ANGELESIA-Articles|Shopping|Tools|E-Mail

You will get all health care and Lifestyle related article here. You can ask question to our Expert doctors too. Its free for now.

customer service software technical support

Live Chat by Comm100

free knowledge base softwarefree newsletter email marketing softwarefree forum bbs software

Get the most visited articles of 2009 Here.            February 2010

Diabetes mellitus is a group of metabolic disease that are characterized by high blood glucose levels resulting from insufficient insulin production, insulin action or both. The World Health Organization estimates that currently more than 180 million people worldwide have diabetes and by 2025 that number will be more than 330 million people. The rapid increase in the incidence of diabetes makes it a global epidemic and healthcare crisis. One of the fastest growing risk factors for type 2 diabetes is obesity. Life style changes such as exercise and diet modification can reduce the weight and prevent the onset of type 2 diabetes. If it is already diagnosed, can reduce the complications such as cardiovascular disease, kidney failure, nerve damage and blindness.

Several studies have shown a relationship between diabetes and incidence and severity of periodontal disease. Other oral complications include burning mouth syndrome, xerostomia, candidiasis, lichen planus, recurrent apthous stomatitis. Xerostomia increases the risk for the dental caries but no studies to date proof it. Children with diabetes have been shown to have a higher prevalence of gingival inflammation affecting more sites compared to non diabetic children with similar plaque accumulation. Periodontal disease starts earlier in life for diabetic children and can more severe in late adolescence and early adult period. Adult with diabetes have also shown an increase in gingival inflammation and extent and severity of periodontitis.

Dental professionals are in a unique position to have a positive impact on patient health. Many patients with diabetic are not aware of their risk for periodontal disease. It is important to discuss and document the type, duration, medication and self monitoring frequency. Based on this information and oral assessment, develop a comprehensive treatment plan. Traditional aids can work well such as tooth brushing, inter dental cleaners and mouthwash. Ultrasonic cleaners also effective. The dental professional is a key component that support and treat people with diabetes significantly impacting their quality of life.

For any specific query you can write to our expert at : support@angelesia.com  (Members only) with subject line -   HEALTH & LIFESTYLE.

YOU CAN FIND OTHER ARTICLES IN ARCHIVE

______________________________________________________________

DEFINITION :-

      Bronchial asthma is chronic inflammatory condition of the airways characterised by reversible airway obstruction producing cough, wheeze, tightness of chest and shortness of breath. In other words it is the hypersensitiveness of the bronchi in response to a wide variety of stimuli so that they undergo narrowing very easily. So in simple words it is bronchospasm which is the basic pathology behind this very common respiratory disease.                        

      One of the common diseases that have a very prominent winter aggravation is bronchial asthma.  Though people suffering from asthma usually suffer from breathing difficulty throughout the year, most of the patient tends to suffer mostly a marked increase in respiratory distress in the cold weather. Though bronchial asthma is not popularly put under the common name of COPD (chronic obstructive pulmonary diseases), some cases in which the FEV1 (forced expiratory reserved volume in one minute) value is below 80%, they are considered as a type of COPD.

CAUSES OF BRONCHOSPASM :-

•    Different types allergens (dusts, smokes, pollens, cold weather etc.).
•    Infections.
•    Exercise.
•    Different environmental and occupational irritants.
•    Different drugs.
•    Certain emotional disturbances.

VARIETY OF BRONCHIAL ASTHMA :-

•    ACUTE / EXTRINSIC VARIETY :-

      This type has an episodic attack. This is commonly due to some allergen. Onset of disease is usually early i.e. young age. It is often atopic, that is there is some family history. There is increased levels of serum Ig and eosinophils. Skin test in such patients often gives the evidence of allergy.

•    CHRONIC / INTRINSIC VARIETY :-

     There is no episodic attack, patient is a chronic sufferer, but there is acute exacerbation from time to time. This type is commonly due to some kind of infection. Onset of disease in such case is late i.e. in adult or advanced age. There is usually no family history. There is no evidence of allergy as such.

