Belching:
See Burping link:https://apollosugar.com/blogpost/a_z_section/burp/

Bypass operations:

Also known as coronary artery bypass graft (CABG), bypass operations are surgical procedures that are done to rectify a blocked or obstructed coronary artery in order to restore normal blood flow. A coronary artery supplies blood from and to the heart. People suffering from coronary artery disease (See: Coronary Artery Disease) and ventricular dysfunction experience angina (a chest pain caused due to reduced blood supply to the heart). This is due to the buildup of plaque and fatty deposits, which obstructs the blood flow to the heart. A major cause for the buildup of plaque, calcium, and fatty deposits is due to arteriosclerosis, and atherosclerosis. A bypass operation is advised when the patient does not exhibit satisfactory responses to medications. The objective of the operation is to reduce the risk of ventricular dysfunction and death. A bypass operation is suggested to patients who have artery blockages from 50% to 90%. The concept of a bypass operation is to bypass the obstructed artery and use a harvested vein from the leg. The harvested vein is attached to the heart so that there is free flow of the blood. Bypass operation can be single, double, triple, quadruple, and quintuple depending upon the number of coronary arteries bypassed. However, coronary arteries that are present inside the heart, less 1.5 mm, and heavily calcified are not suitable for bypass operation. Prior to the surgery, a coronary angiogram is performed in order to identify and assess the number of obstructions and the extent of the obstructions. The number of bypass grafts needed and the exact location for the bypass graft attachment is decided before the surgery. The location and the number of bypass grafts might be changed after surgeons examine the heart directly. During surgery, the patient is given general anesthesia. The heart is stopped and the patient is put on a cardiopulmonary bypass (a heart-lung machine). The most common procedure used is LIMA to LAD. In this procedure, the left internal mammary artery (LIMA) is used to bypass left anterior artery (LAD). This is a proven method and a highly successful procedure for surgical revascularization. LIMA to LAD is the gold standard for coronary artery bypass graft procedures. In other procedures, arteries from the forearm and veins from the leg are harvested. This is done in a keyhole surgical procedure. In the past, bypass operations used to be open-heart, but with new technologies CABG is now minimally invasive. A bypass operation has both risks and benefits. The risks include the risk of bleeding, heart rhythm issues, and risk of blood clots, renal failure, difficulty thinking, and post-pericardiotomy syndrome. It also does not prevent myocardial infarction (heart attack). The benefits include improved blood circulation, better quality of life, reduced angina symptoms, improved longevity, and reduced risk of complications. People with diabetes tend to have higher LDL levels along with higher triglyceride levels. Moreover, they have an inflammatory condition where higher blood sugar levels causes irritation in the blood vessels leading to inflammatory response. The body tends to heal this condition by formation of plaques in order to form a sort of bandage to the irritated area. As such people with diabetes are at an increased risk of atherosclerosis and plaque burden. Added inflammation and plaque break down leads to plaque rupture leading to cardiovascular events. These necessitate a bypass surgery. People with diabetes who undergo bypass operation for severe left ventricular dysfunction are generally known to have poor outcomes. Some of the risk factors include postoperative wound infection of the sternum, and renal failure. Many people with diabetes who undergo bypass operation have to undergo re-hospitalization due to infections, cardiac problems and arrhythmias.

Bursa:

Bursa or bursae (plural) are fluid-filled sacs that are present around joints. They provide cushioning effect to the bones when skin, muscles, or tendons rub against them. Bursae play an important role in providing protection against friction during movement. In case of any disorder of the bursae, movement becomes difficult and painful. Bursae are present all over the body wherever tendons move across bones. While there are around 160 bursae at birth, new ones may form as a result of friction. IN case of people who wear shoes or for someone who has an abnormal foot anatomy, an abnormal bursa might develop in the big toe joint (See: Bunion). Being lubricated fluid-containing sacs, they are present a bone and any opposing surface. Bursae occur in various sizes, but the healthy ones are generally thin. Bursae contain synovial fluid in a synovial membrane. The synovial fluid is itself a viscous fluid and looks like the white of an egg. The viscous nature gives protection against friction. Bursae are of three types – synovial, subcutaneous, and adventitious. Adventitious bursae form with repeated shearing stress on the soft tissue. Subcutaneous bursae form when sheets of fibrous tissue form at the junction of the subcutaneous tissue. Some common conditions of bursae include bursitis (inflammation of the bursae), which is a result of mechanical friction, infectious bursal disease, formation of cysts, tendinitis, and musculoskeletal connective tissue diseases. Diseases of the bursae are diagnosed by an ultrasound, MRI, and in some cases, aspiration. Treatment for bursal diseases include taking rest, prescription of NSAIDs, corticosteroid injections, and treatment for infections, if present. Since bursitis can occur in any of the joints where there is friction, people with diabetes are prone to bursitis. Bursitis generally occurs in the shoulder, elbow, knee, hips, ankle, thigh, and buttocks. Since diabetes and high blood sugar levels act on the immune system and the blood vessels, people with diabetes are prone to get septic bursitis. Reduced blood supply to the tendons and the thickening of tendons in people with diabetes creates susceptibility to tendinitis and bursitis.

