BREAST CANCER & ITS PREVENTION

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast.

WHAT IS A MALIGNANT TUMOR?

A tumor that invades surrounding tissues, is usually capable of producing metastases, may recur after attempted removal & is likely to cause death unless adequately treated.

INTRODUCTION TO BREAST CANCER

Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop.
Cancer occurs as a result of mutations or abnormal changes in the genes responsible for regulating the growth of cells & keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes & “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor.

Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty & fibrous connective tissues of the breast.

INCIDENCE RATE

Approximately 1 in every 9 Pakistani women is likely to suffer from breast cancer. This is one of the highest incidence rates in Asia. Pakistani women show an incidence rate of 50/100,000. The pattern of rapid premenopause increases in breast cancer is also seen in Pakistan, but breast cancer risk plateaus after the age of 45 years.



SIGN & SYMPTOMS


The changes appears in the breasts:

  1. Any unexplained change in the size or shape of the breast
  2. Dimpling anywhere on the breast
  3. Unexplained swelling of the breast (especially if on one side only)
  4. Unexplained shrinkage of the breast (especially if on one side only)
  5. Recent asymmetry of the breasts (Although it is common for women to have one breast that is slightly larger than the other, if the onset of asymmetry is recent, it should be checked)
  6. Nipple that is turned slightly inward or inverted
  7. Skin of the breast, areola or nipple that becomes scaly, red, or swollen or may have ridges or pitting resembling the skin of an orange
  8. An existing lump that gets bigger
  9. Vaginal pain
  10. Unintentional weight loss
  11. Enlarged lymph nodes in the armpit
  12. Too many visible veins on the breast

Any Nipple Discharge—Particularly Clear Discharge Or Bloody Discharge

It is also important to note that a milky discharge that is present when a woman is not breastfeeding should be checked by her doctor, although it is not linked with breast cancer.




RISK FACTORS FOR BREAST CANCER

These risk factors are divided into 2 forms:

  1. Modifiable Factors (which can be changed)
  2. Non-Modifiable Factors (which cannot be changed)

NON-MODIFIABLE RISK FACTORS:

  1. GENDER: Simply being a woman is the main risk factor for developing breast cancer. Men can develop breast cancer, but it’s about 100 times more common among women than men.
  2. AGING: Your risk of developing breast cancer goes up as you get older. About 1 out of 8 invasive breast cancers are found in women younger than 45, while about 2 of 3 invasive breast cancers are found in women age 55 or older.
  3. INHERITING CERTAIN GENES: About 5% to 10% of breast cancer cases are thought to be hereditary, meaning that they are caused by gene defects (called mutations) passed on from a parent.
  4. BRCA1 & BRCA2 GENE CHANGES: The most common cause of hereditary breast cancer.
  5. FAMILY HISTORY OF BREAST CANCER: It is higher among women whose close blood relatives have this disease. Having a first-degree relative (mother, sister, or daughter) with breast cancer about doubles a woman’s risk. Having 2 first-degree relatives increases her risk about 3-fold. Although the exact risk is not known, women with a family history of breast cancer in a father or brother also have an increased risk of breast cancer. Overall, less than 15% of women with breast cancer have a family member with this disease. This means that most (85%) women who get breast cancer do not have a family history of this disease.
  6. PERSONAL HISTORY OF BREAST CANCER: A woman with cancer in one breast has an increased risk of developing a new cancer. This risk is even higher if breast cancer was diagnosed at a younger age.
  7. RACE & ETHNICITY: Overall, white women are slightly more likely to develop breast cancer than are African. In women under 45 years of age, however, breast cancer is more common in African-American women. Asian & Native American women have a lower risk of developing & dying from breast cancer.
  8. DENSE BREAST TISSUES: Breasts are made up of fatty tissue, fibrous tissue & glandular tissue. A woman is said to have dense breasts on a mammogram (radiological test to scan density of breast tissue) when she has more glandular & fibrous tissue & less fatty tissue. Women with dense breasts on a mammogram have a risk of breast cancer that is 1.2 to 2 times that of women with average breast density. A number of factors can affect breast density, such as age, menopausal status, the use of certain drugs (including menopausal hormone therapy), pregnancy & genetics.
  9. STARTING MENSTRUATING BEFORE AGE 12: Women who have had more menstrual cycles (periods) because they started menstruating early (before age 12) have a slightly higher risk of breast cancer. The increase in risk may be due to a longer lifetime exposure to the hormones estrogen & progesterone.
  10. GOING THROUGH MENOPAUSE AFTER THE AGE OF 55: Women who have had more menstrual cycles because they went through menopause later (after age 55) have a slightly higher risk of breast cancer. The increase in risk may be due to a longer lifetime exposure to the hormones estrogen & progesterone.

MODIFIABLE RISK FACTORS

  1. DRINKING ALCOHOL: Drinking alcohol is clearly linked to an increased risk of breast cancer.
  2. BEING OVERWEIGHT OR OBESE: Being overweight or obese after menopause increases breast cancer risk.
  3. PHYSICAL ACTIVITY: Evidence is growing that physical activity in the form of exercise reduces breast cancer risk.
  4. HAVING CHILDREN: Women who have not had children or who had their first child after age 30 have a slightly higher breast cancer risk overall.
  5. BIRTH CONTROL: The use of oral contraceptives. Studies have found that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer than women who have never used them.
  6. DEPOT-MEDROXPROGESTERON ACETATE (DMPA; DEPO-PROVERA): This is an injectable form of progesterone that is given once every 3 months as birth control. A few studies have looked at the effect of DMPA on breast cancer risk.
  7. HORMONE THERAPY AFTER MENOPAUSE: Hormone therapy with estrogen (often combined with progesterone) has been used for many years to help relieve symptoms of menopause & to help prevent osteoporosis (thinning of the bones). This treatment goes by many names, such as post-menopausal hormone therapy (PHT), hormone replacement therapy (HRT) & menopausal hormone therapy (MHT).
  8. COMBINED HORMONE THERAPY (HT): Use of combined hormone therapy increases the risk of getting breast cancer. It may also increase the chances of dying from breast cancer.
  9. TOBACCO SMOKE: In recent years, some studies have found that long-term heavy smoking might be linked to a higher risk of breast cancer.
  10. NIGHT WORK: Some researchers think the effect may be due to changes in levels of melatonin, a hormone whose production is affected by the body’s exposure to light.

SCREENING TEST

Screening is looking for cancer before a person has any symptoms.

The average guidelines for a women to screen herself are as under:

  1. Women ages 40 to 44: should have the choice to start annual breast cancer screening with mammograms if they wish to do so.
  2. Women age 45 to 54: should get mammograms every year.
  3. Women age 55 & older: should switch to mammograms every 2 years, or have the choice to continue yearly screening.

Physical examination

This is one of the most easy & rapid test a women can perform by herself. The method is to gently rub one hand against the breast in search of any abnormal hardness, lump, tenderness(pain on touch), abnormal nipple dislocation, abnormal shape & size of nipple & breast, any discharge if seen.

Imaging procedures

Procedures that make pictures of areas inside the body.

  • Mammograms
  • MRI
  • CT-Scan
  • Ultrasound
  • X-ray
  • PET-Scan.
  • Biopsy
  • Blood Cell Counts
  • Blood Chemistries
  • Blood Marker Tests
  • Bone Scans
  • Breast Cancer Index Test
  • Digital Tomosynthesis
  • Ductal Lavage
  • EndoPredict Test
  • FISH Test (Fluorescence In Situ Hybridization)
  • IHC Tests (ImmunoHistoChemistry)
  • Inform HER2 Dual ISH Test
  • MammoPrint Test
  • Mammostrat Test
  • MarginProbe
  • Molecular Breast Imaging
  • Oncotype DX Test
  • Prosignia Breast Cancer Prognostic Gene Signature Assay
  • SPoT-Light HER2 CISH Test
  • Thermography
  • Tumor Genomic Tests
  • Urokinase Plasminogen Activator Protein Inhibitor Test

PREVENTION

  1. The most important point to prevent the breast cancer is to decrease the risk factors are already mentioned above.
  2. Self physical examination by the females herself.
  3. Early detection & prompt diagnosis of disease.
  4. Use of Antioxidant containing food such as juicy fruits & green vegetables.
  5. Maintaining personal hygiene.
  6. Breastfeed if possible.

COMMON MYTHS ABOUT BREAST CANCER OCCURRENCE

  1. Only women with a family history of breast cancer are at risk.
  2. Exposing a tumor to air during surgery causes cancer to spread.
  3. Breast implants can raise your cancer risk.
  4. All women have a 1-in-8 chance of getting breast cancer.
  5. Wearing antiperspirant increases your risk of getting breast cancer.
  6. Small-breasted women have less chance of getting breast cancer.
  7. You can’t get breast cancer after a mastectomy.
  8. Caffeine can causes breast cancer.
  9. Wearing an under-wire bra increases your risk of getting breast cancer.

