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The heart is located in the thoracic cavity, and acts as a pump. Blood comes to it through a series of wide vessels or veins. At each pump, the blood is cycled through two separate circulations. At first, the oxygen-deprived blood arriving from the system is cycled through the lungs where gas exchanges take place. Carbon dioxide, collected in its journey through the system, is then excreted, to be exhaled with the next breath. In its place, oxygen is taken aboard by the blood, converting it into rich, red blood.

At the next beat, this blood returns to the heart, again to be pumped out HO through the large artery called the aorta to circulate to all parts of the body. When this has been completed, it is again collected via the vein or venous system, to be rechanneled into the heart once more.

This process goes on tirelessly, non-stop year in, year out, for the remainder of the person’s life.

The heart is a large muscle, and its fibers are all interconnected. In there are two chambers on either side. The smaller upper ones are called the atria; the large lower ones are called the ventricles. Both are connected to tubes or vessels, and access is through an intricate system of valves that continually open, then snap shut with the heartbeats.

Blood comes first to the right atrium, then through a valve to the right ventricle. Next it goes via the pulmonary zing) artery to the lungs to be reoxygenated. From here it returns through the pulmonary vein to the left atrium, then through a valve to the left ventricle. This is a massive organ, and when this contracts, it must give the blood sufficient momentum to force its way into a large tube, the aorta, and circulate blood around the system. Imagine the amount of force and strength needed to sieve this.

Don’t you think it’s incredible that babies are born with the heart intact so often and that it’s relatively disease-free for such a long time, especially when so many other dreadful things may occur to them? Considering the number of ailments that the average child gets, it really is surprising that the heart escapes from so much.

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.