Burp:

Also known as belching, burping is the process of expelling air from the digestive tract through the mouth. Burping is caused due to various reasons. Sometimes, it is caused by the release of the air swallowed while eating food or drinking fluids. This air contains a mixture of nitrogen and oxygen. People also swallow air while opening their mouths and release this in the form of burping. In the process of digestion, many bacteria in the intestines breakdown the food particles into vitamins and glucose. In this process, gases like methane and carbon dioxide are produced and are released by burping. Burping is also caused due to the consumption of soft drinks, wine, beer, and other beverages along with antacids containing effervescents. Burping might be the result of acidity, GERD, dyspepsia, and gastritis. Infants tend to accumulate gas while feeding and are relieved after burping. For people with diabetes, the usage of medications like Metformin can cause excessive burping. This is a common side effect. Also, people with diabetes who burp a lot might have to test for gastroparesis.

Burn:

Burning is an injury to the skin and tissues of the body that is caused due to external agents like heat, fire, radiation, electricity, cold, chemicals, and friction among others. The degree of injury caused due to burns vary depending upon the damage caused. An injury that causes damage to the superficial skin (epidermis) alone is called a first-degree burn injury. These injuries appear red, dry and are painful. The second-degree burn injuries involve damage to both the epidermis and the inner layer of the skin (dermis). The site of the injury is red in color, appears blistered, and is swollen with blisters. Third-degree burns annihilate the epidermis and dermis, and enter the underlying tissue (the subcutaneous tissue). The site of this burn injury looks charred and white. Fourth-degree burn injury damages the epidermis, dermis, the subcutaneous tissues, the tendons and muscles, and the bones. All the nerves of this region are destroyed. While superficial burns can be treated with topical creams and pain medications, major burns need hospitalization in special burn centers. In case of second-degree burns, patients might have infections while patients with third-degree burns have contractures, scarring, and require skin grafting and excision. In the case of fourth-degree burns, there might be amputation, functional impairment, and even death. People with diabetes are have an increased risk of burn injuries. Due to their neuropathic symptoms and the subsequent numbness, they might not be able to notice the severity of the burns or feel the pain. These burns might happen while doing household chores and lead to infections, which can be disastrous.

Bulbar conjunctiva:

The conjunctiva (See: Conjunctiva) covers the white of the eye (sclera), and lines the inside of the eyelids. The bulbar conjunctiva is a part of the conjunctiva apart from palpebral conjunctiva, and fornix conjunctiva. The bulbar conjunctiva is the thinnest part of all the three conjunctiva and covers the eyeball. It is almost transparent. The sclera underneath binds this area of the conjunctiva and moves along with the movements of the eyeball. The conjunctiva functions by providing lubrication to the eye. It produces mucus. It even produces a small amount of tears apart from the lacrimal glands. It provides immunity to the eye and protects it from bacteria. The bulbar conjunctiva gets blood supply from the anterior and posterior conjunctival arteries. It contains many arterioles, venules, and capillaries. The nerve connections to it comes from the ciliary nerves. Some common medical conditions of the conjunctiva and the bulbar conjunctiva include conjunctivitis, which can be caused due to allergy, infection, and exposure to foreign chemicals. Other conditions include follicles, papillae, chemosis, trauma, subconjunctival hemorrhage, and scarring. Natural degeneration of the conjunctiva causes conditions like Cogan’s senile plaque, Pterygium, Pinguecula, formation of cysts, and concretions. Some other conditions like formation of lesions, inflammation, and tumors are common. Most conjunctival conditions present themselves with symptoms like red eye, watery eyes, and pain in the eye, irritation, and discharge from the eye. Diagnosis is done by physical examination, patch test, cytology, and differential diagnosis. The management of conjunctival conditions is done as per the cause of it and the intensity of the inflammation. In case of infections, antibiotic eye drops are prescribed. In case of chemical substances, it is irrigated with saline solution. It is well known that people with diabetes are prone to many eye conditions like cataracts, glaucoma, macular degeneration, and diabetic retinopathy. Apart from these disorders, diabetes and high blood sugar levels also create certain vascular disorders in the conjunctiva leading to dry eyes, tortuosity (twisting) of the blood vessels in the bulbar conjunctiva, changes in the conjunctiva, and microaneurysms in the bulbar conjunctiva. Research suggest that as the duration of diabetes increases, there is a decrease in the overall vessel mean area in the smaller blood vessels. This leads to capillary loss and morphological changes in the conjunctiva