TREATMENT PLANS

Your breast cancer treatment plan is based on both medical and personal choices. It is tailored to:

  • The specific kind of breast cancer (the biology of the tumor)
  • The stage of the breast cancer
  • Other medical issues
  • Personal preferences

Because of the differences between tumors the your treatment plan may differ from person to person. Each treatment option has risks & benefits to consider along with your own values & lifestyle.

Whereas, breast cancer treatment can be divided into two parts; Local & Systemic.

1. LOCAL THERAPY: Local therapy removes the cancer from a limited (local) area, such as the breast, chest wall and lymph nodes in the underarm area (axillary nodes). It also helps to ensure the cancer does not come back (recur) to that area. Local therapy includes surgery & radiation therapy to the breast area.

2. SYSTEMIC THERAPY (ADJUVANT THERAPY): Systemic therapy aims to get rid of cancer cells that may have spread from the breast to other parts of the body. This usually means drug therapy, which travels throughout the body to get rid of cancer cells that may have spread. Systemic therapy includes chemotherapy, hormone therapy & targeted therapy. Because systemic therapy is in addition to (an adjunct to) breast surgery, these treatments are often called adjuvant therapy.

Young women WITH BREAST CANCER

Young women with breast cancer have special concerns about early menopause & loss of fertility due to treatment.

SURGICAL THERAPY

Mastectomy (removal of breast) is the effective procedure done to get rid of breast cancer. This depends on the stage of cancer present, it might include the excision of lymph nodes of armpit or a complete armpit removal.



 

P.S. There is no shame in self-examination. It is good to know your body. Prevention is always better than cure! 
#ByeByeOctober #BreastCancerAwarenessMonth #TheWordsCraft

FACTORY FARMED CHICKEN – A CAUSE OF POLYCYSTIC OVARIAN SYNDROME (PCOS) IN WOMEN

Definition

It is defined as hormonal problem that causes women various symptoms including:

  • Acne
  • Excess hair growth
  • Irregular or no periods

Introduction

As a girl grows old & she achieves her puberty certain hormonal changes takes place in females which leads her to puberty & finally she achieves her puberty soon after her first menstrual cycle (periods). These periods must be regular on every month, but if it gets irregular the problem starts from here, girl starts worrying about her cycles & further stress begins.

WHAT IS POLY-CYSTIC OVARIAN SYNDROME (PCOS)?

As per abbreviation PCOS means Poly Cyctic Ovarian Syndrome which means that there are multiple cysts (balloon like structure) present in the ovaries abnormally. Ovaries are the 2 endocrine structures present in the female reproductive tract mainly responsible for certain hormones secretion & egg production which lets a female to achieve her reproductive cycles & to conceive.

The basic problem begins from the pituitary gland which is responsible for the hormone release as the sedentary life style, genetic makeup & obesity combines this causes the hypothalamus to release excessive gonadotrophs which leads to the mismatch between the LH (Luteinizing Homone) & FSH (Follicle Stimulating Hormone). These are the hormones which luteinize & stimulate the follicles from the ovaries to develop & finally shed off leading to the menstrual cycle. Due to this mismatch, the androgens are the hormones which when increase in the blood, causes the ovaries to develop multiple pearl like cysts in the ovaries. Other action of this excessive androgen is on the hair follicles which starts growing on the different parts of body. Due to the increased androgen & cysts formation the regular monthly cycles (period) gets irregular.

HOW IS FACTORY FARMED CHICKEN A CAUSE OF RAPIDLY INCREASING CASES OF PCOS?

In 1957 the average growth period for an eating chicken to reach slaughter weight was 63 days. By the 1990s the number of growth days had been reduced to 38 & the amount of feed required halved. Today these values have dropped to surprising values.



The consumers of chicken are currently way higher than the chicken are produced. In order to fulfill the increased chicken requirement they are being injected by hormonal injections which reduce their growth time resulting the chicken to reach the slaughter weight in a very few days.

The chicken is injected with Bovine Growth Hormone, which can increase insulin-like growth factor one in humans.  Perhaps worse, other hormones such as estrogen & testosterone are approved by the FDA for injection into the animals via an earpiece each animal is implanted with at birth. The FDA claims that even with supplementation the animal’s hormonal profile falls within normal ranges.

Moreover, chickens have been bred through genetic selection for several decades to produce birds that grow larger & faster, on less feed, than chickens of earlier eras. Giving growth hormones to modern farmed poultry would be pointless, as those birds could not possibly grow any faster. Hormones must be injected, not consumed through the intake of feed, in order to work. Chickens would have to be injected with growth hormones on a regular basis, a far too expensive & labor-intensive process for poultry farmers to undertake.

Clinically what happens to a female who has pcos?

The female gets under some changes which includes:

  • Menstrual disorders
  • Adrenal enzyme deficiencies
  • Hirsutism (excessive growth of hair on lips, chin, buttocks, thighs – known as male like hair pattern) are 80% common
  • Infertility (unable to conceive)
  • Obesity & metabolic syndrome
  • Diabetes
  • Decrease breast size
  • Deepening of voice
  • Hair loss (alopecia)
  • Acne
  • Pelvic pain
  • Stress & Depression



 

As PCOS is recently found to be one of the major endocrine disorder in young females. Every female needs answer to the question that why & what causes this PCOS.

  • A female with central obesity (fat on the tummy) is said to be on the major risk of POCS understanding evidently the relation between obesity & PCOS. Obesity means increased fat (adipose tissue) in your body, which increase fats causing androgen production & this androgen as mentioned above causes the multiple pearls formation on the ovaries.
  • Studies suggest that the poultry chicken that are grown in the poultry farms on the basis of injections injected to the chick to grow rapidly are also the cause of PCOS in the young females as the population in our country is more use to of eating junk food in terms of chicken.
  • Genes are always responsible for certain syndromes which includes PCOS as well. We all carry genes from our parents if a parent is affected or even the parent have a mutated gene their offsprings have more chance to have PCOS.
  • Antiepileptic drugs such as valproic acid are also the culprit.
  • Females having type II diabetes are insulin resistant which usually leads to PCOS.
  • Female born with type I diabetes are also on the risk of PCOS.
  • Living sedentary life with lots of junk food in your diet leads to increase adipose tissue as this condition is related to the hormone imbalance the increase in adipose tissue causes insulin resistance which causes the androgens to increase and leads to PCOS.

HOW TO DIAGNOSE PCOS?

The diagnosis is easy as compared to the pathophysiology of the PCOS. PCOS is diagnosed on the criteria knows as ROTTERDAM criteria, the presence of 12 or more cysts in the ovary measuring 2-9 mm in size is the diagnostic criteria for the PCOS.

Other diagnosis is based on the:

  • Increased LH-FSH ratio
  • Abnormal TSH levels
  • Raised androgen levels
  • Fasting glucose level

Getting PCOS diagnosed is not a worrisome condition being worried is not a solution to the problem. PCOS is treated with the medical intervention in worsened cases & conditions.

  • The first thing need to treat is your sedentary lifestyle (a type of lifestyle with little or no physical activity. A person living a sedentary lifestyle is often sitting or lying, while reading, socializing, watching television, playing video games, or using a mobile phone/computer for much of the day) & obesity.
  • Decreasing the weight leads to decreased number of adipose tissue, which as a result decrease the insulin resistance further resulting in decreased androgen formation. When androgens are regulated properly the pearls in ovaries will not be formed.
  • Metformin is the drug of choice in these patients because it has a dramatic role in decreasing the insulin resistance.
  • GNrH analogues can be given
  • Oral contraceptive pills
  • Combined oral contraceptive pills
  • Androgen antagonists

As soon as the hormonal imbalance gets reverse & the balance starts the female achieves her normal cycles back & then the infertility treatment can let her to conceive.

If you are afraid of sharing your condition with your health care provider then this condition may lead to its complication which can be really troublesome for a doctor to treat. Every person in the world is not perfect, no matter what condition you have a doctor is always a good care taker.

PCOS Complications include

  • Infertility
  • Hypertension (high blood pressure)
  • High cholesterol
  • Anxiety and depression
  • Sleep apnea
  • Endometrial cancer
  • Heart attack
  • Diabetes
  • Breast cancer

Homes Remedies include



 

CANCER & ITS PREVENTION

Definition

A malignant growth or tumor resulting an uncontrolled division of cells.

Introduction

  1. PHYSIOLOGICAL (NORMAL MECHANISM): The human body is made up of trillions of multiple types of cell which is known as basic structural unit. As every structure have its own life period up to which it lives. The cell has also the same. Therefore the nature has provided cell, the ability to divide & make its offsprings, expect of few type of cells. The cells continuously keeps on dividing & the other cells keeps on dying apoptosis (programmed cell death). This process of division & killing is regulated by certain genes & regulators. There is strict monitoring of these regulators so that the excessive cells are not formed & the excessive cells and not killed. Once there is an abnormality in the regulator the cells starts excessive division here the word cancer begins.
  2. GENETIC CHANGES: In normal cells, genes regulate growth, maturity and death of the cells. Genetic changes can occur at many levels. There could be a gain or loss of entire chromosomes or a single point mutation affecting a single DNA nucleotide.


