Adult Genetic Screening, Testing, and Intervention: What Are the Consequences?

A longstanding concern about genetic screening and testing is that people at increased risk for a serious condition could face discrimination, which prompted passage of the Genetic Information Nondiscrimination Act (GINA) in 2008. Lawmakers have designed GINA to prevent discrimination from health insurers and employers. There is a question of whether it can be enforced 100 percent of the time.

Someone could obtain another individual’s private DNA information and tested without his or her prior knowledge or authorization. DNA is genetic material present in every cell of your body. DNA is extracted from not only blood but from saliva, skin cells, blood, and hair roots. DNA contains huge amounts of personalized information. We secrete it at all times. It is totally unique to each individual. It has in-depth information about blood-related family members. It can disclose information about your risk of illness. There is presently a potential risk that governments and companies can use it to identify and discriminate against individuals. Though its primary use is in criminal justice applications, DNA from large numbers of innocent people is being routinely stored for indefinite periods. Some states are considering privacy DNA related legislation aimed toward independent oversight and distribution of DNA information.

Direct-to-Consumer Genetic Testing (DTC) is experiencing explosive growth. Health providers do not need to approve this type of genetic testing. DTC is unregulated; there is no independent oversight. The primary marketing medium of DTC genetic testing is the Internet. The services offered range from predicting possible adverse reactions to medications to information for diagnosing genetic disorders. Companies offer subscriptions that are updated as new research and developments break ground. These tests claim to reflect intelligence level, decision-making ability, susceptibility to addiction and other traits. The consumer determines the credibility of the information. The apprehension is that results sent through the mail and/or Internet could be misinterpreted.

Genetic testing for disease has its limitations. Genetic testing cannot tell you everything about inherited diseases. For example, a positive result does not always mean you will develop a disease, and it is hard to predict how severe symptoms may be. Some conditions commonly tested for include: Autism, Down Syndrome, Autosomal Dominant Polycystic Kidney disease, breast cancer, colon cancer, prostate cancer, skin cancer, kidney disease, Crohn’s disease, Duchenne Muscular Dystrophy, Familial Hypercholesterolemia, hemophilia, Huntington’s disease, Parkinson’s disease, sickle cell disease, Tay-Sachs. There is a powerful benefit from genetic testing for some hereditary forms of colon cancer. Less is known about the history and preventative measures for breast cancer. A positive genetic test result can actually prevent the disease by leading people to have early colonoscopy screening to find and remove precancerous polyps. Geneticists and genetic counselors discuss with subjects more specifically about what a particular test will or will not convey, and can help him or her decide whether to undergo testing.

There are emotional impacts. Learning that you or someone in your family has or is at risk for a disease can be frightening. Some people could also feel guilty, angry, anxious, or depressed when they find out their results are positive. Negative results may give subjects a sense of false security. Many diseases and conditions have no effective preventative measures or treatments. There is a question as to whether or not an MRI is more effective toward detecting breast cancer than a mammography. The most effective treatment for breast cancer, Prophylactic mastectomy, is unpopular. Thus, the benefits of genetic testing are lesser than with colon cancer. When you weigh the fact that many diseases have no cure against genetic testing, it decreases its allure.

Predictive or pre-symptomatic genetic screening of individuals is done for families with histories of genetic disorders before any symptoms of the genetic disorder appear in order to discover if they are at risk for developing the disorder. However, only a handful of disorders are preventable or even treatable.

A bright spot on the horizon is Pharmacogenetics Testing, (PGT), the study of how variations in the human genome affect the response to medications, utilizes DNA taken from mouth swab to discover genetic variations that could affect a subject’s clinical responses to medications. Medical providers customize profiles are to fine-tune and tailor the administration of medications to each individual subject or patient.

A trend toward genetics may renew public interest in Eugenics, which is attempting to improve an ancestry or race or by removing undesirable traits from members of that race. It is presented as a mathematical theory. Positive eugenics improving the race by enhancing desirable traits intelligence memory physical ability extended life span. The public deemed Eugenics notorious due to the use in Nazi exploitation of the disabled and handicapped during World War II.

Fascination with genetics is an inevitable part of our future. All being well, our bioethics will not be left by the wayside.

