Why You Should Love Dog Sweaters!

Many people would argue that dogs are animals and have evolved to survive out doors and, therefore, do not need clothing. However, the same argument could also be made for humans and most people do not want to spend their time in the nude! Also, many dogs evolved in one temperature zone but have been moved to another or else they are bred specifically to have very short or fine coats and so are equally unprepared for the cold winters.

If your dogs cower into the back of their dog houses whenever you suggest going for walkies it may be that they simply feel the cold and can not face going out in it. Luckily the answer is at hand in the form of dog sweaters. You may laugh at the idea of ​​your dog wearing a sweater but they are becoming increasingly popular and a much easier pet accessory to buy. Go down to your local pet store and have a look at the range available there and you will soon realize how many people must buy them.

Sweaters come in a range of fabrics including fleece, woolen, nylon and cotton as well as different styles. You may find that your dog needs one with a hood or longer sections on the legs in the middle of the winter but a short, cotton sweater will be sufficient in the autumn or spring.

It does not matter what size or breed of dog you have, you will be able to find a sweater to fit. They even make small dog sweaters for Chihuahuas!

Not only will you come to love your dog sweater because it will encourage your dog to go out and enjoy some exercise again but with all the cool designs and styles your dog will look smart and will get lots of positive comments from other dog walkers.

Common Methods in Dealing with Cellulitis Pain

Cellulitis is an infection that is surely painful and energy-draining. Chills, fever, nausea, sometimes vomiting and diarrhea are cellulitis symptoms that you should face. These are just normal while your body regaining homeostasis from the destruction perpetrated by Staphylococcus bacteria. Pain may differ from one patient to the next. Each patient should also receive a different treatment for cellulitis option than the others. For example, Class I patients with cellulitis on external areas can just convalesce at home with the prescribed antibiotics. Class II, III and Class IV patients on the other hand would definitely need more supervision from their doctor as their infection is associated with more serious illnesses. Pain attacks while at home or in the hospital is a situation that should be handled in all types of patients. Here are common guidelines in dealing with cellulitis pain. 

• Maintain good hygiene and a clean environment. A dirty environment promotes the growth of Streptococcus and Staphylococcus bacteria. Have clean sheets, bandages and mattresses all the time. Somehow, a clean environment can discourage bacteria from spreading. It is also advised that patients with cellulitis keep their own utensils as the bacteria may transfer from the host to the next person who has the ideal bodily conditions for bacterial production. A family member with an open wound or a failing immune system can be susceptible with the infection. 

• Always have easy access with your prescribed antibiotics and pain relievers. Antibiotics like penicillin, cephalosporins, erythromycin, cephalexin and cloxacillin are the usual medicines for cellulitis. Make sure that you report all allergic reactions particularly towards penicillin before taking any of these drugs. Take them as prescribed. Skipping oral treatment will definitely destroy the entire treatment plan. It is also good to prepare analgesics like Acetaminophen and Ibuprofen when pain attacks. T his should be regulated by your doctor as they might cause other complications like hyperacidity reaction and kidney trouble. Other studies also said that Aspirin is not advisable for cellulitis. 

• Maintain the right body positions that can alleviate pain. Patients who have cellulitis in the leg found it effective to raise the affected area higher than the hip. This will promote good blood circulation and distribution of antibodies all throughout the body. In hospitals, this can be easily done with the adjustable electronic beds and straps that raise legs. In homes, you can prop layers of pillows beneath your leg. 
• Use mechanical ways to alleviate pain. Applying pressure on the affected areas can alleviate pain. You can use bandages or wet straps with alcohol or petroleum jelly on your skin. Massaging the skin area slightly will also help. Just make sure that the person applying a massage is fully-protected with gloves. Soaking the skin area in warm water has also been proven to help.  

• Eat the right fruits and vegetables. Recovery is faster when you eat the right foods. Fruits rich in flavonoids and Vitamin C can uplift the condition of your immune system so that the body can fight the Staph bacteria. Citrus fruit groups and green leafy vegetables are found to promote cell resistance from infection.

Thrombophlebitis – Causes, Symptoms and Treatment Methods

Thrombophlebitis is swelling (inflammation) of a vein caused by a blood clot. On rare occasions, thrombophlebitis (often shortened to phlebitis ) can affect veins in your arms. At times, when affecting the greater saphenous vein, thrombophlebitis can progress into the deep venous system, which may lead to pulmonary embolism. When it occurs repeatedly in different locations, it is known as “Thrombophlebitis migrans”. Thrombo means clot. Phlebitis means a vein with inflammation, or the swelling and irritation that happens as the result of an injury. Thrombophlebitis also is known as phlebitis, phlebothrombosis, and venous thrombosis. Thrombophlebitis often is caused by prolonged inactivity, such as from sitting during a long period of travel in an airplane or automobile or from lengthy bed rest after surgery. Often, thrombophlebitis occurs in people with varicose veins; however, most people with varicose veins do not develop thrombophlebitis.

Thrombophlebitis itself may not be too serious, but it can lead to other conditions that are life-threatening. Paralysis, certain types of cancer and use of the hormone estrogen also may lead to thrombophlebitis. An inherited tendency for blood clots places you at higher risk of thrombophlebitis. In rare occasions, some cases can lead to infection and tissue damage from the loss of healthy circulation. There are two parts to thrombophlebitis, inflammation of a vein and blood clot formation. If the inflammation is minor, the disease usually is called venous thrombosis or phlebothrombosis. The main symptoms are tenderness and pain in the area of the affected vein. Redness and/or swelling also may be seen. Paralysis, certain types of cancer and use of the hormone estrogen also may lead to thrombophlebitis. An inherited tendency for blood clots places you at higher risk of thrombophlebitis. If an intravenous line is in use, the risk of superficial thrombophlebitis may be reduced by routine rotation of the IV site and immediate removal of the IV line if signs of inflammation develop.

Causes of Thrombophlebitis

The common causes of Thrombophlebitis include the following:

Sitting for a long period of time (such as on a long airplane trip) increases a person’s risk of thrombophlebitis.

Cigarette smoking.

An infection or an injury to a vein.

You may get a thrombophlebitis from wearing a cast which can cause your blood to pool.

Taking birth control pills.

Intravenous drug use.

Caustic materials, such as lighter fluid and street drugs, injected intravenously.

Symptoms of Thrombophlebitis

Some symptoms related to Thrombophlebitis are as follows:

Warmth and tenderness over the vein.

Skin redness (not always present).

Hard vein.

Local warmth.

A feeling of heaviness in the leg or affected area.

Swelling ( edema ) of the extremities (ankle and foot).

Treatment of Thrombophlebitis

Here is list of the methods for treating Thrombophlebitis:

Nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen to reduce pain and inflammation.

Rest and Firm bandaging.

Apply moist heat to reduce inflammation and pain.

Antibiotics are prescribed if infection is present.

In rare instances, a filter may be inserted into the main vein in your abdomen (vena cava) to prevent clots that break loose in leg veins from lodging in your lungs

Keep pressure off of the area to reduce pain and decrease the risk of further damage.

Surgical removal, stripping, or bypass of the vein is rarely needed but may be recommended in some situations.

Why Translating Exists Despite the Existence of a Universal Language – ENGLISH?

Despite of the many factors like culture, economy, geography etc. in the world we live today, one of the common things that we can observe is that English as a language, thus calling it as the “Universal language”.

In terms of native speakers, English is the third most common language, which it at least 330 million people. But if we consider people who speak it as a second one, it is the most popular language in the world.

1) Not everyone is as literate as we think

Though English is a common language across the globe, there are many nations which consist of people who are not fluent or have little knowledge over the language.

We cannot judge a book by its cover can we? A person who looks spick and span may not have an impressive English communication, as well as a man who looks improper may not be as illiterate as we think. A person may be more comfortable speaking in a language they grew up in and might express better ideas. Maybe ideas he could not have expressed well through English. Here, translation will come in handy, as you get a chance to experience a better process.

2) Being open to culture change

As mentioned earlier, some people may prefer expressing their ideas in a language that they grew up learning. Imagine seeing their expression when you frown, as you don’t understand what they’re saying (if they speak in their native language) or if you do not comprehend what they are trying to say (if they express ideas with great difficulty in English, but fail). It would be strenuous for the both of you to reach a level of understanding wouldn’t it? Now imagine having a translator within your reach. The person feels comfortable and will give their maximum performance as well as showing respect to you as you respect and cooperate to their standards and preferences of culture.

3) As the market grows, language barriers will break

English may be one of the most frequently understood or spoken languages in the world. But it won’t last for long, as online facilities provide a various amount of preferences for language options, making it easier for outsiders to explore the web for their needs. Many other languages exist that have a possibility to dominate the English language. For example, though the majority of the population in the USA speaks English, the natives are mostly inclined towards the Spanish language. There are predictions that Spanish may possibly dominate over English in the foreseeable future due to this reason. So as the expansion of language diversity occurs, the need for translation and comprehension will be in demand.

There’s no doubt that the English language is powerful enough to reach the entire span of the globe. But, translation is important and will remain this way for both individuals and business firms in the upcoming future. Just make sure you choose qualified human translators to ensure your standards in order to make your work or tasks easier to complete. Or as you know there are many online translation services available to help you in your time of need!

