Category: Health

Health related Articles from Pakistan

Tendinopathy and Tenosynovitis

Tendinopathy and tenosynovitis are types of tendon injury. They can often occur together. The most common cause is overuse of the affected tendon. Rest of the affected tendon may be all that is required in some cases. Other treatments include pain relief, physiotherapy and steroid injections.

A tendon is a strong tissue that attaches a muscle to a bone. For example, the tendons that you can see on the back of your hand come from muscles in your forearm and allow you to move the bones of your fingers.

Some (but not all) tendons are covered by a sheath called the synovium. The synovium makes a tiny amount of oily fluid which lies between the tendon and its overlying sheath. The fluid helps the tendon to move freely and smoothly when it pulls on the bone to which it is attached.

Tendinopathy and tenosynovitis are types of tendon injury. They can often occur together. Strictly speaking:

  • Tendonitis means inflammation of a tendon. The term tendonitis is usually used for tendon injuries that involve acute injuries accompanied by inflammation.
  • Tendinosis means chronic degeneration of a tendon without inflammation. The main problem is failed healing of repeated minor injuries rather than inflammation.
  • Tendinopathy is a more general term than tendonitis and tendinosis and just means tendon injury, without specifying the type of injury.
  • Tenosynovitis means inflammation of the sheath that surrounds a tendon. (The sheath is called the synovium.)

It is thought that inflammation of the tendon and the tendon sheath is not the whole picture in all cases. It is thought that most of the time there is overuse or several repeated small injuries or tears, to the tendon. This may initially cause some inflammation of the tendon. But, in the longer term, if these injuries continue, it can lead to tendon damage (degeneration). Doctors now feel that tendonitis and tenosynovitis should actually be called tendinosis or tendinopathy.

These injuries typically occur when tendons are overused. For example, this may be after playing a lot of sport, or overuse in the course of your work. Tenosynovitis commonly occurs around the wrist. Overuse by lots of writing, typing, assembly line work, etc, can trigger inflammation. This type of overuse tendon injury is also known as repetitive strain injury (RSI).

However, in some cases, there is no history of overuse of the tendon, and tendinopathy or tenosynovitis seem to occur for no apparent reason. There are also some other causes of tendinopathy and tenosynovitis:

  • Arthritis – some types of arthritis such as rheumatoid arthritis can sometimes cause inflammation of tendon sheaths as well as joints. You would normally have joint pains and swelling in addition to tendon problems.
  • Infection – this is a rare cause. The infection may occur because a cut or puncture wound to the skin over a tendon may allow germs (bacteria) to get in to infect the tendon and/or tendon sheath. However, infection sometimes spreads from other parts of the body via the bloodstream to infect a tendon sheath. For example, a small number of people who have the sexually transmitted infection called gonorrhoea develop tenosynovitis as a complication.

These problems are more common in middle-aged adults and particularly in people who are quite sporty. They may be more common if your work involves repetitive movements such as writing, typing or use of a computer mouse.

Tendinopathy usually occurs at the part of the tendon that attaches to the bone. The main symptoms are pain, tenderness and sometimes swelling of the affected part of the tendon. The pain is typically when you move the affected area. The overlying skin in that area may also feel warm. You may have reduced movement or weakness of the part of the body that is pulled by the affected tendon. The area may feel stiff. In some cases the condition lasts just a few days and then goes away on its own. In other cases it can last weeks or months if not treated.

Any tendon of your body may be affected. However, some areas of your body are more prone to these problems. For example, tendons around your wrist and hand are the most commonly affected. Some types of tendinopathy and tenosynovitis cause very characteristic symptoms and have their own name. For example:

  • De Quervain’s tenosynovitis. This is a common condition that affects the tendons that are used to straighten (extend) your thumb. The typical symptom is pain over your wrist at the base of your thumb that is made worse by activity and eased by rest.
  • Trigger finger. This most commonly affects your ring finger. The condition prevents your finger from straightening fully. See separate leaflet called Trigger Finger for more details.
  • Tennis elbow (lateral epicondylitis). In this condition, you have pain on the outer side of your elbow. It is usually due to overuse of your forearm muscles. See separate leaflet called Tennis Elbow for more details.
  • Golfer’s elbow (medial epicondylitis). This is similar to tennis elbow but the pain is experienced on the inner side of your elbow.
  • Achilles tendinopathy. This affects the large tendon just behind and above the heel. See separate leaflet called Achilles Tendinopathy for more details.
  • Rotator cuff tendinopathy. Your rotator cuff is a group of four muscles that help to lift and rotate your shoulder. The tendons from these muscles can sometimes become irritated due to overuse. See separate leaflet called Rotator Cuff Disorders for more details.