Coronary Heart Disease

The term coronary heart disease covers a group of clinical syndromes arising particularly from
failure of the coronary arteries to supply sufficient blood to the heart. They include angina
peactoris, coronary thrombosis or heart attack and sudden death without infarction.
There has been a marked increase in the incidence of heart disease in recent years. Heart
attacks have become the number one killer in Western countries. They rank third in India, after
tuberculosis and infections. The disease affects people of all ages and both sexes, although it is
more common in men than in women, especially among those aged 40-60 years.
The heart, the most vital organ in the body, is a muscle about the size of a clenched fist. It starts
working even before birth inside the womb. Weighing less than 350 grms, it pumps about 4,300
gallons of blood per day through the body and supplies oxygen and nourishment to all the
organs. It beats 1,00,000 times a day, continuously pumping the blood through more than
60,000 miles of tiny blood vessels. The heart, in turn, needs blood for its nourishment which is
supplied by coronary arteries Coronary arteries are so called because they are arranged rather
like a crown or carona. In case of strain, etc., the heart needs more blood and the arteries, under
normal conditions, adjust themselves to the increased flow.
In the event of narrowing or hardening of the arteries on account of their getting plugged with
fatty substances, the flow of blood is restricted. The heart then does not get sufficient oxygen.
This condition is known as ischaemia of the heart or angina pectoris. In this condition , exercise
or excitement provokes severe chest pain and so it limits the patient’s physical activity. It serves
as a warning to slow down and prompt preventive measures will prevent a heart attack.
If the narrowed arteries get blocked due to a clot or thrombus inside them, causing death of that
portion of the heart which depends upon the choked arteries, it is called a heart attack or
coronary thrombosis. It may lead to death or heal, leaving a scar. Patients with healed lesions
may be severely disabled or may be able to resume normal life with restrictions in their physical
activities.
Symptoms
A common symptom of heart disease is shortness of breath which is caused by the blood being
deprived of the proper amount of oxygen. Another common symptom is chest pain or pain down
either arm. Other symptoms are palpitation, fainting, emotional instability, cold hands and feet,
frequent perspiration and fatigue. All these symptoms may be caused by many other disorders.
Appropriate tests and studies are, therefore, essential to establish the true nature of these
symptoms.
Causes
The basic causes of heart diseases are wrong dietary habits, faulty style of living and various
stresses. The famous Framingham Heart Study of the National Heart and Lung Institute
identified seven major risk factors in coronary heart disease. These are : (i) elevated blood levels
of cholesterol, triglycerides and other fatty substances ( ii) elevated blood pressure (iii) elevated
blood uric acid levels (mainly caused by high protein diet), (iv) certain metabolic disorders,
notably diabetes, (v) obesity, (vi) smoking, and (vii) lack of physical exercise. Each or a
combination of these risk factors can contribute to heart disease. Most of them are of dietary
origin. These risk factors can be controlled by changing one’s life style and readjusting the diet.
Constant worry and tension stimulates the adrenal glands to produce more adrenaline and
cartisons. This also contributes to constricted arteries, high blood pressure and increased work
for the heart.
Treatment
The fundamental conditioning factor in all heart diseases is the diet. A corrective diet designed to
alter body chemistry and improve the quality of general nutritional intake can, in many cases,
reverse the degenerative changes which have occurred in the heart and blood vessels.
The diet should be lacto-vegetarian, low in sodium and calories. It should consist of high quality,
natural organic foods, with emphasis on whole grains, seeds, fresh fruits and vegetables. Foods
which should be eliminated are all white flour products, sweets, chocolates, canned foods in
syrup, soft drinks, squashes, all hard fats of animal origin such as butter, cream and fatty meats.
Salt and sugar should be reduced substantially. The patient should also avoid tea, coffee,
alcohol and tobacco.
The essential fatty acids which reduce serum cholesterol levels and minimise the risk of
arteriosclerosis can be obtained from sunflower seed oil, corn oil or safflower oil. Several studies
have indicated that garlic can reduce the cholesterol level in persons whose body normally
cannot regulate the cholesterol fractions. Other important cholesterol lowering foods are alfalfa
and yogurt. Lecithin helps prevent fatty deposits in arteries. Best food sources are unrefined,
raw, crude vegetable oils, seeds and grains.
Fruits and vegetables in general are highly beneficial in the treatment of heart disease. Seasonal
fruits are quite effective heart tonics. Apples especially contain heart stimulating properties and
the patients suffering from the weakness of heart should make liberal use of apples and apple
jams. Fresh grapes, pineapples, oranges,custard apples, pomegranaes and coconut water also
tone up the heart. Grapes are effective in heart pain and palpitation of the heart and the disease
can be rapidly controlled if the patient adopts an exclusive grapes diet for few days. Grape juice,
especially will be valuable when one is actually suffering from a heart attack.
Indian gooseberry or amla is considered an effective home remedy for heart disease. It tones up
the functions of all the organs of the body and builds up health by destroying the heterogeneous
elements and renewing lost energy.
Another excellent home remedy for heart disease is onions. They are useful in normalising the
percentage of blood cholesterol by oxidising excess cholesterol. One teaspoon of raw onion
juice first thing in the morning will be highly beneficial in such cases.
Honey has marvellous properties to prevent all sorts of heart disease. It tones up the heart and
improves the circulation. It is also effective in cardiac pain and palpitation of the heart. One
tablespoonful daily after food is sufficient to prevent all sorts of heart troubles.
Patients with heart disease should increase their intake of foods rich in vitamin E, as this vitamin
promotes the functioning of the heart by improving oxygeneration of the cells. It also improves
the circulation and muscle strength. Many whole meal products and green vegetables,
particularly outer leaves of cabbage are good sources of vitamin E. The vitamin B group is
important for heart and circulatory disorders. The best sources of vitamin B are whole grains.
Vitamin C is also essential as it protects against spontaneous breaches in capillary walls which
can lead to heart attacks. It also guards against high blood cholesterol. The stress of anger, fear,
disappointment and similar emotions can raise blood fat and cholesterol levels immediately but
this reaction to stress can do little harm if the diet is adequate in vitamin C and pantothenic acid.
The richest sources of vitamin C are citrus fruits.
The following is the suggested diet for persons suffering from hypertension or some disorder of
the heart :
On rising : Warm water with lemon juice and honey or fresh fruit juice of apple,grapes, orange,
pineapple.
Breakfast : Fresh fruit such as apples, grapes, pears, peaches, pineapple, orange, melons, one
or two slices whole meal toast, yogurt, skimmed milk or soya milk.
Mid-morning : Fresh fruitjuice or coconut water.
Lunch : Combination salad of vegetables such as lettuce, cabbage, endive, carrots, cucumber,
beetroot, tomato, onion and garlic. One or two slices of whole meal bread or chappatis, curd,
fresh grapes and other fruits in season.
Mid-afternoon : One or two wholemeal biscuits and fruit juice.
Dinner : Fresh fruit or vegetable juice or soup, two lightly cooked vegetables, one or two whole
wheat tappets.
The patient should also pay attention to other laws of nature for health building such as taking
moderate exercise, getting proper rest and sleep, adopting the right mental attitude and getting
fresh air and drinking pure water.
Water Treatment
The use of an ice bag on the spinal area between the second and tenth thoracic vertebrae for 30
minutes three times a week, a hot compress applied to the left side of the neck for 30 minutes
every alternate day and massage of the abdomen and upper back muscles are water treatments
which are beneficial in cases of heart disease.
Hot foot and hand baths are excellent for relieving the pain of angina pectoris. To this may be
added hot packs on the chest over the heart for one minute and a cold pack applied alternately
for five minutes.
Asanas such as shavasana, vajrasana, and gomukhasna, yogic kriyas like jalneti and
pranayamas such as shitali, sitkari and bhramari are also helpful in providing relief to heart
patients.

Complications of a Ruptured Ovarian Cyst

The most common problem with diagnosing a ruptured ovarian cyst is that the major symptom is similar to the occurrence of a normal cyst. This means that the pain is centered around the pelvic area.