Cyberknife treatment for Pituitary adenoma

The pituitary gland is called as the master gland of the body. This is because it controls most of the body’s endocrine functions by secreting nine distinct hormones like prolactin, oxytocin, antidiuretic hormone [ADH], thyroid-stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, luteinizing hormone, and human growth hormone. All of which regulates activities of other endocrine glands. The pituitary gland is divided into two lobes: front or anterior and rear or posterior. Benign tumors usually develop on the anterior part of the gland. Tumors rarely develop on the posterior part of it. Most brain tumors are pituitary tumors, making them as the 3rd most common type of it. Among the pituitary tumors, pituitary adenomas are the most common. These adenomas can further be classified depending on the type of hormones they secrete. Hormonal imbalance is a common clinical manifestation of the disease. The etiology of pituitary adenoma is unknown. Researches say that it results from DNA changes that lead to rapid, uncontrolled growth, large enough to compress surrounding cells and structures. In rare cases, these tumors lead to spontaneous hemorrhage or may lead to infarction. Optic chiasm, which is usually found above the pituitary gland, is commonly compressed resulting to double vision and eventually to progressive loss of vision. Other symptoms related to tumor’s location and sites are persistent headache, loss of peripheral vision, ptosis, seizures, facial numbness, hyperphagia or excessive eating and hypophagia or abnormal eating of small amount of food. Other symptoms associated with the hormone it releases are: hyperhydrosis or excessive sweating, appetite loss, loss of sexual interest, nausea, problems concerning menstrual periods, constipation and polyuria or excessive urination, constipation, growth delay, pubertal delays and galactorrhea or milk secretion in the absence of pregnancy. Surgery, radiotherapy, stereostatic radiosurgery and cyberknife are possible treatment for pituitary adenomas.

Treatments for pituitary adenomas depend on its location, type of hormone released and its extent of metastasis. Each treatment aims to normalive hormonal levels and to remove and/or to reduce the tumor’s size. In a surgical procedure, removal of the tumor is done through craniotomy. However, once the pituitary gland is removed or damaged, life-long hormonal replacement therapy is required. Common clinical complication brought about by the procedure is meningitis due to leakage of cerebrospinal fluid through the nose leading to the inflammation of brain and spinal column membranes. On the other hand, radiation therapy may be done as adjunctive therapy to the surgical removal of the tumor. Stereotactic Radiosurgery makes use of highly précised radiation beams to shrink the tumor. This is usually done to patients whose tumors do not respond to surgery or medication.  Among the stereostatic radiosurgeries, cyberknife is the most common and effective.

Cyberknife treatment for Pituitary adenoma possesses the advantages of both the conventional radiation and radiosurgery treatment. The treatment lessens the radiation risk to sensitive structures surrounding the tumor like optic chiasm and hypothalamus. Among the treatments, cyberknife is painless. No screws, scalpels and frames are used. It is uses higher doses of radiation to extremely and accurately target the tumor, minimizing trauma and destruction to surrounding tissues. Also, risk of hemorrhage or blood loss is also prevented. This procedure may be done in an out-patient basis. Thus, patient may get back to his usual lifestyle after the procedure. No recovery time is needed. Known for this effective type of procedure is the Colorado CyberKnife. They use latest and credible hardware and software to help more patients more accurately, in a less time and less risk for complications. All of which enabling them to be known in the field of oncology.

Congestive Heart Failure Definition, Symptoms And Treatments

Congestive heart failure signs and symptoms ordinarily start slowly and may at first be observed only through periods of activity. Having said that, over time, shortness of breath and other indications may be seen even during times of rest. Congestive heart failure is a disease in which the heart becomes an inefficient or weak pump. This report shares information so it is possible to learn to recognize the symptoms linked with this chronic disorder and start to create an online diagnosis making you better prepared for your visit to your medical physician’s office.

This heart problem is a long-term and chronic problem, which typically includes both sides of the heart. Even so, the condition may impact only the right side of the heart (right-sided heart failure) or the left side (left-sided heart failure). The ailment happens when your heart muscle tissue are weakened and can not pump the blood from the heart effectively (systolic heart failure) or when your heart muscle groups are stiff and do not fill up with blood very easily (diastolic heart failure).

In any type of heart failure, the heart becomes incapable of adequately pumping oxygen-rich blood to the rest of the body, especially during instances of physical exercise or exertion.

Congestive Heart Failure Symptoms and Causes

Symptoms have a tendency to grow gradually, nonetheless, they can come about abruptly in certain cases like after a heart attack or other heart problem. Originally symptoms may be viewed only in the course of periods of activity. As time goes on, signs can appear even during periods of rest.

Common signs of congestive heart failure involve:

  • Shortness of breath with exertion or when lying down
  • Cough
  • Inflammation or swelling in legs, feet and ankles (pooling of blood)
  • Swelling of the abdominal area
  • Weight gain
  • Loss of appetite, indigestion
  • Irregular or fast pulse
  • Low blood pressure
  • Weakness and exhaustion
  • Heart palpitations (feeling the heart beat)
  • Problems sleeping
  • Various other signs and symptoms may include:
  • Reduced alertness or capability to concentrate
  • Decreased urine production
  • Nighttime urination (the necessity to get out of bed to go to the rest room)
  • Nausea and vomiting

If congestive heart failure is seen in an infant, a father or mother or guardian may notice the infant sweats during feedings or with various other activities.

Some sufferers may have no apparent signs and symptoms. In these sufferers, signs and symptoms may only exist with an accompanying condition such as anemia, arrhythmias (abnormal heart beat or rhythm), hyperthyroidism, infection with high fever, and kidney ailment.

Congestive heart failure is usually the outcome of a significant complication of some chronic illnesses similar to coronary artery disease, which is a narrowing of the blood vessels which supply the heart. Other causes may involve an infection which weakens the heart muscle (i.e. cardiomyophathy), congenital heart disease, several heart attacks, heart valve disease, or certain infections.

Various other ailments which may lead to heart failure involve, chronic high blood pressure (hypertension), emphysema (lung ailment noticed in long-term smokers), severe anemia, hyperthyroidism.

Congestive Heart Failure Diagnosis and Treatment

Diagnosis may commence with the observation of the earlier mentioned signs and should be confirmed by way of an evaluation by a medical practitioner. The evaluation may involve a physical examination, ECG, chest x-rays, Heart CT scan, MRI of the heart, echocardiogram, angiography (x-ray of the heart and blood vessels using a radiopaque contrast medium), heart catheterization, nuclear heart scan, and blood or urine analysis.

A physician will keep track of your disorder carefully with repeated follow-up visits (i.e. every 3 to 6 months). You could also keep track of your issue closely and weigh yourself regularly. Excess weight gain can indicate that your body is retaining fluid.

Home care comes with taking your medications as directed, limiting salt intake, quitting smoking, remaining physically active under your doctor’s direction, controlling or losing weight, receiving plenty of rest with your feet elevated.

Your medical doctor may prescribe medications to help control signs like:

  • ACE inhibitors, that open up blood vessels and reduce the work load of the heart (i.e. captopril, enalapril, lisinopril, and ramipril)
  • Diuretics, which decrease the accumulation of fluid (i.e. hydrochlorothiazide, chlorthalidone, chlorothiazide, furosemide, torsemide, bumetanide, and spironolactone)
  • Digitalis glycosides, that help the heart muscle contractcorrectly and help treatsome heart arrhythmias
  • Angiotensin receptor blockers (ARBs), which can be taken in place of ACE inhibitors (i.e. losartan and candesartan)
  • Beta-blockers (i.e. carvedilol and metoprolol)

Certain medicines must not be taken as they may worsen congestive heart failure. These medicines include nonsteroidal anti-inflammatory drugs (NSAIDS), thiazolidinediones, metformin, cilostazol, PDE-5 inhibitors (sildenafil, vardenafil), and others. Discuss any medications with your physician

Juicing and Fasting: How Does This Work?

Juicing is one of the best ways to get your body fresh, pure natural ingredients without taxing your digestive system. Juicing requires little in the way of digesting and allows your body to absorb valuable nutrients immediately, which is also why juicing is a very effective means of fasting.

When your body becomes sluggish and lifeless, this could be a sign that there is a buildup of toxins in your system and that your body truly needs a break from all the work it is doing. The typical American diet is rich in processed foods which are difficult for the body to digest and process. When the body gets too many of these difficult to digest foods it begins to slow down and it begins to function less efficiently. This means there is less energy available to you to use, because all of the energy your body can produce is going to work attempting to digest your food. Unless your body is able to catch up and become more efficient in the digestive process, the toxins that have been built up can begin to cause damage in the body and cause illness. To prevent this from happening, a juice fast may be in order. *Please note if you have any existing health conditions, ALWAYS check with your health practitioner prior to starting anything new, including starting a juice fast.

The idea of fasting seems a little frightening, especially because the image one conjures up upon hearing the word fast, is a long, painful stint without food. This does not have to be the case, nor do you need to be taking in a bunch of supplements and vitamins as you starve your body from precious nutrients. A juice fast can be as simple as giving your body a break for one day, giving your digestive system a chance to catch back up and become more efficient again. One day of drinking fresh, vegetable and fruit juices will allow your digestive system, including all the organs included in the process of elimination, to take a break and will simultaneously give your body the necessary vitamins and nutrients necessary to restore healthy function.

If you have not tried juicing before or do not have a diet that includes vegetables and fruits, a juice fast may be too much for your digestive system to handle at once. You should keep the juice fast in mind and prepare your body for this. In order to prepare your body, you will need to take in fruits and vegetables multiple times a day for at least one week. This is because the extreme dietary change could cause your system to overreact. If your body is not accustomed to vegetables and fruits, it will need to have time to adjust before overloading it pure juice and nothing else for an entire day.

To begin a juice fast simply wake up and get ready for the day. For breakfast it may be optimal to try a juice made of a head of romaine lettuce, ½ lemon, 2 carrots, an apple and 4 sprigs of parsley. This will be mild on your system, fill you with nutrients and give you energy to begin your day. The clean feeling from the juice will begin immediately, which will encourage you to keep going throughout the day. Remember the juice fast is only one day in length, but the benefits to your cells, your digestive system and your organs will last for a long time to come.

Throughout the day remember to keep drinking water, water with lemon, herbal teas, and fresh fruit and vegetable juices, nothing with sugar or anything artificial added. It is best to try to stick with predominantly vegetable juices, but fruits may be included in smaller numbers. The sugar in the fruits is not ideal for the fast and thus should be minimized. As you fill your day with fresh juice and plenty of water, you are filling your body with energy, nutrition and rest! A monthly, or even weekly, juice fast is a healthy way of keeping your body functioning at a high rate and a way of decreasing the amount of stress and toxins that accumulate and released in your body. All said, it is a great way to take care of your body so it will continue to perform and take care of you!

