Monthly Archives: September 2018

WANT TO QUIT JUNK FOOD? GET READY TO FACE THE WITHDRAWAL SYMPTOMS! WAIT..WHAT?

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Junk food addiction is a real thing!

Food has developed from a basic necessity to an object of desire. And in the recent times, it has become a substance of abuse. Junk foods are considered something useless, extra or something that is not needed. Not only are those foods extremely unhealthy, but they also impact various aspects of your life. Junk food addiction is the compulsive eating of junk food which is out of control and causing problems for you. Do you crave for junk food and eat it on a regular basis? Do you want to quit it, but you can’t?

Quitting junk food – what it does to your body?

Like any addiction, an abrupt end to junk food can initially cause withdrawal symptoms. One may feel lethargic and have headaches. One may be highly irritable. Withdrawal symptoms can include severe anxiety, headaches, sadness, anger, sweating, shaking, disorientation and depression. They can last anywhere from days to weeks or even months after quitting. Many individuals can’t stop consuming sweeteners, flours, processed foods, and other addictive foods because they have great difficulty getting through the intense period of withdrawal. Cravings create an urge for more serotonin or dopamine. This is a vicious cycle. And it can lead to life-threatening conditions, including obesity, diabetes, heart disease, and cancer.

Researchers in Canada made this discovery after feeding a group of mice a junk-food diet that would shame any glutton: For six weeks, the mice ate foods that had a whopping 58 percent calories from fat. They compared these mice to another group of mice eating relatively lean foods with just 11 percent calories from fat.

To the surprise, the mice that scarfed down the high-fat diet increased their waist size by 11 percent at the end of the six-week study. After the mice raised on a high-fat diet were switched to a healthier one, they acted more anxious and depressed.

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The researchers then examined the brains of the mice and discovered significant changes had occurred: Mice on the high-fat diet had increased levels of corticosterone — a hormone associated with stress — and CREB, a protein closely linked to dopamine functioning. Dopamine is a neurotransmitter that causes feelings of reward and is activated by (among other things) addictive drugs like cocaine and methamphetamine.

The result, explained researchers, is that many people who quit eating sugary, high-fat foods soon return to an unhealthy diet of junk food.

“This explains both the depression and the negative behavior cycle,” said researcher Dr. Stephanie Fulton of the University of Montreal, as quoted. “The chemicals changed by the diet are associated with depression. A change of diet then causes withdrawal symptoms and a greater sensitivity to stressful situations, launching a vicious cycle of poor eating.”

“Bingeing on sugar and other addictive foods is culturally condoned, food company-induced drug addiction,” holistic psychiatrist Ellen Vora, M.D., told mbg.

“At the neurobiological level, the neural substrates of sugar and sweet reward appear to be more robust than those of cocaine.”

And it’s not just about having a so-called “sweet tooth.” Our addiction to such foods is deeply ingrained, and it has less to do with willpower and more to do with the fact that these foods trigger the brain’s dopamine-fueled reward center ( a.k.a. the “good feels” portion of our brain) and tell us we want more.

Based on the study’s findings, the authors believe many people who experience such withdrawal symptoms will end up resorting back to their unhealthy eating habits. But don’t lose hope just yet: This particular study didn’t look at the specific strategies people used to quit junk food, and experts like Dr. Vora believe there are a few effective ways to quit junk food that won’t leave you hangry or giving into cravings two hours later.

The most important key to success is having a plan. Acknowledge the fact that you very well may be irritable or experience flu-like symptoms for a few days, Dr. Vora says, and don’t try to go cold turkey on everything all at once. Start by eliminating one item from your diet per week, nothing changes as you go. That way, it’ll feel less overwhelming and more manageable. When the cravings do hit, integrative medicine doctor Amy Shah, M.D., recommends finding ways to distract yourself—even a short 15-minute walk can go a long way. And definitely be prepared with pre-made meals, sugar-free snacks, and ample hydration.

People who succeed in healing their addictions learn to understand and deal with their physical cravings and withdrawal symptoms. They also become good at managing the intense feelings that often arise during the withdrawal period. But it’s a tough struggle. Despite a strong desire to stop, the complexity of physical withdrawal symptoms and the accompanying emotions can lead an individual back to using mood-altering foods, which only perpetuate the addiction cycle.

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But over the long term, you gain by quitting junk food. Your health improves drastically. The risks of heart disease, diabetes, and kidney disease are reduced. Junk food slows down the brain. Quitting the addiction can help halt the effect and improve your brain function. High-fat, high-sugar junk food is responsible for acne breakouts. You will have fewer acne problems by kicking the habit. You may be spared trips to the dentist too! Processed soft foods high in sugar create havoc with oral health. Shifting to unprocessed coarse foods low in sugar reduces the problems with your teeth. There is so much to gain by abstinence from junk food. But you do have one thing to lose – your weight.

Hit by Dengue? Not to panic!

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Dengue is a mosquito-borne viral disease. Though the disease takes on an epidemic form almost every year creating panic among the public, dengue is preventable.

Who is the culprit causing Dengue?

The virus is contracted from the bite of a female, striped Aedes aegypti mosquito that has previously bitten an infected person. The mosquito flourishes during rainy seasons but can breed in water-filled flower pots, plastic bags, and cans year-round. One mosquito bite can cause the disease.

The virus is not contagious and cannot be spread directly from person to person. It is mosquito-borne, so there must be a person-to-mosquito-to-another-person pathway. The full life cycle of the virus involves the mosquito as the vector (transmitter) and the human as the source of infection.

What is its breeding pattern?