SYMPTOMS AND SIGNS :-

SYMPTOMS – the onset is usually sudden. The attack usually occurs in the late night or towards morning in case of the intrinsic variety (the time of attack in case of cardiac asthma is usually the early part of night).  Patient has a peculiar feeling of tightness in the chest. There is great breathing difficulty and a feeling that there is lack of air in the room. Patient usually wakes up from sleep and sits up in bed, often walks about in the room, opens all windows and doors to have fresh air and becomes very restless. Patient suffers from an episode of dry cough. After some effort patient brings out little expectoration which gives some relief to the patient. The attack usually subsides in an hour or so.

SIGNS – there will be plenty of wheeze which is often audible when going near the patient. Patient is usually found to take a upright or propped up position. There is an increased rate of respiration and pulse rate is usually very high. There is much activity of the accessory muscles of respiration and indrawing of the chest wall. Expansion of the chest is reduced. On palpation of the chest wall there are reduced vocal fremitus. When the chest wall is heard with a stethoscope, the breath sound is reduced vesicular with prolonged expiration. Vocal resonance is reduced. There are plenty of rhonchi and some crepitation. Patient coughs up small amount of thick lumpy mucus which takes the shape of the smaller bronchioles. This is very characteristic, and known as curschmann’s spiral.

DIAGNOSIS :-

Diagnosis is often clinical. But different clinical tests often give very easy diagnosis.

1.    Blood: - differential count of WBC will give an increased count of eosinophils and serum analysis gives an increase in IgE antibody, indicating some allergic condition of the body, which is diagnostic during an acute attack of the allergic variety.
2.    Sputum: - examination of the sputum of the patient gives presence of eosinophils, circulatory Charcot Leyden crystal and  [curschmann’s spiral] which are very characteristic finding.
3.    Lung function test (spirometry):- forced expiratory volume in one minute (FEV1) is reduced and residual volume is increased indicating some obstructive phenomenon.
4.    Chest X ray: - it is usually non significant with only the impression of an hyper inflated lung.
5.     Blood gas analysis:- it is required to diagnose if there is any respiratory failure. Partial pressure of oxygen is often reduced and sometimes the partial pressure of carbon dioxide is increased.
6.    Skin test: - often gives an evidence of allergic response to certain allergens.
7.    ECG:- features suggesting of right ventricular hypertrophy or right ventricular failure which is in fact a long term complication of bronchial asthma.

STATUS ASTHMATICUS:-

   It is also known as acute severe asthma. It is very severe form of asthmatic respiratory distress where there is severe dyspnoea, wheezing, restlessness and very prominent activity of the accessory muscles of respiration. There is severe unproductive cough though there is plenty of pus present in the lungs. There is profuse sweating and blueness of lips, tongue, ear lobules and nail bed. Pulse and respiration rate is much higher. Patient has difficulty in speech, exhaustion and detoriating level of consciousness. This is a very bad sign, especially when blood gas analysis shows features of type II respiratory failure (partial pressure of CO2  increased and partial pressure of O2 reduced), and there is silent chest ( no rhonchi heard though there is plenty of dyspnoea).

For any specific query you can write to our expert at : support@angelesia.com  (Members only) with subject line -   HEALTH & LIFESTYLE.

YOU CAN FIND OTHER ARTICLES IN ARCHIVE

Squamous Cell Cancer of the oral tongue

This tumor is usually located on the side, i.e. the lateral border of the oral tongue. It is usually somewhat ulcerated and is grayish-pink to red in color. It will often bleed easily if bitten or touched. It is generally seen in the older age groups though it is seen in young age group also. Smoking and drinking are known to contribute to the formation of the cancers, although some folks have developed squamous cancer of the tongue with no known extra risk factors.

Most very small cancers of the oral tongue can be quickly and successfully treated by surgical removal leaving behind little cosmetic or functional change. This is not always true, however as there can be many variables and factors that can seriously impact speech and swallowing. This can only be assessed by a face to face Surgeon/Patient meeting and examination.