For most women, an ovarian cyst will develop without symptoms and disappear without the need for any medical intervention. However, it is also possible that serious complications can arise, and these include a ruptured ovarian cyst, or the twisting or pressure on nearby organs.

After a cyst ruptures, the abdomen will be swollen and tender to the touch. It is also possible for ruptured cysts to be connected to hemorrhage. This in turn results in abdominal pain and bloating, especially if the person going through the ordeal is taking anticoagulant medications such as Warfarin. There are also cases where a person with a ruptured cyst may experience anemia or pallor, which shows blood loss or possible internal bleeding. If there is internal bleeding, surgery may be necessary to stem the blood flow and remove the blood from the abdominal cavity.

In addition to pain, other more common symptoms of a ruptured ovarian cyst include fever, nausea and/or vomiting, weakness, dizziness or fainting. If these symptoms are present, you will need to seek medical attention immediately because they could be signs of internal bleeding.

The major complication of a ruptured ovarian cyst includes the twisting of the ovary (due to the location and size of the cyst), which may result in infertility. This condition (also referred to torsion) usually occurs if the cyst is accompanied by a tumor which can restrict the blood supply to the ovary and kill the ovarian tissue (this affects the chances of getting pregnant in the future). A twisted ovary will require a surgical remedy. Most doctors prefer to use an open-abdomen surgery for a twisted ovary compared with a laparoscopic method.

Another complication is that the leakage of cystic fluid into the abdominal cavity can cause sepsis or hemorrhagic complications. In most cases, the right ovary experiences hemorrhagic complications compared with the left because the left ovary is partly cushioned by the large bowel, preventing damage from twisting. Like a twisted ovary, hemorrhage complication will also a surgical remedy to either stop the bleeding, or remove the hemorrhaged matter.

On the long-term ramifications of a ruptured ovarian cyst, scarring or adhesions can happen and should the scarring occur on the ovaries, the ovaries will have limited capacity to release eggs and this can lead to permanent infertility.

Can Beer Make a Yeast Infection Worse

Vaginal yeast infection is a common fungal infection caused by fungi of the Candida specie. It results in excessive itching and burning sensations of the affected area. Wet and moist conditions are favorable for their growth and if not cured in time, the infection becomes severe. Beer is known to make a vaginal yeast infection worse because yeast is used in brewing. Although it does not constitute yeast of the Candida variety, it is enough to allow the Candida albicans that is the yeast infection causing fungi, to grow. Since the yeast infection causing fungi is already present in our body in small quantities, favorable conditions are likely to cause an overgrowth that leads to infection.

Therefore, holistic healers advice against the intake of beer along with other food such as sodas, sugars, vinegar and cheese which are likely to worsen a yeast infection. Moreover, beer is an alcoholic drink and like any other hard drink, it affects the intestinal lining. The permeability of the intestinal lining increases. This allows Candida to pass through it and infect the digestive system. Apart from these, beer can affect the liver and cause severe damage to the body. In such cases the need to take antibiotics may arrive. Antibiotics are known to kill the bad bacteria for helping the body fight the infections. But, in doing so, it actually kill the good and useful bacteria as well. It is this bacterium that fights against fungi like Candida and prevent yeast infections. Therefore, beer can make a vaginal yeast infection worse.

There are a number of food items that stimulate the growth of yeast infection causing fungi. Refined sugar, bread, white flour products, soft drinks and lots of other things contribute towards the overgrowth of yeast. Alcohol is also a major culprit in stimulating yeast growth. So, beer can worsen a vaginal yeast infection. Beer is often consumed by a lot of women and if they are not aware of the manifestations that consumption can have on their infection, their condition deteriorates.

While dietary modifications are required for treating the yeast infection, medicines and home remedies must also be used at the same time. The diet must contain things like yogurt which naturally creates acidophilus which is useful in combating the yeast. Similarly natural antifungal and antibacterial substances like garlic can be implemented into the diet. And since beer and other alcoholic drinks are likely to worsen a vaginal yeast infection, it is necessary to completely stop drinking till the time the infection is cured. Beer, is commonly consumed by people and sometimes they are themselves unaware of the complications associated with it. Therefore, it is necessary to limit consumption of alcoholic drinks, including beer during a vaginal yeast infection.

Danger Untoward Effects of Streptomycin in Anti-tuberculosis Therapy

TOOBSERVE THE UNTOWAED EFFECTS OF AMINOGLYCOSIDES(STREPTOMYCIN)IN COMBINITION THERAPY OF ANTI-TUBERCULOSIS THERAPY IN TUBERCULOSIS PATIENT’S.

Authors:Bhurgri ghulam rasool,Shamim-ur-rehman,Syeda Momina Taki Muhammad,Raj Kumar chohan.Dhri Ghulam Mustafa,Barkat sheikh.

INTRODUCTIONS:

Tuberculosis is chronic granulomatous disease of human and other mammals caused by a group of closely related obligate pathogens, the mycobacterium tuberculosis complex, comprising M. tuberculosis. The human tubercle bacillus – M. bovis – the bovine tubercle bacillus, -agricanum – a heterogeneous type found principally in effuational Africa with properties intermediate between the former two species and M-microti-a rare cause of disease involves and other small mammals but attenuated for humans. Humans are the usual, but not unique, host of M. tuberculosis. M. bovis causes disease in cattle and also in badgers, deer, and other mammals. Humans are incidental hosts, usually acquiring infection by drinking contaminated milk although infection of farm workers may occur by aerogenous route. Human may transmit M. bovis to cattle but human to human is rarely reported (PDO D awis et al, 2003).

The annual tuberculosis infection rate or annual risk of infection is the best single indicator of the status and trend of tuberculosis in both developed and developing countries. It indicates the proportion of the population that will primarily infected or reinfected in the course of one year and is usually expressed as a percentage.

The risk of tuberculosis infection in developed countries is now very low, being less than 0.5% per annum in the majority, 0.1-0 % in most and less than 0.1% in a few countries. The risk of tuberculosis in these countries is declined by about 10% per year.

In developing countries much higher rates are found. The annual risk of infection for the richest and poorest countries is shown in following table. In most industrialized countries the annual rate of infection is now below 0.1% and continues decline by 10% per annum. In Africa, the annual risk of infection may be much as 2.5% or more, and in the present context of increasing tuberculosis, notification due to HIB epidemic is increasing rather than decreasing.