The Truth About Cholesterol


I am going to let you in on something shocking. Cholesterol is not the major culprit in heart disease. I know this may be hard to believe after all we have heard about the dangers of high cholesterol from our doctors, and the media. But the truth is, it is not the cholesterol levels themselves or the cholesterol containing foods that are the culprits in heart disease, it is those foods and any other thing that causes inflammation in your body that is the major cause of heart disease (as well as diabetes and high blood pressure).

What is cholesterol and why do we need it?

Cholesterol is a soft, waxy substance found among the lipids (fats) in the bloodstream and in all your body’s cells. It’s an important part of a healthy body because it’s used to form cell membranes. Cholesterol also aids in the manufacture of bile (which helps digest fats), and is also important for the metabolism of fat soluble vitamins, including vitamins A, D, E and K. It is the major precursor for the synthesis of vitamin D and of the various steroid hormones (which include cortisol and aldosterone in the adrenal glands, and the sex hormones progesterone, the various estrogens, testosterone, and derivatives ).

How could something so good be so bad?

Cholesterol has been wrongly accused because upon inspection of the arteries of someone at risk for a heart attack, levels of cholesterol and plaque build up are very high. Cholesterol is actually being transported to tissues as part of an inflammatory response that is there to repair damage. It will only lodge itself onto the artery and cause plaque if the artery has become damaged. Inflammation in the artery is what causes this damage. In fact, it is now known that the coronary disease that causes heart attacks is now considered to be caused mostly from chronic inflammation.

To blame cholesterol for heart attacks would be the equivalent of blaming increased police security in a high crime area. It was not the police that caused the crime, they were just placed there in response to the crimes.

A more important question to ask ourselves, is how do we decrease the amount of inflammation in our bodies so that cholesterol will not bind to our arteries?

We must decrease all of those things that we do that cause inflammation and increase things that decrease inflammation. First and foremost we must stay away from foods that cause inflammation in our bodies. Any food that causes a fast rise in blood insulin levels will quickly cause inflammation in the body. These foods are sugar, white breads, most dairy products and almost all packaged and processed foods. What does this leave you with? Fresh, wholesome foods such as fruits, vegetables, lean animal proteins, nuts, and lots and lots of water. Also, taking in lots of omega-3 rich foods will dramatically decrease inflammation in the body (salmon, organic eggs, walnuts and sardines).

What about your cholesterol medication?

Some may be thinking, it is just easier to take a pill and not have to change what I am eating. But you may want to think twice considering the side effects of statins (cholesterol lowering drugs). The most common side effects reported are fatigued, headaches, nausea and the most common of them all, severe muscular pains and muscular degeneration. If you remember that cholesterol is essential for the formation of cell membranes, taking a drug that is drastically lowering cholesterol may be causing membrane damage in neural and muscle tissue. Most people on statins complain of neck, back or leg pain.

Millions of Americans are now on cholesterol lowering drugs, but the number of people suffering from heart attacks and heart disease is only increasing. Let’s take a personal responsibility for our health and truly get to the root of the problem. Managing your diet and staying away from those foods that are causing an inflammatory response in your body is your first step to decreasing your chance of heart disease and heart attacks.

Get Started on Your Own Weight Loss and Health Goals right away with these Simple and Effective Healthy Meal Plans.

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Type 2 Diabetes – Lower Your Blood Sugar Levels and Body Weight Without Goal Setting

Our suggestion to not set health and fitness goals may come to you as a surprise. Most people believe in setting goals, which is not inherently wrong. It is ambitious, it can be fruitful, and it may even be fulfilling. But you should note there are no guarantees – whether it ultimately proves successful is entirely conditional. As you are about to discover, more often than not health and fitness goals lead to disappointment, if not outright failure.

The alternative is to set your sights on the process, or system, instead of the objective. While you could argue doing so implies you are striving towards an ultimate goal regardless, the difference is what merits your attention. And it is where your focus lies that determines your chances of succeeding.

To clarify, let us go over an example. We will start with a health and fitness goal of losing 20 pounds and lowering your blood sugar levels.

We are not suggesting you do not do your best to lose weight or reverse your prediabetes or Type 2 diabetes. But if you set highly specific goals, you are going to burden yourself with big expectations. You will regularly remind yourself you “need” to lose 20 pounds and lower your blood sugar. When you are making progress, this is fine. But when you stall, you are going to start second-guessing: you are going to fear failure. Your confidence in your ability to succeed will take a hit, which could make you take your hard-earned progress for granted.

Congratulations if you do succeed. But what comes next? Will you feel you need to set another goal due to your goal-setting mentality making you feel aimless without one? Even if you succeed with some important goals, you are going to miss out on others. This is likely to hurt your self-esteem, and potentially make you feel depressed at your inability to succeed.

If your intention is to lose weight and better your health, it is infinitely better to focus on the responsible process or system. In the case of lowering your blood sugar and reducing your weight by say 20 pounds, this involves healthy eating and exercising. Instead of focusing on your ultimate goal, concentrate on eating well today. Exercise not to help you to reduce your weight but because it is necessary for a healthy body. And trust your blood sugar is going to be lower the next time you go in for a check-up because you have changed your food choices and adopted a healthier lifestyle.

When you concentrate on the process itself, it is impossible to feel upset. Consequently, you are more likely to make progress. If you live a healthier life by actively managing your food choices and overall lifestyle, you will avoid the ups and downs that come with goals, while gaining the same benefits. And you will avoid feeling aimless or frustrated, which is common for goal-setters.

Why Is Vitamin D So Important?

In the last 20 years, there has been tremendous research in the field of vitamin D. The findings are astounding! We now know that vitamin D affects almost every organ system in the body. New Scientific Research Links Vitamin D Deficiency to Cancer, Heart Disease, Diabetes, High Blood Pressure, Kidney Disease, Fibromyalgia, Chronic Fatigue, Osteoporosis, Arthritis, Lupus, M.S., Asthma, Thyroid Diseases, Dental Problems and Depression.

We now know that:

  1. Vitamin D plays a vital role in the health of muscles and bones. It not only helps in the absorption of calcium and phosphorus from the intestines, but it also exerts a direct effect on the health of the bones. Therefore, vitamin D can prevent as well as treat muscle aches, bone pains, chronic fatigue and osteoporosis.
  1. Vitamin D plays a vital role in the normal functioning of the immune system. Therefore, vitamin D can prevent as well as treat immune disorders such as asthma, rheumatoid arthritis, Type 1 diabetes, Crohn’s disease and Multiple Sclerosis (MS). By boosting up your immunity, it can also protect you against infections such as common colds and tuberculosis.
  1. Vitamin D controls the growth of normal as well as cancerous cells. Hence, vitamin D can play an important role in the prevention as well as treatment of various cancers especially cancer of the colon, prostate, pancreas and breast.
  1. Vitamin D stimulates the production of insulin from insulin – producing cells in the pancreas. It also reduces insulin resistance. Therefore, vitamin D can help in the prevention as well as treatment of Type 2 diabetes.
  1. Vitamin D inhibits the Renin Angiotensin Aldosterone System (RAAS). Renin is a chemical normally produced in the body. It leads to the production of another chemical, called Angiotensin which is responsible for maintaining your blood pressure. Angiotensin also causes release of another chemical, called Aldosterone which is also involved in maintaining your blood pressure. Together, this system of inter-related chemicals is called Renin Angiotensin Aldosterone System (RAAS).  If RAAS becomes overactive, it causes high blood pressure (hypertension), kidney disease and heart failure. Now consider this: Vitamin D inhibits RAAS, and therefore, it can prevent hypertension, kidney disease and heart failure.
  1. Vitamin D can prevent coronary heart disease through a number of mechanisms which include inhibition of RAAS, reduction in insulin resistance and reduction of inflammation in the blood vessel wall.
  1. Vitamin D affects the normal function of the skin and therefore can be helpful in the treatment of skin disorders such as Psoriasis.
  1. Vitamin D affects the health of the teeth and therefore can play an important role in preventing many dental problems.
  1. Vitamin D affects one’s mood and therefore can play an important role in the prevention and treatment of mood disorders such as depression.

Isn’t it obvious that vitamin D plays a crucial role in maintaining our health?  It’s a breakthrough discovery!  Now we can truly prevent and treat a number of diseases through proper vitamin D supplementation.

“Why hasn’t my Doctor told me about all the beneficial effects of Vitamin D?”

Unfortunately, this exciting new knowledge hasn’t reached the radar screen of most physicians, nor has it reached the curriculum of medical schools. Why? Because no drug company is behind it.  It’s not a drug. It’s cheap and you can obtain it over the counter. Unfortunately, most of our medical research, medical guidelines for practicing physicians and medical knowledge in text books is dependent upon drug companies in one way or another. Sad but true!

It may take years before this revolutionary knowledge finds its way into medical books and physician’s offices. But you don’t have to wait that long. Get involved in taking charge of your health.  Reading Power of Vitamin D is a step in the right direction.

Effective Church Growth Strategies for Christian Leaders

Many new found churches aspire to know the secrets of church growth. Studies, conferences and books are full with advice on effective church growth strategies that Christian leaders should consider to become mega churches. These recommendations usually come from churches that experienced significant growth and success stories. Christian churches believe that only God can make a church grow and that growth is defined not in numbers but in the quality of its members. However, this does not stop them from finding ways to better serve God and the congregation.

