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Measurement of urine for the ratio of trimethylamine to trimethylamine oxide is the standard screening test. A blood test is available to provide genetic analysis. The prominent enzyme responsible for TMA N-oxygenation is coded by the "FMO3" gene.
False positives can occur in the following conditions, where elevated TMA can be present in the urine without any underlying TMAU:
- Urinary tract infection
- Bacterial vaginosis
- Cervical cancer
- Advanced liver or kidney disease
A similar foul-smelling odor of the urine has also been associated with colonization of the urinary tract with a bacterium called "Aerococcus urinae", especially in children.
There is no known cure or treatment for the disorder.
The metabolic and clinical manifestations of TMAU are generally regarded as benign, as there is no associated organ dysfunction. This
designation, and the fact that the condition is often unrecognised by doctors, can have important ramifications including missed or delayed diagnosis.
Affected individuals experience shame and embarrassment, fail to maintain relationships, avoid contact with people who comment on their condition, and are obsessive about masking the odour with hygiene products and even smoking. The malodorous aspect can have serious and destructive effects on schooling, personal life, career and relationships, resulting in social isolation, low self-esteem, depression, paranoid behaviour, and suicide. Delayed diagnosis, body odour and the lack of cure may lead to psychosocial issues. When the condition is suspected or known to occur in a family, genetic testing can be helpful in identifying the specific individuals who have or carry the disorder.
Ways of reducing the fishy odor may include:
- Avoiding foods such as egg yolks, legumes, red meats, fish, beans and other foods that contain choline, carnitine, nitrogen, sulfur and lecithin
- Taking low doses of antibiotics such as neomycin and metronidazole in order to reduce the amount of bacteria in the gut
- Using slightly acidic detergent with a pH between 5.5 and 6.5
Additionally, at least one study has suggested that daily intake of the supplements activated charcoal and copper chlorophyllin may improve the quality of life of individuals afflicted with TMAU by helping their bodies to oxidize and convert TMA to the odorless "N"-oxide (TMAO) metabolite. Study participants experienced subjective reduction in odor as well as objective reduction in TMA and increase in TMAO concentration measured in their urine. The study found that:
- 85% of test participants experienced complete loss of detectable "fishy" odor
- 10% experienced some reduction in detectable odor
- 5% did not experience any detectable odor reduction
Recovery is most likely if it is spotted within the first 24–48 hours, and you should seek veterinary advice—a vet may choose to give the animal drugs.
The sick animal should be kept in a cage by itself so that others do not catch the disease—wet tail can be very contagious so sanitize all objects the animal has come in contact with (wheel, food dish, huts, etc.).
If the animal doesn't want to eat, then dry, unflavored oats can be hand fed, which can also help with the diarrhea. The animal should only be fed dry foods, any foods with a high water content should be avoided.
If the animal has an unclean or matted rear-end, this should not be remedied using a bath in water—instead a q-tip (cotton bud) or cotton ball can be used to very gently clean the animal's rear end to avoid discomfort or rashes.
If the animal is not drinking, hydration can be aided by scruffing (i.e. very gently holding the rodent by the extra skin on the back of the neck) the animal so that they open their mouth; then in small, short intervals, water can be provided with a 1 ml syringe. It is very important that this is done slowly, to avoid getting water down the animal's wind pipe. Unflavored pedialyte can be purchased from a grocery store and can be very helpful with wet tail. If feeding is also an issue, a suggested aide is to feed extremely small amounts of no garlic, no onion, no added sugar mashed baby food, and administered using the same scruffing method, and again at a very slow pace.
Body odor may be reduced or prevented or even aggravated by using deodorants, antiperspirants, disinfectants, underarm liners, triclosan, special soaps or foams with antiseptic plant extracts such as ribwort and liquorice, chlorophyllin ointments and sprays topically, and chlorophyllin supplements internally. Although body odor is commonly associated with hygiene practices, its presentation can be affected by changes in diet as well as the other factors.
