Urticaria is a raised, red, itchy rash that appears on the skin. The raised marks in the rash are called weal. Each weal is short-lived, but the rash can move about. The rash normally disappears after a few days, but can sometimes last longer.

When urticaria lasts less than six weeks, it is described as acute. If it occurs daily, or more or less daily, for six weeks it is called chronic urticaria.

Acute urticaria is a common condition, and it affects one in five people at some point in their life. It is more likely to affect children. Chronic urticaria is much rarer, and affects one in every 1,000 people.

Symptoms

Most episodes of urticaria peak between 8 to 12 hours, then stop after 24 hours. The weal of urticaria is raised, and pink or red in colour. They are usually very itchy and range in size from a few millimetres to the size of a hand.

Individual weal normally fades after a few hours, but can be replaced by new ones elsewhere on the body. They may appear on just one part of the body or across a large part of it. The skin returns to normal as soon as the weal fades.


Types

• Urticaria vasculitis

  Urticaria vasculitis is a rare form of this condition. The weal is tender, last more than 24 hours and leave a bruise. They need to be urgently looked at by a dermatologist (skin specialist).

• Angioedema

  Around half of people with chronic (persistent) urticaria and a quarter of people with acute (short-term) urticaria also get a related condition called Angioedema.

  Angioedema is swelling in the deeper layers of the skin, usually in the eyelids, lips and sometimes the mouth, although it can occur anywhere. Angioedema causes a burning sensation but is not usually itchy. It usually clears within a few days.

Tonsillitis is an infection of the tonsils. The main symptom of tonsillitis is a sore throat. There may be several other symptoms such as coughing, headaches and a fever. Tonsillitis can be caused by either a virus or bacteria, although most cases are viral. The incubation period (the time between picking up the infection and symptoms starting to appear) is usually two to four days.


Tonsillitis can spread from person to person through hand contact (then touching your mouth with contaminated hands), breathing in the airborne droplets after someone with tonsillitis has sneezed or sharing the utensils or toothbrush of an infected person. Children and adolescents aged 5-15 years old are most likely to get tonsillitis, but it can affect anyone.

Based on his vast experience in the field of Disease Management, Dr Abraham has observed that Chronic Tonsillitis affecting people with low immunity may later be developed as Asthma. Children with recurrent sneezing, sore-throat, throat pain or tonsillitis may soon develop asthma especially if there is a family history.


Symptoms
The main symptom of tonsillitis is a sore throat. Other common symptoms include:

• red and swollen tonsils,
• pain when swallowing,
• high temperature (fever) over 38°C,
• coughing,
• headache,
• tiredness,
• pain in your ears or neck,
• white pus-filled spots on your tonsils, and
• Swollen lymph nodes (glands) in your neck.

Less common symptoms of tonsillitis may include:

• vomiting,
• constipation,
• a ‘furry’ tongue,
• bad breath, and
• Difficulty opening your mouth.

1. Cervical Spondylosis

   
   Overview

   Cervical spondylosis is a disorder in which there is abnormal wear on the cartilage and bones of the neck. This is also called cervical osteoarthritis.
   
   
   Causes
   Cervical spondylosis is caused by chronic wearing away of the cervical spine, including the cushions between the neck vertebrae (cervical disks) and the joints between the bones of the cervical spine. There may be abnormal growths or “spurs” on the bones of the spine (vertebrae).

   These changes can, over time, press down on one or more of the nerve roots. In advanced cases, the spinal cord becomes involved. This can affect not just the arms, but the legs as well.

   The major risk factor is aging. By age 60, most women and men show signs of cervical spondylosis on x-ray. Other factors that can make a person more likely to develop spondylosis are:

   • Past neck injury (often several years before)
   • Severe arthritis
   • Past spine surgery

   
   Symptoms
   Symptoms often develop slowly over time, but may start suddenly.

   More common symptoms are:

   • Neck pain (may radiate to the arms or shoulder)
   • Neck stiffness that gets worse over time
   • Loss of sensation or abnormal sensations in the shoulders, arms, or (rarely) legs
   • Weakness of the arms or (rarely) legs
   • Headaches, particularly in the back of the head

   Less common symptoms are:

   • Loss of balance
   • Loss of control over the bladder or bowels (if spinal cord is compressed)

   
   Complications

   Some common complications of cervical spondylosis are:

   • chronic neck pain
   • progressive loss of muscle function or feeling
   • inability to retain faeces
   • urinary incontinence

2. Lumbar Spondylosis

   
   Overview

   Lumbar spondylosis is the degeneration of the nerves in the lower part of the body that reduces the ability of the involved segment to proceed through its normal range of motion. The common Symptoms of Lumbar Spondylosis are recognized to be back pain and stiffness of the lower region of the body.
   
   
   Causes

   Lumbar spondylosis is a disease which affects an individual in the later life. The major factors that are held responsible for the development of lumbar spondylosis can be concluded as: old age, obesity, sitting for prolonged periods, Prior injury and Heredity. As a person ages the healing ability of the body decreases and developing arthritis at that time makes the disease progress faster. It is seen that persons reaching over 40 years of age are more prone to developing lumbar spondylosis.

   Excessive weight also plays a foremost role in causing Lumbar spondylosis. Overweight puts excess load on the joints as the lumbar region carries most of the body`s weight, making a person prone to lumbar spondylosis. Other factors such as sitting in one position for prolonged time puts pressure on the lumbar vertebrae and highlight the risk of developing the disease.
   