 

There are 2 broad categories of genes which are affected by these change:

  • ONCOGENES: These are cancer causing genes. They may be normal genes which are expressed at inappropriately high levels in patients with cancers or they may be altered or changed normal genes due to mutation. In both cases these genes lead to cancerous changes in the tissues.
  • TUMOR SUPPRESSORGENES: These genes normally inhibit cell division & prevent survival of cells that have damaged DNA. In patients with cancer these tumor suppressor genes are often disabled. This is caused by cancer-promoting genetic changes. Typically, changes in many genes are required to transform a normal cell into a cancer cell.


 

There are usually two broad terms used in case of cancer:

  1. Benign
  2. Malignant

The term Benign is used in case of tumor which does not have the potential to spread or replicate so fast and does not have the ability to metastasize to the other organs. They are usually not worrisome.

The tern Malignant is used in those tumors which are relatively aggressive then benign & have the potential to replicate faster then benign & have the ability to metastasize to the other organs.

Types of cancers according to the Morbidity & Mortality




 

There is a big question in everyone’s mind is what causes the cancer but the answer is still unknown to the science yet certain mediators certain may be responsible which are as follows:

CHEMICAL CARCINOGENS

  • Cigarette smoking
  • Aflatoxins
  • Asbestos
  • Poly-cyclic hydrocarbons
  • Cancer chemotherapeutic drugs
  • Benzene
  • Chromium

RADIATIONS

  • Ultra-Violet rays
  • X-rays

VIRUSES

  • RNA Virus (HIV, Human T-cell virus)
  • DNA Virus (HPV, Hepatitis B, C, HSV type II).

DIETARY FIBERS

  • Low fiber diet
  • High fat Diet
  • Alcohol consumption

It is said that certain chronic diseases may lead to Cancer which includes:

  • Chronic varicose ulcer
  • Chronic osteomyelitis
  • Old burn scars
  • Tropical burns scars
  • Gastric ulcers
  • Gall stones
  • Crohn’s & Ulcerative colitis

What if I have a tumor? How can I know that is it benign or malignant? Do I have to wait for a Doctor to tell me?

The answer to your question is NO. You can yourself evaluate between the benign & malignant but always remember always meet a doctor for the confirm diagnosis.

Here come the difference between the clinical benign & malignant tumors:

The benign tumors are always:

  • Slow growing
  • They are mobile (can move not fixed)
  • Do not have Ulceration
  • They are soft to touch
  • Does not bleed

Where as the malignant tumors are always:

  • Rapidly growing in nature
  • They are fixed adhered to the wall
  • Shows ulceration
  • Firm to hard while touching
  • Usually bleeds on touch or otherwise

These signs can give you an idea about the severity of you disease.

What can be the symptoms?

Yes!! The symptoms can also give the hint.

The benign tumors usually are symptom less they are found on the examination usually which may include:

  • Pain at any site
  • Pressure effects
  • Compression to any nerve or vessel
  • Vague pain or complains
  • Can produce the signs of obstruction or any hormone production

A malignant tumor produces the symptoms which includes:

  • Pain at any site
  • Bleeding from any site
  • Edema formation (Swelling sign)
  • Fever
  • Infections
  • Anemia
  • Malignant Cachexia (Weakness, Loss of weight, Insomnia, Loss of Apatite & Fatigue)

How to investigate a Cancer?

There are two types of investigations done for the purpose of cancer:

  1. For the purpose of diagnosis
  2. For the purpose of spread & Mets.

Cancer investigations includes a complete history with a complete physical examination, lab reports & radiology reports.

CYTOLOGICAL EXAMINATION: The cellular study is performed where the cells are seen live under microscope their nature activity & biology gives the evidence of being cancerous or non-cancerous. The methods to take the cells are:

  • FNAC (fine needle aspiration cytology)
  • Trucut biopsy
  • Core cut biopsy
  • Frozen section

SEROLOGICAL EXAMINATION: The serological study is designed to perform via blood examination where certain specific & non-specific tumor marker are detected to know about the presence of type of cancer such as:

  • CEA
  • AFP
  • HCG
  • PSA
  • Monoclonal immunoglobulins.

RADIOGRAPHIC STUDY: This is performed in a dual beneficial aspect to know the morphology of the tumor & also to know about the spread of disease beneficial in treatment & staging which includes:

  • X-ray
  • Ultrasound
  • CT-Scan
  • MRI
  • DEXA-Scan
  • Sestamibi-Scan
  • Isotope-Scan
  • PET-Scan
  • Mammography
  • HIDA-Scan

How can I prevent from being attacked from Cancer?

Cancer prevention is an important topic to be discussed the preventive measures. Certain cancers can be prevented by early detection soon when the changes are about to begin.

  • Such as PEP smear for cervical cancer
  • Mammography & breast examination
  • Testicular cancer by testis examination

Early sign or symptom of any condition discussed above if seen in any patient can prevent the person from malignancy.

Dietary factors can also prevent this condition which are:

  • Use of antioxidant fruits & vegetables
  • Sour fruits
  • Juicy fruits
  • One of the best fruit yet found is know as SOUR SOP and its leave the other name of this fruit is GAYA BANO.


How can I get treated form cancer?

There are many types of cancer treatment. The types of treatment that you have will depends upon the type of cancer you have & how advanced it is. Some people with cancer will have only 1 treatment, but most people have a combination of treatments, such as surgery with chemotherapy or radiation therapy. You may also have immunotherapy, targeted therapy, or hormone therapy.

THE Side effects of Cancer therapy

The effects varies from person to person but few of them are:

  • Anemia
  • Appetite Loss
  • Bleeding & Bruising (Thrombocytopenia)
  • Constipation
  • Delirium
  • Diarrhea
  • Edema
  • Fatigue
  • Hair Loss (Alopecia)
  • Infection & Neutropenia
  • Lymphedema
  • Memory or Concentration Problems
  • Mouth & Throat Problems
  • Nausea & Vomiting
  • Nerve Problems (Peripheral Neuropathy)
  • Pain
  • Sexual & Fertility Problems (In Both Men & Women)
  • Skin and Nail Changes
  • Sleep Problems
  • Urinary and Bladder Problems

 

BENEFITS OF BLACK CUMIN (KALONJI)

Also known as Nigella Sativa (Kalonji). It is native to Mediterranean region but also has been grown on the Arab peninsula, Africa & Western Asia. It belongs to Ranunculacease .
 
Black Cumin is not only used for adding flavour to foods but also therapeutic. It is rich in unsaturated fatty acids & essential oils. Other nutrients including proteins, carbohydrates & many vitamins. The plant grows up to 30 cm & have white flowers with black seeds. Our beloved Prophet Muhammad (peace be upon him) told us about black cumin & its benefits 14 centuries ago.
“There is healing for all disease expect death.” (Bukhari 7:71)
There is another Hadith regarding Black Cumin our beloved Prophet Muhammad (peace be upon him) puts emphasis on consistent use of Black Cumin with the phrase “hold on to use of the seed.”
 
Recent research tells us the benefits of Black Cumin in the induction of apoptosis (cell death) in cancer cell lines & in decreasing blood sugar levels. Black seed extracts and its oil have been shown to strengthen the immune system, radio protectively, reduces high blood pressure, pain reliever, anti-inflammatory, hypoglycemic, anti-fungal, anti-tumor. Black Cumin maladies such as respiratory disorders, skin disorders & allergies. One research even shows that Black Cumin oil is more effective than the Omega 3-s oil in fish oil. Black Cumin is a natural cure that people have been using since 1400 years.

SOMETHING ACCIDENTALLY FOUND IN YOUR BRAIN – “PITUTARY ADENOMA”

What is an Adenoma?

A benign epithelial tumor in which the cells form recognizable glandular structures or in which the cells are derived from glandular epithelium.
These tumors are usually found accidentally in the brain during certain investigations hence they are known as Incidentaloma, when found with other investigations such as MRI, CT-Scan & SPECT.
These patients are usually A-symptomatic & have no symptoms, even people do not know that they may be carrying this tumor for years in their cranial cavity.



Some times the patients may have some vague complains of Headache, vertigo, blurring of vision. Whereas, females may encounter this condition soon after their first visit to a Gynecologist may be with the complain of irregular menstrual cycle or with a complain of infertility.

These tumors are mainly divided into 2 categories:
1. Functional (Secreting)
2. Non-Functional (Non-Secreting)

Further the Functional tumors are divided according to their Secretions:
1. Prolactin cell Adenoma
2. Growth hormone cell Adenoma
3. ACTH cell Adenoma
4. Gonadotroph cell Adenoma
5. Mixed Adenoma.

The Non-Functional Adenomas are silent do not secretes any hormone, hence no hormone specific symptoms are produced.