Usually not. The diagnosis of tenosynovitis and tendinopathy can usually be made when your doctor talks to you and examines the affected area. If an infection is the suspected cause (uncommon) then blood tests and other tests may be done to find the cause of the infection. Sometimes, if the diagnosis is uncertain, your doctor may suggest an X-ray, an ultrasound scan or an MRI scan of the affected area.

The best treatment for tendinopathy or tenosynovitis is uncertain. However, one or more of the following treatments may be used:

  • Rest. It is important to rest, or at least reduce the use of the affected area, to allow the condition to settle. Sometimes a splint, firm bandage or brace is put on a wrist if this is the area affected. This forces your hand and wrist to stay in the same position for a time to allow rest of the affected tendon.
  • Ice packs over the affected area may ease swelling and pain. A simple ice pack can be made by wrapping a pack of frozen peas in a tea towel. Apply it to the affected area for 10 minutes twice a day to reduce pain.
  • Anti-inflammatory painkillers are often prescribed (for example, ibuprofen). These ease pain and reduce inflammation. However, as discussed above, inflammation may not be the main problem in tendinopathy and tenosynovitis. They will, however, provide pain relief. Some anti-inflammatory painkillers also come as creams or gels which you can rub over the painful area. These tend to produce fewer side-effects than those taken by mouth. There are various brands which you can buy, or obtain on prescription. Ask your doctor or pharmacist for advice.
  • Other painkillers. If you cannot take anti-inflammatory painkillers, other painkillers such as paracetamol, with or without codeine added, may be helpful.
  • Physiotherapy is recommended if the condition is not settling with the above measures. A physiotherapist will give you a programme of exercises to gradually make the muscles of the affected tendon stronger. This will involve doing exercises that increase the load that the muscle can bear. These exercises are called eccentric loading exercises. They may be a bit painful but this does not mean they are harmful.
  • A steroid injection into the affected area may be given if the above measures do not work. Steroid injections may be helpful in easing pain in the short term but they don’t treat the underlying problem and pain tends to come back in many people.
  • Surgical release of a tendon is rarely needed.
  • Antibiotic medicines are needed in the uncommon situation where infection is the cause.

Other treatments are also being used to treat tendinopathy and tenosynovitis. These include:

  • Shock-wave therapy. This uses high-energy sound waves to treat the condition. A special device allows the shock waves to be passed through your skin to the affected area. A local anaesthetic may also be given, as sometimes the shock waves can be painful. One or more treatment sessions may be needed. The procedure appears to be safe but it is not clear yet exactly how well it works; more research is needed.
  • Autologous blood injection. Blood is taken from you and then injected into the area around the damaged tendons. It is thought that the blood helps to heal the tendons. A local anaesthetic is often given as a pain relief during the procedure. Several treatment sessions may be needed. This procedure is generally only considered if all other treatments have failed. Again, it is not clear yet whether this treatment works; more research is needed.

There is no proof that anything can prevent a bout of tenosynovitis or tendinopathy. However, the following are sensible suggestions that may help to prevent a recurrence:

  • Avoid a sudden increase in repetitive movements and overuse of the affected area. This may be very difficult if your job involves repetitive movements. If it is a recurring problem then you should discuss this with your employer. A change of duties may help.
  • Exercises to strengthen the muscles around the affected tendon may help. It may be best to seek advice from a physiotherapist to find the best exercises to use.


Spirulina is incredibly good for you. It is loaded with nutrients that can have powerful effects on your body and brain.

Spirulina facts

Here are 10 evidence-based health benefits of spirulina.

1. Spirulina is Extremely High in Many Nutrients
Spirulina is an organism that grows in both fresh and salt water.

It is a type of bacteria called cyanobacterium, which is often referred to as blue-green algae.

Just like plants, cyanobacteria can produce energy out of sunlight, via the process called photosynthesis.

Spirulina was consumed by the Aztecs back in the day, but became popular again when NASA proposed that it could be grown in space and used by astronauts.

A standard daily dose of spirulina is 1-3 grams, but doses of up to 10 grams per day have been used effectively.

It is actually quite amazing how nutritious it is.