The female mosquito bites on the elbows and ankles. The female dengue mosquito never sucks a stomach-full of blood at one go but darts from one person to another takes just a sip, until the dengue virus spreads to several people. After every meal, she lays a batch of 400 to 500 eggs, which happens about 5 times in her lifespan. The mosquito lays the eggs in a different place every time. Aedes aegypti lays eggs on the sides of containers and these remain stuck to the surface like glue. The eggs can survive without water for almost a year and hatch as soon as they are submerged in water. The larvae that emerge from the eggs are also tough and can survive in water for a long time even if the temperature is unfavorable. This makes it more important to avoid water stagnation in any form. The dengue mosquito prefers to rest indoors as this protects them from climatic changes thereby increasing their lifespan. Unlike malaria mosquitoes, dengue mosquitos bite during the day with their activity peaking at dawn and dusk. Dengue mosquitoes can’t breed once the temperature falls below 16 degrees. They are generally active between the time period of August-October, which is the peak period for both malaria and dengue.

When do you need to rush to the doctor?

The clinical features of dengue fever vary according to the age of the patient. Individuals should suspect dengue when a high fever (40°C/ 104°F) is accompanied by two of the following symptoms:

  • A severe headache
  • Pain behind the eyes
  • Nausea, Vomiting
  • Swollen glands
  • Rash
  • Muscle and joint pains

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Also known as “break-bone” fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking.
Symptoms usually last for 2-7 days, after an incubation period of 4-10 days after the bite from an infected mosquito.

One should immediately go to the doctor if experiencing symptoms like recurrent vomiting, intolerable severe aches, headache/body ache, high-grade fever, low BP, drowsiness, severe exertion, bleeding from any body part, rapid fall in platelets etc. The period of maximum risk is between the third and the seventh day of illness. But there is no need to panic and no platelet transfusion is required unless platelet count is less than 10,000 or there is a presence of spontaneous bleeding. During epidemics, people of all ages are involved otherwise the disease is more common in children. Presence of restlessness (oxygen deficiency in the brain), abdominal pain and black stools (GI bleeding), minor bleeding from skin, nose, mouth etc signifies urgency. Most dengue infections result in relatively mild illness, but a very small percentage of infections can develop into the far more serious dengue hemorrhagic fever (DHF). This disease is identified with low platelet count, leaking blood vessels causing bleeding from bodily orifices through nose, mouth, and gums. Bruising can be another sign of bleeding inside the body. Unavailability of right treatment at right time can result in the collapse of the blood vessels causing shock (Dengue shock syndrome) and very often death. Thus it is very necessary to seek for urgent medical help if the patient starts bleeding from body orifices. Dengue hemorrhagic fever is a serious condition responsible for 10% of total dengue-related mortality.

How long does dengue fever last?

The acute phase of dengue with fever and muscle pain (myalgia) lasts about one to two weeks. Convalescence is accompanied by a feeling of weakness (asthenia) and fatigue, and full recovery often takes several weeks.

Drinking papaya leaves juice, goat’s milk etc will help in gaining blood platelets?
FALSE. It’s a myth.

How is Dengue Fever diagnosed?

There are four main laboratory methods to diagnose dengue infection: NS1 Antigen, viral isolation in culture, detection of viral RNA by PCR technique, and specific IgM/IgG antibodies in paired sera. The gold standard is usually a combination of dengue NS1 and serology (Antibodies) methods. Dengue NS1 is positive in 80% cases in first day and in 2-3 days it is 60-80% positive. IgM test may take 5-7 days to become positive. Viral isolation is costly, the results are usually available after 6 to 10 days and it is only obtainable in laboratories with the appropriate infrastructure for cell culture or mosquito colonies.

The RT-PCR and other PCR-based techniques give results within 24 hours but they are also costly and they are not available for most clinicians.

On the contrary, there are commercially available immunochromatographic and ELISA tests for the detection of IgM/IgG antibodies which give results within minutes or few hours. However, the detection of antibodies in a dengue-infected person is only possible after 4-5 days of disease onset.

How can it be treated?

There is no specific treatment for dengue fever.
Patients should seek medical advice, rest and drink plenty of fluids. Paracetamol can be taken to bring down fever and reduce joint pains. However, aspirin or ibuprofen should not be taken since they can increase the risk of bleeding.
For severe dengue, medical care by physicians and nurses experienced with the effects and progression of the disease can frequently save lives. Maintenance of the patient’s circulating fluid volume is the central feature of such care.

Not to worry! Dengue Fever can be prevented!

The World Health Organization recommends an Integrated Vector Control program
Vector control
Preventing or reducing dengue virus transmission depends entirely on controlling the mosquito vectors or interruption of human-vector contact. WHO promotes the strategic approach known as Integrated Vector Management (IVM) to control mosquito vectors, including those of dengue.

Methods of vector control
Ae. Egypt uses a wide range of confined larval habitats, both man-made and natural.
Some man-made container habitats produce large numbers of adult mosquitoes, whereas others are less productive. Consequently, control efforts should target the habitats that are most productive and hence epidemiologically more important rather than all types of container, especially when there are major resource constraints.

Vector transmission is reduced through the use or combination of these three methods:

  •  Environmental management
  • Chemical control
  • Biological control

Individual and household protection
Clothing that minimizes skin exposure during daylight hours when mosquitoes are most active affords some protection from the bites of dengue vectors and is encouraged particularly during outbreaks.

Repellents may be applied to the exposed skin or to clothing. The use of repellents must be in strict accordance with label instructions.

Insecticide-treated mosquito nets afford good protection for those who sleep during the day (e.g. infants, the bedridden and night-shift workers).

Where indoor biting occurs, household insecticide aerosol products, mosquito coils or other insecticide vaporizers may also reduce biting activity.