What is Pituitary Gland?

The pituitary gland is a small, bean-shaped organ that sits at the base of the brain, behind the bridge of the nose. It sits in a small pocket of bone in the base of the skull called the sella turcica.
The internal carotid arteries & the nerves that control eye movement lie on the sides of the pituitary. Directly above the pituitary gland is the optic chiasm, which is responsible for vision. The gland is basically responsible for the hormonal secretions & its regulation.

What if I have this tumor?

The tumor is more or less benign(non-cancerous) in nature only few of them are malignant & rapidly growing. Hence the tumor does not produce symptoms for years soon from its initial growth.
The Adenoma is said to be slow growing 1mm/year.

How will I know that I have the tumor?

If a patient is suffering from the Non-Functional Tumor it will not produce specific hormonal symptoms. The symptoms are produced due to the pressure effects on the adjacent structures as the cranial cavity is a bonny structure & does not have the ability to expand.
If the tumor is large (Macro-Adenoma sizes more then 10mm), usually produces the symptoms such as:

  • Bi-temporal hemianopsia (Decreased ability to see the peripheral objects when eyes are focused to the central point of focus) or decreased field of vision.
  • Vomiting
  • Nausea
  • Headache
  • Blurring of vision
  • Depression
  • Anxiety
  • Apathy
  • Mood swings

If a patient is suffering from the Functional tumor secretory type usually produce the hormone specific symptoms:

  1. PROLACTIN SECRETING PITUTARY ADENOMA (PROLACTINOMA): The pituitary tumor causes & overproduction of prolactin, causing loss of menstrual periods & breast milk production in women. In men, high Prolactin levels can lower testosterone levels, leading to diminished sexual interest.
  2. GROWTH HORMONE SECRETING PITUTARY ADENOMA: An excessive production of growth hormone (GH) causes acromegaly in adults or gigantism in children. Symptoms include enlarged hands & feet & other changes in the body.
  3. ACTH SECRETING PITUTARY ADENOMA: Excessive ACTH hormone production causes Cushing’s disease. Symptoms include unexpected weight gain, easy bruising of the skin & muscle weakness.
  4. TSH SECRETING PITUTARY ADENOMA (THYROTROPINOMA): Excessive TSH hormone production leads to hyperthyroidism.

Associated features which Pituitary Adenoma shows are as follows:
When the tumor compresses the normal pituitary gland, it can cause it to fail leading to pituitary insufficiency (hypopituitarism). The symptoms will depend upon which hormone is involved.

  • Reduction of sex hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
  • In men, this can lead to a low testosterone level, causing decreased sexual drive and impotence.
  • In some cases, there can be loss of body and facial hair.
  • In women, this can lead to infertility.
  • Reduction in TSH production can lead to hypothyroidism, which can cause appetite loss, weight gain, fatigue and decreased mental function.
  • Reduction in ACTH production causes adrenal insufficiency, because Cortisol production is reduced. Symptoms include fatigue, low blood pressure, electrolyte abnormalities. If severe, death can occur.
  • Reduction in growth hormone (GH) production is called growth hormone insufficiency.
  • In children, this results is stunted growth and delayed puberty.
  • In adults, the effects can be subtle but can include generalized tiredness, loss of muscle mass and tone.
  • Reduction in Prolactin production is uncommon and occurs with severe pituitary insufficiency.
  • Large pituitary tumors can slightly elevate blood Prolactin levels. Doctors think this occurs because of compression of the pituitary stalk, the connection between the pituitary gland and the brain. It is called the “stalk effect.”
  • In menopausal women, this can lead to reduction or loss of menstrual periods and/or breast milk production (galactorrhea).
  • Prolactin levels are only slightly elevated, as opposed to prolactinomas in which the Prolactin level is usually very high.


Keeping these features in mind if a person experiences above mentioned features should go for some lab investigation & imaging techniques like:

Lab Investigations

  • Prolactinomas
  • Serum Prolactin levels.
  • Serum Prolactin level >200 mcg/L in a patient with a macroadenoma greater than 10 mm in size is diagnostic of a prolactinomas. Levels below that range in a macroadenoma suggest hyperprolactinemia secondary to hypothalamic compression.
  • Growth hormone abnormalities
  • Growth hormone (GH) levels are elevated in acromegaly but can fluctuate significantly.
  • Intravenous (IV) GH levels every 5 minutes for 24 hours may show consistent elevation of GH.
  • Oral glucose tolerance test is the definitive test for the diagnosis of acromegaly; a positive result is the failure of GH to decrease to < 1 mcg/L after ingesting 50-100 g of glucose.
  • Thyrotrophin releasing Hormone (TRH), 200 mcg, can be given to increase the test’s accuracy. A GH level > 5 mcg/L suggests acromegaly.
  • Failure to decrease the GH concentration to < 2 mcg/L after a glucose load and after TRH stimulation is highly suggestive of acromegaly
  • Cushing disease and Cushing syndrome
  • 24 hour urine is collected for free cortisol. Usually 2 baseline values are obtained.
  • If Cortisol levels are increased abnormally, corticotrophin releasing factor (CRF) in a dose of 100 mcg can be given to differentiate between Cushing disease & other causes of hypercortisolism (ie, Cushing syndrome). With pituitary adenomas, Cortisol secretion is increased over the baseline.
  • Glycoprotein hormones – Thyroid stimulating hormone, follicle stimulating hormone, luteinizing hormone.
  • Pituitary adenomas that are associated with thyroid-stimulating hormone (TSH) hypersecretion are uncommon. These patients have increased T3 and T4 levels, hyperthyroidism & goiter with inappropriately high levels of TSH.
  • Increased follicle stimulating hormone (FSH) levels may be apparent in the histologic examination of a pituitary adenoma in patients without apparent preoperative endocrine abnormalities & in some patients with hypogonadism.
  • Increased luteinizing hormone (LH) levels also may be seen in patients with hypogonadism. The secreted hormone is not intact LH & serum testosterone levels are not increased.

Imaging techniques

  • MRI
  • CT-Scan
  • SPECT
  • PET-Scan

How can I get Rid from this medical condition?

1. MEDICAL THERAPY: Usually the Hormone secreting tumors are best treated on medical therapy such as prolactinomas.

2. SURGICAL INTERVENTION: Keeping in mind that the brain is one of the most delicate & major organ of human body so many approaches are being performed to prevent the open cranium (skull) surgery which may include:

  • Craniotomy


  • Trans-sphenoidal (Endoscopic nasal approach)


  • Key hole surgery via eyebrow
  • Trans-labial Approach.
    One of the major advancement in the field on Radio-surgery is:
  • Gamma knife
  • Stereo-tactic radio surgery

One of the major question the patient asks is about the recovery after surgery and its outcomes

The recovery after surgery depends upon the size of Adenoma, its nature, skills & number of surgeries the neurosurgeon have performed.
Usually the recovery is fast & the patient can go home within few days again depends on the approach the surgeon chooses. Sometimes the normal pituitary tissues are also excised during surgery which leads to the decreased hormonal production leading to hypo-pituitarism which shall sometimes requires life long hormone replacement therapy in the form or oral medications.

Another question, which people wants to know is that how to choose my surgeon?

The answer to this question is based on few questions to be asked from the doctor:

  • Do you specialize in pituitary surgery?
  • How many pituitary surgeries do you perform every week/month/year?
    It is said that 2 – 5 operations per month are the minimum for a neurosurgeon to perform to maintain a high degree of surgical competency.

patients with Prolactin secreting macro adenomas should always be treated through surgery?

No patient with a pituitary Adenoma should go to surgery without a pituitary hormone level baseline test being done & a decision made as to whether medical or surgical treatment would be most appropriate. Decisions would be based upon the individual circumstances. In general, however, there is an increasing trend to treat these tumors with drugs to shrink the tumor mass. In many instances this is used as primary treatment, with surgery used only if drug therapy fails to bring about the desired tumor shrinkage.

COMMON COLD

“The common cold is an infection of the upper respiratory system, including the nose, throat, sinuses, Eustachian tubes, larynx & bronchial tubes.”

It is an illness caused by a tiny, living thing called a virus. Although more than 200 different viruses can cause a cold, but 30-50% are caused by a group of rhinoviruses. The corona virus is responsible for about 20% of the cases, while the respiratory syncytial virus (RSV) & para-influenza virus cause 10% of colds. Almost all colds clear up in less than 2 weeks without compilation.

Colds, sometimes called rhinovirus or corona virus infections, are the most common illness to strike any part of the body. It is estimated that the average person has more than 50 colds during a lifetime. Anyone can get a cold, although pre-school & grade school children catch them more frequently than adolescents & adults. Repeated exposure to viruses causing colds creates partial immunity.

Although colds resolve on their own without complications, they are a leading cause of visits to the doctor. Treating symptoms of the common cold has given rise to a multi-million dollar industry over-the-counter medications.