As many as 90% of Americans and 92% of teenagers use antiperspirants or deodorants. In 2014, the global market for deodorants was estimated at 13.00 billion USD with a compound annual growth rate of 5.62% between 2015 and 2020.
Wet-tail or proliferative ileitis, is a disease of hamsters. It is precipitated by stress. Even with treatment, the animal can die within 48–72 hours. Baby hamsters are much more likely to get the disease than older hamsters. It commonly is found when the hamster is being weaned at about four weeks of age.
Diagnosis is usually made upon inspection. Differential diagnosis of tonsilloliths includes foreign body, calcified granuloma, malignancy, an enlarged temporal styloid process or rarely, isolated bone which is usually derived from embryonic rests originating from the branchial arches.
Tonsilloliths are difficult to diagnose in the absence of clear manifestations, and often constitute casual findings of routine radiological studies.
Imaging diagnostic techniques can identify a radiopaque mass that may be mistaken for foreign bodies, displaced teeth or calcified blood vessels. Computed tomography (CT) may reveal nonspecific calcified images in the tonsillar zone. The differential diagnosis must be established with acute and chronic tonsillitis, tonsillar hypertrophy, peritonsillar abscesses, foreign bodies, phlebolites, ectopic bone or cartilage, lymph nodes, granulomatous lesions or calcification of the stylohyoid ligament in the context of Eagle syndrome (elongated styloid process).
Excision biopsy is required to confirm the diagnosis of saree cancer. In many cases local excision with skin grafting is considered the appropriate treatment.
Different ways of wearing the petticoat may help saree-wearers to prevent saree cancer. Some such strategies are:
- Loosening the petticoat
- Changing the usual rope-like belt to broader ones that reduce pressure on the area
- Continuously changing the level at which the petticoat is tied
When untreated, the prognosis for ORS is generally poor. It is chronic, lasting many years or even decades with worsening of symptoms rather than spontaneous remission. Transformation to another psychiatric condition is unlikely, although very rarely what appears to be ORS may later manifest into schizophrenia, psychosis, mania, or major depressive disorder. The most significant risk is suicide.
When treated, the prognosis is better. In one review, the proportion of treated ORS cases which reported various outcomes were assessed. On average, the patients were followed for 21 months (range: 2 weeks to 10 years). With treatment, 30% recovered (i.e. no longer experienced ORS odor beliefs and thoughts of reference), 37% improved and in 33% there was a deterioration in the condition (including suicide) or no change from the pre-treatment status.
Dysmelia can refer to
- missing (aplasia) limbs: amelia, oligodactyly, congenital amputation e.g. Tibial or Radial aplasia
- malformation of limbs: shortening (micromelia, rhizomelia or mesomelia), ectrodactyly, phocomelia, meromelia, syndactyly, brachydactyly, club foot
- too many limbs: polymelia, polydactyly, polysyndactyly
- others: Tetraamelia, hemimelia, Symbrachydactyly
Anosmia can be diagnosed by doctors by using acetylcysteine tests. Doctors will begin with a detailed elicitation of history. Then the doctor will ask for any related injuries in relation to anosmia which could include upper respiratory infections or head injury. Psychophysical Assessment of order and taste identification can be used to identify anosmia. A nervous system examination is performed to see if the cranial nerves are damaged. The diagnosis as well as the degree of impairment can now be tested much more efficiently and effectively than ever before thanks to "smell testing kits" that have been made available as well as screening tests which use materials that most clinics would readily have. Occasionally, after accidents, there is a change in a patient's sense of smell. Particular smells that were present before are no longer present. On occasion, after head traumas, there are patients who have unilateral anosmia. The sense of smell should be tested individually in each nostril.
Many cases of congenital anosmia remain unreported and undiagnosed. Since the disorder is present from birth the individual may have little or no understanding of the sense of smell, hence is unaware of the deficit. It may also lead to reduction of appetite.