Annual risk of infection

Areas

Current

Level

Annual decline

Trend (%)

Health resource

Availability

Industrialized

0.04-0.1

>10

Excellent

Middle income Latin America

West Asia

0.5-1.5

5-10

Good

Middle income East and South

Eest Asia

1.0-2.5

<5

Good

Sub-Saharan Africa

Indian Subcontinent

1.0-2.5

0-3

Poor

                                                                                                (A Gordon Leitch, 2000)

In 1990 the commission on Health Research for development stated that “the magnitude of tuberculosis problem is matched only by is relative neglect by the international community”. A decade later 2000 ministers of Health and Finance from 20 countries that have 80% of world’s tuberculosis cases met in Amsterdam and issued the Amsterdam Declaration”. This stated that the global situation was both alarming and unacceptable” and that we commit ourselves to accelerate action against tuberculosis through expansion of coverage of population with the World Health Organization (WHO) recommended strategy to combat tuberculosis Direct observe treatment strategy (DOTS), providing for at least 70% detection of infectious cases by the year 2005″ (Philip C Hopwell, 2002).

EPIDEMIOLOGY

About 8 million people developed tuberculosis in 1990 and 2.6 to 2.9 million people died of it, mostly in Asia. It is estimated that one third of world’s population (1700 million) is infected with mycobacterium tuberculosis. The disease is not limited to Asia alone and its prevalence is increasing in developed countries also where it linked to acquired immunodeficiency syndrome (AIDS). According to estimate, approximately 160,000 children die from tuberculosis annually worldwide. The situation in developing countries is different where malnutrition and tuberculosis co-exist (Nizami SQ, 1998).

Developing countries in Asia have an estimated 50-100/100,000 cases of smear positive tuberculosis annually. The 1990 incidence of tuberculosis disease in Pakistan has recently been reported at 250/100,000 of which 45% are likely to be smearing positive pulmonary tuberculosis. At these rates, Karachi, a city of approximately 100,000 would have between 5000 and 11250 new cases of smear positive disease annually. Analyzed causes of deaths among adults, age 15-50 years in impoverished Karachi communities, tuberculosis, is identified as the second leading cause of adult death at an annual rate of 30/100,000 which is consistent with incidence -estimates, assuring overall case fatality ratios of 50% for untreated and 15% for treated tuberculosis (Marsh et al., 1996).

PATHOGENESIS:

INDEX CASE WITH INFECTOUS TUBERCULOSIS

Cough and generate droplet nuclei, which are inhaled by a contact

Primary

Onset of CMI response

Bacillimia                                      Apical Implant

                            Sterilization of the primary complex

Immunosuppressive event

Multiple of tubercle bacilli

Restoration of CMI

Cessation of necrosis

        Infectous tuberculosis

Figure: Schematic representation of the basic events in the pathogenesis of tuberculosis.

CMI: Cell mediated immune.

(VB Balasurbramanian et al., 1994).

DIAGNOSIS OF TUBERCULOSIS

The different diagnostic methods are as follows:

1.                History and clinical features.

2.                2Blood CP and ESR.

3.                Chest radiography.

4.                Sputum for AFB (Acid Fast Bacilli). (Sputum is stand with Zeihl Neilson (ZN) stain.

5.                Culture on Lowenstein Jensen medium.

6.                Bronchoscopy if no sputum is available.

7.                Biopsy with histological examination.

(Saurders, 1998).

DRUG TREATMENT OF TUBERCULOSIS

Tuberculosis is among the top ten cause of global mortality and affects low-income countries in particular. The treatment of smear positive tuberculosis using World Health Organization (WHO) directly observed treatment, short course, Direct observe treatment strategy (DOTS) has far highest impact while BC immunization reduces childhood tuberculosis mortality (Martien W Borgdorff et al. 2002).

Drugs used in the treatment of tuberculosis can be divided into two major categories. First line after combined the greatest level of efficacy with unacceptable degree of toxicity. These include isoniazid, rifampin, ethambutol, streptomycin and pyrazinamide. Excellent results for patients with non drug resistant tuberculosis can be treated with 6 month course of treatment, for the first 2 months, isoniazid, rifampin and pyrazinamide are given, followed by isoniazid and rifampin for remaining 4 months (William A Petri Jr, 2001).

STREPTOMYCIN

Streptomycin is tuberculocidal, but less effective than isoniazid or rifampin, acts only on extracellular bacilli (because of poor penetration into cells). Thus, host defense mechanisms are needed to eradicate the disease. It penetrates tubercular cavities, but doesnot cross to the cerebrospinal fluid (CSF), and has poor action in acidic medium. Resistance developed rapidly when streptomycin was used alone in tuberculosis most patients had a relapse (Tripathi, 2003).

Streptomycin is bactericidal for tubercle bacillus in vitro. Concentration as low as 0.4 mg/ml may inhibit the growth. vast majority of strains of mycobacterium tuberculosis are sensitive to 10mg/ml (William A Petri Jr, 2001).

 It crosses the placenta and fetal serum levels are half of those in maternal blood, the drug is excreted almost entirely by glomerular filtration and dosage must be modified in renal failure to avoid toxicity (A Gordan Leitch, 2000).

Untoward effects include rash and fever, auditory and vestibular function of eighth cranial nerve is affected (William A Petri Jr, 2001).

Popularity of streptomycin in treatment of tuberculosis had declined due to need for intramuscularly injections and lower margins of safety because ototoxicity and nephrotoxicity especially in the elderly and those with impaired renal function.

Streptomycin is ototoxic and nephrotoxic. Vertigo and hearing loss are most common side effects and may be permanent. Toxicity is dose related and risk is increased in the elderly. As with all aminoglycosides the dose must be adjusted according to renal function. Toxicity can be reduced by limited therapy to no more than 6 months (Henry FC, 2001).

Minor adverse effects are pain, rash, swelling and pus formations at injection site, numbness around the mouth and tingling soon after the injection.

Major adverse effects are cutaneous hypersensitivity, vestibular and auditory nerve damage to the patient and in a pregnant woman, also in fetus, renal damage (A Harries, 2003).