CAUSATIVE ORGANISMS

  • Rhinovirus
  • Coronavirus
  • RSV & para-influenza
  • Pikorna virus
  • Influenza virus

SIGN & SYMPTOMS

  • Scratchy or sore throat
  • Sneezing
  • Stuffy nose
  • Watery eyes
  • Mucus draining from your nose into your throat
  • Cough
  • Body Ache
  • Fever
  • Lethargic (feeling of tiredness)
  • Associated with Diarrhea

DIAGNOSIS

Colds are diagnosed by observing a person’s symptoms.

Nasal congestion, sneezing, a runny nose & coughing are all classic signs of a cold. In most cases, common colds go away on their own, and it is not necessary to make an appointment with your doctor or your child’s pediatrician for an evaluation & diagnosis. Sometimes, the common cold may develop into more serious complications, such as bronchitis or pneumonia. Ear infections are a common complication in children.

TREATMENT

The treatment is based on symptoms:

  • Decongestants & Antihistamines
  • Nasal Sprays
  • Cough Medicine & Cough Syrups
  • Aches & Pain
  • Antibiotics & Colds

HOME REMEDIES FOR COLD

  1. Garlic
  2. Honey
  3. Spice Tea
  4. Red Onion
  5. Ginger
  6. Chicken Soup
  7. Milk

COMPLICATIONS

1. SINUSITIS: It is an infection of the small air-filled cavities inside the cheekbones & forehead.

2. MIDDLE EAR INFECTION (OTITIS MEDIA): It develops in an estimated 1 in every 5 children under the age of 5 with a cold.

3. CHEST INFECTION: A chest infection is an infection that affects your lungs, either in the larger airways or in the smaller air sacs. There is a build-up of pus & mucus. The airways become swollen, making it difficult to breathe.

4. ASTHMA ATTACK: It is the inflammation, swelling or the tightening of the muscles of the lining of airways which make it harder to breath.

5. STREP THROAT: It is caused by streptococcal bacteria that spread in the same way a cold does. You can get it from touching an infected person or surface from airborne particles when a person coughs or sneezes or from sharing infected items with an infected person.

6. PNEUMONIA: This complication can be especially dangerous & sometimes deadly for people in high-risk groups. These groups include the young, the elderly & those with existing conditions. Therefore, it is important to see your doctor at the first sign of pneumonia symptoms.

8. BRONCHITIS: It is an inflammatory condition of the smallest airways in the lungs (bronchioles). This is a common but sometimes severe infection that is most commonly due to respiratory syncytial virus (RSV).

9. CROUP: It is a condition characterized by its harsh cough similar to that of a barking seal. Other symptoms include fever and a hoarse voice.

PREVENTION

  • Wash your hands often.
  • Avoid touching your face, especially the nose, mouth & eye area.
  • Do not smoke.
  • Keep household surfaces clean.
  • If your child has a cold, wash his or her toys as well when you are cleaning household surfaces & commonly-used items.
  • Use paper towels in the kitchen & bathroom for drying hands after hand washing.
  • Throw tissues away after use.
  • Maintain a healthy lifestyle.
  • Control stress, studies have shown that people experiencing emotional stress have weakened immune systems & are more likely to catch a cold than their calmer counterparts.

HYPERTENSION & CEREBRAL ANEURYSM FORMATION

As promised in our previous post Reason For Being Awayhere is our post about Cerebral Aneurysm.

It is said 1 in 50 people have a brain aneurysm. The annual rate of rupture is approximately 8 per 100,000 people or about 30,000 people in the United States suffer a ruptured brain aneurysm. There is a brain aneurysm rupturing every 18 minutes. Ruptured brain aneurysms are fatal in about 40% of cases. Of those who survive, about 66% will suffer some permanent deficit. There are almost 500,000 deaths worldwide due to ruptured brain aneurysms & half of the victims are younger than the age of 50.

So here we begin with the understanding of hypertension & cerebral aneurysms.

HYPERTENSION (BLOOD PRESSURE)

The pressure of the blood against the inner walls of the blood vessels, varying in different parts of the body during different phases of contraction of the heart & under different conditions of health, exertion, etc.

CEREBRAL ANEURYSM

Cerebral or brain aneurysm is a cerebra-vascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.

Hypertension is known to be a silent killer (by killing the person silently without any symptoms). Its silence can be very dangerous sometimes which can be fatal or can leave a serious morbidity behind. Hypertension may cause many health problems but this is article is written with the idea to provide you information about cerebral aneurysm.

The blood vessels are made up of three layers .i.e. tunica intima, media & adventitia.

When the Tunica Intima the inner most layer gets damaged usually due to high blood pressure or due to trauma, the vessel’s elasticity is compromised & the blood gets turbulence leading to the ballooning of vessel known as False Aneurysm formation. The True Aneurysm is said when all three layers of vessel is involved.

These Aneurysm can occur anywhere is the human body such as Abdominal Aorta or other blood vessels. If this aneurysm occurs with in the cranial cavity in the cerebral vessels it is known to be Cerebral Aneurysm.

HOW DO ANEURYSM FORM?
(PATHO-PHYSIOLOGY)

Aneurysm is a weak bulging spot on the wall of a brain artery very much like a thin balloon or weak spot on an inner tube. Over time, the blood flow within the artery pounds against the thinned portion of the wall & aneurysms form silently from wear & tear on the arteries. As the artery wall becomes gradually thinner from the dilation, the blood flow causes the weakened wall to swell outward. This pressure may cause the aneurysm to rupture & allow blood to escape into the space around the brain, which may be Fatal or can be a serious Complication.

TYPES OF ANEURYSMS

  1. SACCULAR ANEURYSM: It is a round shaped aneurysm that accounts for the vast majority of intracranial aneurysms. They are also the most common cause of non-traumatic subarachnoid haemorrhage.
  2. FUSIFORM ANEURYSM: Also known as Spindle Shaped Aneurysm. It is a variable in both diameter & length; their diameters can extend up to 20 cms.
  3. BERRY ANEURYSM: It is a small aneurysm that looks like a berry & classically occurs at the point at which a cerebral artery departs from the circular artery (the circle of Willis) at the base of the brain.
  4. MYCOTIC ANEURYSM: It is a localized, irreversible, atrial dilation due to destruction of the vessel wall due to infection.

ANEURYSM FORMATION

  1. Smoking
  2. High blood pressure or Hypertension
  3. Congenital resulting from inborn abnormality in artery wall
  4. Family history of brain aneurysms
  5. Age over 40
  6. Gender, women compared with men have an increased incidence of      aneurysms at a ratio of 3:2
  7. Other disorders like Ehlers-Danlos Syndrome, Polycystic Kidney Disease, Marfan Syndrome & Fibromuscular Dysplasia(FMD)
  8. Presence of an arteriovenous malformation (AVM),
  9. Drug use, particularly cocaine
  10. Infection
  11. Tumor
  12. Traumatic head injury
  13. Hardening of the arteries (arteriosclerosis)
  14. Heavy alcohol consumption
  15. Certain blood infections
  16. Lower estrogen levels after menopause



 

SIGN & SYMPTOMS OF HAVING AN ANEURYSM

Aneurysms are usually silent they will not let you know where and when you got the Aneurysm certain series of events & some features can let you know about an Aneurysm

UNRUPTURED ANEURYSM

  1. Pain above and behind an eye
  2. A dilated pupil
  3. Change in vision or double vision
  4. Numbness
  5. Weakness or paralysis of one side of the face
  6. A drooping eyelid.

LEAKING ANEURYSM

  • Sudden, extremely severe headache

RUPTURED ANEURYSM

It is usually known as Subarachnoid Hemorrhage (SAH). It is presented with the typical feature of worst pain ever as the patient complains of a severe headache that he/she had never experienced before. Other features may include:

  1. Nausea and vomiting
  2. Stiff neck
  3. Blurred or double vision
  4. Sensitivity to light
  5. Seizure
  6. A drooping eyelid
  7. Loss of consciousness
  8. Confusion

DIAGNOSIS OF AN ANEURYSM

Diagnosis is usually based on two things; a positive history with a positive series of events & radiological images.



  • MAGNETIC RESONANCE IMAGING (MRI): MRI uses a magnetic field & radio waves to create detailed images of the brain, either 2-D slices or 3-D images. A type of MRI that assesses the arteries in detail (MRI angiography) may detect the site of a ruptured aneurysm.
  • COMPUTERIZED TOMOGRAPHY (CT): A CT scan, a specialized X-ray exam, is usually the first test used to determine if you have bleeding in the brain. The test produces images that are 2-D “slices” of the brain. With this test, you may also receive an injection of a dye that makes it easier to observe blood flow in the brain and may indicate the site of a ruptured aneurysm. This variation of the test is called CT angiography.
  • CEREBROSPINAL FLUID TEST: If you have had a subarachnoid hemorrhage, there will most likely be red blood cells in the fluid surrounding your brain and spine (cerebrospinal fluid). Your doctor will order a test of the cerebrospinal fluid if you have symptoms of a ruptured aneurysm but a CT scan has not shown evidence of bleeding. The procedure to draw cerebrospinal fluid from your back with a needle is called a Lumbar Puncture or Spinal Tap.
  • CEREBRAL ANGIOGRAM: During this procedure, your doctor inserts a thin, flexible tube (catheter) into a large artery — usually in your groin — & threads it past your heart to the arteries in your brain. A special dye injected into the catheter travels to arteries throughout your brain.
  • X-RAY IMAGES: They can then reveal details about the conditions of your arteries and the site of a ruptured aneurysm. This test is more invasive than others and is usually used when other diagnostic tests don’t provide enough information.

