip, there is a series of tiny, apparently unimportant bones collectively called the coccyx (or tail). In animals, the coccygeal bones are for the tail structure. As the spinal column of nervous tissue descends through this strongly protected (but movable) canal, nerves are given off at each side, between successive vertebrae. These supply structures on each side of the body.

In the lower cervical, upper dorsal region, several major roots (as they are called) are given off, and these join, divide and redivide in a maze of nervous tissue called the brachial plexus. In turn this gives rise to the major nerves of the upper limbs. In this manner each part of the arms, hands and fingers is supplied with nerve fibers. They are all part of the total nervous network.

Further down, in the lumbar region, massive nerve roots are given off on either side to form the giant sciatic nerve. This supplies the lower limbs, including feet and toes. The large nerve gradually divides into smaller and smaller branches until every part, skin, blood vessel walls, muscles etc, receives a nervous supply.

There are many functions of the nervous system, but only the chief ones will be pointed out.

Motor Function

This part of the brain controls the action (or motor function) of the various parts of the body. It acts by producing electrical contraction of the muscle fibers that make up muscles. Contraction causes a shortening of the muscles. In turn this produces active movement.

If we desire to move the upper limb, the conscious idea goes to the part of the brain (called the cerebral hemisphere) governing limb movement. Electrical impulses are channeled along the correct nerve that goes to the muscle groups involving the upper limbs – a fraction later, the muscle fibers contract. The limb moves, or bends, or does whatever activity is required.

Similarly, if we desire to bend it in the opposite direction, impulses are sent to Micrograph of human nerve cells. There are two types of branching processes: an axon extends from each cell body to transmit nerve impulses away from the cell body, and dendrites receive incoming impulses and act as sensory receptors for the cell, the opposite muscle groups. The first set of muscles relax as no more impulses are sent, and the opposite ones then carry out a similar function, so enabling an opposite movement.

This all happens in a fraction of a second. In an incredible manner, our computerized system knows which messages to send to which muscle fibers, merely by a conscious thought. It surely represents the finest coordination and smoothest working ever devised.

Sensory Function

Apart from the strictly motor activity, the nerves have a sensory function as well. Most parts of the body have receptors to the various sensations. For example, we are able to appreciate heat (or lack of heat, which equals cold), pressure, pain, the awareness of space. The hands and fingers are plentifully endowed with sense end organs (as they are called), for this all forms a part of nature’s inbuilt protection system of the body.

The cranial nerves also have specialized senses, such as being able to appreciate vision, hearing, the sense of smell and taste.

When stimulated, similar electrical impulses are conveyed through the nervous system back to the brain, and an awareness of these different sensations is possible.

When the two systems are coordinated, it will be seen that they are basically operational for our own welfare. We may see, hear, feel and sense danger. This will immediately give us the message consciously to set our motor system into action and take appropriate steps.

If we are exposed to excessive heat, we quickly move from the spot. We immediately remove any part of the body from a source of pain. If we see danger approaching (whatever the form), our legs immediately work and bodily remove us from this threat.

The gradations may be on a small scale (such as pulling the finger from a hot stove) or a more major one (when we run across the road to escape an oncoming vehicle, or flee for our lives in the event of a more ominous life-endangering threat from hostile foes). There are many degrees. But the essential basic principles are the same. The nervous system is geared to keep the body protected and in first-class working order at all times.

Just to make the total operation more effective, there are certain actions that are governed by so-called “reflex” movements. This circumvents the brain, and acts at the same level as the activity. For example, if the knee is tapped just below the kneecap, a “reflex” movement occurs and the foot jumps forward.

Many such reflex circuits occur in the body. They are automatic protective devices geared to preserve the body.

Sympathetic Nervous System

This is another silently working system that is also operating at all times. It is basically geared to carry out many unconscious functions necessary to the normal everyday wellbeing of the body. For example, the sweat glands of the skin are under the control of this system. Nobody consciously tells the sweat glands to start to work when the weather becomes hot, and the body desires to lose fluid. It just happens. This is because the sympathetic system automatically operates when stimulated by certain situations (e.g. temperatures rising). Sweat is produced, and pours onto the skin surface.

Here it dries, and in so doing, takes a lot of heat from the body. The result is that the body cools down, and so does not reach dangerously high levels that could have an adverse effect on the general function. As the temperatures (internally and externally) reduce, so the need for sweating is reduced, and we perspire less. Once more this is an entirely automatic, computerized function and result. It occurs in the specialized tissues of the brain cells.

This simple example is multiplied thousands of times so that every activity and possible function is covered. Fortunately, this is quite out of conscious control, for if we had to think each time we needed the assistance of one of these functions, we would be hard pressed.

The circulation of the blood, the production of hormones and chemicals by the internal glands, the beating of the heart and in fact nearly every part of the system is, to a greater or lesser extent, under this automatic nervous system control.