Apart from hypersensitivity reactions such as fever and rash, Streptomycin also potentiate neuromuscular blocking agents used during anesthesia and should be avoided in-patient with myasthenia gravis (T Frieden and M Espinal, 2003).

Significantly rare adverse effects of aminoglycosides include fever, rash, neuromuscular blockade, hypokalemia and hypomagnesaemia (Edward D Chan et al.,2004).

MATERIAL AND METHODS

This study was carried out in the department of Pharmacology and Therapeutics, Free T.B Clinical of Muhammad Medical College Mirpurkhas SINDH, Pakistan, under kink supervision of Dr,. SHAMIM-UR-REHMAN, Head of Department from January 2005 to June 2005.

The 100 newly diagnosed patients of pulmonary tuberculosis, enrolled is this study after taking informed and written consent.

The patients were selected as diagnosed cases of pulmonary tuberculosis from medical chest OPD and chest ward of Muhammad medical college mirpurkhas. Out of these 97 patients were associated through out the study period. Out of remaining three have not come for follow up.

                           

All patients, in this study, were selected according to following criteria:

 INCLUSION CRITERIA

  • Diagnosed cases of pulmonary tuberculosis.
  • Age between 20 to 70 years.
  • Sex either male or female.

EXCLUSION CRITERIA

  • Patients suffering from liver disease.
  • Patients suffering from cardiac disease.
  • Patients suffering from renal disease.
  • Patients suffering from diabetes mellitus.
  • Patients suffering from other respiratory disease.
  • Patients suffering from HIV infections.
  • Pregnant or nursing women.
  • Patients with previous multiple drug resistance.

The study period extended up to 24 weeks and 12 follow up visits of patients were taken. The required information such as name, age, sex, occupation, address, details of follow up visits and laboratory investigations etc, of each patients were recorded on proforma especially designed for this study.

The selected patients were divided according to untoward effects of drugs during study period.

Group A:         In this group those patients were included who manifested the nephrotoxicity in different age group and gender.

Group B:         In this group those patients were included who manifested the ototoxicity in different age group and gender.

MATERIALS:

Streptomycin — 15 mg/kg – maximum 1 gm

D/syringes

Ophthalmoscope

Rhinoscope

DETERMINATION OF CREATININE

  • Take a 5 cc disposable syringe.
  • Take a cotton spirit swab.
  • Clean the arm with spirit swab.
  • Prick the needle incubital vein.
  • Take 3-5 ml of blood.
  • Put the blood sample into plain tube.
  • Wait for clotting the sample for ½ to 1 hour.
  • The sample was centrifuged and collected the serum.

PRINCIPLE

            Protein free filtrate (pH below 2) in treated with alkaline picrate solution (Jaffe’s reaction ) to yield red colour of creatinine picrate. This colour is due to tautomer of creatinine picrate and is dependent on formation of a salt and ketoenol changed creatinine molecule. The red yellow colour thus formed is compared photometrically to a series of standards prepared from pure solution of creatinine.

Reagents

Sodium tungstate 5%:   Dilute 1:1 10% Sodium tungstate.

Sulfuric acid:                 2/3N

Picric acid:0.04 M        (9.16g/l) It may be dried between filter paper or an allowance of 10-12% made for the added water.

Sodium hydroxide:        0.75N

Stock standard:            (1mg/ml) dissolve 1 g of pure creatinine in 0.1 N hydrochloric acid and make up to one litre with the acid. The solution is stable indefinitely.

Working standard:        (0.2 mg/ml): Dilute 2 ml stock standard to 1dl.

PROCEDURE:

A)    For plasma/serum creatinine:

Protein precipitation / sample preparation:

·        2 ml plasma + 2 ml distilled water + 2 ml sodium tungstate. Mix and let stand for 5 minutes, and the centrifuge.

·        To the 3 ml of above protein free filtrate add 1 ml picric acid, heat in biling water bath for about 45 minutes.

·        Make up to volume 4 ml with distilled water after heating. Add 1 ml NaOH. Let stand for 15 minutes and read with standards.

COLOUR DEVELOPMENT

Materials

Standards S1 to S6

Total creatinine

Blank

Wouking standard

0.5 50 3.0 ml

Distilled water

Up to 3 ml

3.0 ml

Protein-free       filtrate

3.0 ml

Picric acid

1.0 ml to each tube

Sodium hydroxide

1.0 ml to each tube

Let stand for 15 minutes and then read at 520 nm against blank.

CALCULATION

                                        OD of test                                                                          100

Creatinine (mg/dl)  =     ___________              X         Amount of Std           X     _________

                                        OD of Std                                                                   Sample used

Creatinine = (Total creatinine – preformed creatinine) 1.16

(Where 1.16 is the ratio of the molecular weight of creatinine to creatine).

DETERMINATION OF BLOOD UREA NITROGEN (BUN)

PRINCIPLE

            Diacety1 monoxime is hydrolyzed in acidic medium to diacety1, which reacts with urea in the presence of ferric ions, to form a condensed coloured molecule. The colour is intensified and stabilized by thiosemicarbazide.The intensity of red colour comples formed is proportion to the quantity of urea present in the sample.

Urea                             = urea nitrogen 2.14

Urea nitrogen                = Urea 0.4665

REAGENTS

Oxime solution Dissolve 1 gm diacety1 monoxime (also called 2,3 butanedione monoxime), 0.2 gm thioemicarbazide and 9 gm naCI in water and dilute to 1L.

Acid solution                Cautiously add 60 ml concentrated sulfurc acid and 10 ml 85% orthophosphoric acid to 800 ml distilled water. Add 0.1 gm FeCI3 and dilute to 1I.

Standard stock solution: (1mg/ml) 100 mg of urea in 100 ml of distilled water.

Standard working (0.01 mg/ml) Dilute 1 ml of stock standard

Solution:                       solution up to 100 ml distilled water.

PROCEDURE

To 0.1 ml serum/plasma add 9.9 ml distilled water.