Household fixtures such as window and door screens and air-conditioning can also reduce biting.
Safe use of insecticides
All pesticides are toxic to some degree. Safety precautions for their use – including care in the handling of pesticides, safe work practices for those who apply them, and appropriate field application – should be followed.

WHO Pesticide Evaluation Scheme (WHOPES) has published specific guidelines on the use of insecticides, safety procedures, quality control and guidelines for testing.

New and novel methods to combat dengue are being researched upon every day.
Sanofi’s vaccine, Dengvaxia which is designed to coax the body’s immune system into making antibodies against all four forms of dengue, is a live virus comprised of an attenuated yellow fever virus. (Yellow fever virus and dengue virus have the same genus.) For the vaccine, however, the virus is genetically engineered to include genes encoding for dengue proteins.
Some other examples include the release of sterile male mosquitoes and a promising method which involves infecting the mosquito with a harmless natural bacterium called Wolbachia. This bacterium blocks the dengue virus from growing in the mosquito’s body.

Bleeding Rectum? No it’s not Piles necessarily!

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Bleeding per rectum means bleeding in any segment of the gastrointestinal tract(GI) from ESOPHAGUS to RECTUM.

The color of the blood can indicate where the bleeding is coming from:

  • Bright red blood usually indicates bleeding low in the colon or rectum (lower GI)
  • Dark red or maroon blood usually indicates bleeding higher in the colon or the small bowel (upper GI)
  • Melena usually means bleeding in the stomach, such as bleeding from ulcers

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Not all rectal bleeding is visible to the eye. In some cases, rectal bleeding can only be seen by looking at a stool sample through a microscope. There is also a test, called a Hemoccult® test that s done in the lab.

What other than Hemorrhoids or Piles could cause Rectal Bleeding?

 

Bleeding Rectum may occur for many reasons. Common causes of rectal bleeding include:

  • Anal fissure (a small tear in the lining of the anal canal)
  • Constipation
  • Hard stools

Less common causes of rectal bleeding include:

  • Anal cancer
  • Angiodysplasia (abnormalities in the blood vessels near the intestines)
  • Colon cancer
  • Colon polyps
  • Crohn’s disease
  • Diarrhea
  • Diverticulosis (a bulging pouch that forms on the wall of the intestine)
  • Ischemic colitis (colon inflammation caused by reduced blood flow)
  • Proctitis (inflammation of the lining of the rectum)
  • Pseudomembranous colitis (colon inflammation caused by an infection)
  • Radiation therapy
  • Rectal cancer
  • Solitary rectal ulcer syndrome (ulcer of the rectum)
  • Ulcerative colitis (a type of inflammatory bowel disease)

What can be the Frequency and Duration of bleeding in various cases?

Bleeding per rectum is persistent or intermittent in polyps. Acute bleeding may be due to diverticular disease, angiodysplasia, jejunoileal diverticula, Meckel’s diverticulum, neoplasms/lymphomas, enteritis/Crohn’s disease, Peptic ulcer, gastritis/duodenitis, and esophageal varices. Angiodysplasia, small bowel tumors, small bowel ulcers and erosions, Crohn’s disease, small bowel diverticulosis, and radiation enteritis are causes for chronic intermittent bleeding.

What could be the Nature of Pain?

Painless bleeding may be due to hemorrhoids, colorectal carcinoma, polyps, diverticular disease, and Bleeding will be painful in anal fissure which is a severe sharp pain occurring with straining on defecation and resolves within an hour after defecation. Strangulated hemorrhoids are usually associated with pain.

Rectal Bleeding in Children

Rectal bleeding in small children should be taken seriously. Some children may require admission to the hospital and evaluation by a surgeon.

Intussusception: This condition occurs when the bowel folds in upon itself. It is the most common cause of intestinal obstruction and rectal bleeding in children up to 36 months. A majority of cases occur within the first year of life.

The three cardinal symptoms are:

1. intermittent abdominal pains,
2  vomiting, and
3. rectal bleeding that looks like currant jelly.

However, these are not always present. Admission to the hospital is warranted because observation, further imaging tests, and surgery may be required.

3Rectal Bleeding During Pregnancy

Hemorrhoids in the second and third trimesters of pregnancy are common. The cause is generally an increased pressure on the blood vessels in the pelvic area. Constipation and straining during bowel movements can also put pressure on the blood vessels. Straining during delivery can also exacerbate hemorrhoids.
If rectal bleeding occurs during pregnancy, even if a woman suspects the cause to be hemorrhoids, consult a physician.

When to Seek Medical Care for Rectal Bleeding?

When rectal bleeding is present with one or more of the following symptoms, call a doctor:

  • Fever
  • Stomach pain or swelling
  • Nausea or vomiting
  • Bleeding continues or worsens
  • Recent weight loss
  • Altered bowel habits
  • Severe or prolonged diarrhea
  • Pencil-sized stools, involuntary seepage of stools, or inability to have a bowel movement

If any of these signs and symptoms are present, a visit to the hospital’s emergency department is warranted:

  • Black or maroon stools
  • Large volume blood loss
  • Rectal pain or trauma
  • Dizziness, weakness, or fainting spells
  • Rapid or irregular heartbeat
  • Difficulty breathing

How Is Rectal Bleeding Diagnosed?

A physical examination will be performed by the physician. If necessary, diagnostic tests may be ordered.
Physical exam: The focus is on finding the source and extent of bleeding. Priority is to identify significant low blood volume and begin appropriate treatment. This is the most life-threatening situation.

The physician will focus on three aspects:
1. Vital signs: Low blood pressure and elevated heart rate will indicate a significant loss of blood. An elevated temperature will suggest infection.
2. Abdominal examination: The physician will search for abdominal distension, discomfort, or tenderness that may suggest a possible bleeding ulcer. A mass the doctor can feel is cause for concern about cancer.
3. Anal and digital rectal examination: The anus will be inspected for possible external sources of bleeding such as trauma, foreign body, or hemorrhoids. A finger examination is performed to assess tenderness, the character of stool, and the presence of masses.