A single tablespoon (7 grams) of dried spirulina powder contains :

Protein: 4 grams.
Vitamin B1 (Thiamin): 11% of the RDA.
Vitamin B2 (Riboflavin): 15% of the RDA.
Vitamin B3 (Niacin): 4% of the RDA.
Copper: 21% of the RDA.
Iron: 11% of the RDA.
It also contains decent amounts of magnesium, potassium and manganese, and small amounts of almost every other nutrient that we need.
This is coming with only 20 calories, and 1.7 grams of digestible carbohydrate.

Gram for gram, this means that spirulina may literally be the single most nutritious food on the planet.

A tablespoon of spirulina contains a small amount of fat (around 1 gram), including both omega-6 and omega-3 fatty acids in about a 1.5:1 ratio.

The quality of the protein in spirulina is considered excellent, comparable to eggs. It contains all the essential amino acids that we need.

It is often claimed that spirulina contains vitamin B12, but this is false. It contains pseudovitamin B12, which has not been shown to be effective in humans.

2. Spirulina Has Powerful Antioxidant and Anti-inflammatory Properties

Oxidative damage can harm our DNA and cells.

This damage can drive chronic inflammation, which contributes to cancer and other diseases.

Spirulina is a fantastic source of antioxidants, which can protect against oxidative damage.

The main active component is called phycocyanin. This antioxidant substance also gives spirulina its unique blue-green color.

Phycocyanin can fight free radicals and inhibit production of inflammatory signalling molecules, providing impressive antioxidant and anti-inflammatory effects.

Bottom Line: Phocyanin is the main active compound in spirulina. It has powerful antioxidant and anti-inflammatory properties.
3. Spirulina Can Lower LDL and Triglyceride Levels

Heart disease is currently the world’s biggest killer.

It is known that many measurable factors, termed risk factors, are linked to an increased risk of heart disease.

As it turns out, spirulina has been shown to have beneficial effects on many of them.

For example, it can lower total cholesterol, LDL cholesterol and triglycerides, while raising HDL (the “good”) cholesterol.

In a study of 25 people with type 2 diabetes, 2 grams per day of spirulina significantly improved these markers.

Another study in people with high cholesterol found that 1 gram of spirulina per day lowered triglycerides by 16.3% and LDL by 10.1% (10).

Several other studies have shown favorable effects, but with higher doses of 4.5-8 grams of spirulina per day.

Bottom Line: Studies have shown that spirulina can lower triglycerides and LDL cholesterol, and sometimes may raise HDL (the “good”) cholesterol.
4. Spirulina Protects LDL Cholesterol From Becoming Oxidized

Fatty structures in the body are susceptible to oxidative damage.

This is known as lipid peroxidation, which is known to be a key driver of many serious diseases.

For example, one of the key steps in the pathway towards heart disease is LDL lipoproteins in the blood becoming oxidized.

Interestingly, the antioxidants in spirulina appear to be particularly effective at reducing lipid peroxidation. This has been shown numerous times, in both human and animal studies.

In a study of 37 individuals with type 2 diabetes, 8 grams of spirulina per day significantly reduced markers of oxidative damage. It also increased levels of antioxidant enzymes in the blood.

Bottom Line:

Fatty structures in the body can become oxidized, which drives the progression of many diseases. The antioxidants in spirulina can help prevent this from happening.
5. Spirulina Appears to Have Anti-Cancer Properties, Especially Against Oral Cancer
Some evidence suggests that spirulina can have anti-cancer properties.

For example, some research in test animals shows that it can reduce cancer occurrence and tumor size.

Spirulina has been particularly well studied with regard to oral cancer, which is cancer of the mouth.

One study looked at the effects of spirulina on 87 people from Subcontinent with precancerous lesions called OSMF in the mouth.

After using 1 gram per day for 1 year, 45% of the spirulina group had a complete regression of lesions in the mouth, compared to only 7% in the control group.

When they stopped taking the spirulina, almost half of the responders developed these lesions again the following year.

In another study of 40 subjects with OSMF precancerous lesions, 1 gram of spirulina per day led to greater improvement in symptoms than the drug Pentoxyfilline.

Bottom Line: Spirulina may have some anti-cancer properties, especially against a type of precancerous lesion called OSMF (oral submucous fibrosis).
6. Studies Show That it May Reduce Blood Pressure

High blood pressure is an important driver of many killer diseases.

This includes heart attacks, strokes and chronic kidney disease.

While 1 gram of spirulina is ineffective, a dose of 4.5 grams per day has been shown to reduce blood pressure in individuals with normal blood pressure levels.