For the detection of "Staphylococcus aureus" food poisoning which can lead to staphylococcal enteritis a stool culture may be required. A stool culture is used to detect the presence of disease-causing bacteria (pathogenic) and help diagnose an infection of the digestive tract. In the case of staphylococcal enteritis, it is conducted to see if the stool is positive for a pathogenic bacterium.
Cases have been reported from many different countries around the world. It is difficult to estimate the prevalence of ORS in the general population because data are limited and unreliable, and due to the delusional nature of the condition and the characteristic secrecy and shame.
For unknown reasons, males appear to be affected twice as commonly as females. High proportions of ORS patients are unemployed, single, and not socially active. The average age reported is around 20–21 years, with almost 60% of cases occurring in subjects under 20 in one report, although another review reported an older average age for both males (29) and females (40).
Dysmelia can be caused by
- inheritance of abnormal genes, e.g. polydactyly, ectrodactyly or brachydactyly, symptoms of deformed limbs then often occur in combination with other symptoms (syndromes)
- external causes during pregnancy (thus not inherited), e.g. via amniotic band syndrome
- teratogenic drugs (e.g. thalidomide, which causes phocomelia) or environmental chemicals
- ionizing radiation (nuclear weapons, radioiodine, radiation therapy)
- infections
- metabolic imbalance
Merciful anosmia is a condition in which the person is unaware of the foul smell emanating from his own nose. This condition is seen in atrophic rhinitis. In atrophic rhinitis, the turbinates, venous sinusoids, seromucinous glands and nerves undergo atrophy, resulting in a foul smelling discharge. As the nerve fibres sensing smell are also atrophied, the patient is unable to appreciate the foul smell.
Diagnosis is usually made by characteristic history and physical examination. Diagnosis can be confirmed by x-ray (80% of salivary gland calculi are visible on x-ray), by sialogram, or by ultrasound.
X-rays are usually necessary, but this is not always the case. A physical examination will be carried out, which sometimes involves a rectal examination and/or neurologic examination.
Often, no treatment is needed, as few stones produce symptoms.
Some people are able to remove tonsil stones using the tip of the tongue. Oral irrigators are also simple yet effective and will thoroughly clean the tonsil crypts. Most electric oral irrigators are unsuitable for tonsil stone removal because they are too powerful and are likely to cause discomfort and rupture the tonsils, which could result in further complications such as infection. Irrigators that connect directly to the sink tap via a threaded attachment or otherwise are suitable for tonsil stone removal and everyday washing of the tonsils because they can jet water at low pressure levels that the user can adjust by simply turning the sink tap, allowing for a continuous range of pressures to suit each user's specific requirements.
More simply still, gargling with warm, salty water may help alleviate the discomfort of tonsillitis, which often accompanies tonsil stones. Vigorous gargling each morning can also keep the tonsil crypts clear of all but the most persistent tonsilloliths.
Staphylococcal enteritis may be avoided by using proper hygiene and sanitation with food preparation. This includes thoroughly cooking all meats. If food is to be stored longer than two hours, keep hot foods hot (over 140 °F) and cold foods cold (40 °F or under). Ensure to refrigerate leftovers promptly and store cooked food in a wide, shallow container and refrigerate as soon as possible. Sanitation is very important. Keep kitchens and food-serving areas clean and sanitized. Finally, as most staphylococcal food poisoning are the result of food handling, hand washing is critical. Food handlers should use hand sanitizers with alcohol or thorough hand washing with soap and water.
Tips for hand washing:
1. Wash hands with warm, soapy water before and after handling raw foods.
2. Always wash your hands after using the bathroom, after changing a baby's diaper, after touching pets or other animals, and after sneezing or coughing
3. Properly dress or glove.
When accompanied by the combination of situs inversus (reversal of the internal organs), chronic sinusitis, and bronchiectasis, it is known as Kartagener syndrome (only 50% of primary ciliary dyskinesia cases include situs inversus).
One theory (Kristina Palacio) explains "usog" in terms of child distress that leads to greater susceptibility to illness and diseases. There are observations that a stranger (or a newcomer or even a visiting relative) especially someone with a strong personality (physically big, boisterous, has strong smell, domineering, etc.) may easily distress a child. Thus, the child is said to be "overpowered" or "nauusog" and thus may feel afraid, develop fever, get sick, etc.
