Nobody wants to consider the possibility of becoming a victim of personal injury or illness but, given the number of ways and places in which personal injury or illness can occur; it is perhaps unsurprising that this represents one of the most common forms of legal action pursued in the UK every year. Personal injury can happen at home, at work, while driving a motor vehicle, as the result of a faulty or defective product, or while on holiday – demonstrating just how easy it is to fall victim to it. These are some of the major types of personal injury cases handled by the specially trained legal team employed by Irwin Mitchell.

Management of obesity (BMI of 30 or more) is not an easy task. Information should be obtained by proper history taking, proper physical examination and certain diagnostic tests for making a management plan for obesity. The decision of how aggressively an obese person should be treated or managed as well as modality of management used is generally based available resources, risk status and expectation of the individual from the management.

Aim of treatment/management of obesity:

The initial aim of weight loss of 10% over 6 months should be aimed, which is realistic. Generally management of obesity starts with lifestyle modifications and need of pharmacotherapy or surgery depends on BMI risk categories.

Lifestyle management in obesity:

Lifestyle management for treatment of obesity includes diet therapy, physical activity therapy and behavioral therapy. Obesity is actually nothing but energy (calorie) imbalance, i.e. consuming more calories than required. Obese persons must learn about calorie consumption through various foods and calorie expenditure through exercise and also BMR (basal metabolic rate, which is calories required per hour to maintain basic body functions if a person is in absolute resting state). These learning’s should be incorporated into daily life, which is behavioral therapy.

Urethritis is inflammation (mostly due to infection by pathogenic microorganisms) of urethra, which is a common health problem among sexually active adults.

What are the symptoms of urethritis in men?

The common symptoms of Urethritis in men are discharge through urethra and dysuria (pain during urination/micturation) or both symptoms may be present in one person. Frequency of urination generally does not increase in case of Urethritis in men.

Causes of Urethritis in men:

The commonest cause of Urethritis in men is infection by Neisseria gonorrheae. Other causative agents include Chlamydia trachomatis, Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis, HSV (herpes simplex virus). Sometimes adenovirus can also cause Urethritis. These are called non-gonococcal Urethritis (NGU). Coliform bacteria (such as E. coli) can cause urethritis in men if they practice insertive anal intercourse (with men or women).

The non-cholera vibrios do not cause cholera and include V. parahaemolyticus, Non-O1 V. cholerae, V. vulnificus, V. alginolyticus etc.

Mode of transmission of non-cholera vibrios:

The mode of transmission of non-cholera vibrios is usually by ingestion of seawater of ingestion of undercooked shellfish infested with non-cholera vibrios, because non-cholera vibrios can reach high concentrations in the tissues of shellfish.

Symptoms of non-cholera vibrios infection:

There are two major types of syndromes gastrointestinal illness and soft tissue infections. Very rarely V. vulnificus can lead to sepsis in immune compromised individuals.

The World Health Organization (WHO) and many other organizations around the world such as National Diabetes Data Group of United States have issued diagnostic criteria for diabetes mellitus based on certain facts such as (1) the spectrum of fasting plasma glucose (FPG) and the response to an oral glucose load (OGTT or oral glucose tolerance test) varies among different normal individuals, and (2) diabetes mellitus should be diagnosed if the level of blood glucose is at or higher, at which diabetes-specific complications occur.

For example the criteria for diagnosis of diabetes mellitus given below may not be applicable to Native Americans (Pima Indian population) because the prevalence of retinopathy (a complication of diabetes) begins to increase at fasting plasma glucose of more than 6.4 mmol/Liter (116 mg/100 ml of blood).

The results of medical negligence – or clinical negligence as it is sometimes referred to as – can be devastating both or the patient directly affected by it, but also for their families. Illness or disease itself is hard enough to cope with without the additional emotional strain and possible physical impact caused by failures in diagnosis or treatment. Medical negligence refers to any part of the care or treatment of a patient, from the initial diagnosis stage to the actual treatment and then the after care, where medical staff fails to meet the required standards of service. Should this apply to your case you are entitled to seek and explanation at least, and possibly even financial compensation.

Once you are confident that you have a legitimate claim for negligence and have decided to proceed with the claim, you will need to look into obtaining legal representation to help you with your compensation case. Ideally, you should look to secure a lawyer specialising in this area of the law, as there are a number of these available and many of them take cases on a no-win no-fee basis. It is important that you have proper legal representation, because claims for medical negligence are resisted very strongly by the medical profession.

Diabetes can be called an iceberg disease, as there are many individuals with diabetes who do not know they have diabetes, because they do not have any diabetes symptoms. By the time diabetes becomes symptomatic it may take several years. So screening is an important tool for diagnosis of diabetes among asymptomatic individuals and for prevention of complications and morbidity due to diabetes. It is to note that approximately 50% of patients have some diabetes related complication at the time of diagnosis, especially in type-2 diabetes, hence screening is very important.

Testing of Fasting Plasma Glucose (FPG) for screening of diabetes is recommended, especially for type-2 diabetes, because (1) there are large number of people who meet the criteria for diagnosis of diabetes, but unaware that they have diabetes, as they are asymptomatic, (2) approximately 50% of individuals with type-2 diabetes have one or more diabetes complications at the time of diagnosis (3) epidemiologic studies have proved that type-2 diabetes may be present asymptomatically for up to a decade before diagnosis made and (4) appropriate management of type-2 diabetes can favorably alter the natural history of diabetes and become beneficial for the patient.

The type-1 diabetes is also called IDDM or insulin-dependent diabetes mellitus, as the patient must be treated (supplemented) with exogenous insulin, due to destruction of beta cells of pancreas which secrete insulin. As the insulin secreting beta cells are destroyed the pancreas (beta cells of pancreas) can not produce insulin and must be supplied from outside.

Autoimmune cause of type 1 diabetes:

The main cause of type diabetes is autoimmune (“immune-mediated form” of type I diabetes mellitus). Due to autoantibodies directed against the insulin secreting beta cells of pancreas, in the patient’s blood the beta cells are destroyed by the autoantibodies. The numbers of beta cells of pancreas are normal at the time of birth, but months or years after birth due to development of autoantibodies the destruction of beta cells of pancreas starts. The time taken for destruction of beta cells of pancreas may vary from patient to patient.

More than 95% of patient with type-1 diabetes develop the disease before 25 years of age. The onset of type 1 diabetes is usually acute (developing over a period of a few days to weeks). The acuteness of type 1 diabetes is destruction of more than 80% of beta cells of pancreas. The pancreas can maintain supply of insulin if beta cell mass of at least 20% is functioning and if the functional beta cell mass falls below 20% the clinical symptoms of diabetes develop.

The types of diabetes with known causes are included and grouped in “other specific types of diabetes”. The “other specific types of diabetes” was previously known as MODY or maturity onset of diabetes of the young. The causes of “other specific types of diabetes” are several and varied and ranges from genetic defect to defect in insulin function to infection to drug or chemical-induced. The known causes of the “other specific types of diabetes” are discussed below.

Genetic defects of beta-cell function:

Diabetes due to genetic defect in beta-cell of pancreas function generally appears before the age of 25 years and with mild hyperglycemia. The genetic defect in beta-cell of pancreas function may be due to mutation in different (several) locations and mutation at different location causes different types of diabetes.