This is thought to be driven by an increased production of nitric oxide, a signalling molecule that helps the blood vessels relax and dilate (23).

Bottom Line: In one study, a higher dose of spirulina has been shown to lead to lower blood pressure levels, a major risk factor for many diseases.
7. Spirulina Improves Symptoms of Allergic Rhinitis

Allergic rhinitis is characterized by inflammation in the nasal airways.

It is triggered by environmental allergens, such as pollen, animal hair or even wheat dust.

Spirulina is a popular alternative treatment for symptoms of allergic rhinitis, and there is evidence that it can be effective.

In one study of 127 people with allergic rhinitis, 2 grams per day dramatically reduced symptoms like nasal discharge, sneezing, nasal congestion and itching.

Bottom Line: Spirulina supplements have been shown to be very effective against allergic rhinitis, helping to reduce various symptoms.
8. Spirulina May be Effective Against Anemia

There are many different forms of anemia.

The most common one is characterized by a reduction in hemoglobin or red blood cells in the blood.

Anemia is fairly common in the elderly, leading to prolonged feelings of weakness and fatigue.

In a study of 40 older people with a history of anemia, spirulina supplementation increased the hemoglobin content of red blood cells. Immune function also improved.

However, this is just one study, and more research is needed before any recommendations can be made.


Bottom Line: One study shows that spirulina may be effective against anemia in the elderly. More research is needed.
9. Muscle Strength and Endurance May Improve
Exercise-induced oxidative damage is a major contributor to muscle fatigue.

Certain plant foods have antioxidant properties that can help athletes and physically active individuals minimize this damage.

Spirulina appears to be beneficial, with some studies showing improved muscle strength and endurance.

In two studies, spirulina was shown to enhance endurance, significantly increasing the time it took for people to become fatigued.

Another study in college athletes found that spirulina supplementation increased muscle strength, but did not have any effect on endurance.

Bottom Line: Some studies have shown that spirulina supplementation can enhance endurance, and one study shows that it can increase muscle strength.
10. Spirulina May Help With Blood Sugar Control

Animal studies have shown that spirulina can significantly lower blood sugar levels.

In some cases, it has outperformed popular diabetes drugs, including Metformin.

There is also some evidence that spirulina can be effective in humans.

In a study of 25 patients with type 2 diabetes, 2 grams of spirulina led to an impressive reduction in blood sugar levels.

HbA1c, a marker for long-term blood sugar levels, decreased from 9% to 8%, which is substantial. Studies estimate that a 1% reduction in this marker can lower the risk of diabetes-related death by 21%.

However, this study was small and only lasted for 2 months, so take this with a grain of salt.

11. Anything Else?
Spirulina may also have other beneficial effects, such as helping to “detoxify” the heavy metal arsenic from the body.

At the end of the day, spirulina is incredibly healthy. It is one of the few “superfoods” that are actually worthy of that term.


Diatomaceous Earth

Diatoms are a major group of algae, and are among the most common types of phytoplankton. Most diatoms are unicellular, although they can exist as colonies in the shape of filaments or ribbons (e.g. Fragilaria), fans (e.g. Meridion), zigzags (e.g. Tabellaria), or stars (e.g. Asterionella). Diatoms are producers within the food chain. A unique feature of diatom cells is that they are enclosed within a cell wall made of silica (hydrated silicon dioxide) called a frustule. These frustules show a wide diversity in form, but are usually almost bilaterally symmetrical, hence the group name. The symmetry is not perfect since one of the valves is slightly larger than the other allowing one valve to fit inside the edge of the other. Fossil evidence suggests that they originated during, or before, the early Jurassic Period. (Source) Diatomaceous earth has so many health benefits primairy due to its high mineral content, which consists of approximately  89% amorphous silica and approximately 20 trace minerals. The silica in diatomaceous earth is also very effective in preventing premature aging. Silica can also make age spots fade and also helps to repair and maintain lung tissue elasticity.

Silica is the most abundant trace mineral on earth and specifically in our bodies. Healthy individuals walk around with more silica than any other mineral. It is involved in endless amounts of body functions and is critical to proper mineral absorption.

