Asthma is a chronic lung disease characterized by a decreased ability to breathe easily. The flow of air in and out of the lungs is obstructed in the airways that carry air to the air sacs deep inside the lung. The larger airways (bronchi), branches into smaller airways (bronchioles), which may be obstructed by tightening of muscles, irritation or swelling in the airways, and accumulation of mucous thereby resulting in asthma. Asthma can either be acute or chronic. Symptoms associated with asthma are coughing, wheezing, shortness of breath and chest tightness.
Common Causes of Asthma
Allergy to pollen, dust mites
Air pollution
Respiratory infections
Non-specific hyperirritability
Sulfites in food
Certain medications
Home Remedies for Asthma
Mix 1 tsp honey with ½ tsp cinnamon powder. Consume just before sleeping.
Boil 8-10 cloves of garlic in ½ cup of milk. Have at night. Good for early stages of asthma.
Figs are good for draining phlegm. Wash 3-4 dry figs with water. Soak in 1 cup of water. Eat these on an empty stomach and drink the water that the figs were soaked in also. Do not eat anything else for an hour at least. Do this for 2 months.
Add 1 tsp of honey in very hot water and sip slowly. Take this just before sleeping to remove phlegm from the throat.
In 1 cup of water soak 1 tspn of Fenugreek seeds overnight. Strain. Add 1 tspn of Ginger juice and 1 tspn of honey to this. This should be taken morning and evening.
Metastatic Breast Cancer Rising in Patients Younger than 40
Diagnosis of metastatic breast cancer in women younger than 40 has increased 2% a year, every year, from 1976 to 2009, according to a study published Tuesday in the Journal of the American Medical Association. The increase was seen in women aged 25 to 39 of all races and ethnicities, living in both rural and urban areas. It's a devastating diagnosis, particularly because a woman younger than 40 who is diagnosed with breast cancer is more likely to have an aggressive form of the disease and face lower survival rates. But for perspective, the overall population of women who are affected still remains small. "If you project these data out to the number of people in the U.S., there were about 250 cases per year ... in 1976 and that's now risen to 850 cases of breast cancer per year," said Dr. Rebecca Johnson, the study's lead author and medical director of the Adolescent and Young Adult Oncology program at Seattle Children's Hospital. Those numbers, she says, refer to metastatic breast cancer in women younger than 40. The rise, she says, was "really concerning." Johnson is a breast cancer survivor. She found a lump in her breast and was diagnosed with the disease when she was 27. It was not metastatic. In previous research, she found that a woman younger than 40 had a 1 in 173 chance of developing breast cancer. For this study, she wanted to look specifically at advanced breast cancer within that same population. "Along with my colleague, Dr. Archie Bleyer, a couple of years ago, we just wanted to ask the question, how common is this? Because once I was diagnosed, I had friends and friends of friends getting diagnosed and I didn't know if this was happening more or if I was hearing about it more," she says. Johnson and her team used three U.S. Surveillance, Epidemiology, and End Results (SEER) databases of the National Cancer Institute to obtain data about breast cancer incidence from 1973 to 2009, 1992 to 2009, and 2000 to 2009. They chose 1976 as their starting year. Not only did they find an increase in incidence of metastatic breast cancer in women younger than 40, the team also calculated that the average age of diagnosis was 34.3 years of age in women aged 25 to 39. "From a cancer point of view, it is an important study because it suggests an early signal that there's a significant increase, a sustained increase over a prolonged period of time," said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, who was not affiliated with the study. "There's a suggestion this rate is accelerating and it could have a much greater impact so it's important we ... continue to monitor this, we try to understand what its influences are." There is no solid explanation for what's driving the increased incidence, but Johnson and her team suggest there's likely more than one cause. Yet neither she or Lichtenfeld believe the study's findings should change current screening guidelines for breast cancer. "If there is an action item, at this time it's awareness: Breast cancer can happen (in younger women) and if it gets to be metastatic by the time it's diagnosed, that's a problem," said Johnson. Yet while the rate of breast cancer incidence in young women has increased, Johnson and her team found that mortality rates over the last 30 years have been stable. "It's great, except it's not great - the five-year survival rate used to be 15%, and now it's 30%. So that's something to be thankful for, but it's still very bad," she said. "If women could be diagnosed earlier (before the cancer spreads), then each individual woman that that happens to stands to do a whole lot better, stands a better chance of living." Lichtenfeld agreed. "This study reinforced the message, know your body better than anyone else does," he said. "If there is a lump on the breast ... swelling in the breast, discharge from the nipple, redness in the skin of the breast, or unexplained pain in the breast, see your doctor."