One of the conferences that taught effective church growth strategies was How to Grow a High Impact Church Conference.  It aims to encourage and empower church leaders to grow a church with high impact. It emphasizes that having a high impact is not just about growing in number but is concerned with making a difference in the community, the result of which is giving glory to God for what He extraordinarily does through ordinary people. High impact churches have three salient characteristics: lost people come to Christ, found people begin to mature and the church influences the community. Churches are taught to understand the twelve laws of building a healthy growing church:

  1. The Law of Purpose– growing churches know the purpose of the church, which is to have a great commitment to the Great Commission and the Great Commandment.
  2. Te Law of Expectation- growing churches believe in the natural, supernatural and imperative growth of the church.
  3. The Law of design- growing churches empowers leaders to equip members for service.
  4. The Law of Liberation- growing churches train members to exercise their spiritual gifts.
  5. The Law of Dependency-growing churches have members that spend regular times of prayer and fasting individually and corporately.
  6. The Law of Structure- growing churches understand that there are God ordained roles and functions within the church and they understand their church structures
  7. The Law of Inspiration-growing churches are devoted to develop and enhance worship service.
  8. The Law of Focus- growing churches have an outward focus and emphasize evangelism in obedience to God’s commission.
  9. The Law of Community- growing churches care and shepherd their flocks through small groups
  10. The Law of Intentionality- growing churches proactively develop church plans and courses to take to fulfill their mission.
  11. The Law of Love- growing churches promotes a loving and caring fellowship among its members
  12. The Law of the Kingdom-growing churches promotes unity with likeminded churches through joint prayer, worship, interaction and support in times of need.

C. A. Schwarz conducted a study to determine the causes of church growth. The survey, which was attended by 4.2 million respondents in 32 countries, served as the basis of determining a number of distinguishing attributes of a healthy growing church. These are: an effective leadership, convenient outlets for spiritual gifts, passion and desire for service, ideal facilities and resources, exalting praise and worship, growth through discipleship and small groups, consistently reaching out to the lost, and healthy relationships between members. The study concludes that people can and should do effective church growth strategies. However, people should also understand what they could not do because it is in God’s domain.

Monoculture Farming – Disadvantages And Negative Effects On The Environment

The term monoculture in agriculture refers to the growing of a single crop over a large area. Monoculture is the norm in most large-scale commercial agriculture in the U.S. and in many parts of the world. Monoculture has certain short-term benefits, primarily in terms of economy of scale, and automation of the production process (and thus reduction of labor costs). However, in the long-term, the disadvantages of monoculture are overwhelming – this farming method has numerous negative effects on the environment, and furthermore, these negative effects tend to become amplified over the long-run. This article weighs the pros and cons of this sort of uniform approach to agriculture, and points to some alternative practices that are more sustainable, both environmentally and economically, and thus superior on all counts in the long-run.

Pros and cons of monoculture farming: what are its advantages?

It is immediately evident that I am not a fan of or advocate for monoculture. But there are some direct and strongly compelling reasons that people engage in this destructive practice. Before we talk about why this practice is so harmful, I find it fruitful to first examine its benefits or advantages.

The main advantage is economy of scale, primarily through automation. Especially in the U.S., labor costs are very high, so anything that can reduce the use of labor in agriculture is highly likely to result in cost savings. This is often true even when the automation reduces yield per acre. For example, if a crop has been grown, it can often be harvested in different ways, with different levels of automation. Greater automation in harvesting might result in greater waste, such as grain left in the fields, but if it requires less labor (such as one person driving a large machine which covers the ground very quickly, as opposed to several people driving smaller, slower machines, or many people harvesting the crop by hand) it may be superior in a cost-benefit analysis, even if it results in greater waste.

Disadvantages of monoculture farming:

The most compelling disadvantage of monoculture farming is that it is not adaptable. Wild ecosystems are diverse, and wild populations of plants and animals are also diverse. An ecosystem contains numerous different species, each with unique adaptations to its environment, and distinct strengths and weaknesses in response to changing conditions. Similarly, the natural population of a plant or animal species has genetic variability, and each individual plant or animal has slightly different traits. Furthermore, each population, and the ecosystem as a whole, is constantly changing, adapting to the changing environmental conditions and the conditions imposed by the other populations and species in the system.

Monoculture smooths out this variability, destroying the diversity and replacing it with, at best, a single species, and at worst (as is the norm in the U.S.), a single cultivar – rows and rows of genetically identical crops, essentially cloned, reproduced through cuttings or genetically engineered seed stock.

Susceptibility to pests:

The ecological landscape of monoculture is that there is a massive range of genetically identical plants, against a backdrop of wild pests, which include fungi, bacteria, insects, and numerous other organisms. These pests each have a wild population with its own biodiversity, and their populations are constantly changing and adapting to being able to eat the crops or benefit from the presence of whatever crops are being grown. The monoculture crops, however, are not.changing, and are not able to adapt because they have no genetic variability and are not allowed to reproduce naturally. Plant pests, weeds, also adapt, seeding into the fields of crops, taking advantage of the extra sunlight, as most monoculture crops let through ample light and are not making full use of the sun’s energy.

The only way to control pests in this setup is to expend ever-greater energy and resources on chemical control, either through the spraying of pesticides, fungicides, or bactericides on crops, or through the genetic engineering of crops to enable them to produce these chemicals themselves. But without the natural adaptation, pests will eventually evolve to resist any of these defenses. The setup of monoculture is inherently doomed, as it is working against the natural ways in which ecosystems work. It is completely unsustainable in the long-run.

Negative environmental impacts of monoculture:

Because monoculture farming requires ever-increasing levels of chemical inputs, the negative impacts on the environment are also continuously increasing. Although people often prefer to use safer chemicals when they exist, and use them in as low a concentration as possible, any safe chemical will necessarily eventually stop working. Many of the chemicals used in commercial agriculture are known to be toxic and/or carcinogenic, or have other negative impacts on humans. But even chemicals that are safe for human consumption or exposure can have negative impacts on the environment; for example, roundup, a widely used herbicide, is much more toxic to amphibians than it is to humans.

Other negative effects of monoculture:

Besides the negative environmental effects, monoculture also destroys our culture. Monoculture and large-scale factory farming is in large part responsible for or associated with the alienation of Americans from the practice of farming, and the move from an economy in which a large portion of people were directly involved in farming towards a society in which people see food as an industrial product to be purchased in a store, with little idea of where it comes from.

Beyond monoculture: how you can help protect the environment and food and farming culture:

The empire of factory farming and wide-scale monoculture is thankfully crumbling. You can do your part by learning more about gardening, by experimenting with growing some of your own food, even if you just have a small city yard, or even growing some indoors or on a porch or balcony if you do not have a yard. You can also explore farmer’s markets with locally grown food, and encourage small-scale, local production, by diversified farming methods, by using your money to support these farmers. As we return to diversified agriculture, we will become more connected to our food, and help protect our environment as well.

Bone Up on Extensive CPT Changes to Musculoskeletal System Codes

CPT and the AMA may have just made the orthopedic coder’s life a little easier. CPT 2002 includes 89 changes to codes in the musculoskeletal system chapter, 31 of which are new codes. Eight of these new codes deal with arthroscopic surgery and will in many cases eliminate the need for submitting unlisted-procedure codes for surgeries that up until now had no CPT code .

The 2002 changes go into effect Jan. 1, 2002. Practices should plan changes to super bills, encounter forms, charge tickets, etc., but hold off on implementation until after Jan. 1.

According to Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopedic Associates in New Brunswick, N.J., many carriers do not update their fee schedules until February or March, so poll your major payers to determine when they will activate new CPT codes. Jumping the gun can result in a rash of denied claims” ” Stout says.

Note: New codes appear here in bold type and revised codes are in plain type. As in past issues all new revised and deleted codes are listed in Appendix B of CPT 2002.

Dotting I’s and Crossing T’s

Many of the changes to existing codes involve the slightest grammatical or even punctuation changes but even those slight revisions can change the nature of the code. For instance 20225 now reads: biopsy bone trocar or needle; deep (e.g. vertebral body femur). The only change in the code definition is the addition of “e.g.” But the change means that a deep bone biopsy includes but is not limited to the vertebral body or the femur.

The most minor changes appear in the 21182-21184 code group (reconstruction of orbital walls rims forehead nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone [e.g. fibrous dysplasia] with multiple autografts [includes obtaining grafts]; total area of bone grafting ). The choice of code depends on the size of area of bone grafting e.g. 40 square centimeters. That measurement used to be shown as 40cm but the term for the measurement is now 40 sq. cm.

New and Revised Injection Codes

The 20000 series of injection codes includes a number of new entries. These new codes offer options for reporting injection of the carpal canal for carpal tunnel syndrome as well as a range of codes for reporting those troublesome trigger-point injections. Expansion of this section of codes will allow for more accurate reporting and less confusion about location purpose and number of injections rendered.

  • 20526 injection therapeutic (e.g. local anesthetic corticosteroid) carpal tunnel.
  • 20550 injection; tendon sheath ligament ganglion cyst.
  • 20551 injection; tendon origin/insertion.
  • 20552 injection; single or multiple trigger point(s) one or two muscle group(s).
  • 20553 injection; single or multiple trigger point(s) three or more muscle groups.

    Miscellaneous Changes

    Several other codes have been rewritten with slight additions or deletions of terms to make them clearer or more consistent with current medical terminology.

  • 21750 closure of median sternotomy separation with or without debridement (separate procedure).
  • 23000 removal of subdeltoid calcareous deposits open.
  • 23350 injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography.
  • 27447 arthroplasty knee condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty).

The term “soft tissue” was added to a number of codes for the excision of subcutaneous and deep tumors (24075 24076 25075 25076 26115 and 26116) to solidify their use for soft tissue masses only and not bony tumors.

More Elbow Room

Important additions were made to the humerus (upper arm) and elbow section which has remained essentially untouched for years providing coders with a wider more specific range of codes for identifying surgeries to the arm. Stout says the big plus with these new codes is that for many common surgeries they eliminate the need for an unlisted-procedure code (24999 unlisted procedure humerus or elbow) and the accompanying reimbursement hassles. Physicians who perform ulnar collateral ligament repairs will be especially pleased with the new codes for reporting this service.