Diatomaceous Earth’s mode of action for parasite and insect control is strictly mechanical. The microscopically sharp edges contact the foreign invader, and pierce their protective coating, so they soon dehydrate and die. The larvae is affected in the same way. The sharp points found on fossilized diatom exoskeletons create a safe and non-toxic strong abrasive that scrubs intestinal walls and cuts up any parasites present in the digestive tract. Additionally, as it passes the digestive tract, it attracts and absorbs pathogens such as bacteria, viruses, protozoa, and fungi. It also absorbs and removes drug residues, heavy metals and pesticides. So, it is useful for people, pets and in the garden.

Diatomaceous earth

Following are the benefits of using DE:

Helps clear “dampness”

  • Natural colon detoxifier
  • Natural colon deodorizer
  • Heavy metal detoxifier
  • Helps to “clear the terrain” to restore healthy bowel movements
  • Natural anti-parasitic
  • Detoxes bacteria, viruses and candida
  • Yeast infections
  • Regulate blood pressure and cholesterol
  • Help with aches and pain
  • Helps with stubborn belly fat and weight loss
  • Strengthens hair, supports the skin and toughens nails
  • Healthy teeth and gums (can be used in remineralizing tooth paste)
  • Restores energy levels (best to take in the a.m.)
  • Kills bed bugs



Meningococcal Meningitis kills 137 people every day


Worldwide, one person is infected with meningitis every minute and in Pakistan, eight per cent of post-neonatal deaths each year are a result of this infection.

Meningococcal meningitis is a bacterial illness and a leading cause of bacterial meningitis in infants and children up to 18 years of age. The infection affects the fluid surrounding the brain and spinal cord.

On Sunday, the ‘Trust for vaccines and immunisation’ attempted to raise awareness about this infection at a symposium organised at the Pearl Continental Hotel. Experts from different medical institutions were invited to talk about the disease and ongoing research.

Dr Syed Asad Ali from the Pediatrics department at the Aga Khan University Hospital (AKUH) spoke about meningitis on a global level while AKUH woman and child health division head Dr Zulfiqar A Bhutta talked about meningitis with a Pakistani perspective.

Research showed that meningitis was common in infants under the age of one, people with certain medical conditions such as the surgical removal of the spleen and young adults between the age of 15 and 19. According to statistics presented on Sunday, nearly 137 people die every day because of meningitis and about 0.5 million people get meningitis every year worldwide.

Causes of deaths in children in Pakistan during 2005

The research further showed that the 10 to 14 per cent of people who recovered from meningitis, end up developing medical conditions which led them to lose their hearing, body parts or create complications with their nervous systems.

The doctors explained that some people did not catch the disease but became carriers. “It is a contagious disease that spreads by close contact, smoking, coughing and sharing utensils,” they said.

The research showed how students living in dormitories, military recruits, anyone going on a religious pilgrimage or living in a part of the world where the disease was common including Africa were susceptible to the disease. It added that anyone with terminal complement component deficiency (an immune system disorder) and people who might have been exposed to meningitis during an outbreak were at high risk of being infected and were recommended to get vaccinated. For example before travelling to Saudi Arabia, it is necessary to show the health ministry a vaccination certificate.

“Meningococcal meningitis is also a major cause of deaths and disabilities in Pakistan but somehow it is overlooked,” said Dr Ali. “It is spreading like wildfire and the government should take action to spread awareness.” He added that the meningitis vaccination should available at lower costs. Dr Bhutta told The Express Tribune that the only thing they can do is to save the people from meningitis was through spreading awareness, improving laboratories and research along with help from the government.

source: Published in The Express Tribune, September 19th,  2011

Meningitis risk and travel: what you need to know!

Travelers should be concerned by the spread of meningitis because the disease is typically associated with groups of people in close quarters, such as prisons, military barracks and … hostels.

Meningitis takes its name from the delicate tissue layer surrounding the brain and spinal cord (meninges) and the inflammation that results from the infection(-itis). Meningitis is a contagious disease, meaning it can be spread from person to person, and is divided into two basic forms based on cause: Viral and Bacterial.

Symptoms of meningitis are similar in both forms of the illness and include headaches, stiff neck, fever and sensitivity to bright light (photophobia).

  • Types of meningitis
  • Meningitis diagnosis & treatment
  • Vaccinations for meningitis
  • Avoiding meninigitis while travelling

Types of meningitis

Viral Meningitis

Viral Meningitis can be caused by a large number of viruses with exotic sounding names like Echovirus and Coxsackievirus. Fortunately, this a serious health concern but rarely fatal in people with a competent immune system.

Viral meningitis can also manifest from tick borne encephalitis.