TREATMENT IF TESTS ARE POSITIVE

Treatment of depends upon the condition, size & location of aneurysm.

TREATMENT FOR UNRUPTURED ANEURYSMS

  • MEDICAL THERAPY: Small, unruptured aneurysms that are not creating any symptoms may not need treatment unless they grow, trigger symptoms or rupture. It is very important to have annual checkups to monitor blood pressure, cholesterol & other medical conditions. Small, unruptured aneurysms require regular imaging examinations to make sure that they have not grown or changed significantly.
  • NEUROSURGERY: Depending upon the person’s risk factors, open surgery may be recommended. Patients are placed under general anesthesia, an opening is made in the skull, the brain tissue is spread apart & the aneurysm is surgically exposed. Then the neurosurgeon places a surgical clip around its base. The clip seals off the aneurysm in a way that blood can not enter. For an uncomplicated surgical clipping procedure, the hospital stay is usually 4-6 days. Full recovery usually takes several weeks to months.
  • NEUROINTERVENTIONS / NEURORADIOLOGY: Depending on the aneurysm’s size, location & shape, it may be treatable from inside the blood vessel. This minimally invasive procedure is similar to the cerebral angiogram. However, in addition to taking pictures, a catheter is directed through the blood vessels into the aneurysm itself. Then, using X-ray guidance, the endovascular surgeon carefully places soft platinum micro-coils into the aneurysm and detaches them. The coils stay within the aneurysm and act as a mechanical barrier to blood flow, thus sealing it off. For an uncomplicated procedure, the hospital stay is usually 1-2 days. Recovery after the operation usually takes 5-7 days. For a complicated surgery or endovascular treatment, or if an aneurysm has bled into the brain, hospitalization may last from 1-4 weeks, depending on the patient’s medical condition & any complications caused by the hemorrhage.

TRETAMENT FOR RUPTURED ANEURYSMS

  • SURGICAL CLIPPING: It is a procedure to close off an aneurysm. The neurosurgeon removes a section of your skull to access the aneurysm & locates the blood vessel that feeds the aneurysm. Then he/she places a tiny metal clip on the neck of the aneurysm to stop blood flow towards it.




 

  • ENDOVASCULAR COILING: It is a less invasive procedure than surgical clipping. The surgeon inserts a hollow plastic tube (catheter) into an artery, usually in your groin & threads it through your body to the aneurysm.


OTHER TREATMENTS

Other treatments for ruptured brain aneurysms are aimed at relieving symptoms & managing complications, which include:

  1. Pain relievers
  2. Calcium channel blockers
  3. Interventions to prevent stroke from insufficient blood flow
  4. Anti-seizure medications
  5. Ventricular or lumbar draining catheters & shunt surgery

WHAT IF I AM AFRAID OR NEUROSURGERY & CARRY ON WITH MY ANEURYSM?

Living with an aneurysm is like living with a tiny time bomb constantly ticking in your head. The worst thing is not knowing that you have a aneurysm.

  • RE-BLEEDING: It occurs in nearly 19% of SAH patients. SAH patients who experience re-bleeding at any time, approximately 70% will die. Re-bleeding is most likely to occur within the first 2 weeks of the SAH. Peak times within this time frame are within the first 24-48 hours & between 7-10 days.
  • VASOSPASM: It is the narrowing of a cerebral blood vessel due to irritation. Vasospasm results in reduced cerebral perfusion, cerebral ischemia, potential infarction & deterioration of neurological function. The mortality rate from vasospasm is between 40-50%.
  • HYDOCEPHALUS: It is a condition that occurs when fluid builds up in the skull & causes the brain to swell. The name means “water on the brain.”

    Brain damage can occur as a result of the fluid buildup. This can lead to developmental, physical & intellectual impairments. It requires treatment to prevent serious complications.

  • HYPONATREMIA: Subarachnoid hemorrhage from a ruptured brain aneurysm can disrupt the balance of sodium in the blood supply. This may occur from damage to the hypothalamus, an area near the base of the brain. A drop in blood sodium levels (hyponatremia) can lead to swelling of brain cells & permanent damage.

GENERAL MEASURES TO TAKE DURING HEART ATTACK

 

            A huge number of people die due to heart attack on daily basis. The reason is not knowing about the basic symptoms. Most people feel the symptoms & name them as Heartburn, Muscular Pain, Digestion Problem, etc. due to lack of awareness. It is important that people should at least be aware of the basic symptoms, which are if observed then a person should immediately be taken to the hospital for proper treatment so that their life could be saved.


14643104_701210153374924_1177488754_n-1


HEART ATTACK?

“Damage to an area of the heart muscle that is deprived of oxygen, usually due to blockage of a diseased coronary artery, typically accompanied by chest pain radiating down one or both arms, the severity of the attack varying with the extent & location of the damage; myocardial infarction.”

UNDERSTANDING HEART ATTACK

Heart & blood vessel disease is known as heart disease, includes numerous problems, many of which are related to a process called atherosclerosis. Atherosclerosis is a condition that develops when a substance called as plaque builds up in the walls of the arteries. This buildup narrows the arteries making it harder for blood to flow through. If a blood clot forms it can stop the blood flow. This can cause a heart attack or stroke.

A heart attack occurs when the blood flow to a part of the heart is blocked by a blood clot. If this clot cuts off the blood flow completely, the part of the heart muscle supplied by that artery begins to die. Most people survive their first heart attack & return to their normal lives to enjoy many more years of productive activity. But having a heart attack does mean you have to make some changes. The doctor will advise you of medications & lifestyle changes according to how badly the heart was damaged & what degree of heart disease caused the heart attack.

RISK FACTORS

  1. MODIFIABLE
  • Smoking
  • High LDL (Bad Cholesterol)& Low HDL (Good Cholesterol)
  • Uncontrolled hypertension (High blood pressure)
  • Physical inactivity
  • Obesity (More than 20% over one’s ideal body weight)
  • Uncontrolled diabetes
  • High C-Reactive protein
  • Uncontrolled stress & anger
  • Alcohol abuse


2. NON-MODIFIABLE RISK FACTORS

  • Age
  • Gender
  • Race
  • Genetic Makeup
  • Diabetes
  • Heredity (Positive family history)

HOW TO RECOGNIZE THE SYMPTOMS OF A HEART ATTACK?

If you are suffering from a heart attack, you first need to be able to identify its symptoms.
Classical symptoms of a heart attack include:

  • SEVERE CHEST PAIN: Chest pain like squeezing, heaviness or pressing at the central or left part of the chest. The pain may also radiate to the left upper arm, neck or jaw.
  • PROFUSE SWEATING: A feeling of impending doom.

      About 90% of heart attack sufferers experience the classical symptoms. However, the elders, females & those suffering from diabetes may develop non-classical heart attack symptoms. These include shortness of breath, mild chest pain, nausea, vomiting & pain in the epigastric region (upper central portion of the abdomen).


22


OTHER SYMPTOMS

  • Shortness of breath.
  • Headache
  • Nausea
  • Floating heart
  • Aura (Sometimes people do not feel any symptoms except for having a feeling that something is wrong in the chest)
  • Flushing of face (Redness of face)
  • Loss of consciousness
  • Mood swings
  • Light headedness
  • Extreme fatigue
  • Fainting
  • Dizziness
  • Pressure in the upper back

            Once you identify that the symptoms are of a heart attack, this is what you need to do next.

STEPS TO TAKE

Call for the medical emergency to a hospital or ambulance as soon as possible or take the person to the hospital.

While waiting for an approach of a medical emergency team you should do:

  • Posture – Put the person in a seated position, with knees raised.
  • Chew a regular dose aspirin to help prevent blood clots.
  • Initiate CPR if the person stops breathing (if you are lucky enough that you have a person nearby who knows how to perform CPR).
  • Take with a glass of water.
  • Cough
  • If you have been prescribed nitroglycerin tablets or spray for angina, take 1-3 doses to see whether symptoms are relieved.
  • Lie down, breathe deeply and slowly, and try to stay calm.
  • Take deep breaths
  • According to Gilbert Renaud apply ice directly above each ear.
  • According to  Norman Walker, author of Colon Health, apply intense pressure with your thumb directly on the heart access point on the bottom of your left foot. (*See image)

oj


      Remember, exertion can strain your heart & can worsen the damage caused by a heart attacker.