A healthy diet is necessary for well being and prevention of lifestyle-related diseases, irrespective of whether you are a man or a woman. But nutrition varies a little depending on your gender and age.
Here’s an account of nutrition all men need. The calorie requirement depends on your age, lifestyle and size (weight). For example, an active man of 70 kg requires about 2700 to 3000 calories per day depending upon the intensity of his physical activity. On an average, a healthy man needs about 2500 calories to maintain his weight. Men older than 50 years of age need 2000 to 2800 calories depending on how active they are. Factors such as thyroid hormones, some medications like steroids, or illnesses can affect the calorie expenditure.
ProteinIn general, 10 to 35 percent of your daily calories must come from protein. Recommended Dietary Allowance for protein is 52g per day for boys aged 14 to 18 years while men aged 19 and above require 56g of protein per day. For example, a 5ft 10 inches tall man physically active 30 to 60 minutes a day requires 7 ounces of protein foods in his 2800 calorie diet. Lean meat, poultry, fish, milk and milk products, eggs, and cheese are considered high-quality proteins. Legumes, nuts and seeds, and tofu are good vegetable protein sources.
There’s no harm if you take more than the recommended portion of protein unless you have kidney disease or are counting calories on a weight-loss mission.
CarbohydratesFoods high in fiber content include dried, fresh or frozen beans, peas and other legumes; whole grains, rye, oats, buckwheat and stone-ground cornmeal; nuts; dried fruits; broccoli; baked potato with skin; spinach, kale and other greens; Brussel sprouts, plums, pears and apples (high in pectin). Almonds, Brazil nuts, walnuts and peanuts, and coconut are also high in fiber content but they are high in fat content as well; so, consume these sparingly.
Fats For well being and weight control, only 20 to 35 percent of your diet must come from fats and that too from unsaturated fats (MUFA and PUFA) such as extra virgin olive oil, canola oil, sesame oil, almonds, walnut and avocado.
Vitamins and Minerals Fruits and vegetables are loaded with vitamins and minerals; and whether fresh, frozen, canned or dried, they are ‘good-for-you foods’ according to the Academy of Nutrition and Dietetics (formerly called the American Dietetic Association).
Older men require more vitamin D and calcium to maintain healthy bones and avoid osteoporosis. Low-fat and fat-free milk and yogurt, fortified cereals and fruit juices, dark green leafy vegetables and canned fish with soft bones are rich in calcium. If you are not getting enough of these products, take calcium supplements and multivitamins containing vitamin D.
If you are a sportsman or work out a lot, make sure you eat every two to three hours so that your body gets a constant supply of nutrients. Also, carbohydrates are the main source of energy and must be included in every meal.
Eating a well-balanced diet that includes whole grains, fruits and vegetables, good proteins, and low-fat dairy products is the best way to stay healthy and free from lifestyle-related diseases.
Convulsions / Seizures / Fits - Symptom Evaluation A seizure or a convulsion is a result of abnormal electrical activity in the brain. It can affect an individual at any age. However, not all convulsions amount to epilepsy. The term ‘epilepsy’ is used when the person suffers from 2 or more apparently unprovoked seizures at an interval of at least 24 hours.
Repeated seizures can cause brain damage; hence it is necessary to diagnose the cause and treat it. In some cases, where the cause of seizures is not known, it is necessary to prevent seizures from recurring by taking daily medications.
Seizures may be focal (partial) or generalized. In partial seizures, jerking is observed in a limb or a part of the body. Such seizures are seen when a part of the brain is affected. On the other hand, generalized seizures affect the whole body. Generalized seizures occur when both sides of the brain are affected. The patient often loses consciousness.