  • 24075 excision tumor soft tissue of upper arm or elbow area; subcutaneous.
  • 24076 excision tumor soft tissue of upper arm or elbow area; deep (subfascial or intramuscular).
  • 24300 manipulation elbow under anesthesia.
  • 24332 tenolysis triceps.
  • 24343 repair lateral collateral ligament elbow with local tissue.
  • 24344 reconstruction lateral collateral ligament elbow with tendon graft (includes harvesting of graft).
  • 24345 repair medial collateral ligament elbow with local tissue.
  • 24346 reconstruction medial collateral ligament elbow with tendon graft (includes harvesting of graft).

Clarifications for Wrist and Forearm Surgeries

A range of new and revised codes will offer more accurate coding options for surgery to the wrist and forearm. The code changes offer greater specificity as evidenced by the expanded range of codes for decompressive fasciotomies.

Many of the changes are minor giving more clarification as to what is and isn’t included in surgeries of the wrist and forearm. Some of the most notable new codes here are 25001 for release of flexor carpi radialis tunnel syndrome 25259 for manipulation of the wrist joint and 25651 and 25652 for treatment of ulnar styloid fracture. Again the need to report an unlisted-procedure code (25999 unlisted procedure forearm or wrist) has been eliminated by the addition of these new codes.

  • 25001 incision flexor tendon sheath wrist (e.g. flexor carpi radialis).
  • 25020 decompression fasciotomy forearm and/or wrist flexor or extensor compartment; without debridement of nonviable muscle and/or nerve.
  • 25024 decompression fasciotomy forearm and/or wrist flexor and extensor compartment; without debridement of nonviable muscle and/or nerve.
  • 25025 decompression fasciotomy forearm and/or wrist flexor and extensor compartment; with debridement of nonviable muscle and/or nerve.
  • 25075 excision tumor soft tissue of forearm and/or wrist area; subcutaneous.
  • 25076 excision tumor soft tissue of forearm and/or wrist area; deep (subfascial or intramuscular).
  • 25259 manipulation wrist under anesthesia.
  • 25274 repair tendon or muscle extensor forearm and/or wrist; secondary with free graft (includes obtaining graft) each tendon or muscle.
  • 25275 repair tendon sheath extensor forearm and/or wrist with free graft (includes obtaining graft) (e.g. for extensor carpi ulnaris subluxation).
  • 25394 osteoplasty carpal bone shortening.
  • 25405 repair of nonunion or malunion radius or ulna; with autograft (includes obtaining graft).
  • 25420 repair of nonunion or malunion radius and ulna; with autograft (includes obtaining graft).
  • 25430 insertion of vascular pedicle into carpal bone (e.g. Harii procedure)
  • 25431 repair of nonunion of carpal bone (excluding carpal scaphoid [navicular[ (includes obtaining graft and necessary fixation) each bone.
  • 25440 repair of nonunion scaphoid carpal (navicular) bone with or without radial styloidecto my (includes obtaining graft and necessary fixation).
  • 25443 arthroplasty with prosthetic replacement; scaphoid carpal (navicular).
  • 25520 closed treatment of radial shaft fracture and closed treatment of dislocation of distal radioulnar joint (Galeazzi fracture/dislocation).
  • 25526 open treatment of radial shaft fracture with internal and/or external fixation and open treatment with or without internal or external fixation of distal radioulnar joint (Galeazzi fracture/dislocation) includes repair of triangular fibrocartilage complex.
  • 25645 open treatment of carpal bone fracture (other than carpal scaphoid [navicular]) each bone.
  • 25651 percutaneous skeletal fixation of ulnar styloid fracture.
  • 25652 open treatment of ulnar styloid fracture.
  • 25671 percutaneous skeletal fixation of distal radioulnar dislocation.

A Fist Full of Changes in Terminology

There is only one new code (26340) in the hands and fingers section but numerous terminology changes were made that clarified codes and removed obsolete terms. For example the term “zone 2” replaces “digital flexor tendon sheath” in CPT codes 26350 and 26356; “synthetic” replaces “prosthetic” in 26390 26392 26415 and 26416; and “polydactylous” replaces “supernumerary” in CPT code 26587.

The addition of the word “each” to the codes for treatment of carpometacarpal joint (CMC) dislocations (26670 26676 and 26685) and arthrodesis of the CMC joint (26843) invites coders to report these codes as multiples when this is appropriate. Code 26340 again offers a viable alternative to the unlisted-procedure code for finger manipulation.

  • 26115 excision tumor or vascular malformation soft tissue of hand or finger; subcutaneous.
  • 26116 excision tumor or vascular malformation soft tissue of hand or finger; deep (subfascial or intramuscular).
  • 26160 excision of lesion of tendon sheath or joint capsule (e.g. cyst mucous cyst or ganglion) hand or finger.
  • 26340 manipulation finger joint under anesthesia each joint.
  • 26350 repair or advancement flexor tendon not in zone 2 digital flexor tendon sheath (e.g. no man’s land); primary or secondary without free graft each tendon.
  • 26356 repair or advancement flexor tendon in zone 2 digital flexor tendon sheath (e.g. no man’s land); primary or secondary without free graft each tendon.
  • 26390 excision flexor tendon with implantation of synthetic rod for delayed tendon graft hand or finger each rod.
  • 26392 removal of synthetic rod and insertion of flexor tendon graft hand or finger (includes obtaining graft) each rod.
  • 26415 excision of extensor tendon with implantation of synthetic rod for delayed tendon graft hand or finger each rod.
  • 26416 removal of synthetic rod and insertion of extensor tendon graft (includes obtaining graft) hand or finger each rod.
  • 26426 repair of extensor tendon central slip secondary (e.g. boutonniere deformity); using local tissue(s) including lateral band(s) each finger.
  • 26428 repair of extensor tendon central slip secondary (e.g. boutonniere deformity); with free graft (includes obtaining graft) each finger.
  • 26510 cross intrinsic transfer each tendon.
  • 26585 deleted use 26587.
  • 26587 reconstruction of polydactylous digit soft tissue and bone.
  • 26590 repair macrodactylia each digit.
  • 26597 deleted use 11041-11042 14040-14041 15120 15240.
  • 26607 closed treatment of metacarpal fracture with manipulation with external fixation each bone.
  • 26607 closed treatment of carpometacarpal dislocation other than thumb with manipulation each joint; without anesthesia.
  • 26676 percutaneous skeletal fixation of carpometacarpal dislocation other than thumb with manipulation each joint.
  • 26685 open treatment of carpometacarpal dislocation other than thumb; with or without internal or external fixation each joint.
  • 26843 arthrodesis carpometacarpal joint digit other than thumb each.

    Pelvis and Hips Feet and Toes Revisions

    The pelvis and hip joint section of CPT has several code revisions but no additions. As with the other changes they are more specific but offer little substantive difference from the past edition of CPT.

  • 27110 transfer iliopsoas; to greater trochanter of femur.
  • 27130 arthroplasty acetabular and proximal femoral prosthetic replacement (total hip arthroplasty) with or without autograft or allograft.
  • 27132 conversion of previous hip surgery to total hip arthroplasty with or without autograft or allograft.
  • 27140 osteotomy and transfer of greater trochanter of femur (separate procedure).
  • 27185 epiphyseal arrest by epiphysiodesis or stapling greater trochanter of femur.

    There are a few changes to nomenclature in the foot and toes section but no new codes. The narrative for CPT code 28299 was tightened up a bit by replacing “other methods” with “by double osteotomy.”

  • 28104 excision or curettage of bone cyst or benign tumor tarsal or metatarsal except talus or calcaneus.
  • 28238 reconstruction (advancement) posterior tibial tendon with excision of accessory tarsal navicular bone (e.g. Kidner type procedure).
  • 28299 correction hallux valgus (bunion) with or without sesamoidectomy; by double osteotomy.
  • 28737 arthrodesis with tendon lengthening and advancement midtarsal tarsal navicular-cuneiform (e.g. Miller type procedure).

Casts and Strapping

One new code was added to the section on casts and strapping and one was revised.

  • 29049 application cast; figure-of-eight.
  • 29086 application cast; finger (e.g. contracture).

Arthroscopy Codes Added

The most meaningful changes to CPT 2002 for orthopedics are the addition of several new codes for arthroscopy. Sports medicine orthopedists should be pleased since they now have a means for reporting arthroscopic Bankart repairs (capsulorrhaphy) SLAP lesion repairs and distal clavicle resections.

The addition of 29806 29807 and 29824 alone means there are now codes to describe common arthroscopic shoulder surgeries that formerly had to be reported using 29909 (unlisted procedure arthroscopy). Orthopedic coders are painfully familiar with the denials extra documentation reimbursement reductions and other pitfalls that came with submitting this code. And as if to put those headaches to bed permanently CPT has eliminated 29909 replacing it with 29999. The change is largely symbolic as the language for 29999 remains just as it was for 29909 (unlisted procedure arthroscopy).

  • 29805 arthroscopy shoulder diagnostic with or without synovial biopsy (separate procedure).
  • 29806 arthroscopy shoulder surgical; capsulorrhaphy.
  • 29807 arthroscopy shoulder surgical; repair of SLAP lesion.
  • 29815 deleted use 29805.
  • 29824 arthroscopy shoulder surgical; distal claviculectomy including distal articular surface (Mumford procedure).
  • 29900 arthroscopy metacarpophalangeal joint diagnostic includes synovial biopsy.
  • 29901 arthroscopy metacarpophalangeal joint surgical; with debridement.
  • 29902 arthroscopy metacarpophalangeal joint surgical; with reduction of displaced ulnar collateral ligament (e.g. stenar lesion).
  • 29909 deleted use 29999.
  • 29999 unlisted procedure arthroscopy.