HOME REMEDIES

1. GARLIC: Several studies have found garlic to be beneficial for conditions like high blood pressure, high cholesterol & coronary heart disease. It helps slow the development of atherosclerosis or hardening of the arteries. Plus, garlic improves circulation & has antithrombotic & antiplatelet aggregatory effects.

  • Eat one or two freshly crushed garlic cloves daily as you wake up in the morning (before having breakfast).

Note: Garlic may interfere with certain medications due to its blood-thinning properties. Consult your doctor before taking this herb.

2. HAWTHORN: In western herbalism, hawthorn is a well-known herb for heart conditions because it is excellent for the cardiovascular system. It helps increase blood flow to the heart & improves cardiac muscle contractions, thus leading to a stronger pumping action. It also helps increase cardiac performance &reduces the heart’s workload. Plus, it has an anti-arrhythmic effect that helps steady the heartbeat.

Note: Though this herb is safe to use, consult your doctor before taking this or any other herbal remedy.

3. ARJUNA: Terminalia arjuna is an important Ayurvedic herb for heart conditions. It is considered a natural cardio-tonic & cardiac restorative. The herb strengthens the cardiac muscle, reduces arterial congestion & lowers blood pressure.

A study by researchers at Kasturba Medical College in India found that this herb helped reduce angina attacks by 30%. Moreover, prolonged use of this herb did not have any adverse effects.

  • Add one-half teaspoon of arjuna tree bark powder & a little honey to a glass of warm water. Drink this three times daily for a few months.

4. CHINESE HIBUSCUS: Researchers from Taiwan found that an extract of hibiscus flowers had anti-atherosclerosis activity. They believe that hibiscus contains antioxidant compounds that help prevent the oxidation of low-density lipoprotein (LDL), or bad cholesterol, which contributes to atherosclerosis & heart disease. An infusion prepared from this herb is also believed to help regulate high blood pressure.

  • Boil two petals of a hibiscus flower in one cup of water.
  • Strain & add one teaspoon of raw honey.
  • Drink this once daily for a few weeks.

5. TURMERIC: Studies indicate that turmeric can help prevent atherosclerosis. Turmeric has an active ingredient called curcumin that helps maintains heart health by reducing cholesterol oxidation, plaque buildup & clot formation.
Plus, it helps lower LDL & provides anti-inflammatory benefits. Being a potent antioxidant, it also neutralizes free radicals that contribute to aging & several chronic diseases.

  • Use turmeric regularly in your cooking.
  • You can also boil one teaspoon of turmeric powder in one cup of water or milk. Drink it once or twice daily for several weeks to a few months.

6. CAYENNE: Cayenne pepper contains a compound called capsaicin that is beneficial for treating heart & circulatory problems. It also helps reduce the risk of irregular heart rhythms & lowers cholesterol levels. The phytochemicals present in this spice also purify the blood & enhances immunity.

  • Add one-half to one teaspoon of cayenne pepper to a cup of hot water. Stir well & drink it. Repeat two or three times daily for a few weeks. You can follow up with a cup of hibiscus tea to heal the burning sensation & promote heart health.

“Keep a healthy heart, so we won’t be apart!”
– With love from The Words Craft.

DENGUE

As the weather is becoming cooler & winter is near, the number of mosquitoes is increasing rapidly. Mosquitoes are small, that look like flies, constitute the family Culicidae. Females of most species are ectoparasites, whose tube-like mouth parts pierce the host’s skin to consume blood leading to red bumps on the skin that causes itching.

Dengue is one of the disease that is caused by mosquitoes. It is said that malaria spreads the most in winters because the number of mosquitoes is highest at that time. But dengue does not wait for winters, in fact it is likely to spend the most in the rainy season. As the dengue mosquito lays its egg in water filled containers or places where there is enough water. The dengue larvae spreads the most in areas where water is found. Moreover, the dengue virus bearing mosquito can fly up to 400 meters finding water, to lay its egg. The peak biting periods of dengue mosquitoes are early in the morning & in the evening before the dusk.

INTRODUCTION

Dengue (Deng-gey) Fever also known as Break-bone Fever is a mosquito-borne disease that occurs in tropical & subtropical areas of the world which causes flu, cough, cold, high fever, rash & muscle and joint pain. A severe form of dengue fever is also called Dengue Hemorrhagic Fever which can cause severe bleeding, a sudden drop in blood pressure (shock) & death.

According to the local media, 10,000 dengue cases were reported in year 2015, in Pakistan. Out of which 9899 cases were registered, including 7 fatalities during the course of year. Other than this, in the past 50 years the incidence of dengue worldwide has increased 30 folds.

CAUSATIVE ORGANISM: There are 4 different type of viruses that cause dengue fever but the most common is “Aedes aegypti” which is a female mosquito.


 14489666_690548807774392_1842651558_o


SIGN & SYMPTOMS

A symptom is something the patient feels or reports, while a sign is something that other people, including the doctor detects. A headache may be an example of a symptom, while a rash may be an example of a sign.

These are divided into 3 categories:

  1. Mild Dengue Fever
  2. Dengue Hemorrhagic Fever (DHF)
  3. Dengue Shock Syndrome

MILD DENGUE FEVER: Symptoms can appear up to 7 days after the mosquito carrying the virus bites & usually disappear after a week. This form of the disease hardly ever results in serious or fatal complications.

The symptoms of mild dengue fever are:

  • Aching (painful) muscles & joints
  • Body rash that can disappear & then reappear
  • High fever
  • Intense headache
  • Pain behind the eyes
  • Vomiting & feeling nauseous

DENGUE HEMORRHAGIC FEVER (DHF): Symptoms during onset may be mild, but gradually worsen after a number of days. DHF can result in death if not treated in time.

Mild dengue fever symptoms may occur in DHF, as well as the ones listed below:

  • Bleeding from mouth/gums
  • Nosebleeds
  • Clammy skin (Pale Coloured Skin)
  • Considerably damaged lymph and blood vessels
  • Internal bleeding, which can result in black vomiting & stool
  • Lower number of platelets in blood (Platelets are the cells that help clot your blood)
  • Sensitive stomach
  • Small blood spots under your skin
  • Weak pulse

DENGUE SHOCK SYNDROME: It is the worst form of dengue which can also result in death, again mild dengue fever symptoms may appear, but others likely to appear are:

  • Intense Stomach Pain
  • Disorientation (Lack of Concentration)
  • Sudden Hypotension (Fast Drop in Blood Pressure)
  • Heavy Bleeding
  • Regular Vomiting
  • Blood Vessels leaking Fluid
  • Death

 


14509141_690550647774208_2068259464_n


DIAGNOSIS

Dengue fever is diagnosed by a medical care giver by the relatively characteristic sequence of high fever, rash appearance & other symptoms in a person who has a history of recent travel to dengue endemic areas (place where the disease is more common) & recalls mosquito bites while in the endemic area. However, if not all of the symptoms are present or the history is not complete, the care giver is likely to run a number of tests to obtain a definitive diagnosis.

BLOOD SAMPLE: This sample can be tested in a laboratory in a number of ways to find signs of the dengue virus. If the dengue virus is detected diagnosis is straightforward; if this fails there are other blood tests which can identify antibodies, antigens & nucleic acids, including:

  • ELISA (enzyme-linked immunosorbent assay)
  • HI assay (hem agglutination inhibition assay)
  • RT-PCR (reverse transcriptase-polymerase chain reaction)

TREATMENT

There is no specific medicine to treat dengue infection. If you think you may have dengue fever, you should use pain relievers & avoid medicines such as aspirin, which could worsen bleeding. You should also rest, drink plenty of fluids to get hydrated & see your doctor as soon as possible. If you start to feel worse in the first 24 hours after your fever goes down, you should get to a hospital immediately to be checked for complications.

If you have severe dengue fever, you may need:

  • Supportive care in a hospital
  • Intravenous (IV) fluid & Electrolyte replacement
  • Blood pressure monitoring
  • Transfusion to replace blood loss

COMPLICATIONS (IF NOT TREATED)

The complications of dengue fever are usually associated with the more severe forms of dengue fever; hemorrhagic & shock syndrome. The most serious complications, although infrequent, are as follows:

  • Dehydration
  • Hemorrhage (Bleeding)
  • Low platelets
  • Hypo-tension (Low blood pressure)
  • Bradycardia (Slow heart rate)
  • Liver damage
  • Neurological damage (Seizures, Encephalitis)
  • High fever
  • Damage to the lymphatic system
  • Damage to blood vessels
  • Bleeding from the nose
  • Bleeding from the gums
  • Liver enlargement
  • Circulatory system failure
  • Death

PREVENTION

There are currently no vaccines for dengue fever. The best way to prevent the disease is to avoid being bitten by mosquitoes altogether. Although there is no certain treatment for dengue, it can be treated as long as it is caught before developing into dengue shock syndrome or dengue hemorrhagic fever.