Diagnostic tests: Depending on the type and severity of bleeding, special tests may be performed to aid in diagnosis.

  • Blood tests: Blood samples are taken to assess the extent of blood loss, the clotting ability of blood, and the possibility of infection.
  • Nasogastric tube: A flexible tube is passed through the nose into the stomach to check for the presence of active bleeding. This may be uncomfortable, but can be a vital diagnostic test.

Scope examinations:

  • Anoscopy: A plastic or metal scope placed into the anus allows for quick examination of the rectal vault.
  • Flexible sigmoidoscopy: A flexible tube inserted into the rectum is used to evaluate the rectum and lower end of the colon.
  • Colonoscopy: A soft tube equipped with a light and camera is inserted into the rectum and pushed into the colon. The entire large colon is visualized. It is used to locate areas of bleeding, masses, or irregularities.
  • Barium enema X-ray: This study uses liquid barium inserted into the rectum. An X-ray is taken to highlight problem areas such as tumors or diverticula. However, sites of active bleeding cannot be distinguished.
  • Nuclear medicine studies: A tagged red blood cell scan may be used to pinpoint areas of slow bleeding.
  • CT scan: May be used to diagnosing diverticulitis or tumors in the bowel.
  • Angiography: A contrast dye study is used to evaluate active areas of brisk bleeding.
  • Radionuclide scans: There are two types of radionuclide scans that are used for determining the site of gastrointestinal bleeding; a Meckel’s scan, and a tagged red blood cell (RBC) scan.

5How is rectal bleeding treated?

The treatment of rectal bleeding depends on the cause of the bleeding. Bleeding due to diverticular disease, colitis or angiodysplasia may resolve spontaneously without intervention. However, recurrent bleeding may require endoscopic therapy, and severe massive life-threatening bleeding may sometimes even require surgery.

Hemorrhoids are generally treated with a combination of lifestyle and dietary advice, medications and/ or rubber band ligation of the hemorrhoids. This is done in the outpatient clinic. Surgery may be performed if the bleeding is recalcitrant in spite of medical therapy.

Bleeding as a result of colorectal cancer should be managed with surgery for the primary tumor

Medicine: Given to decrease pain.
Vasoconstrictors: This medicine decreases the size of blood vessels and helps stop the bleeding.
Iron supplement: Iron helps the body make more red blood cells.
Steroids: This medicine decreases inflammation in the rectum. It may be applied as a cream, ointment, or lotion.
IV:To compensate dehydration. Extra liquids recommended.
Blood transfusion: Blood is tested for diseases, such as hepatitis and HIV, to be sure it is safe.
Surgery: Surgery to remove hemorrhoids, tumors, or polyps.

What Is the Prognosis for Rectal Bleeding?

The majority of people with significant rectal bleeding are elderly. Members of this population commonly have many other medical problems. As a result, they tend to suffer increased rates of illness and death.

In recent years, death from rectal bleeding has significantly decreased. This reduction is due to more efficient emergency departments, recent advances in procedures, and evolving surgical management.

The majority of complications from rectal bleeding occur when large amounts of blood have been lost.

The areas causing acute rectal bleeding may rebleed. This underscores the need for making a definitive diagnosis and in discovering the source of the bleeding so that the corrective actions may be made.

Rectal bleeding with symptoms of weakness, dizziness, or fainting is associated with at least 1 liter (2 pints) of blood loss is a medical emergency. Seek medical care immediately. Sudden loss of 2 liters (4.2 pints) or more of blood can be dangerous, if not fatal.

How Increasing Air Pollution is Taking a Toll On Your Life?

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FYI: Polluted air kills each year more people than malaria or tuberculosis.

Air Pollution and Respiratory Problems

Air pollution affects our health in different ways from simple to serious problems.
Air quality has an impact on the health of our lungs and the entire respiratory system. In addition to oxygen, the air contains other substances such as pollutants, which can be harmful to health. The inhalation of those pollutants may have harmful effects on the lungs and other organs of the body.

Many air pollutants can travel long distances from their source, posing risks to our health even in concentrations below the threshold of smell. In other words, we might not even feel that we are breathing polluted air. However, over long periods of time, even low concentrations of contaminants in the air may have devastating health effects. Obviously, the most exposed people are those working and living in polluted air environments (e.g. various industries and buildings with pollutants in indoor air due to various causes). Additionally, big city smog is a reality all over the world, involving outdoor air pollution and potentially affecting a large number of people.

There are two main types of air pollutants:

Gases (inefficient combustion of fuels for transport, power generation and other human activities like home heating and cooking.)
Particulate matter (tiny solid particles suspended in the air, such as dust particles).

PM10 particles, which are particles of 10 micrometers or less, can penetrate into the lungs and may enter the bloodstream, causing heart disease, lung cancer, asthma, and acute lower respiratory infections

Combustion processes produce a complex mixture of pollutants that comprises both primary emissions, such as diesel soot particles and lead and the products of atmospheric transformation, such as ozone and sulfate particles.

Indoor cooking and heating with biomass fuels (agricultural residues, dung, straw, wood) or coal produce high levels of indoor smoke that contains a variety of health-damaging pollutants. There is consistent evidence that exposure to indoor air pollution can lead to acute lower respiratory infections in children under age five, and chronic obstructive pulmonary disease and lung cancer in adults. Children are particularly at risk due to the immaturity of their respiratory organ systems. Acute lower respiratory infections, in particular, pneumonia, continue to be the biggest killer of young children

Mechanism of action of air pollutants

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The respiratory system is particularly sensitive to air pollutants because it is made up of a mucous membrane covering its internal surface. The lungs are designed to absorb large amounts of air (400 million liters on average over a lifetime) in close contact with the bloodstream and facilitate the transport of oxygen.

