Archive for June, 2011

Causality

A rudimentary understanding of cause and effect seems to be acquired by most people on their own much earlier than it could have been taught to them by someone else. Even before they can speak, many youngsters understand the relation between crying and the appearance of a parent or other adult, and the relation between that appearance and getting held, or fed. A little later, they will develop theories about what happens when a glass containing milk is dropped or turned over, and what happens when a switch on the wall is pushed from one of its resting positions to another. While theories such as these are being formulated, a more general causal theory is also being formed. The more general theory posits that some events or states of nature are causes of specific effects. Without a general theory of causation, there would be no skeleton on which to hang the substance of the many specific causal theories that one needs to survive.
Nonetheless, the concepts of causation that are established early in life are too primitive to serve well as the basis for scientific theories. This shortcoming may be especially true in the health and social sciences, in which typical causes are neither necessary nor sufficient to bring about effects of interest. Hence, as has long been recognized in epidemiology, there is a need to develop a more refined conceptual model that can serve as a starting point in discussions of causation. In particular, such a model should address problems of multifactorial causation, confounding, interdependence of effects, direct and indirect effects, levels of causation, and systems or webs of causation (MacMahon and Pugh, 1967; Susser, 1973). This chapter describes one starting point, the sufficient-component cause model (or sufficient-cause model), which has proven useful in elucidating certain concepts in individual mechanisms of causation.

Abnormal Skin Pigmentation

Increased skin pigmentation can be caused by excessive ACTH secretion in Addison’s disease and can occur after bilateral adrenalectomy for Cushing’s disease (Nelson’s syndrome). Pigmentation can be generalized or may be localized to palmar creases, extensor joint surfaces, tongue, nails, belt or bra lines, freckles, or new scars.

Pigmentation of the upper lip, forehead, or malar eminences, known as chloasma, can be caused by pregnancy (“mask of pregnancy”), oral contraceptives, or estrogen replacement therapy.

Acanthosis nigricans presents as velvety brown thickened skin of the neck and axillae. It may be associated with syndromes of severe insulin resistance type A (ovarian dysfunction and hirsutism) or type B (autoimmune). It may also be familial or associated with obesity, acromegaly, or thyroid disease. Acanthosis presenting after age 35 years is often a sign of an underlying malignancy, such as hepatocellular carcinoma.

Pretibial areas of pigmentation are common in diabetes (“diabetic shin spots”) as a result of minor trauma or following necrobiosis lipoidica diabeticorum.

Prominent lentigines can be a sign of Carney’s complex, an autosomal dominant condition associated with atrial myxomas, schwannomas, and endocrine overactivity (eg, tumors of the thyroid, gonads, or pigmented adrenal nodular hyperplasia). Similar skin pigmentation is seen in Peutz–Jeghers syndrome with an increased risk of intestinal polyposis, adenocarcinoma, breast cancer, and tumors of the gonads and thyroid.

Diffuse hyperpigmentation is seen in POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes) syndrome; adrenal insufficiency, hypoparathyroidism, diabetes, osteosclerotic bone lesions, or thiamine deficiency may occur.

Gray-brown (“bronze”) hyperpigmentation is caused by hemochromatosis, which can cause endocrine deficiencies such as diabetes mellitus. An orange skin discoloration is characteristic of jaundice and carotenodermia (caused by ingestion of large amounts of carotene in vegetables, seaweed, or vitamin preparations).

Patchy hypopigmentation can be due to vitiligo, a condition sometimes associated with Addison’s disease and with other endocrine deficiencies as part of the polyglandular autoimmune syndrome. Hypopigmentation can also be a manifestation of cobalamin deficiency, trisomy 13, and various dermatologic conditions.

Patients undergoing chronic hemodialysis frequently become hyperpigmented, and hypopigmentation has also been reported. Other causes of hyperpigmentation include sprue, malnutrition, HIV infection, and porphyria. Hyperpigmentation may be caused by certain drugs: amiodarone, arsenic, bleomycin, busulfan, clofazimine, hydroxychloroquine, chlorpromazine, doxorubicin (nail beds), imipramine, methimazole, minocycline, niacin, primaquine, propylthiouracil, topical tretinoin, and zidovudine (nails).

Dental Care for a Reliable Smile

Dentistry is the branch of science dealing with the dental care, diagnosis, impediment and management of dental infections including those of gum and associated structures of mouth including repairing of the flawed teeth. Dental care is an integral part of the overall health care as tooth has vital function in numerous bodily functions. Dental care is the main key to hygienic and healthy living.

It is well known fact that face is the index of mind and shiny teeth play a significant role brightening one’s facial appearance. An eternal smile is the perfect impression one may possess and an attractive smile is enhances by the healthy and glossy teeth. One can win the hearts of the intermingling people very easily with a glossy smile. Teeth do have a natural color and enamel is the outer protective layer of it.

Dental care engrosses taking excellent care of the teeth, gums along with the associated composition of mouth. Anticipation and management of ailments of the gum, teeth, the subrogation or mending of flawed teeth are normally included under dental care. The traditional mode of dental care rather free dental care is brushing of the teeth daily and this practice must be given the top priority in dental health care.

A smile revives the face healthier and lively than any sorts of make-up can effect will make everyone look and stare and pearly white and clean with fresh smelling breath will absolutely be a life altering factor. The world health organization in collaboration with Indian dental association various free dental care camps are being organized. Dental care mission is the mission of total good and healthy living for all with healthy tooth.

Several people are suffering from dental illness due to absolute idleness and short of knowledge for proper dental attention. They are unsuccessful to comprehend that vigorous teeth, gum and related mouth structures are extremely important a sound health and overall well being. Proper dental fitness is not merely important for our healthy physical appearance but it is indispensable to the safety and welfare of the complete body.

Dental care may also be interpreted as tooth whitening system which is the most safe and gentle way of purging discolorations and blemishes on the teeth or enhancing and maintaining the natural color. Dental care efforts can be done once the person attains his teeth and remain for the whole life but this should be critically given importance to the permanent set of teeth.

Maintaining excellent dental care may found to be costly and thus we can go for the better dental insurance that encloses the costs for the dental treatment whether it is a regular dental health check or an urgent situation. Acquiring dental insurance from a sound dental insurance companies alleviate the worries and hassles of otherwise expensive rate oral or dental care.

Brushing teeth twice is a necessary dental care for preventing tooth decomposition and gum ailments. The size and form of toothbrush and appropriate toothpaste containing fluoride is the best tip for dental care. Fluoride assist in protection from teeth decay and is a fundamental dental care fir those who clean the teeth using interdental cleaners or floss which eliminate plaque from the amid areas where the toothbrush can’t accomplish thus preventing the gum disease.

Proper and in time diagnosis of the dental problems are the key factors for dental care. At the same time prevention of the tooth decay is very essential as it is well known fact that prevention is far better than cure. Good dental hygiene must be a habit for all to keep charming and enthralling smile on face and excellent dental health incorporated to the total good health and well being.