Types of generalized seizures are: Tonic / Clonic Convulsions: The patient may experience a premonition just before the seizure. This is followed by the stiffening of limbs in the tonic phase. The tonic phase is followed by the clonic phase in which the person starts shaking and jerking. The patient may bite his /her tongue. This stage is followed by deep sleep. Loss of bladder and bowel control may be seen during the seizure.
Absence Seizures: Absence seizures more commonly affect children. The child may show a temporary blackout that lasts for a short duration.
Atonic Seizures: During an atonic seizure, the tone of the muscles is lost and the person goes floppy and may fall down.
Myoclonic Seizures: In myoclonic seizures, the legs, arms, head or whole body will jerk up, often after the patient has just woken up. Types of partial seizures are:
Simple Partial Seizures: Simple partial seizures are when one part of the body like the face, arms or legs are affected but consciousness is not lost. Complex Partial Seizures: Complex partial seizures are localized seizures with impairment of consciousness. Status Epilepticus: Status epilepticus is a condition where a patient suffers from repeated partial or generalized seizures without regaining consciousness between the seizures.
Tests used to diagnose the presence of epilepsy or the causes of seizures are:
EEG Monitoring: An EEG (Electroencephalography) is a test used to record the electrical activity of the brain. It should ideally be performed within the first 24 hours of a patient suffering from a seizure. It may be abnormal in an epileptic patient, even while the patient is not suffering from the seizure.
Brain Scans: Brain scans like CT and MRI can detect structural abnormalities of the brain like tumors and cysts. PET scan is used to monitor the brain’s activity. SPECT scan is sometimes used to localize the seizure focus in the brain. Blood Tests: Blood tests help to detect metabolic or genetic disease. They also help to detect conditions like infections, lead poisoning, anemia, and diabetes that may cause the seizure.
Causes
In many cases, the cause of seizures cannot be detected despite all tests. In some other cases like genetic, the cause can be detected but cannot be completely eliminated. These patients are controlled using antiseizure drugs. In some other cases like brain tumor and low blood sugar levels, the seizures may stop after the cause is treated, provided there has been no damage to the brain. Some of the causes of seizures are listed below: Genetic Causes: Mutations in the genes may make a person more susceptible to seizures. Conditions like Lafora disease and myoclonus epilepsy are caused due to genetic abnormalities. More than themselves causing seizures, these genetic abnormalities may make a person more prone to seizures in the presence of another provoking factor like a head injury. Epilepsy of genetic origin sometimes runs in families, but this depends on a variety of factors including the type of epilepsy. Head Injury: Head injury may result in a single seizure or an epileptic syndrome within 2 years following the injury. In some cases, it can cause a bleed within the skull, resulting in seizures. A history of head injury can be elicited in these patients. Head injuries may occur during birth resulting in seizures that usually manifest in infancy or early childhood. Metabolic Disorders: Metabolic disorders can cause seizures in individuals of any age. Many of these seizures can be controlled by treating the metabolic disorder. For example, low or high blood sugar levels in diabetics can cause seizures. Kidney failure can cause increased urea levels and electrolyte abnormalities, which can precipitate seizures. Phenylketonuria is an inherited condition where there is lack of an enzyme called phenylalanine hydroxylase. This results in accumulation of a substance called phenylalanine in the blood, which could result in seizures. Symptoms in patients with classical phenylketonuria usually manifest when the child is a few months old. Besides seizures, the child may develop behavioral problems and psychiatric disorders. The excess phenylketonuria may cause a musty or mouse-like odor. The skin and hair may be lighter and the children may also suffer from eczema.
Drugs, Alcohol and Poisons: Sudden withdrawal from alcohol and drugs acting on the brain could precipitate generalized seizures. Seizures may follow lead or carbon monoxide poisoning, exposure to street drugs and medications like antidepressants.
Brain Tumors: Tumors affecting the brain can result in seizures. Middle aged and older patients suffering from seizures should be particularly investigated using imaging studies like CT scan and MRI to rule out brain tumors. The seizures are usually focal in nature and symptoms depend on the location of the tumor. Brain Infections: Brain infections can cause seizures. These infections may be due to bacteria like meningitis or brain abscess or virus like herpes encephalitis. A lumbar puncture is useful in diagnosing these infections. Patients with AIDS may suffer from seizures due to toxoplasmosis, cyptococcal meningitis, viral encephalitis or other infections. Neurocysticercosis is a parasitic infection that results in the formation of cysts in the brain. This condition affects pork eaters. The cyst can be diagnosed using imaging studies.