The cells of the lung tissue can be damaged by air pollutants such as ozone, metals and free radicals. Ozone can cause damage to the alveoli – air sac in the lungs where the exchange of oxygen and carbon dioxide is produced. More specifically, the airway tissues, which contain a large number of bio-activation enzymes, can transform organic pollutants into reactive metabolites, which can cause lung injuries, neuro-behavioral disorders, and cancers possibly including breast cancer.

Effects of Air Pollution on Human Health

The level of effect usually depends on the length of time of exposure, as well the kind and concentration of chemicals and particles exposed to.
Short-term effects include irritation to the eyes, nose, and throat, and upper respiratory infections such as bronchitis and pneumonia. Others include headaches, nausea, and allergic reactions. Short-term air pollution can aggravate the medical conditions of individuals with asthma and emphysema. Long-term health effects can include chronic respiratory disease, lung cancer, heart disease, and even damage to the brain, nerves, liver, or kidneys. Continual exposure to air pollution affects the lungs of growing children and may aggravate or complicate medical conditions in the elderly.

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Respiratory and lung diseases:

 

Asthma: Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles. This among other factors leads to bouts of narrowing of the airway, causing airflow obstruction, and bronchospasm and the classic symptoms of wheezing, coughing and shortness of breath.

Low air quality from factors such as traffic pollution or high ozone levels has been associated with both asthma development and increased asthma severity.
The most effective treatment for asthma is identifying triggers, such as cigarette smoke, allergens, etc and eliminating exposure to them. If trigger avoidance is insufficient, the use of medication is recommended. Bronchodilators are recommended for short-term relief of symptoms.

 

Bronchitis: Bronchitis is an inflammation or swelling of the bronchial tubes (bronchi), the air passages between the mouth and nose and the lungs. Individuals with bronchitis have a reduced ability to breathe air and oxygen into their lungs; also, they cannot clear heavy mucus or phlegm from their airways.

Bronchitis can be caused by viruses, bacteria, and other particles that irritate the bronchial tubes. Symptoms include coughing up mucus, wheezing, shortness of breath, and chest discomfort. Bronchitis is divided into two types: acute and chronic.

 

Acute bronchitis is a short-term illness that often follows a cold or viral infection. It consists of a cough with mucus, chest discomfort or soreness, fever, and, sometimes, shortness of breath. Acute bronchitis usually lasts a few days or weeks. It is normally caused by viruses, typically those that also cause colds and flu. It can also be caused by bacterial infection and exposure to substances that irritate the lungs, such as tobacco smoke, dust, fumes, vapors, and air pollution.

Chronic bronchitis is a serious, long-term illness characterized by a persistent, mucus-producing cough that lasts longer than 3 months out of the year for more than 2 years. People with chronic bronchitis have varying degrees of breathing difficulties, and symptoms may get better and worse during different parts of the year.

If chronic bronchitis occurs with emphysema, it may become chronic obstructive pulmonary disease (COPD).

Chronic bronchitis is caused by repeated irritation and damage to the lung and airway tissue. Smoking is the most common cause with other causes including long-term exposure to air pollution, dust, and fumes from the environment, and repeated episodes of acute bronchitis.

Diagnosis is typically based on a person’s signs and symptoms.

Treatment for acute bronchitis usually involves rest, paracetamol, and NSAIDs to help with the fever. Cough medicine has little support for its use.

Chronic bronchitis is treated symptomatically and may be treated in a nonpharmacologic manner or with pharmacologic therapeutic agents. Typical nonpharmacologic approaches to the management of COPD including bronchitis may include pulmonary rehabilitation, lung volume reduction surgery, and lung transplantation. Inflammation and edema of the respiratory epithelium may be reduced with inhaled corticosteroids. Wheezing and shortness of breath can be treated by reducing bronchospasm (reversible narrowing of smaller bronchi due to constriction of the smooth muscle) with bronchodilators.

  • Avoid lung irritants such as smoke, dust, fumes, vapors, and air pollution. If avoiding exposure is not possible, wear a mask that covers the nose and mouth.

Chronic Obstructive Pulmonary Disease –COPD

A type of obstructive lung disease characterized by long-term breathing problems and poor airflow. The main symptoms include shortness of breath and cough with sputum production. COPD is a progressive disease, meaning it typically worsens over time. Eventually, everyday activities, such as walking or getting dressed, become difficult.

 

Tobacco smoking is the most common cause of COPD, along with air pollution. One of the common sources of air pollution is poorly vented heating and cooking fires. Long-term exposure to these irritants causes an inflammatory response in the lungs, resulting in narrowing of the small airways and breakdown of lung tissue. The diagnosis is based on poor airflow as measured by lung function tests. In contrast to asthma, the airflow reduction does not improve much with the use of a bronchodilator.

While treatment can slow worsening, no cure is known. COPD treatments include smoking cessation, vaccinations, respiratory rehabilitation, and often inhaled bronchodilators and steroids.

Conditions like a chronic obstructive pulmonary disease, asthma may predispose to pneumonia eventually.

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An inflammatory condition of the lung affecting primarily the small air sacs known as alveoli. Typically symptoms include some combination of a productive or a dry cough, chest pain, fever, and trouble breathing. Severity is variable.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications and conditions such as autoimmune diseases.

