Eustachian tube dysfunction
Eustachian tubes are small passageways that connect behind the nose to the middle ears. When you sneeze, swallow or yawn, the Eustachian tubes open to allow air to flow in and out. However, sometimes, Eustachian tubes can become blocked which is called Eustachian tube dysfunction. When this happens, sounds become muffled and your ear may feel full.
The most common causes of Eustachian tube dysfunction is caused by cold (flu) or sinusitis.
Most of the time, the Eustachian tube dysfunction will resolved without any treatment.
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Eczema
Eczema is a common skin condition affecting people of all age. The affected skin becomes dry, red and itchy. Sometimes, these affected areas of skin can become cracked, weepy and then scab over.
Eczema can be well controlled with appropriate skin care and topical cortisone treatment will need to be continued for many years.
Eczema can affect any part of body. Common areas affected are at flexural areas such as elbows, wrists, knees and ankles. Certain occupations involving hands washing, cleaning, handling tools and etc can cause Eczema rash on palms and fingers. In severe form of Eczema, the rash can cover the whole body. In rare situation, severe Eczema covering the whole body can cause Erythroderma (intense and widespread reddening of the skin due to inflammation causing skin to peel off in scales or layer which can sometimes be life threatening).
Pernicious anaemia
Pernicious anaemia is an autoimmune condition, causes Vit B12 deficiency. It is a condition that prevents formation of the vitamin B12-intrinsic factor complex which causes decrease absorption of Vit B12. Intrinsic factor is produced in stomach to allow absorption of vitamin B12. It also affects the parietal cells in stomach (parietal cells produce gastric acid to aid digestion of food) through the production of antiparietal cells antibodies results in chronic failure of gastric acid production. Due to this condition, it is known to be associated with increased risk of stomach cancer.
Pernicious anaemia is often associated with other autoimmune disorders such as autoimmune thyroid disease, adrenal insufficiency, Type 1 diabetes mellitus, coeliac disease and vitiligo. It is essential for anyone who has been diagnosed with pernicious anaemia to be tested for other autoimmune disorder.
It is typically presented with anaemia (low red blood cells count). Signs and symptoms are pallor with yellow skin (jaundice), tiredness (happen early), gastrointestinal symptoms and variable neurological abnormalities (happen later).
Blood tests are required to diagnose this condition. Doctor will order blood tests such as full blood counts (FBE). If the FBE show macrocytic anaemia, the doctor will order more tests to check for vitamin B12 and folate levels. If vitamin B12 is found to be low, then further testing for intrinsic factor antibodies, antiparietal antibodies, methylmalonic acid and homocysteine.
Treatment is with regular Vit B12 injection administered weekly until the deficiency is corrected and then once every other month. However, high dose oral vitamin B12 therapy can also be effective, provided that the dose is sufficient, medication adherence is good, and a response is documented.
Individuals with pernicious anaemia should undergo gastroscopy soon after pernicious anaemia diagnosis and/or if they develop gastrointestinal symptoms.