Conditions Affecting Blood Supply to the Brain: Vascular disorders are the most common cause of seizures in individuals over the age of 60 years. Strokes and heart attacks reduce oxygen supply to the brain and can result in seizures. Bleeding within the skull can also reduce the blood supply and can occur at any age from infancy to adulthood. Congenital Abnormalities: Epilepsies due to congenital malformations in the brain usually manifest during infancy or childhood.
Brain Degenerative Diseases: Brain degenerative diseases like Alzheimer’s disease can result in seizures in older individuals. Features of the underlying degenerative disease are usually obvious in these patients. Febrile Seizures: Febrile seizures are triggered by a fever and most commonly occur in children.. Most children with a febrile seizure usually do not suffer from a repeat seizure, unless they have some predisposing factors.
Eclampsia: Eclampsia is a life-threatening condition that occurs in some pregnant women. The patient suffers from very high blood pressure and seizures during pregnancy. It usually does not result in additional seizures once the pregnancy is over. Psychogenic Seizures: Psychogenic non-epileptic seizures are seizures that are not associated with abnormal electrical activity of the brain. The condition may be precipitated by a need for attention, avoidance of stressful situations, or specific psychiatric conditions. This condition is treated by a psychiatrist.
Constipation - Symptom Evaluation Constipation is often a result of faulty habits. It could also be caused by conditions affecting the digestive tract, general muscle diseases and systemic conditions.
Constipation is a troublesome symptom wherein the patient suffers from persistent, difficult, infrequent and seemingly incomplete passing of stools. Most people have at least 3 bowel movements per week. But a decrease in frequency alone does not amount to constipation. Some people may have a normal frequency but suffer from other problems like excessive straining, hard stools, a feeling of fullness or incomplete evacuation.
Various causes of constipation are listed below:
Faulty habits:
Faulty habits that contribute to constipation include: Excessive use of laxatives Prolonged travel Insufficient fiber or fluid in diet Habitual ignoring or delaying bowel movements
Cultural factors may also play a role in the development of constipation. A person may become greatly concerned with the absence of a bowel movement if the parents give a lot of importance to daily bowel movement. Some children may withhold bowel movements to gain attention.
Intestinal Problems: Problems in the small and large intestines that could lead to constipation include:
Irritable bowel syndrome, constipation predominating or alternating: In irritable bowel syndrome with constipation, the patient suffers from fewer than three bowel movements per week, hard or lumpy stools, and /or straining during bowel movements. Diagnosis is usually based on exclusion of other causes of constipation.
Mechanical obstruction in the intestines: Obstruction to the passage of stools in the intestines can be caused by conditions like cancer, stricture formation (an abnormal narrowing by fibrous or other tissues), foreign bodies, hernia and volvulus (twisting of the intestine). The patient may complain of distention of the abdomen, pain, fullness and gas, bad odor in breath and vomiting along with constipation.
Colonic pseudo-obstruction: Colonic pseudo-obstruction occurs in the absence of a mechanical cause of obstruction. It could occur due to conditions like paralytic ileus, slow-transit constipation, and megacolon (Hirschprung’s, Chagas). Paralytic ileus, a condition where the motility of the intestines is inhibited, results in pseudo–obstruction and constipation. It could be a result of electrolyte abnormalities, complication of surgery, obstruction in blood supply to the intestines, intra-abdominal infection, kidney or lung disease or the use of certain medications. Slow transit constipation occurs due to a neuromuscular problem in the intestinal wall that reduces motility of the intestines. It is characterized by infrequent bowel movements, uncontrolled soiling, abdominal pain, nausea and poor appetite. Megacolon could occur in babies due to lack of nerves in the colon (the condition is called Hirschprung’s disease), or in adults due to a parasitic infection (the condition is called Chagas disease).