In a research, it was found out that long-term exposure to higher levels of nitrogen dioxide and particulate matter is significantly associated with hospitalization for community-acquired pneumonia. The ground level NO2 is derived predominantly from emissions from vehicles during traffic. Prolonged exposure to ambient air pollution predisposes patients to pneumonia.
Also, nitrogen dioxide exposure may lead to epithelial cell damage, reducing mucociliary clearance. This could lead to reductions in bronchial macrophages, natural killer cells, macrophages, and CD4 to CD8 ratios — which may increase susceptibility to bacterial pathogens.
Pneumonia is typically diagnosed based on a combination of physical signs and a chest X-ray
Prevention includes vaccination, environmental measures and appropriate treatment of other health problems
Reducing indoor air pollution, such as that from cooking indoors with wood or dung, are both recommended. Smoking appears to be the single biggest risk factor for pneumococcal pneumonia in otherwise healthy adults.

 

Pulmonary cancer: Exposure to air pollution can cause “oxidative stress,” that is, damage to the cells of the body caused by oxidation. This, in turn, can lead to the development of cancer. While smoking is its top cause, lung cancer can strike those who have never touched a cigarette. For example, radon, a radioactive gas found in homes and businesses, can cause lung cancer. Pollution coupled with the body’s inability to detoxify the carcinogens causes inflammation which turns on tumor-promoting genes and increases insulin-like growth factor, interleukin six, and activating protein one, all of which promote the development of lung cancer.

Lung cancer, also called pulmonary carcinoma, is divided into three main categories. Non-small cell lung cancer is a variety that encompasses several similar sub-types, including adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. This type is the most common, accounting for 85 percent of lung cancers, according to the American Cancer Society (ACS). Small cell lung cancer comprises about 10 percent to 15 percent of all cases and is a fast-growing form of lung cancer, according to the ACS. Lung carcinoid tumors are rare, grow very slowly and usually do not spread.

Cases that include both main types are called mixed small cell/large cell lung cancer, according to the National Institutes of Health (NIH).

Symptoms include: Persistent, prolonged cough, Coughing up blood, Wheezing and shortness of breath, Chest pain, Appetite loss, Hoarseness, Unexplainable weight loss, Fatigue or weakness, Difficulty swallowing.

Diagnosis include : Imaging tests such X-rays, positron emission tomography (PET) scans, CT scans or MRI scans of the chest, Sputum test, which examines coughing-induced phlegm for abnormal cells ,Biopsy, which examines cells from one or more procedures that retrieve a tissue sample, Bronchoscopy, Mediastinoscopy (wherein a lighted tube is inserted above the breastbone through a small incision to see the center of the chest cavity) which helps to determine the extent of the cancer, or stage.

How lung cancer is treated depends on a number of factors, such as the overall health of the patient, the type of cancer, the stage of cancer and the size of cells present and whether they have spread. Often, combinations of therapies are used.

Surgery is often used to remove the cancerous tissue. Chemotherapy or Radiation therapy is used to kill the cancer cells.

Pleural mesothelioma: Mesothelioma is a type of cancer that develops from the thin layer of tissue that covers many of the internal organs (known as the mesothelium). The most common area affected is the lining of the lungs and chest wall.

Symptoms or signs of mesothelioma may not appear until 20 to 50 years (or more) after exposure to asbestos. Shortness of breath, cough, and pain in the chest due to an accumulation of fluid in the pleural space (pleural effusion) are often symptoms of pleural mesothelioma.

More than 80% of mesothelioma cases are caused by exposure to asbestos. The greater the exposure the greater the risk. High rates of disease occur in people who mine asbestos, produce products from asbestos, work with asbestos products or work in buildings containing asbestos. Asbestos exposure and the onset of cancer are generally separated by about 40 years. Washing the clothing of someone who worked with asbestos also increases the risk.

The diagnosis may be suspected based on chest X-ray and CT scan findings and is confirmed by either examining fluid produced by cancer or by a tissue biopsy of cancer.

Mesothelioma is generally resistant to radiation and chemotherapy treatment. Long-term survival and cures are exceedingly rare. Mesothelioma can be prevented in most cases by preventing exposure to asbestos. The US National Institute for Occupational Safety and Health maintains a recommended exposure limit of 0.1 asbestos fiber per cubic centimeter.
Although the government is enforcing stricter regulations to prevent further emissions of air pollutants, there is still a lot to do on an individual level. The key to adopting measures that do not pollute the air as much so that e can have a healthier and disease-free life.

 

 

 

Reason behind increasing advent of Sudden Cardiac Death in young people!

Medical stethoscope and red heart with cardiogram

Do you know what is Sudden Cardiac Death?

When you hear about a young person dropping dead, you may think “heart attack.” But sudden cardiac arrest (also referred to as sudden cardiac death) is different.
A heart attack stems from a circulation problem of the heart, according to the Sudden Cardiac Arrest Association. It happens when a sudden blockage in a coronary artery severely reduces or cuts off blood flow to the heart, damaging heart muscle.
In contrast, a sudden cardiac arrest (SCA) is due to an “electrical” problem in the heart. It happens when electrical signals that control the heart’s pumping ability essentially short-circuit. Suddenly, the heart may beat dangerously fast, causing the heart’s ventricles, its main pumping chambers, to quiver or flutter instead of pumping blood in a coordinated fashion. This rhythm disturbance, called ventricular fibrillation, occurs in response to an underlying heart condition that may or may not has been detected.
It is characterized by the unexpected loss of heart function, breathing, and consciousness, and it usually strikes without warning.
Two-thirds of SCA victims are unaware they have underlying heart conditions. Unfortunately, the condition is usually fatal, as only 6% to 7% of those who experience SCA survive, thus the majority succumb to sudden cardiac death (SCD).

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 Who’s at Risk of SCD?