COLOUR DEVELOPMENT

Materials

Standards S1 to S6

Total creatinine

Blank

Working standard

0.1 to 1.0 ml

Distilled water

Up to 2 ml

1.5 ml

2.0 ml

Protein-free    filtrate (PFF)

0.5 ml

Add to each tube 2 ml of mixed colour reagent and w ml of mixed acid reagent. Heat for 20 minutes in boiling water. Cool and dread at 540 nm (colours are stable for several minutes.

CALCULATION

                                       OD of test                                                                            100

Urea nitrogen (mg/dl)=  ___________      X     Amount of Std        X     _________

                                        OD of Std                                                                   Sample used

All the patients examined for optic neuritis before anti-tuberculosis treatment

Method

Ocular examination

Visual acuity

Pupil reaction

Fundus examination by Keeler direct ophthalmoscope

Colour vision

Befor antituberculosis therapy

Visual acuity                 6/6

– Normal                      6/6

Pupil reaction

Round – regular – reactive

Fundus

Optic disc pale

Visible margins

Cup / disc ratio 0:3

Normal vascular pattern

Macula looks normal

Colour vision:   no red /green defect.

EXAMINATION OF EAR

            Ototoxicity as an acverse effect of streptomycin

First we ruled out the, wax, foreing body, or any other ear disease.

            Then we cheked the position of tympanic membrane, any kind of perforation of iy. Then we checked the function of middle ear and inner ear. Then we do the test for hearing and balance

1.      Whisper Test:

It was done in ENT OPD room (silent), the distance of patient and doctor was about 1 meter and talked slowly and gradually increased voice frequency.

2.      Tunning Fork test

a.       Renies test: We see in this test the ear conduction is better than bone conduction.

b.      Weber’s test: In this test, we characterized the disease of ear, and function of proni conduction.

c.       ABC (Air Bone Conduction test): We rule out the waning proth doctor, and patients.

d.      PTA (Pure tone Audionetery): By this method we watch air conduction, bone conduction .

Cochlear function tests are infact tests of hearing and include:

a)      voice tests.

b)      Tuning fork tests.

c)      Audiometery.

Voice tests are the tests which we do with the gelp of our voice. Depending on the type of voice which we use they are called the whisper voice test , conversation voice test, and loud voice test, Normal distances from which the various voices should be couuectly heard by the patient are as follows:

Whisper                       =          20 feet

Conversation                =          40 feet 

Loud                            =          100 feet

Thesedistances gowever, apply to tests done in a sound proof room and not in the noisy background of the out patient department .

            For accurate results of voice tests, one has to observe the following rules:

  • Ear being tested should face the doctor.
  • Patient should be blind folded.
  • Opposite ear should be plugged.
  • Use only forced expiration speedh i.e., words spoken during the expiration following a deep inspiration.
  • Use only phonetically balanced worlds (P.B. words), e.g., ninety nine, fifty five etc.
  • Start from the maximum normal audibility range and then gradually come nearer to the patient.

The main merit of the voice tests is that they are simple to perform and do not repiure any specialized equipment.But they are not very accurate and only give a rough idea as to whether the patient is deaf or not.

Tuning fork tests tell us about the type of hearing loss, i.e., conductive or perceptive, and include RINNE’s tests, ABC or SCHWABACH’s test, and WEBER’s test, In addition, GELLE’s test also merits description. Lidke any other instrument we must know the correct use of tuning fork which is as follows:

Always hold it by its stem.

Always hit it gently against one of tour bony points, either elbow or knee cap.

While putting it over the external meatus, make sure that the acoustic axis of the fork coincides with the long axis of the external auditory canal.

Whenever tou put it over the mastoid, you must block the gearing across the skull bones by making the opposite ear, either with Barany’s nioise box or with a piece of paper.

Rinne’s test: Rinne’s test is the test of conductive defness. It compares the air conduction of the ear with its bone conduction. Normally, the air conduction is twice more than the bone conduction (Rinne’s positive). In nerve deafness, the air conduction is more than the bone conduction but both are reduced (Rinne’s reduced positive).In conductive deafness, the bone conduction is more than the air conduction (Rinne’s negative).

Absoluter bore conduction test: A,B,C test or schwabach’s test is the test of nerve deafness. It compares the bone conduction of the patient with that of the doctor . Normally, the two are equal. Same is the case in conductive deafness. In nerve deafness, the patient’s bone conduction is reduced and is less than the doctor’s bone conduction. Weber’s test: Weber’s test is the test of lateralization. In conductive deafness, it is lateralized to the more diseased ear. We take a tuning fork, hit it gently against one of our bony points, place it over the middle of patient’s forehead, and ask him as to where does he hear it best, Normally, he either hears it best in the middle of the forehead or equally well in the two ears. In conductive deafness, he hears it better in the more diseased ear. In nerve deafness, he hears it better in the more normal ear.

Gelle’s test: Gelle’s test is the test of stapedial mobility. A vibrating tuning fork is placed over the patient’s mastoid and he is asked to note the intensity. The air pressure in the esternal auditory canal is then increased either by pressing the tragus or withy the help of siegle’s speculum and he is aked to note the intensiye once again. Afailure to hear the fork better means that the stapes is fixed.

Audiometery is testing the hearing with an electrical instrument called the audiometer and plotting the result on a graph paper called the audiogram. It is of three types, namely.

a)      Pure tone audiometery.

b)      Speech audiometery.

c)      Bekesy’s audiometery.

d)      Impedance audiometery.

Pure tone audiometery is the one which we commonly do in our departments. It uses the pure tones as the sound stimuli and finds the threshold of hearing for the various audible frequencies. In the audiogram, the sound intensities are marked on the vertical lines and the sound frequencies, ranging from 250 c.p.s. to 8000 c.p.s. are marked on the horizontal lines.

Caloric tests

Caloric tests are tests of vestibular function, using hot and cold water for stimulation.

Instruments

a)      Water can.

b)      Kidney tray.

c)      Centigrade thermometer.

d)      Stop watch.

Materials

a)      Water at 44*C

b)      Water at 30*C.

Canal stimulated

Lateral semicircular canal.

To make it vertical we put a pillow under the head and thus fles the neck by 30*C.

Method

Run water into the ear for 40 seconds.

Notice the after nystagmus, its direction, and its amplitude. The time duration is couted right from the moment we start running water into the ear.

N.B.