   
   Symptoms

   Symptoms of Lumbar Spondylosis depend on where the spine is affected by spondylosis or spinal osteoarthritis. These symptoms range from mild to severe and may become chronic or even disabling.

   • Frequent Pain
   • Morning low back stiffness
   • Pain that decreases with rest or after exercise
   • Low back tenderness or numbness
   • Sciatica (mild to intense leg pain)
   • Weakness, numbness, or tingling in the low back, legs, or feet
   • Difficulty in walking
   • Bowel or bladder problems

Sinusitis is inflammation (swelling) of the lining of the sinuses, caused by a viral or bacterial infection. Sinusitis typically causes a high temperature, pain and tenderness in the face, and a blocked or runny nose. It is a common condition and can affect people of any age.


Types

Sinusitis is classed as either:

• acute, when it develops quickly (over a few days) following a cold or flu and clears up within 12 weeks, or
• chronic, when symptoms last for more than 12 weeks.

Chronic sinusitis is common and can sometimes last for many months.


Symptoms

The most common symptoms of sinusitis include:

• A blocked or runny nose. If your nose produces green or yellow mucus, you probably have a bacterial infection.
• Pain and tenderness in the face (near the infected sinuses). You may experience a throbbing pain that is worse when you move your head, and toothache or pain in your jaw when you eat.
• A high temperature.

Other possible symptoms include:

• tiredness,
• headache,
• cough,
• bad breath (halitosis),
• pressure in your ears,
• loss of taste and smell, and
• a feeling of being generally unwell.

Causes

There are a number of ways your sinuses can become inflamed and blocked.

• Infections

  The most common cause of sinusitis is a viral infection, usually the common cold or influenza (flu). The cold or flu virus spreads to the sinuses from the upper airways. Sometimes, a secondary bacterial infection can develop, leading to swelling inside the sinuses. An infected tooth may also cause the sinuses to become infected.

• Other causes

  There are a number of other factors that can make the sinuses more vulnerable to infection. These include:

  • Substances that may irritate the sinuses, such as air pollution, smoke, chemicals (such as pesticides), disinfectants and household detergents.
  • Allergies, such as allergic rhinitis, asthma and hay fever.
  • Anything that causes narrowing of the nose passages, such as facial injuries or a nasal polyp(growth) inside the nose. Mucus can build up behind the narrowed areas, leading to sinus infection.
  • Cystic fibrosis, a genetic condition that causes thick, sticky mucus to build up within the body, making you prone to infections.

Chronic sinusitis

This is a common condition in which the cavities around nasal passages (sinuses) become inflamed and swollen. Chronic sinusitis lasts 12 weeks or longer despite treatment attempts.

Also known as chronic rhino sinusitis, this condition interferes with drainage and causes mucus to build up. If you have chronic sinusitis, it may be difficult to breathe through your nose. The area around your eyes and face may feel swollen, and you may have throbbing facial pain or a headache.

Chronic sinusitis may be caused by an infection, but it can also be caused by growths in the sinuses (nasal polyps) or by a deviated nasal septum. Chronic sinusitis most commonly affects young and middle-aged adults, but it also can affect children.

Patients with Chronic Sinusitis may later suffer from the following conditions.

• Migraine
• Cervical and Lumbar Spondylosis
• Arthritis
• Chronic Bronchitis
• Bronchial Asthma
• Extreme tiredness

Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales. The condition is not infectious and most people are affected only in small patches on their body.

The severity of psoriasis varies greatly from person to person. For some people it is just a minor irritation, but for others it has a major impact on their quality of life.


There are several different types of psoriasis. Normally, people have only one form of psoriasis at a time, although two different types can occur together. One type may change to another type or may become more severe.


Some Common Types and Symptoms

• Plaque psoriasis:

Its symptoms are dry, red skin lesions, known as plaques that are covered in silver scales. They normally appear on your elbows, knees, scalp and lower back but can appear anywhere on your body. The plaques can be itchy, sore or both. In severe cases, the skin around your joints may crack and bleed.

• Guttate psoriasis:

This normally occurs following a streptococcal throat infection and is more common among children and teenagers. It causes small (less than 1cm or 1/3 inch) drop-shaped sores on your chest, arms, legs and scalp.

• Scalp psoriasis:

This can occur on parts of your scalp or on the whole scalp. It causes red patches of skin covered in thick silvery-white scales. Some people find scalp psoriasis extremely itchy, while others have no discomfort. In extreme cases it can cause hair loss, although this is usually only temporary.

• Nail psoriasis:

This affects your nails, causing them to develop tiny dents or pits, become discoloured and grow abnormally. Often nails can become loose and separate from your nail bed. In severe cases, your nails may crumble.

• Inverse (flexural) psoriasis:

This affects areas of the skin that are in folds or creases, such as the armpits, groin and the skin between the buttocks and under the breasts. It can cause large, smooth red patches in some or all of these areas. Inverse psoriasis is made worse by friction and sweating, so it can be particularly uncomfortable in hot weather.

Myositis (inflammatory) is the popular term used to describe a number of inflammatory myopathies:

These diseases cause swelling and loss of muscle. Inflammatory myopathies are thought to be autoimmune diseases, meaning the body’s immune system, which normally fights infections and viruses, is misdirected and attacks the body’s own normal, healthy tissue through inflammation, or swelling. All of these diseases can cause muscle weakness, but each type is different.

• Muscle weakness, sometimes with muscle pain
• General tiredness and fatigue
• Trouble climbing stairs, standing from a seated position, or reaching up