The incidence of this disease is about one in 500 for heterozygotes, and one in 1,000,000 for homozygotes.HLPIIa is a rare genetic disorder characterized by increased levels of LDL cholesterol in the blood due to the lack of uptake (no Apo B receptors) of LDL particles. This pathology, however, is the second-most common disorder of the various hyperlipoproteinemias, with individuals with a heterozygotic predisposition of one in every 500 and individuals with homozygotic predisposition of one in every million. These individuals may present with a unique set of physical characteristics such as xanthelasmas (yellow deposits of fat underneath the skin often presenting in the nasal portion of the eye), tendon and tuberous xanthomas, arcus juvenilis (the graying of the eye often characterized in older individuals), arterial bruits, claudication, and of course atherosclerosis. Laboratory findings for these individuals are significant for total serum cholesterol levels two to three times greater than normal, as well as increased LDL cholesterol, but their triglycerides and VLDL values fall in the normal ranges.To manage persons with HLPIIa, drastic measures may need to be taken, especially if their HDL cholesterol levels are less than 30 mg/dL and their LDL levels are greater than 160 mg/dL. A proper diet for these individuals requires a decrease in total fat to less than 30% of total calories with a ratio of monounsaturated:polyunsaturated:saturated fat of 1:1:1. Cholesterol should be reduced to less than 300 mg/day, thus the avoidance of animal products and to increase fiber intake to more than 20 g/day with 6g of soluble fiber/day.
Actinomycetoma is a chronic bacterial subcutaneous infection caused by Actinomyces that affect the skin and connective tissue. It is, therefore, a form of actinomycosis. Mycetoma is a broad term which includes actinomycetoma and eumycetoma under it. However, eumycetoma is caused by fungal infection in contrast to actinomycetoma that is caused by bacteria mostly anaerobic. The predominant site of infection is the foot and leg. Both actinomycetoma and eumycetoma show very similar clinical and radiological presentations. And both chronic infections are endemic in tropical countries. == References ==