Buccal Mucosa:

Buccal refers to the cheeks and mucosa refers to the mucus membrane. Buccal mucosa is the inner mucus membrane of the cheek and the lips. Belonging to the oral mucosa, the buccal mucosa is the inner lining of the mouth floor, and cheeks. The oral cavity consists of teeth, gums, tongue, soft palate, hard palate, the lips, and the floor of the mouth, the buccal mucosa and the retromolar trigone. The function of the oral cavity is to protect, provide sensation, secrete saliva, and regulate temperature. The oral cavity does these functions with the help of the buccal mucosa. The mucosa in the oral cavity is both keratinized and non-keratinized. Buccal mucosa is non-keratinized and a lining mucosa that has a soft surface texture, can be stretched and compressed, and can act as a cushion. It contains elastic fibers and submucosa that assist people while chewing food and while speaking. Some common diseases of the oral mucosa and the buccal mucosa include viral diseases like herpes, chickenpox, warts, bacterial and fungal infections, candidiasis, lichen planus, ulcers, traumatic ulcers, and cancer of the mouth and buccal mucosa. Cancers of the mouth and the mucosa are generally caused due to smoking, chewing tobacco, and excessive consumption of alcohol. People with diabetes have numerous oral manifestations that come up in the form of recurrent infections, bleeding gums, gum diseases, periodontitis, and inflammation of the gums, dry mouth, and ulcers. High blood sugar levels are known to affect the soft tissues in the mouth leading to many conditions. Since the immune system of a person with diabetes is also compromised, the mucosa is also prone to numerous infections and disorders.

Bruit:

Bruit is a sound that is heard through the stethoscope. This is one as part of the physical examination. Bruits are sounds that are heard in the neck caused due to turbulence in the flow of blood in the arteries. These sounds are heard in the neck from the artery that supplies blood from the heart to the brain. In most cases, bruit is caused due to stenosis (See: Stenosis) of the artery because of the buildup of plaque. Carotid artery bruits may also occur in people without any stenosis and this is called innocent carotid bruits. Often, called carotid bruit, bruits are confused with basal heart murmurs that are sounds, which are sounds originating from the heart. In the neck bruits are heard with more intensity than heart murmurs. There are other types of sounds called “bruits & thrills,” and “bruits & hums” that are heard in the arteries and veins when blood flows. Bruits are indicative of carotid artery disease. People with diabetes are more prone to have carotid artery disease due to hyperglycemia, arterial hypertension, and high cholesterol. People with diabetes who exhibit cerebrovascular symptoms (generally above 60 yrs.) benefit from carotid ultrasound as this can assess the risk of carotid artery disease and stroke.

Bruise:

A bruise is a region of injured blood vessels or capillaries. Also known as a contusion, a bruise occurs when there is a trauma to the soft tissues. This trauma can be the result of an injury causing the breakage of capillaries. This leads to blood leaking out. The skin on the site of the bruise turns reddish and purple due to the hemorrhage of the capillaries into the surrounding tissues. Bruises are a type of hematoma (See: Hematoma) of the small veins and the capillaries. Bruises which do not turn white when pressure is applied might be deeper than the skin involving the subcutaneous tissue, and the muscle. Bruises are a result of internal bleeding that are most likely caused due to blunt injuries that cause pain. In some cases though it might indicate the presence of an underlying disorder of coagulation or platelets. Bruises are generally treated with anti-inflammatory medications, ice, topical creams, and elevation of the bruised area. People with diabetes are more prone to have wounds and bruises due to changes in their skin and are prone to a condition called diabetic dermopathy. Moreover, these bruises take a long time to heal due to a compromised immune system along with an increased risk of infection.