Typical symptoms last for 1-2 weeks and resolve without further problems. This infection is commonly spread through the inhalation or contact with respiratory droplets or secretions like saliva or mucous. The best way for travelers to avoid viral meningitis is a regular routine of proper hand washing.

Perhaps the biggest concern with viral meningitis is not being able to differentiate it from bacterial meningitis, which is a much more serious and life threatening disease. For this reason, all cases of suspected meningitis need prompt medical evaluation.

Bacterial Meningitis

Bacterial Meningitis is a serious and life-threatening emergency and needs immediate medical treatment.

The two most common forms of bacteria involved are Neisseria Meningitidis and Streptococcus Pneumoniae. Symptoms of bacterial and viral meningitis are similar and those with fevers, headaches and neck stiffness should consider meningitis as a cause.

Neisseria is famous for causing a rash with a special feature: the rash does not Blanche when pressed with a glass. Typical rashes lose their redness when pressed and return to a rash appearance when the pressure is removed. A drinking glass works well for this as you can apply pressure and still see through at how the rash is behaving. A rash that does not turn back to normal skin color when pressure is applied can be a warning sign of a Neisseria bacterial infection, especially when found with headaches, fevers and neck stiffness. This infection requires immediate antibiotics as death can occur rapidly, within 24-48 hours. Long term complications can include deafness and other neurological disability.

Meningitis diagnosis & treatment

Doctors differentiate bacterial and viral meningitis by testing a sample of spinal fluid, obtained during a lumbar puncture (yes, the long needle in the spine) or “spinal tap”. This is a safe procedure, carries few risks and is vital in proper diagnosis.

Treatment of bacterial meningitis requires intravenous antibiotics immediately, while the more benign viral type is largely supportive care consisting of fluids with pain and fever control. Special concerns exist for those who have come in close contact with a confirmed case of bacterial meningitis and those people may require oral antibiotics as prophylaxis (disease prevention).

Vaccinations for meningitis

Both Neisseria and “Strep. Pneumo” are bacteria for which there are vaccines to prevent illness. Vaccines for S. Pneumo are typically given during childhood, in developed nations. The vaccine for Neisseria Meningitidis covers 4 of the 5 strains of the bacteria including types A, C, Y, and W-135. Each serotype has certain geographical preferences with Group A being most common in the “African Meningitis Belt” and Asia.

There is a group B type of Neisseria Meningitidis that is not covered by the vaccine. Unfortunately, this is one of the most common forms, especially in the Americas and Europe and full protection is not guaranteed by the vaccines at present.

Avoiding meninigitis while travelling

Clearly, those traveling to areas know for meningitis risk should do a review of the immunisations and discuss the need for a meningitis vaccine with their health care provider. Even with vaccines for bacterial meningitis already taken, taking precautions such as:

  • Practicing good personal hygiene by washing your hands
  • Not sharing food, drinks or cutlery
  • Washing fruit and vegetables before eating
  • Making sure food is thoroughly heated through before eating
  • Not sharing toothbrushes, lip balms or lipstick
  • Keep your immune system healthy
  • Know who you are kissing. Meningitis can be passed on via saliva.


Fungal disease simply defeated.

As a Healthcare professional I almost every week I get cases of mild to severe fungal infections, my response for their cure is very calculated one, simple steps to be followed one after the other for complete recovery and then prevention strategy will keep you at bay from them…..may be for good.

Living in warm humid country like UAE is itself one of the biggest causes to get fungus, most probably between your toes, thanks to pronlonged wearing of closed shoes providing maximum dampness for fungal spores to thrive happily. studies have shown that fungal spores are present almost universally all around the world lying dormant waiting for favorable conditions to grow, this is what they get in the shoes, perfect environment. It starts as a very mild itch which is hardly noticed at first, feet are unfortunate in the way they are the farthest most part of one’s body, so late identification is common, its noticed when it is reddened and itchy may be oozing fluid. This is commonly called athlete’s foot, or simple fungal infection of toes.

First response to cure this type of infection is to identify it properly, faint itch, restlessness and skin damage may be the first signs of a fungal infection, simply go to the nearest pharmacy purchase a cream with miconazole or terbinafine which are the cheapest and most effective remedies for it.

Key to complete recovery is apply daily without a break, keep your feet dry and clean, may be its better to switch to open sandals than shoes, if wearing shoes remove them every 2 hourly and let them have air for 15 minutes. and thats it….it will go for sure….donot forget to continue applying antifungal cream for atleast 7 days of apparent recovery.