For children under the age of 14, there are very few instances of sudden cardiac death. For people aged 35 and under, there are 12 young sudden deaths every week, which is around 600 every year. It’s one of the most common causes of death in young people after suicide and road traffic accidents. In fact, it’s the most common cause of death in young athletes.

Why is that?

About one in 300 people have an underlying cardiac condition that is potentially life-threatening. When one engages in sport, one tends to push the body to its limits. A person with an underlying heart condition, the chances of him\her having a cardiac arrest is three to four times higher than with somebody who isn’t pushing their body to the same limits. This is why there is a focus on screening.

 What causes Young Sudden Cardiac Death?

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In younger people, the most common causes are:

 

Hypertrophic cardiomyopathy (hypertrophy=to grow abnormally large + cardio=heart + myopathy = diseased muscle).

This disease is often hereditary, and the walls of the ventricle are larger than they should be. This makes the pumping chamber of the heart smaller, and the heart has to work harder to pump blood out of the heart. As well, the thickened muscle narrows the space for the blood to flow through the aortic valve and to the rest of the body. During exercise, this decreased blood flow can irritate the heart muscle itself and cause ventricular fibrillation, collapse, and sudden death.

Anomalous coronary arteries can also cause sudden death in the young. The heart is a muscle itself, and like any muscle, it needs a blood supply to provide oxygen for it to work. Normally, the coronary arteries lie on the surface of the heart. Anomalous arteries dive into the heart muscle itself and may be occluded when the heart muscle that surrounds the abnormally placed artery squeezes aggressively, as with exercise, shutting off blood supply to part of the heart. This irritates the electrical system and can cause ventricular fibrillation and sudden death.

Long QT syndrome an inherited heart rhythm disorder can cause fast, chaotic heartbeats, often leading to fainting. Young people with long QT syndrome have an increased risk of sudden death.
Other causes of sudden cardiac death in young people include structural abnormalities of the heart, such as undetected heart disease that was present at birth (congenital) and heart muscle abnormalities.
Other causes include inflammation of the heart muscle, which can be caused by viruses and other illnesses. Besides long QT syndrome, other abnormalities of the heart’s electrical system, such as Brugada syndrome, can cause sudden death.
Commotio cordis is a situation in which the heart stops when the chest is hit by an object. News stories occasionally report of baseball players who are hit in the chest by a ball and collapse because their heart stops beating. The heart sits behind the breastbone, and the electrical system can be short-circuited when a direct blow is sustained.

Are there any warning signs?

In 20 percent of young sudden deaths, there are some warning signs, the red flags are exercise-related chest pain or exercise-related passing out(syncope). However, in 80 percent of cases, there are no warning signs at all, which is why parents are encouraged to put their child forward for cardiac screening when their child turns 14.

What are the symptoms of sudden cardiac arrest?

  • The heart stops beating and blood is not supplied to the body.
  • Almost immediate loss of consciousness occurs.
  • The person will fall or slump over.
  • No pulse is felt (palpable).
  • No signs of breathing.

Can sudden death in young people be prevented?

Sometimes. If one is at high risk of sudden cardiac death, the doctor usually suggests avoiding competitive sports. Depending on underlying condition, medical or surgical treatments might be appropriate to reduce your risk of sudden death.
Another option for some, such as those with hypertrophic cardiomyopathy, is an implantable cardioverter-defibrillator (ICD). This pager-sized device implanted in the patient’s chest like a pacemaker continuously monitors the heartbeat. If a life-threatening arrhythmia occurs, the ICD delivers electrical shocks to restore a normal heart rhythm.
Syncope, or loss of consciousness, is a significant risk factor for sudden death. While some reasons for passing out are benign, there is always a concern that the reason being an abnormal heart rhythm to be subsequently spontaneously corrected. The fear is that the next episode can be a sudden cardiac arrest. Depending on the healthcare provider’s suspicion based on the patient’s history, physical examination, laboratory tests, and EKG, the healthcare practitioner may recommend inpatient or outpatient heart monitoring to try to find a clue as to whether the passing out was due to a deadly heart rhythm. Depending on the situation, prolonged outpatient monitoring lasting weeks and months may be necessary. Use of electrophysiologic testing may help identify high-risk patients (the electrical pathways are mapped using techniques similar to heart catheterization).

In people with symptoms of chest pain, aside from making the diagnosis, monitoring both the heart rate and rhythm are emphasized. The purpose of watching people with chest pain in a hospital setting is to prevent sudden cardiac arrest.

Using implantable defibrillators in high-risk patients, especially those with markedly decreased ejection fractions can reduce the incidence of sudden cardiac arrest. These devices are placed under the skin in the chest wall and have wires that are attached to the heart itself. When they detect ventricular fibrillation, a shock is automatically delivered to the heart, restoring a heartbeat and averting sudden death.

How does screening help?

Young people are screened with an electrocardiogram (ECG or EKG), which records the electrical signals in the heart. However, this type of screening is expensive and can produce false-positive results — indications that an abnormality or disease is present when it isn’t — which can cause unnecessary worry and additional tests.
It’s not clear that routine exams given before athletes are cleared to play competitive sports can prevent sudden cardiac death. However, they might help identify some who are at increased risk.
For anyone with a family history or risk factors for conditions that cause sudden cardiac death, further screening is recommended. Repeat screening of family members is recommended over time, even if the first heart evaluation was normal.

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 Importance of screening at age of 14

The vast majority of sudden deaths occur after the pubertal spurt which is whys screening after the age of 14 years old is recommended. Before the age of 14, the heart is changing. So whilst conditions can be identified before then, waiting until the child has gone through that pubertal spurt is preferred when there are fewer changes in the heart. There are very few sudden deaths before the age of 14, but there can be a lot of false positives, a lot of abnormalities identified known as juvenile ECG patterns — meaning the young person has to then be tested regularly until they have gone through their growth spurt.