The downside to the new arthroscopy codes is that they may present bundling issues in 2002. According to Terry Fletcher BS CPC CCS-P CCS a healthcare coding consultant based in Laguna Beach Calif. bundling was less of an issue when unlisted-procedure codes were reported with other surgeries performed at the same setting. “Now with the new codes ” she says “coders should be aware of all of the new bundling issues that come with them and reimbursements will definitely be affected. It’s a good idea to start negotiating contracts with payers as soon as possible.”

Spotting the Signs of Lung Cancer

Lung canker is a very deadly disease. The most significant venture caused of this disease is cigarette smoking. Lung canker proves to be one of the most deadly vigor problems among Americans.

Studies show that lung blight account for twenty-eight percent of all plague deaths among American men and women.

Records extend show that lung canker is the most lethal spiteful growth worldwide causing up to three million deaths annually.

Even with the recognition that cigarette smoking is the major threat dynamic of lung growth, it is important to footnote that not all smokers die of lung melanoma but just the same, not all non-smokers are safe from lung bane.

It is more important to concede that early symptoms of lung disease will help guarantee modest management of this health risk provision.

Doctors deem that detection of early symptoms of lung pest will help halt the progression of lung growth and put the symptoms to cutback.

There are diverse treatments unfilled against this disease but if you will neglect the early symptoms of lung melanoma, it may be hard to cope and perhaps, it is already impossible to sway. This is because difficult perform of the disease already involves lesser bane sites developed in the other parts of the body.

Various treatments compose surgery, chemotherapy, radiation therapy, immunotherapy, radio immunotherapy and the new lung disease therapy, photodynamic therapy.

All the lung melanoma treatments will become rubbish especially if the detection of the bane is already on its superior scaffold.

Thus, it is required to identify early symptoms of lung growth to guarantee you will be able to halt the symptoms and not merely diminish the symptoms.

Early symptom of lung bane such as persistent coughing is usually associated with sheer pimples of the throat from smoking. This makes smokers neglect it and set it whisper.

Most smokers commonly care about lung sarcoma symptoms only when they see blood in the sputum. Do not tumble quarry to this site because, when you finally see blood in the sputum, this means that you are already on the complex podium of the lung sarcoma.

Other communal early symptoms of lung bane that is regularly neglected are hasty credence shortfall, chest agony and frequent tiredness, when you create concern all these signs and you are a smoker, you may neediness to see your physician and have him examine you for feasible signs of lung tumor.

The next symptoms of lung tumor, which will place to a future scaffold of the disease are habitual suitcases of pneumonia or bronchitis, and isthmus and facial abscess.

Ensure that you will not neglect early symptoms of lung melanoma to help you manage the disease properly. Visit your physician if you are a smoker torment from persistent coughing and recurrent fatigue.

Furthermore, if you are working in an environment where you are regularly exposed to impure air such as chemicals and asbestos ashes, even if you are not a smoker, you may poverty to repress with your doctor when you feel anything related to the early symptoms of lung melanoma.

There is yet no known therapy for this disease, thus detection of early symptoms of lung plague is the only defence you have to dodge this lethal cancer from touching your life.

It would also help to make surely you will not bear from lung cancer if you diminish smoking or fully remove smoking from your life and live a vigorous and active lifestyle.

Regular effect and ingestion a well-balanced diet will ensure you will not bear from lung cancer and will not experience even the early symptoms of lung cancer.

Swine Flu: Symptoms, Prevention and Treatment

Swine Flu: Symptoms, Prevention and Treatment

1Rathore K.S., 1Chauhan Priyanka, 1Sharma Surabhi, 1Rathore Savita, 1Vinod Kanwar, 2Nema R.K., 3Sisodia S.S.

1B.N.Girls College of Pharmacy, Udaipur-Raj.313002

2Rishiraj College of Pharmacy, Indore-Mp

3BN Pg College of Pharmacy, Udaipur


Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses known as H1N1) that infect the respiratory tract of pigs and result in nasal secretions, a barking-like cough, decreased appetite, and listless behavior. Swine flu produces most of the same symptoms in pigs as human flu produces in people. Swine flu can last about one to two weeks in pigs that survive. Swine influenza virus was first isolated from pigs in 1930 in the U.S. and has been recognized by pork producers and veterinarians to cause infections in pigs worldwide.

In a number of instances, people have developed the swine flu infection when they are closely associated with pigs (for example, farmers, pork processors), and likewise, pig populations have occasionally been infected with the human flu infection. In most instances, the cross-species infections (swine virus to man; human flu virus to pigs) have remained in local areas and have not caused national or worldwide infections in either pigs or humans. Unfortunately, this cross-species situation with influenza viruses has had the potential to change.

Investigators think the 2009 swine flu strain, first seen in Mexico, should be termed novel H1N1 flu since it is mainly found infecting people and exhibits two main surface antigens, H1 (hemagglutinin type 1) and N1 (neuraminidase type1). Recent investigations show the eight RNA strands from novel H1N1 flu have one strand derived from human flu strains, two from avian (bird) strains, and five from swine strains.

Influenza, commonly called “the flu,” is an illness caused by RNA viruses that infect the respiratory tract of many animals, birds, and humans. In most people, the infection results in the person getting fever, cough, headache, and malaise (tired, no energy); some people also may develop a sore throat, nausea, vomiting, and diarrhoea. The majority of individuals has symptoms for about one to two weeks and then recovers with no problems. However, compared with most other viral respiratory infections, such as the common cold, influenza (flu) infection can cause a more severe illness with a mortality rate (death rate) of about 0.1% of people who are infected with the virus.

The history of swine flu (H1N1) in humans

In 1976, there was an outbreak of swine flu at Fort Dix. This virus is not the same as the 2009 outbreak, but it was similar insofar as it was an influenza A virus that had similarities to the swine flu virus. There was one death at Fort Dix. The government decided to produce a vaccine against this virus, but the vaccine was associated with neurological complications (Guillain-Barré syndrome) and was discontinued. Some individuals speculate that formalin, used to inactivate the virus, may have played a role in the development of this complication in 1976.

There is no evidence that anyone who obtained this vaccine would be protected against the 2009 swine flu. One of the reasons it takes a few months to develop a new vaccine is to test the vaccine for safety to avoid the complications seen in the 1976 vaccine. New vaccines against any flu virus type are usually made by growing virus particles in eggs. A serious side effect (allergic reaction such as swelling of the airway) to vaccines can occur in people who are allergic to eggs; these people should not get flu vaccines. Individuals with active infections or diseases of the nervous system are also not recommended to get flu vaccines.

Swine flu is caused by The H1N1 or “swine flu” virus, which first appeared in April 2009, has gone on to become a worldwide “pandemic.” H1N1 influenza is a virus that causes illness in people and spreads from one person to another in the same way as the common flu. Detected first in April 2009 in Mexico, the disease soon spread across different countries in the world and was declared the swine flu pandemic by the World Health Organization in June 2009. After conducting several laboratory tests, it was determined that the virus responsible for swine influenza was similar to those found in pigs, thus prompting scientists to name it the swine (pig) flu.

Illness caused by the swine flu virus ranges from mild to extreme in different cases. While many of the patients have recovered even without medical treatment, the virus has also caused a number of deaths as well as hospitalizations, which has made it a matter of grave concern for the authorities. Any person, irrespective of age or sex can contract the disease but the risk seems bigger in children and old age people as also in people with lower immunity levels, pregnant women and people suffering from heart disease, kidney ailment or asthma. A person displaying swine flu symptoms should consult a medical practitioner immediately and get himself tested.

 Link between Guillain-Barre syndrome and swine flu vaccines

Guillain Barre Syndrome (GBS), a rare neurological disorder, was an identified risk with swine flu vaccines used in the United States in 1976 – it is thought that one extra case of GBS occurred with every 100,000 doses of vaccine. The reason why the 1976 vaccine increased the risk of GBS remains unknown. Many studies have looked at whether other flu vaccines used since 1976 carry a risk of GBS and no robust evidence of a causal link has been found. No cases of GBS have been found in the clinical trials of H5N1 vaccines.

Most illnesses caused by the swine flu epidemic were of a mild nature and patients recovered even without or with very little medication required. However, recently the virus has caused a lot of panic after a number of deaths were reported. The swine flu virus is extremely contagious and spreads through coughing and sneezing or when a person touches a contaminated surface and then touches his nose or mouth. The symptoms of swine flu are very similar to those of the seasonal flu such as high fever, runny nose, loss of appetite, cough, sore throat etc.

Infectious Period

Persons with swine influenza A (H1N1) virus infection should be considered potentially contagious for up to 7 days following illness onset. Persons who continue to be ill longer than 7 days after illness onset should be considered potentially contagious until symptoms have resolved. Children, especially younger children, might potentially be contagious for longer periods. The duration of infectiousness might vary by swine influenza A (H1N1) virus strain. Non-hospitalized ill persons who are a confirmed or suspected case of swine influenza A (H1N1) virus infection are recommended to stay at home (voluntary isolation) for at least the first 7 days after illness onset except to seek medical care.

Reason for why swine flu (H1N1) now infecting humans

Swine flu viruses may mutate (change) so that they are easily transmissible among humans. Many researchers now consider that two main series of events can lead to swine flu (and also avian or bird flu) becoming a major cause for influenza illness in humans.

First, the influenza viruses (types A, B, C) are enveloped RNA viruses with a segmented genome; this means the viral RNA genetic code is not a single strand of RNA but exists as eight different RNA segments in the influenza viruses. A human (or bird) influenza virus can infect a pig respiratory cell at the same time as a swine influenza virus; some of the replicating RNA strands from the human virus can get mistakenly enclosed inside the enveloped swine influenza virus. For example, one cell could contain eight swine flu and eight human flu RNA segments. The total number of RNA types in one cell would be 16; four swine and four human flu RNA segments could be incorporated into one particle, making a viable eight RNA segmented flu virus from the 16 available segment types.