Larger cancers may indeed have some effect on speech and on swallowing, but one must remember that not treating this problem would cause far more significant problems and including death can occur.

There is a school of thought that small oral tongue cancers can be better managed by radiation therapy alone, and this is indeed true in some cases, especially where the patient has serious heart and/or lung disease that might make anesthesia risky. Fortunately, this is a rare occurrence.

The main reason for treating small sqamous cell cancer of the oral tongue with surgery is that it is at least as curative as radiation, possibly better, it is over with quickly, oftentimes done as an out patient procedure instead of 5 - 6 weeks of daily therapy, it may be significantly less expensive, and finally, and most importantly, it means that if a patient were to later present with a 2nd or 3rd Squamous Cell Cancer of the mouth/throat/or voice box area, you would still have radiation therapy as a treatment option, perhaps then being able to avoid a significant and disfiguring operation. There is a limit as to how much radiation normal tissue can take before it dies.

Some cases of Oral Tongue Cancer can be treated with just removal of the primary tumor in the tongue. But as the size of the primary tumor increases the statistical possibility of some cancer cells spreading through lymphatic vessels to the lymph nodes of the neck increases. The site and pattern of the involved lymph nodes is pretty much constant --- that is to say we know where in the neck to look for enlarged lymph nodes that might contain metastatic cancer cells from the oral tongue cancer. Exceptions to these rules are sometimes seen, but they are uncommon. When the presence of enlarged lymph nodes in the neck is detected or when the index of suspicion is high that there may be cancer cells present in lymph nodes, then an operation called a neck dissection is performed to remove these "secondary" deposits of cancer. Remember, the oral tongue cancer is the "primary" tumor from where the spreading cells originate.

There are many forms of neck dissections from radical to conservative. Suffice to say that this is an area of medical judgment and decision making that relies heavily on the experience of the surgeon. While many physicians may have had some exposure to neck dissections at some point in their career, there are very few Head and Neck Surgeons, usually found in large medical centers, who can truly say that their career has been dedicated to this type of disease and they have done hundreds or perhaps thousands of these procedures.

Finally, there may sometimes be the need to perform plastic surgery and/or reconstruction following removal of the tumor, and radiation treatments may have to be given after the surgery to try to minimize the possibility of recurrence of the disease and ultimate treatment failure. Yes, sometimes in spite of every effort, every bit of hard work, in spite of supportive care and even our prayers, some patients will be lost to this disease. It is a sad thing to have to watch and be a part of, but it is one of life's unpleasant realities. For now, we will have to content ourselves with the knowledge that most of our tongue cancer patients survive quite nicely and hope that new research and new discoveries in the future will allow us to help our patients even more.

While it may technically feasible to surgically remove some base of tongue cancers, in that case should be treated by radiotherapy. These tumors are arguably more sensitive to radiation treatment than some other cancers. Certainly, there are exceptions to this. Radiation therapy can also be used to control the cancer in the neck nodes as long as it is not too advanced. Interestingly, in those cases, we will sometimes remove massive neck node disease before starting radiation therapy when we know that x-ray therapy alone would not be successful in controlling the neck disease.

The prognosis after treatment of base of tongue cancer will vary from patient to patient as with any type of malignant disease. It has been our experience that the cure rate is good, but not quite as good as for early detected oral tongue cancer. The fact that base of tongue cancers are usually larger at the time of diagnosis probably is a significant contributing factor to this disparity. Very large base of tongue cancer may require a combination of surgery and radiation.

For any specific query you can write to our expert at : support@angelesia.com  (Members only) with subject line -   HEALTH & LIFESTYLE.

YOU CAN FIND OTHER ARTICLES IN ARCHIVE

______________________________________________________________

PREVENTION:-

        The disease is to some extent preventable by some very common habitual measures, some very simple daily practices, though enough methods of prevention often fails to provide is enough protection from this most common viral infection.