Brown Fat:

Brown fat is also called brown adipose tissue (BAT). The adipose tissue (See: Adipose tissue) consists of white fat and brown fat. The function of the brown fat cells is to burn fat in the form of heat (chemical energy) when needed. These cells contain uncoupled protein, which helps the release of energy in the form of heat. Brown fat is a key constituent for humans to combat cold temperatures. Brown adipose tissue is significantly present in infants in areas around the trachea, pancreas, and kidneys. Though it is believed that most of the brown adipose tissue transforms into white fat or white adipose tissue, recent studies on positron emission tomography has shown that human adults do have significant amounts of brown fat deposits in them stored in the upper chest and the neck areas. For people with diabetes, brown fat is known to activate insulin sensitivity. This means that people suffering with diabetes and having impairment of insulin function benefit from the activation of brown fat. Brown fat activation can also increase bone density and lower levels of C-reactive protein. However, it has been stated that in non-diabetics, activation of brown fat has led to mild elevation of blood sugar levels.

Bronchospasm:

Bronchospasm is a condition of the bronchi (See: Bronchi). In this condition, the muscles in the walls off the bronchioles suddenly constrict. Bronchospasm causes breathing problems that can be mild to severe. When the muscles of the bronchioles constrict, the airways get narrow. This leads to a difficulty in breathing and reduced amount of oxygen to the body. Bronchospasm occurs either due to the contraction of the smooth muscles in the bronchi and bronchioles, excessive production of sputum blocking the airways, drying or overcooling of the airways, or due to an inflammation of the airways. This condition causes cough, wheezing, tightness or pain in the chest, and fatigue. Bronchospasm normally affects people with asthma. It even affects people who smoke, inhale fumes or smoke from fire, infections of the lungs, and exposure to allergic substances. It occurs in certain disease conditions like emphysema, bronchitis, and COPD. A bronchospasm is diagnosed using tests like spirometry, lung diffusion capacity, lung volume test, pulse oximetry, chest x-ray, and CT scan. Treatment for bronchospasm includes medications like long and short-acting bronchodilators, and oral and intravenous steroids. In case of an infection-induced bronchospasm, antibiotics and other medications are prescribed. Diabetes is known to cause lung complications due to persistent high blood sugar levels. In some people with diabetes, especially those who take medication for high blood pressure and are aged above 60 years, the risk of bronchospasm is present. Also, the presence of diabetes and COPD is another risk factor for bronchospasm. Bronchospasm can be life-threatening when it comes with anaphylaxis, and when it is a side effect of a medication like beta blockers.

Bronchoscopy:

Bronchoscopy is an endoscopic test done to visualize the insides of the lungs. It is done to evaluate the functioning of the bronchi, to detect diseases and disorders of the lungs, and to provide certain therapies. A bronchoscopy is done with the help of an instrument called the bronchoscope. It is usually a clinical procedure done in an operating room or a room designated for bronchoscopy. Prior to the procedure, the patient is advised not to consume any liquids or solid food for at least 12 hours. The patient is given a local anesthetic in the nose, pharynx, larynx, and trachea along with an antianxiety and anti-secretion medication. The patient’s vitals along with the blood pressure, and heart rate is done. A continuous ECG and pulse oximetry is also conducted during the test. Bronchoscopy is done either with a flexible bronchoscope or a rigid bronchoscope. The probe of the bronchoscope is inserted in the trachea and into the bronchial system. Imaging occurs in three types – in the form of CT scans (virtual bronchoscopy), ultrasound (endobronchial ultrasound), and fluorescence bronchoscopy where a florescent light is attached along with the probe. A bronchoscopy detects lung diseases, bronchial disorders, infections, and other conditions. It is also used for therapies like removal of foreign substances, blood, and others from the lungs, resection of bronchial tumors, tracheostomy, and stent insertion in lungs.

Bronchi (Bronchus):

Bronchi is the plural of bronchus, which is a passage way present in the lungs. The bronchus is an airway that allows air to move in and move out facilitating respiration. They are the extensions of the windpipe. The bronchi begins at the trachea (windpipe), and it branches into the main left bronchus and the main right bronchus. As they move into the lungs, they further branch out into lobar bronchi and bronchioles. The bronchioles further open out into tiny air sacs called alveoli. While the right main bronchus is wider and shorter, the left main bronchus is longer. The bronchi contain cartilage and have mucosal lining. This mucosal lining produces mucus in order to trap foreign particles that enter the lung and the bronchopulmonary segment. The smooth muscle that is present in the bronchi are controlled involuntarily. They expand and contract as per the messages of four nerve networks centered at the dorsal respiratory group in the medulla, ventral respiratory group in the medulla, pneumotaxic center in the nuclei of pons, and apneustic center in the nuclei of the pons. Though the process of expansion and contraction of the bronchi is involuntary, there are certain exceptions like voluntary breathing exercises, yawning, holding breath while swimming, blowing and others. The main function of the bronchi is to allow air in to exchange oxygen and to release carbon dioxide. Some common conditions of the bronchi include asthma, bronchitis, aspiration pneumonia, bacterial pneumonia, bronchospasm, bronchopulmonary dysplasia, bronchiolitis, and bronchiectasis. In people with diabetes, some uncommon complications of the respiratory system include bronchial obstruction, and pulmonary edema. Some common complications of diabetes involve obstructive sleep apnea, reduced lung function, and decreased levels of diffusing capacity for carbon monoxide, pulmonary fibrosis, and pneumonia. Damage to the lungs occurs in people with diabetes due to the fact that high blood sugar levels tend to stiffen the tissue of the lungs. Moreover, fat tissue present in the chest and the abdomen tends to restrict the lung capacity.