First we complete the test with water at 44*C and then we do it with water at 30*C.

In hot water test, the nystagmus is directed towards the ipsilateral side.In cold water test, the nystagmus is directed towards the opposite side.

Contra-indications

Acute suppurative otitis media.

Chornic suppurative otitis media.

Perforated ear drum.

Labyrinthitis.During the attack of Meniere’s disease, vestivular neuronitis etc.

Results

Normal value.

Normally, the ensuing nystagmus lasts 120-180 second.

Plotting.

Major abnormalities:

Meniere’s disease, canal paresis.

Dead labyrinth, no response.

In order to poick the nystagmus better, direct observation of the eyes has been replaced by electronystagmography, which depends on detecting the difference in electrical potential between the cornea and retina and gives us an automatically recorded graph, called the electronystagmograph.

RESULTS AMD OBSERVATIONS:

Table 1 and figure 1 shows nephrotoxicity as an adverse effect. Streptocomycin was main drug to manifest the nephrotoxicity in combined therapy during treatment of pulmonary tuberculosis in combined therapy during treatment of pulmonary tuberculosis patients. Out 97 patients, there were 3 reactions documented in this table.

Table 2 and figure 2 shows nephrotoxicity in gender after taking the anti tuberculosis drugs. Two males and one female was affected during the study.

            Table 3 and figure 3 shows the nephrotoxicity in different age group. In the age group 30-39 1, 40-49 1, and 50-59 1 reaction was documented in this study.

Table 22 and figure 22 show the ototoxicity after taking anti tuberculosis drugs. There were 2 reactions recorded in this study.

TABLE 1

DRUGS AND NEPHROTOXICITY

Drugs

Yes

No

Total

Combined therapy*

3

94

97

Streptomycin

3 (3.1%)**

94

97

Pyrazinamide

Rifampin

Ethambutal

Isoniazid

*Occurance of nepgrotoxicity is tested by excluding combined therapy.

**Percentage in calculated out of 97 patients.

TABLE 2

DRUGS AND NEPHROTOXICITY IN GENDER

Drugs

Male

Female

Total

Combined therapy*

2

1

3

Streptomycin

2 (2.1%)**

1 (1.03%)

3

Pyrazinamide

Rifampin

Ethambutal

Isoniazid

*Occurance of nephrotoxicity is tested by excluding combined therapy.

**Percentage is calculated out of 97 patients.

TABLE 3

DRUGS AND NEPHROTOXICITY ACCORDING TO AGE

Drugs

20-29

30-39

40-49

50-59

60-69

Total

Combined therapy*

0

1

1

1

3

Streptomycin

0

1 (1.03%)**

1 (1.03%)

1 (1.03%)

3

Pyrazinamide

Rifampin

Ethambutal

Isoniazid

*Occurance of nephrotoxicity is tested by excluding combined therapy.

**Percentage is calculated out of 97 patients.

TABLE 4

DRUGS AND OTOTOXICITY AS AN ADVERSE EFFECT

Drugs

Yes

No

Total

Combined therapy*

2

95

97

Streptomycin

2 (2.1%)**

95

97

Pyrazinamide

Rifampin

Ethambutal

Isoniazid

*Occurance of ototoxicity is tested by excluding combined therapy.

**Percentage is calculated out of 97 patients.

TABLE 1

Frequency of Nephrotoxicity

In Anti tuberculosis Drugs

FIGURE 2

Nephrotoxicity according to gender in Anti tuberculosis Drugs

FIGURE 3

Nephrotoxicity according to Age Groups in

Anti tuberculosis Drugs

FUGURE 4

Frequency of Ototoxicity in

Anti tuberculosis Drugs

Table 5 and figure 5 shows the ototoxicity in different gender. There was one reaction in male and female resplectively after taking anti tuberculous therapy.

Table 6 and figure 6 shows the ototoxicity in different age group. The age group between 20-29 and 40-49 were manifested ototoxicity in this study after taking anti tuberculous drugs.

TABLE 5

DRUGS AND OTOTOXICITY AS AN ADVERSE EFFECT IN GENDER

Drugs

Male

Female

Total

Combined therapy*

1

1

2

Streptomycin

1 (1.03%)**

1 (1.03%)

2

Pyrazinamide

Rifampin

Ethambutal

Isoniazid

*Occurrence of ototoxicity is tested by excluding combined therapy.

**Percentage calculated out of 97 patients.

TABLE 6

DRUGS AND OTOTOXICITY ACCORDING TO AGE

Drugs

20-29

30-39

40-49

50-59

60-69

Total

Combined therapy*

1

0

1

0

0

2

Streptomycin

1 (1.03%)**

0

1 (1.03%)

0

0

2

Pyrazinamide

Rifampin

Ethambutal

Isoniazid

*Occurance of ototoxicity is tested by excluding combined therapy.

**Percentage is calculated out of 97 patients.

FIGURE 5

Ototoxicity according to gender

In Anti tuberculosis Drugs

FIGURE 6

Ototoxicity according to age Groups in

Anti tuberculosis Drugs

DISCUSSION:

Streptomycin (1 g per day) – it was started with other drugs. After 3-7 weeks of medication, 3 patients complaint of oliguria and 2 patients presented during follow up with hearing deficit. These reactions proved clinically and laboratory investigations.

Nephrotoxicity was recorded in these patients two in male and 1 in female. According to age group 1 in 30-39, 2 40-49 and 1 50-59 side effects were documented in this study. Drug was stopped for 3 weeks and found that blood urea nitrogen and creatinine levels were decreased, therefore this drug was permanently stopped and the remaining four drugs were continued.

The proximal renal tubule cells may accumulate aminoglycoside, accounting for nephrotoxicity associated with aminoglycosides. The mechanism of renal toxicity is hypothesized to by the inhibition of intracellular phospholipase in the proximal tubule.

The renal insufficiency is typically characterized by the nonoligouric decrease in glomerular filtrate rate occurring after at least taking a week therapy. Baseline and periodic surveillance of analysis blood urea nitrogen levels, creatinine values is indicated (Edward et al., 2004).

Streptomycin is nephrotoxic and should used with caution in patients with renal impairment. If reaction is trouble some which is an infrequent occurrence, the dose may be reduced (NCG,2002).