There is no vaccine to prevent dengue fever. The best way to prevent the disease is to prevent bites by infected mosquitoes, particularly if you are living in or traveling to a tropical area. This involves protecting yourself & doing efforts to keep the mosquito population down.

TO PROTECT YOURSELF                                       

  • Stay away from areas that have water nearby.
  • Use mosquito repellent. Permethrin can be applied to your clothing, shoes & bed netting. You can also buy clothing made with permethrin already in it. For your skin, use a repellent containing at least a 10% concentration of DEET.
  • When outdoors, wear long-sleeved shirts & long pants.
  • When indoors, have net doors & mosquito killers installed.
  • Make sure window & door screens are secure & free of holes or unnecessary opening. If sleeping areas are not screened, use mosquito nets.
  • If you have symptoms of dengue, immediately speak to your doctor.
  • To reduce the mosquito population, get rid of the places where mosquitoes can breed. These include plantation/flower pots, bird & pet’s water dishes, open areas, water storage, etc.

14509270_690550601107546_959993741_n


FEW KEY POINTS TO KNOW IF YOU HAVE DENGUE FEVER

  • High Grade fever (104°F)
  • Chills, Headache, Pain under the eyes & Body ache
  • Appearance of Rash (Spots on body).
  • Bradycardia (Decrease Heart Rate)
  • Hypo-tension (Low Blood Pressure)If you are feeling these signs and symptoms then you must approach to your health care provider.

MODE OF INFECTION


tgj


 

ARE YOU A DIABETIC PATIENT?


14397198_684434478385825_599505612_n


Sweet! A term seems really sweet to all but actually can be worse than bitter for a few.

The mother of all diseases lies on this simple word “Sweet.” Without sweets life is tasteless. The excess can make you gain weight & even become diabetic patient, but the restriction & control can make all your worries fly away. There are a few things that one should know in order to stay healthy, especially those who are suffering from this health condition.

Diabetes is a metabolic condition which is characterized by either simple carbohydrate intolerance or either by the absolute or relative deficiency of insulin or its receptors. Understanding the normal can make you understand the abnormality.

WHY & HOW A HEALTHY PERSON HAS NORMAL GLUCOSE LEVELS?

When we ingest any carbohydrates, fats & glucose (sweet) containing product in our diet this undergoes metabolism where these carbohydrates, fats & other products are broken down into glucose. Here the mechanism starts, where this glucose tries to enter into the human body cells that require INSULIN. This insulin is responsible to let the glucose molecules enter into the cell & digest further going under ATP formation. As soon as the glucose enters the cell the glucose molecules in the blood circulations gets decreased & the total serum glucose levels drops to normal, in a normal person.

WHY A DIABETIC PATIENT DOES NOT HAVE NORMAL GLUCOSE LEVELS?

This is a question that is asked by diabetic patients all around the world. Let’s figure it out!

According to the definition of diabetes; “It is either an absolute or relative deficiency of insulin or its receptors.” Now keeping this phrase in mind, we can say that, when a glucose molecule tries to enter the cell the most responsible agent INSULIN which let the glucose molecules enter are either deficient or not strong  enough to let the glucose get inside the cell.

These two problems lead to the persistent increased burden of glucose molecules in the blood ultimately leading to the high serum blood glucose levels.

WHERE DOES THE INSULIN COME FROM?

People are most of the times wandering about the insulin what is it from where we can get it naturally?

Insulin is a Glycoprotein which is formed in the islets of Langerhans; the pancreatic cells generally known as Beta cells. Insulin is formed & stored in the pancreas & is released even before we ingest anything. It is an example of feet forward mechanism to compensate the normal blood glucose levels.

DIABETES & ITS SUB TYPES

  • TYPE-1 DIABETES (Juvenile / Childhood Type Early Onset): The insulin is absolutely absent. It might be due to the destruction of insulin secreting gland which is the Pancreas.
  • TYPE-2 DIABETES (Late Onset / Adult Type): The insulin is usually present but the receptors are destroyed or either absent.
  • GESTATIONAL DIABETES: Occurs during pregnancy.

            As Diabetes is a major health problem worldwide people usually like to talk about it, sometimes people are worried about themselves, AM I LIKELY TO GET DIABETES TOO?”

  Always keep one thing in mind, that every normal condition converting to abnormal has some causative factors.

These include:

FOR TYPE-1:
  • Positive family history
  • Genetic susceptibility
  • Previous viral infection (Coxsackie’s virus)
  • Auto-immune conditions (where the body starts eating its own tissues/organs)
  • Dietary factors (early exposure to cow/formula milk before age of 4months)
  • Geographical conditions
FOR TYPE-2:
  • Genetic factor
  • Environmental factor: life style (Over-eating, junk food, artificial sweeteners, lack of exercise, stress)
  • Certain pancreatic pathology
  • Race
  • Age
  • High blood pressure
  • Other medical conditions such as PCO, Thyroid raised levels, Cushing syndrome, Pancreatitis

HOW WILL I FEEL IF MY BLOOD GLUCOSE LEVEL IS INCREASING?

Honestly speaking there is no any particular sign or symptom of hyperglycemia (raised glucose levels).

People generally feel the following symptoms:

  • Polyuria (Increased frequency of urine)
  • Polydipsia (Increased frequency of thirst)
  • Generalized weight loss
  • Blurring of vision
  • Parestheisa (Loss of sensation in feet and fingers)
  • Ketoacidosis (A condition in which there is absolute insulin deficiency characterized by sweet smell in your breath)

FED UP OF THIS CONDITION… CAN’T CONTROL MY DIABETES!!

Your health is auspicious for your loved ones; the solution is to take care of your health as much as possible. You look on your easy going life right now & after your uncontrolled diabetes how it could be:

  • Multiple attacks of infections (TB, Urinary tract infections, Prurient itching all over the body)
  • Deterioration of vision
  • Peripheral neuropathy
  • Diabetic foot (Ulcer formation leading to the amputation of foot)
  • Myocardial infarction (Heart Attack)
  • Renal failure
  • Increased risk of Alzheimer’s disease
  • Stroke

WHAT INVESTIGATIONS CAN BE PERFORMED TO DIAGNOSE & CHECK THE DIABETES?

  • RBS (Random Blood Sugar)
  • FBS (Fasting Blood Sugar)
  • OGTT (Oral Glucose Tolerance Test)
  • HbA1c (Glycosylated Hemoglobin) gives the record of past 90 days the blood glucose level usually used to check the control of diabetes
  • Serum Fructosamine
  • Urine Glucose

TREATMENT GOALS

As diabetes is the major health problem & most health concerning issue many clinical trial are performed to treat this condition but unfortunately none of the trial is proved to be beneficial. Whereas, the Insulin & Oral hypoglycemic drugs are the supportive treatment. The specific treatment which can either start the insulin secretion or can up-regulate the receptors are not yet found. Recent study was done where a vaccine is formed to treat the Type-1 Diabetes patient by killing the auto antibodies against beta cells but it has to be yet approved by FDA.

PREVENTION IS BETTER THAN CURE keeping this phrase in mind population can modify their life style & decreasing the burden of risk factors can prevent the condition to some extent.

 

HOW CAN I CONTROL MY DIABETES? WHAT CAN BE MY DIET PLAN??

Majority of patients are only concerned with this question so here is the answer.

The Hand Rule tells us about how much amount you can eat & what.

  • FRUITS/GRAINS & STARCHES: Choose an amount the size of your fist for each of Grains, Starches & Fruit.

1

  • VEGETABLES: Choose as much as you can hold in both hands.

2

  • MEAT & ALTERNATIVES: Choose an amount up to the size of the palm of your hand & the thickness of your little finger.

3

  • FATS: Limit fat to an amount the size of the tip of your thumb.

4

The meal should always be maintained. It should be 3 big meals & 3 small meals (snacks). The big meals are your Breakfast, Lunch & Dinner. If the breakfast contains proteins (eggs) & carbohydrates (bread) then the Lunch should contain Grains & Starch. The dinner should have Fruits & Vegetables. Taking Carbohydrates, Fats, Starch & Fruits at same time can disturb your blood glucose levels therefore it must be divided accordingly.


kkk


THINGS TO EAT

  • Apples
  • Asparagus
  • Avocado
  • Beans
  • Blueberries
  • Broccoli
  • Carrots
  • Cranberries
  • Fish
  • Flax seeds
  • Garlic
  • Kale
  • Melon
  • Nuts
  • Oat meals
  • Quinoa
  • Grapefruit
  • Red onions
  • Tea
  • Spinach
  • Tomatoes
  • Chicken
  • Papaya
  • Plums
  • Guava
  • Apricot
  • Brown rice
  • Porridge
  • Pulses
  • Legumes
  • Wheat

THINGS NOT TO EAT

The key rule is to avoid all those things which contain artificial sugars, extra fats & are highly rich in glucose are strictly prohibited.


14383303_684434475052492_947429792_n


“Every hum,an being is the author of his own health or disease!”
– Buddha.