Should young people with a heart defect avoid physical activity?

If one is at risk of sudden cardiac death, one should talk to the doctor about physical activity. Whether he/she can participate in exercise or sports depending on the condition.
For some disorders, such as hypertrophic cardiomyopathy, it’s often recommended that one must avoid most competitive sport. But this doesn’t mean one needs to avoid exercise.

Thus young population needs to be made aware of appropriate screening along with health education including heart problems.

After floods, Kerala to combat deadly Rat-Bite Fever. What is this Rat Fever?

Rat

According to the Directorate of Health Services (DHS), between August 1 and September 2, 10 people were confirmed to have died from rat fever, a bacterial disease that spreads through water or soil contaminated by infected animals.

Suspected cases: 719

Confirmed cases: 302

Suspected deaths: 46

Confirmed deaths: 10

 

What is Rat-Bite Fever?

Rat bite fever is a zoonotic disease, that is it is transmitted from animals to people It is caused by bacteria and transmitted by rodents.

Well, it is of two types:

Streptobacillus, caused by streptobacillus moniliformis

Spirillosis, caused by spirillum minus.

In the United States, the most common form of the illness is caused by Streptobacillus moniliformis. The latter is commonly found in Asia. And hence the one that has hit Kerala is Spirillosis, transmitted by the Gram-negative coiled rod bacterium. While the illness carries a mortality rate of 13 percent if left untreated, its symptoms are nonspecific, which may prevent an early diagnosis. This condition is also known as a spirillary fever, streptobacillus, streptobacillary fever, or sudoku, depending on the region of the world where it is diagnosed and which bacterium is responsible.

You thought Rat Fever is something new!

History of the Disease

Rat-bite fever was first described in India more than 2,300 years ago. It was first reported in the U.S. in 1839. In North America, Streptobacillus moniliformis has been known to infect laboratory technicians and the poor. Since rats have become popular pets, children now account for more than 50 percent of cases in the U.S.

How does Rat Fever Spread?

Spirillum minus and Streptobacillus moniliformis are both transmissible from rats or mice to people, but not from person to person, so someone who has this disease is not at risk of passing it on to someone else. Several people get a rat-bite fever when they come in contact with urine or mucociliary secretions either from the eyes, nose or mouth of an infected animal. Rat bite fever mostly occurs through a bite, but in some cases, it may occur quickly through contact with such secretions. It may occur through consumption of contaminated water or food by rat’s urine or feces. The primary source of infection is a rat. Other animals that may cause this disease include squirrels, gerbils or weasels. Furthermore, pets like cats or dogs can transmit this disease to humans if they are in contact with these infected animals.

Signs and Symptoms

Streptobacillary RBF Symptoms

• Fever

• Vomiting

• Headache

• Muscle pain

• Joint pain

• Rash

Symptoms usually occur 3-10 days after exposure to an infected rodent, but can be delayed as long as 3 weeks. By this time, any associated bite or scratch wound has usually healed. Within 2-4 days after fever onset, a maculopapular rash may appear on the hands and feet. This rash is identified by flat, reddened areas with small bumps. One or more joints may then become swollen, red, or painful. redd

Spirillary RBF (also known as Sodoku) Symptoms

Symptoms can vary and often include:

 

• Fever (that may occur repeatedly)
• Development of an ulcer at the bite wound (when applicable)
• Swelling near the wound
• Swollen lymph nodes
• Rash (occurs following partial healing of the wound)

These symptoms usually occur 7-21 days after exposure to an infected rodent.

 

How can you know and be sure it is it?

Rat bite fever diagnosis is made by detecting the bacteria either in blood, skin, joints fluid or lymph nodes. Diagnosis of rat bite fever caused by Streptobacillus is made by collecting a blood sample or a fluid sample from a joint, which is then cultured to permit their growth. Microscopic Examination allows the identification of Streptobacillus moniliformis bacteria. It appears as a gram-negative, pleomorphic bacillus in chains or clumps with irregular lateral swellings. Diagnosis of rat-bite fever caused by Spirillum minus is confirmed by a blood sample or tissue sample from the site of the wound by culture or by direct visualization. PCR can also be used to identify the bacteria.

What can you do if you or a closed one gets a Rat Fever?

If you have any symptoms of rat-bite fever after exposure to rats or other rodents, please immediately contact your health care provider. Be sure to tell your provider of your exposure to rodents. If you have RBF, your doctor can give you antibiotics that are highly effective at curing the disease. d Penicillin is the antibiotic most often used. If you are allergic to penicillin, Tetracycline or erythromycin are given an alternative.

However, Without treatment, RBF can be serious or potentially fatal. Severe illnesses can include:

• Infections involving the heart (endocarditis, myocarditis, or pericarditis)

• Infections involving the brain (meningitis)

• Infections involving the lungs (pneumonia)

• Abscesses in internal organs

The following measures of prevention can be followed to minimize the risk of its spread:

• Minimize the contact with rodents.

• Proper washing of face and hands should be done if in contact.

• Clean the scratches and apply antiseptics.

• There are no available vaccines in the market for this disease.

• Mostly Animal handlers, sanitation, sewer workers and laboratory handlers are exposed to this disease so they should be advised for special precautions.

• Avoid touching rodents whether alive or dead.

• Pets should not be permitted to feed on rodents.

• People residing in areas with sanitation issues and overcrowding are more prone to catch the Rat-bite fever. It is a difficult task for people residing in rat-infested buildings to shift from such places.

• Streptobacillary type of fever can occur quickly after consumption of contaminated milk or dirty water, so it’s advised to drink pasteurized and milk and drink properly boiled water.


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