Various combinations of RNA segments can result in a new subtype of virus (known as antigenic shift) that may have the ability to preferentially infect humans but still show characteristics unique to the swine influenza virus. It is even possible to include RNA strands from birds, swine, and human influenza viruses into one virus if a cell becomes infected with all three types of influenza (for example, two bird flu, three swine flu, and three human flu RNA segments to produce a viable eight-segment new type of flu viral genome). Formation of a new viral type is considered to be antigenic shift; small changes in an individual RNA segment in flu viruses are termed antigenic drift and result in minor changes in the virus. However, these can accumulate over time to produce enough minor changes that cumulatively change the virus’ antigenic makeup over time (usually years).

Second, pigs can play a unique role as an intermediary host to new flu types because pig respiratory cells can be infected directly with bird, human, and other mammalian flu viruses. Consequently, pig respiratory cells are able to be infected with many types of flu and can function as a “mixing pot” for flu RNA segments. Bird flu viruses, which usually infect the gastrointestinal cells of many bird species, are shed in bird feces. Pigs can pick these viruses up from the environment and seem to be the major way that bird flu virus RNA segments enter the mammalian flu virus population.

Swine flu emergency

Children should get urgent medical attention if they have fast breathing or trouble breathing, have bluish or gray skin color, are not drinking enough fluid, are not waking up or not interacting, have severe or persistent vomiting, are so irritable that the child doesn’t want to be held, have flu-like symptoms that improve but then return with fever and a worse cough, have fever with a rash, or have fever and then have a seizure or sudden mental or behavioral change. Adults should seek urgent medical attention if they have trouble breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, or flu-like symptoms that improve, but then come back with worsening fever or cough.

Swine flu precautions

Swine flu or the H1N1 virus is a type A influenza, which is normally reported in pigs and has rarely affected humans in the past. A few cases that had been reported in people, who had been around pigs, over the past few years, were of a mild nature. However, in April 2009, swine flu started to affect thousands of persons around the world, just days after being reported in a Mexican village, and thus prompted the World Health Organization to declare it a pandemic.

It is advisable to avoid travelling to affected countries and stay away from crowded places. The easily available swine flu mask can also protect from the virus. While there are no vaccines available that can guard against swine flu, certain precautions can ensure protection from this deadly disease.

Swine Flu High Risk Groups –

Swine flu high risk groups, people who are thought to be at risk for serious, life-threatening infections, are a little different and can include:

  • pregnant women
  • people with chronic medical problems, such as chronic lung disease, like asthma, cardiovascular disease, diabetes, and immunosuppression
  • children and adults with obesity

It is already known that you are particularly at risk if you have:

  • chronic (long-term) lung disease,
  • chronic heart disease,
  • chronic kidney disease,
  • chronic liver disease,
  • chronic neurological disease (neurological disorders include motor neurone disease, multiple sclerosis and Parkinson’s disease),
  • immunosuppression (whether caused by disease or treatment) or
  • diabetes mellitus.

Also at risk are:

  • patients who have had drug treatment for asthma within the past three years,
  • pregnant women,
  • people aged 65 and older, and
  • young children under five.
  • It is vital that people in these higher-risk groups who catch swine flu get antivirals and start taking them as soon as possible.

The complications of swine flu

One of the most common complications of any type of flu is a secondary bacterial chest infection, such as bronchitis (infection of the airways).This can become serious and develop into pneumonia. A course of antibiotics will usually cure this, but the infection sometimes becomes life-threatening. Other rare complications include:

  • tonsillitis,
  • otitis media (a build-up of fluid in the ear),
  • septic shock (infection of the blood that causes a severe drop in blood pressure),
  • meningitis (infection in the brain and spinal cord), and
  • encephalitis (inflammation of the brain).

Swine flu symptoms – Know it to avoid it

As the H1N1 Influenza spreads its wings over different parts of the globe, it is extremely important to be familiar with the symptoms of swine flu so that the disease can be detected at an early stage and preventive measures can be taken to check its rise.

If you or any of the persons around you are suffering from fever in excess of 100.4 °F as well as any of the other below mentioned H1N1 influenza symptoms, then you may have contracted swine flu.

  • The most common of all swine flu symptoms is high body temperature, in excess of 38 °C/100.4 °F.
  • Swine flu (swine influenza) is a respiratory disease caused by viruses (influenza viruses) that infect the respiratory tract of pigs and result in nasal secretions, a barking-like cough, decreased appetite, and listless behavior.
  • Headache
  • Loss of appetite
  • Stinging throat
  • Runny nose
  • Extreme tiredness (fatigue)
  • Aching muscles
  • dyspnea
  • chills
  • Loss of energy, vomiting
  • Diarrhea
  • myalgia
  • influenza-like illness (fever, cough or sore throat)
  • mild respiratory illness (nasal congestion, rhinorrhea) without fever and occasional severe disease also has been reported
  • Conjunctivitis
  • Sudden, persistent cough

While these symptoms can be considered an indication of swine flu, the symptoms have also been reported in people suffering from other diseases. Therefore, despite having these symptoms, the patient or the doctor cannot be sure of swine flu until the test reports confirm the same. The disease is especially dangerous for children, where it can result in neurological disorders or alterations in the state of mind. It is still not clear why the situation occurs, but if not treated, it can prove to be fatal.

As with any sort of flu, how bad the symptoms are and how long they last will vary depending on treatment and individual circumstances. Most cases reported in the UK to date have been relatively mild, with affected people starting to recover within a week.

You can go back to school or work when you are feeling well and are no longer infectious. Adults are most infectious soon after they develop symptoms and remain infectious while their symptoms continue, which is usually for up to five days. They can normally return to work within seven days. In children, symptoms continue for up to seven days and they can normally return to school within 10 days.

Diagnosis of swine flu (H1N1)

Swine flu is presumptively diagnosed clinically by the patient’s history of association with people known to have the disease and their symptoms listed above. Usually, a quick test (for example, nasopharyngeal swab sample) is done to see if the patient is infected with influenza A or B virus. Most of the tests can distinguish between A and B types. The test can be negative (no flu infection) or positive for type A and B. If the test is positive for type B, the flu is not likely to be swine flu (H1N1). If it is positive for type A, the person could have a conventional flu strain or swine flu (H1N1). However, the accuracy of these tests has been challenged, and the U.S. Centers for Disease Control and Prevention (CDC) has not completed their comparative studies of these tests. However, a new test developed by the CDC and a commercial company reportedly can detect H1N1 reliably in about one hour; as of October 2009, the test is only available to the military.

Swine flu (H1N1) is definitively diagnosed by identifying the particular antigens associated with the virus type. In general, this test is done in a specialized laboratory and is not done by many doctors’ offices or hospital laboratories. However, doctors’ offices are able to send specimens to specialized laboratories if necessary. Because of the large number of novel H1N1 swine flu cases (as of October 2009, the vast majority of flu cases [about 99%] are due to novel H1N1 flu viruses), the CDC recommends only hospitalized patients’ flu virus strains be sent to reference labs to be identified.

Points to remember

Swine flu spreads through an infected person’s secretion released at the time of sneezing or coughing. People with symptoms of swine flu can pass on the disease to others from one day before to seven days after getting the infection. The virus can also contaminate surfaces and infect a healthy person if he happens to touch his nose or mouth after touching the dirty surface.

Swine Flu Test

Swine flu or the H1N1 virus is a disease that has spread in a large number of countries around the world in a very short span of time. It is the alarming rate with which the disease spreads that has worried experts, who are trying to check its rise. Swine flu symptoms are a lot like the symptoms of seasonal flu, which makes it extremely difficult to distinguish between the two without carrying out prescribed swine flu tests in the laboratories set-up especially for the purpose.

Steps to ensure swine flu protection

Simply by following the simple guidelines here, you should at least lessen your chances of becoming sick with Swine Flu. Like in the case of seasonal flu, the below mentioned precautions can help protect you against the H1N1 virus:

  • Avoid going near people with swine flu symptoms.
  • Avoid going to crowded places.
  • Cover your mouth and nose properly with a tissue while sneezing or coughing and dispose off the infected tissue in a proper way, away from the reach of other people.
  • It is recommended to get a seasonal flu vaccination. Though it may not prevent you from swine flu, it won’t do any harm.
  • Keep good hygiene and wash your hands regularly with soap and warm water. It is advisable to use an alcohol based hand wash. Use the antibacterial soaps to cleanse your hands. Wash them often, for at least 15 seconds and rinse with running water.
  • Get enough sleep -Try to get 8 hours of good sleep every night to keep your immune system in top flu-fighting shape.
  • Drink sufficient water-Drink 8 to10 glasses of water each day to flush toxins from your system and maintain good moisture and mucous production in your sinuses.
  • Sick people should stay home to avoid passing on the disease to others.
  • Always wear the swine flu mask when travelling to crowded places.
  • Disposing of dirty tissues promptly and carefully.
  • Cleaning hard surfaces, such as door handles, often and thoroughly using a normal cleaning product.
  • Carry anti-viral medicines with you.
  • If you feel sick or show any of the swine flu symptoms, consult your doctor immediately and get yourself tested for the virus.
  • Boost your immune system-Keeping your body strong, nourished, and ready to fight infection is important in flu prevention. So stick with whole grains, colorful vegetables, and vitamin-rich fruits.
  • Keep informed-The government is taking necessary steps to prevent the pandemic and periodically release guidelines to keep the pandemic away. Please make sure to keep up to date on the information and act in a calm manner.
  • Do not risk it. If you are experiencing influenza like symptoms, simply stay home. Since these symptoms mirror regular cold and influenza symptoms, it is better to be safe than sorry.
  • Find out how to cough and sneeze. Here’s the deal – cough or sneeze into the interior of your elbow on your arm. This is the only way to keep from spreading germs to your hands and to everything you touch.
  •  A little hand sanitizer goes a long, long way. Simply have a tube of hand sanitizer with you at all time. This way you can continually clean your hands.
  •  Be wary of public places. Door handles and even ink pens are breeding grounds for germs. Avoid touching them at all costs.
  •  Be cautious on airplanes, trains and buses. The close quarters of an aeroplane is a place where germs like the swine flu pathogen lurk so protect yourself.
  • Wash your vegetables and fruit entirely. Purchase your vegetables and vegetables locally if you can. Wash them with water and soak them to extend the effectiveness.
  •  Go to your doctor. If you are experiencing any flu like symptoms you should see your doctor at once. As stated earlier, only your health practitioner can diagnose your particular strain of the flu.