1.    Proper protective measures against the winter season and change in life style and little alteration in our common food habits render us less vulnerable to the injurious effect of the cold weather and thus keep our immune strength much higher. A habit of wearing proper winter garments from the very point of first temperature fall, even though the temperature fall may seem very minimal is very effective. It’s the early part of the season change when the body finds the maximum difficulty in adaptation, and this is the high time for the viral infection. The foods we usually consume in summer is not always ideal for the winter season (like a plenty of cold drinks, ice creams etc) and should be better avoided.

2.    In winter season as we share mostly a closed room with a more number of population, that is increased time spent indoor at close proximity to others, the chance of contamination of virus by simple sneezing, coughing or simply by contact of body parts increases by many folds. Some behavioural change like putting a handkerchief before mouth while coughing may reduce the chance of easy contamination considerably.

3.    A regular based hand wash with anti bacterial and non anti bacterial soaps is after all the best method of prevention. This simple habit reduces the chance of common cold by 20% and all respiratory infection by 16%. The alcohol based hand sanitizers are also very effective in reducing the bacterial infection, and is popularly advised.

4.    Probiotics when used for at least 6 months in children between 3 to 5 years is also found to be very effective method of prevention.

5.    Attempts are constantly been made to develop an effective vaccine against common cold, though, till date all attempts have ended unsuccessfully. The main reasons of the failure is considered to be the large variety of virus responsible and also because they mutate very rapidly.

MANAGEMENT:-

A.    Medical treatment: - no modern or herbal medicine is known to reduce the duration of suffering in this viral infection, but medicines are definitely essential as they reduces the suffering considerably. Usual concept is to treat common cold with the normal over the counter medicines like analgesics and antipyretics (ibuprofen , acetaminophen etc.) . There is no evidence that the common cold medicines are more effective than the simple analgesics and thus not very popular as well. Antibiotics and antiviral medicines are also not very widely used. Antibiotics are better avoided due to their side effects and antiviral medicines are not very effective. Plenty of rest, rehydration by drinking fluid and warm saline water gurgling, and saline nasal drops help a lot to reduce the suffering. Inhalation of hot vapour also helps to reduce the nasal congestion considerably.

B.    Alternative treatments:- alternative methods of treatments like Homoeopathy and Ayurveda are widely popular in treatment of common colds throughout the world. Homoeopathy has proven its efficacy in reducing the intensity of suffering in common cold, without the unnecessary side effects of strong drugs and more importantly proper constitutional treatment with homoeopathy has also been found effective in increasing the immunity and reducing the hereditary tendencies to catch cold easily. The treatment is like other diseases purely symptomatic. When the disease is in the very prime stage caused mostly due to exposure to dry cold wind with very sudden onset, mental anxiety, profuse thirst, redness of cheeks and heat the most common medicine is Aconitum napellus-6,30; when the first stage is over, there is involvement of throat with little catarrh and feverish sensation Ferrum phos 6x, 30 often helps. When again this stage passes through without treatment, disease may turn violent with severe throbbing headache, congestion of paranasal sinuses, redness of face and eyes, complete thirstlessness and anxiety Belladonna may be called for. With a presentation of profuse watering from nose as well as eyes with or without headache Allium cepa, Arum triphyllum, Dulcamara, Euphrasia, Mercurius solubilise, Natrum mur, Sabadilla etc in different potencies are considered. There are plenty other effective medicines in homoeopathy found helpful in treating common cold. Deep acting remedies like Calcarea carb, Hepar sulphuris, Psorinum, Silicea, sulphur and Tuberculinum in high potencies often help to reduce the constitutional tendency to catch cold easily and render the patients more resistant to these viral infections.

PROGNOSIS:- common cold is usually a very mild self limiting seasonal disease and the overall prognosis is very good.

For any specific query you can write to our expert at : support@angelesia.com  (Members only) with subject line -   HEALTH & LIFESTYLE.

YOU CAN FIND OTHER ARTICLES IN ARCHIVE

______________________________________________________________

 About us    Guestbook  Contact  Link  Twitter      

Article by Team Angelesia is licensed under a Creative Commons Attribution-Non-Commercial-No Derivative Works 2.5 India License.