Acute abdomen: Conditions that cause an acute severe pain in the abdomen like appendicitis (inflammation of the appendix), salpingitis (inflammation of the fallopian tubes in women), perforation and colic can cause constipation. The features of the underlying conditions are usually obvious in these cases.
Rectal Problems: Disorders of rectal evacuation: The rectum is the lowermost part of the large intestine just above the anus. Patients with disorders of rectal evacuation complain of incomplete rectal emptying, a feeling of rectal fullness and straining while passing stools. The problem of rectal evacuation may be due to: Structural defects: These include Excessive pelvic floor descent: The pelvic floor consists of muscles, ligaments and fascia that provide support to pelvic organs and controls continence of the anus as well. Excessive pelvic floor descent may be associated with constipation.
Rectocele: Rectocele is a condition where the anterior wall of the rectum bulges forward. Thus, the bulged portion may continue to remain filled even after defecation.
Intussusception: Intussusception is a condition where one part of the intestine tunnels into another. It may be accompanied by symptoms like severe abdominal pain that comes and goes, blood in stools, nausea and vomiting.
Functional defect:
Anismus (Functional pelvic incoordination): Anismus is the inability to relax the muscles of the pelvic floor voluntarily during defecation, thus leading to constipation.
In some cases, both structural and functional defects may be observed.
Anal Problems:
Anal sphincter spasm: Painful anal conditions like anal fissure and painful piles can cause spasm of the anus and constipation.
Generalized muscle disorders:
Muscle disorders like progressive systemic sclerosis, scleroderma, myopathies and myotonia can also result in constipation.
Systemic causes:
Other causes that can result in constipation include:
Endocrine problems: Hormonal conditions like hypothyroidism (low thyroid hormone levels), hypercalcemia (increased calcium levels), pregnancy and hypokalemia (low potassium levels) could decrease intestinal contractions and result in constipation.
Psychiatric disorders: Depression and eating disorders may also cause constipation.
Neurologic disease: Diseases affecting the brain and nerves like Parkinsonism, multiple sclerosis and spinal cord injury can result in constipation.
Medications and poisoning: Drugs like calcium channel blockers, antidepressants, opioids, atropine and tricyclic antidepressants decrease the contractions of the intestines leading to constipation.
Reproductive tourism, people crossing international borders to purchase assisted reproductive technologies is a multi-million dollar industry. But there are legal and ethical problems when citizens of wealthy countries travel to poorer countries to purchase the services of a surrogate mother.
The fastest growth country for ART, and certainly the largest market for providing surrogate mothers is India. Some reports value the Indian ART industry between $500 million and $3 billion.
In an academic paper, "Ethical concerns for maternal surrogacy and reproductive tourism" in the Journal of Medical Ethics, Professor Raywat Deonandan of the Interdisciplinary School of Health Sciences at the University of Ottawa, with students Samantha Green and Amanda van Beinum, identify specific ethical challenges posed by this emerging new industry.
The authors identify the tension between business ethics and medical ethics as being at the heart of the industry’s ethical problem, along with an insufficiently broad definition of “informed consent.” When desperately poor, illiterate and vulnerable village women are entering into complicated contracts to sell their reproductive health to wealthy foreigners, some physical and social risks are not fully communicated to them, such as their risk of estrangement from their communities, or the risk of domestic unease with their spouses and existing children.
The research points out that there is no ethical framework for establishing rights and responsibilities; In a business deal each party is only concerned about their own best interests only; but in a a medical deal, the clinic is morally responsible for everyone’s interests, including both the surrogate’s and the client’s.
The extent to which Indian ART clinics cater to the needs of non-Indians has always been difficult to determine, as is any sort of measurement of how many foreigners travel to India specifically to seek out ART services, especially maternal surrogacy services.
In another recent paper, “Measuring reproductive tourism through an analysis of Indian ART clinic websites” in International Journal of General Medicine, Professor Deonandan and students Mirhad Loncar, Prinon Rahman and Sabrina Omar analyzed the official websites of 159 Indian ART clinics to determine how many were actively seeking a foreign clientele. 86% of the clinics made some mention of reproductive tourism services, with 47% offering surrogates to clients.