Swine flu treatment – Don’t panic

Although swine flu has been spreading at a rapid pace in India as well as in most other countries of the world, it must be remembered that swine flu is a curable disease and can be effectively cured if treated properly. As is the case in seasonal flu, the treatment of swine flu includes-

  • Proper rest and care.
  • A swine flu patient must not be involved in too much strenuous work and
  • Should drink plenty of liquids to keep himself hydrated.
  • Alcohol and tobacco are strictly prohibited for swine flu patients and medicines such as paracetamol can be taken to get relief from fever and muscle pain.
  • In extreme cases, antiviral drugs and hospitalization may be required. The best way, however, to avoid any emergency situation is to contact your doctor immediately if you suspect of having swine flu. If you happen to recently travel to an infected region or have been around those infected with the virus, then contact your doctor and take all preventive steps to ensure your safety. Remember, early detection will lead to proper treatment being administered and could mean the difference between life and death.
  • Keep the patient in a separate room, away from other members of the household.
  • Everyone in the house should wash their hands regularly and wear a mask while going near the patient.
  • The members of the house should also take antiviral drugs such as tamiflu, if the doctor prescribes it.
  • Children should not be given medicines such as aspirin for its tendency to cause neurological disorders.

Remember, prevention is better than cure

Although no swine flu vaccine is available in the market to ensure safety against the disease, certain medicines, which can cure the disease, are available. This virus is resistant to the antiviral medications amantadine (Symmetrel) and rimantadine (Flumadine). There are 2 medications in the market that have been shown to be effective against swine flu zanamivir (Relenza) and oseltamivir (Tamiflu). These medicines have to be administered within 2 days of the onset of symptoms (which last about a week), and are said to shorten the duration of symptoms by about 2 days. Because early detection is vital for the efficacy of these drugs, rapid detection is necessary. Many manufacturers are currently working on versions of a rapid swine flu test to allow early detection in minutes, as opposed to days as is with traditional virus testing.

To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of itself. Relenza stops the release of new copies of the virus from infected cells in the lungs. This slows the spread of the virus, reduces the symptoms and length of time that you feel unwell for and makes it harder for the virus to spread to other people. Relenza should first be taken within 48 hours of symptoms appearing in adults (36 hours in children). It works better the earlier you start taking it.

To reproduce and spread, a virus has to enter your body, take over healthy cells and force them to make copies of it. Tamiflu stops the flu virus entering your cells and blocks the release of new copies of the virus. This slows the spread through your body, reduces the symptoms and the length of time that you feel unwell for and makes it harder for the virus to spread to other people. Tamiflu should first be taken within 12 to 48 hours of symptoms appearing. It works better the earlier you start taking it.

Relenza reduces the duration of flu symptoms by one-and-a-half days on average. Tamiflu reduces the duration of symptoms by up to two days.

Vaccine for H1N1 swine flu

The best way to prevent novel H1N1 swine flu would be the same best way to prevent other influenza infections, and that is vaccination. The CDC has multiple recommendations for vaccination based on who should obtain the first doses when the vaccine becomes available (to protect the most susceptible populations) and according to age groups. The CDC based the recommendations on data obtained from vaccine trials and infection reports gathered over the last few months. The current (October 2009) vaccine recommendations from the CDC say the following groups should get the vaccine as soon as it is available:

  • pregnant women,
  • people who live with or provide care for children younger than 6 months of age,
  • health-care and emergency medical services personnel,
  • people between 6 months and 24 years of age, and

People from the ages of 25 through 64 who are at higher risk because of chronic health disorders such as asthma, diabetes, or a weakened immune system.

Currently, the CDC is stating that people ages 10 and above are likely to need only one vaccine shot to provide protection against novel H1N1 swine flu and further suggest that these shots will be effective in about 76% of people who obtain the vaccine. New vaccine trial data showed that healthy adults produce protective antibodies in about 98% of people in 21 days. Unfortunately, the vaccine shot in children ages 6 months to 9 years of age is not as effective as it is in older children and adults. Consequently, the CDC currently recommends that for ages 6 months up to and including 9 years of age, the children obtain two shots of the novel H1N1 vaccine, the second shot 21 days after the first shot.

Pregnant women are strongly suggested to get vaccinated as stated above. Although some vaccine preparations (multidose vials) contain low levels of thimerosal preservative (a mercury-containing preservative), the CDC still considers the vaccine safe for the fetus and mother. However, some vaccine preparations that are in single-dose vials will not have thimerosal preservative, so those pregnant individuals who are concerned about thimerosal can get this vaccine preparation when it is available.

Another type of vaccine (currently named Influenza A [H1N1] 2009 Monovalent Vaccine Live, Intranasal) has been made available during the first week in October 2009. It is a live attenuated novel H1N1 flu vaccine that contains no thimerosal, is produced by MedImmune, LLC, and is sprayed into the nostrils. This vaccine is only for healthy people 2-49 years of age, and some data suggest that it is less effective in generating an immune response in adults than the vaccine injection. The dosing schedule is as follows:

  • Children 2-9 years of age should receive two doses (0.1 ml in each nostril; total equals 0.2 ml per dose) — the second dose should be given the same way about one month after the first dose
  • Children, adolescents and adults, 10-49 years of age should receive one dose — (0.1 ml in each nostril; total equals 0.2 ml per dose)

The following is a list of the CDC-approved H1N1 vaccines and the companies that name and manufacture them as of 10/29/09:

  • Influenza A (H1N1) 2009 Monovalent Vaccine by CSL Limited
  • Influenza A (H1N1) 2009 Monovalent Vaccine by Novartis
  • Influenza A (H1N1) 2009 Monovalent Vaccine by Sanofi Pasteur
  • Influenza A (H1N1) 2009 Monovalent Vaccine Live, Intranasal by MedImmune, LLC

The following vaccination schedule is recommended in the UK:


  • For all children aged from six months to nine years: – two half doses (0.25ml each) given with a minimum of three weeks between doses.
  • For individuals aged 10-59: – one dose (0.5ml) given.
  • For individuals aged 60 years and over: – one dose given (this advice will be reviewed when more data become available).
  • For individuals aged 10 years and over with weakened immune systems:- two doses (0.5ml each) given with a  minimum of three weeks between doses.


  • For children aged from six months and adults:- two doses (0.5ml each) given with a  minimum of three weeks between doses. 
  • This dosage schedule is based on advice given by the Joint Committee on Vaccination and Immunisation, following consideration of clinical data available on the vaccines. The dosage and recommendations will be kept under review as more clinical data become available.

Recommendations for public health personnel

For interviews of healthy individuals (i.e. without a current respiratory illness), including close contacts of cases of confirmed swine influenza virus infection, no personal protective equipment or antiviral chemoprophylaxis is needed. See section on antiviral chemoprophylaxis for further guidance. For interviews of an ill, suspected or confirmed swine influenza A virus case, the following is recommended:

  • Keep a distance of at least 6 feet from the ill person; or
  • Personal protective equipment: fit-tested N95 respirator [if unavailable, wear a medical (surgical mask)].

For collecting respiratory specimens from an ill confirmed or suspected swine influenza A virus case, the following is recommended:

  • Personal protective equipment: fit-tested disposable N95 respirator [if unavailable, wear a medical (surgical mask)], disposable gloves, gown, and goggles.
  • When completed, place all PPE in a biohazard bag for appropriate disposal.
  • Wash hands thoroughly with soap and water or alcohol-based hand gel.

Recommended Infection Control for a non-hospitalized patient (ER, clinic or home visit):

Separation from others in single room if available until asymptomatic. If the ill person needs to move to another part of the house, they should wear a mask. The ill person should be encouraged to wash hand frequently and follow respiratory hygiene practices. Cups and other utensils used by the ill person should be thoroughly washed with soap and water before use by other persons.

When crowded settings or close contact with others cannot be avoided, the use of facemasks or respirators in areas where transmission of swine influenza A (H1N1) virus has been confirmed should be considered as follows:

  • Whenever possible, rather than relying on the use of facemasks or respirators, close contact with people who might be ill and being in crowded settings should be avoided.
  • Facemasks should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people’s coughs and to reduce the wearers’ likelihood of coughing on others; the time spent in crowded settings should be as short as possible.
  • Respirators should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must care for a sick person (e.g., family member with a respiratory infection) at home.

The types of face masks and respirators

Unless otherwise specified, the term “facemasks” refers to disposable masks cleared by the U.S. Food and Drug Administration (FDA) for use as medical devices. This includes facemasks labeled as surgical, dental, medical procedure, isolation, or laser masks.

Such facemasks have several designs-

  • One type is affixed to the head with two ties, conforms to the face with the aid of a flexible adjustment for the nose bridge, and may be flat/pleated or duck-billed in shape.
  • Another type of facemask is pre-molded, adheres to the head with a single elastic band, and has a flexible adjustment for the nose bridge.
  • A third type is flat/pleated and affixes to the head with ear loops. Facemasks cleared by the FDA for use as medical devices have been determined to have specific levels of protection from penetration of blood and body fluids.
  • Unless otherwise specified, “respirator” refers to an N95 or higher filtering facepiece respirator certified by the U.S. National Institute for Occupational Safety and Health (NIOSH).

Take note of what you’ve learned here about the swine flu. Look after yourself and protect yourself as best as you possibly can.


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