Bromocriptine:

Bromocriptine is a medication that is prescribed for the symptoms of Hyperprolactinemia. Hyperprolactinemia is a condition characterized by increased levels of serum prolactin that is produced in the anterior part of the pituitary gland. Hyperprolactinemia causes symptoms like lack of or no periods (amenorrhea), infertility, hypogonadism, and discharge from the nipples. Hyperprolactinemia is generally caused due to the presence of tumors in the pituitary glands. This medication is also prescribed for conditions like Parkinson’s disease, other pituitary tumors, neuroleptic malignant syndrome, acromegaly, amenorrhea, ovarian hyperstimulation syndrome and type 2 diabetes. Bromocriptine is a dopamine agonist, which means this medication can be used to treat low dopamine conditions also. Side effects of this medication include nausea, vomiting, heartburn, stomach cramps, constipation, headaches, and difficulty in sleeping, depression, fainting, seizures, blurred vision, chest pain, and shortness of breath. Since this medication is a dopamine agonist, other side effects might include euphoria and hallucinations. People who are prescribed this medication should discuss about the usage of other vitamin and nutritional supplements along with the usage of alcohol. Lactating mothers should not use this medication as it can suppress the production of milk. In people with diabetes, Bromocriptine is sometimes prescribed along with a diet and exercise plan for type 2 diabetes. The mechanism of action of Bromocriptine in the treatment of type 2 diabetes lies in regulating circadian neuroendocrine rhythms. It is known to improve metabolic effects and improves serum lipid profile levels.

Brittle Diabetes:

Brittle diabetes is a term used to describe a diabetic condition that becomes hard to control. It is also called labile diabetes. In this condition, a person has huge swings of blood sugar levels. Blood sugar levels might reach higher levels and cause hyperglycemia and plummet causing hypoglycemia. This condition can disrupt the quality of life of a person and is generally common among people with type 1 diabetes. Being a severe form of diabetes, it can be stressful, both physically and psychologically, for a patient and it can also lead to hospitalization. Known to commonly affect people among their 20s and 30s, especially women, brittle diabetes causes drastic symptoms. The symptoms include extreme hunger, trouble sleeping, severe headaches, shivering hands, weakness, dizziness, and irritability. These symptoms occur when the blood sugar levels go down. When the blood sugar levels spike, patients experience symptoms like increased urination and increased thirst, blurry vision, and dry skin. People with diabetes and hormonal imbalances, hypothyroidism, depression, obesity, and high stress levels are prone to brittle diabetes. Also, people who have gastrointestinal problems like malabsorption, and autonomic neuropathy are prone to brittle diabetes. Emotional stress, poor personal upkeep, and alcohol or drug use can also lead to brittle diabetes. Other conditions like adrenal insufficiency, Celiac disease, and abnormal insulin absorption can lead to brittle diabetes. People with psychological problems having diabetes should be cautious as the psychological issue can reinforce brittle diabetes. If left unmanaged, brittle diabetes can lead to diabetic coma, recurrent diabetic ketoacidosis, weight gain, thyroid disease, and diseases of the adrenal glands. Management of brittle diabetes involves stabilizing blood sugar levels and preventing hypoglycemia and hyperglycemia. Also, continuous glucose monitoring (See: Continuous Glucose Monitoring), and usage of subcutaneous insulin pumps (See: Insulin Pump) are considered effective strategies for managing brittle diabetes. Also, adequate psychological treatment is advised in order to avoid making brittle diabetes into a self-perpetuating condition. Apart from these medical practitioners measure the mean of daily differences, mean amplitude of glycemic excursions, low blood glucose index, and lability index in order to assess the condition and the progress of brittle diabetes.