In "usog", the child's distress is the consequence of the child's failure to adapt to change. It is, in medical terms, the consequence of the disruption of homeostasis through physical or psychological stimuli brought about by the stranger. Technically, the condition results from the child-environment interaction that leads the child to perceive a painful discrepancy, real or imagined, between the demands of a situation on the one hand and their social, biological, or psychological resources on the other. The stressful stimuli to the child may be mental (stranger is perceived as a threat, malevolent or demanding), physiological (loud and/or high-pitched voice of the stranger that is hurting to the child's eardrum; strong smell of the stranger that irritates the child's nasal nerves), or physical (stranger has heavy hands or is taking up too much space).
The stranger's act of gently placing his finger with his saliva to the child's arm, foot, or any particular part of the child's body, could make him more familiar to the child, and thus, reduce if not remove the stress. As the stranger keeps gently saying, "Pwera usog... pwera usog...," the child is made to feel and assured that he means no harm. The "usog" is said to be counteracted because the child is prevented from succumbing to an illness since the child is no longer in distress. Children or even adults who are shy or have weak personalities are more susceptible to "usog" in accordance with observations and theory. Some have observed that at times even praising a shy child by a visiting relative caused an "usog".
The saliva from the stranger, granted that he or she is healthy and consistent with his or her oral hygiene, is relatively clean and contains enough antimicrobial compounds such as lactoferrin, lactoperoxidase, and secretory immunoglobulin A which can help clear pathogens from the child and benefit the child against infection. Furthermore, human saliva has opiorphin, a newly researched pain-killing substance. Initial research with mice shows the compound has a painkilling effect of up to six times that of morphine. It works by stopping the normal breakdown of natural pain-killing opioids in the spine, called enkephalins. Opiorphin in human saliva is a relatively simple molecule, and the child's immune system may trigger a biochemical cascade (complement system) to produce other stress-reducing compounds.
Usog can also, though less commonly, affect adults, and it may induce vomiting and stomach ache rather than fever. Supposedly, it can be prevented by stopping a stranger or visitor from greeting the person.
Unlike "lihi", however, usog is not yet medically accepted. More than the superstitious folks, researchers dealing with Filipino Psychology say they have observed this phenomenon with regularity and suggest that this be added to the Psychiatric Disorders Handbook DSM-V.
Several diagnostic tests for this condition have been proposed. These include nasal nitric oxide levels, light microscopy of biopsies for ciliary beat pattern and frequency and electron microscopic examination of dynein arms. Genetic testing has also been proposed but this is difficult given that there are multiple genes involved.
Fortunately for patients afflicted with parosmia, symptoms usually decrease with time. Although there are instances of parosmia affecting patients for years at a time, this is certainly not the majority of cases. There have been experiments done to treat parosmia with L-Dopa, but besides that there are no current treatments other than inducing anosmia or hyposmia to the point where the odors are negligible.
Local damage and inflammation that interferes with the taste buds or local nervous system such as that stemming from radiation therapy, glossitis, tobacco use, and denture use also cause ageusia. Other known causes include loss of taste sensitivity from aging (causing a difficulty detecting salty or bitter taste), anxiety disorder, cancer, renal failure and liver failure.
People with hypermethioninemia often do not show any symptoms. Some individuals with hypermethioninemia exhibit learning disabilities, mental retardation, and other neurological problems; delays in motor skills such as standing or walking; sluggishness; muscle weakness; liver problems; unusual facial features; and their breath, sweat, or urine may have a smell resembling boiled cabbage.
Hypermethioninemia can occur with other metabolic disorders, such as homocystinuria, tyrosinemia and galactosemia, which also involve the faulty breakdown of particular molecules. It can also result from liver disease or excessive dietary intake of methionine from consuming large amounts of protein or a methionine-enriched infant formula.