Ototoxicity – there were 2 reactions recorded in this study. According to gender, 1reaction was in male and 1 in female was documented in this study. Side effects of streptomycin were recorded. One in age group 20-29 and one in 40-49. The drug was astopped and patients were advised to consult in Ear Nose and Throat OPD. Remaining other drugs were continued.

Interestingly, the damage may be fairly isolated to either the choclear or vestibular component, or rarely both. The mechanism for the cochlear toxicity is unclear, although the target site is considered to the outer hair cells of the organ of corti.

Aminoglycoside induced cochlear dysfunction is generally considered to be irreversible. Infury to the hair cells of the ampullar cristae by aminoglycosides is the mechanism of the vestibular toxicity. Sign and symptoms of vestibular toxicity include nausea, vomiting, vertigo and nystagmus (Edward et al., 2004).

It proved that like other anti-biotic streptomycin must be careful to continue in combination therapy of Anti-Tuberculosis Therapy.

Tuberculosis is a granulomatous disease, caused by mycobacterium tuberculosis. As world Health Organization estimates more than 300,000 new cases of tuberculosis develop in Pakistan every year. Cure of infectious cases of tuberculosis is the key to effective control of the disease. Treatment of tuberculosis patients reduces suffering and, if adequately, prevents death from tuberculosis. The first tine of drugs used in the treatment of tuberculosis consists of isoniazid, pyrazinamide, rifampin, streptomycin, and ethambutol. The major side effects are those giving rise to serious health hazards, and require discontinuation of the drug and referral to chest physician. Minor side effects

Cause relatively little discomfort; they often respond to symptomatic or simple treatment but occasionally persist for the duration of drug treatment. Chemotherapy should be stopped or temporarily interrupted only of severe drug intolerance toxicity occurs. In fact tuberculosis drugs are relatively toxic and mild side effects are not uncommon but most do not warrant drug withdrawal.

REFERENCES

A Harries. What are the most common adverse drug events to first line tuberculosis drugs, and what is procedure for reintroduction of drugs. Bulletin of WHO 2004; 154-158.

Agordon Leitch. “Management of Tuberculosis”, Crofton and Douglas’s Respiratory Disease 5th edition 2000; 444-564.

Agordon Leitch. “Tuberculosis”, Crofton and Douglas’s Respiratory Disease 5th edition, 2000; 476-505.

Balasubramanian V CH, Weigeshaus BT Taylor and Smith DW. Pathogeneses of tuberculosis pathway to apical localization. Tubercle and Lung Disease 1994; 75:168-178.

BTS “Adverse reactions to tuberculosis therapy”. Joint Tuberculosis Committee of British Thoracic Society. Thorax 1998; 3:536-548.

D Marsh, B Hashim, F Hassany and L Hussain. Front line management of pulmonary tuberculosis: analysis of tuberculosis and treatment practices in urban Sindh, Pakistan. Tubercle and Lung Disease 1996; 77:86-92.

Edward D Chan, Celphi Chaterjee, Michael D Iseman. Pyrazinamide, ethambutol, Aminoglycosides 2nd edition, Philadelphia, Lippincott William and Wilkins 2004; 573-589.

Henry F, Chambers. “Antimycobacterial drugs”. In: Basic and Clinical Pharmacology, eight edition ,edited by Bertram G Katzung International edition Lame Medical books New York 2001; pp. 803-8114.

Martein W Borgdorf. ” Annual risk of tuberculosis infection time for an up date” . Bullentin of WHO 2002; 501-503.

Nizami SQ. Childhood TB. J Pak Med Assoc 1998;48:88.

PDO Dawis, DJ uirling and JM Grange. Pulmonary disease IN: Infectious desease 6th edition, Lippincott Williams and Wilkins, Philadelphia 2003; pp. 1644-657.

Pelletier, Yee et al. Incidence of serious side effects from first line antituberculosis drugs among patients treated for active tuberculosis. AJP and Crit care Med 2003.

Philip C Hopwell. Tuberculosis control how the world has changed since 1990. Bulletin of WHO 2002; 427-728.

Saunder Pocket “Diagnosis of tuberculosis”. In: Wssential of Clinical M edicine 2nd edition, New Delhi, Japee Brothers 2003; pp.698-708.

Tripathi KD. “Antitubercular drugs” In: Essentials of Medical Pharmacology 5th edition, New Dehli, Japee Brothers 2003; pp.698-708.

William AP Jr. “Anticicrobial agents” Goodman and Gilmans the Pharmacological bases of therapeutics 10th edition, (Joe1 G Hardman, Ph.D. Lee E. Limbird et a1). McGraw Hill Medical Publishing Division, New York 2001, pp.1273-1295.

Black Cohosh And Men – Mix With Caution

Black cohosh is an herbal remedy that has gained a lot of popularity as a

potential treatment for a number of different conditions. It has really gained

ground in regard to treating some of the more troublesome symptoms of menopause.

And while many believe this herb works well for menopause symptoms, the truth is

there have been very few studies to suggest effectiveness when black cohosh and

men mix. Most scientific data involves black cohosh and women.

With many of the symptoms of male menopause mimicking those of female menopause,

black cohosh and men are not at all an uncommon combination. Men take black

cohosh for the same reasons as women. They wish to relieve hot flashes, mood

swings and other symptoms that can go along with hormonal change. There are some

reports of black cohosh and men having good results, but the truth is very few

focused studies have been completed.

The unfortunate truth is that this particular herb can cause some very serious

potential side effects in both men and women. Despite some very strong concerns,

black cohosh and men and even women does show some promise for menopausal

treatment. Some studies have suggested that mood swings, hot flashes, heart

palpitations and more can actually improve when black cohosh is taken. These

studies, however, have focused more on women rather than black cohosh and men.

Also, there is a lack of solid, long-term studies about this herb’s use over

extended periods of time.

The use of this herb originated with the American Indians, who used it to treat

a variety of conditions. Through the years, it has been thought to be effective

for everything from gynecological problems and snakebites to arthritis and

fever.

The number one concern with black cohosh and men and women, too, is liver

inflammation and potential hepatitis development. The usage of black cohosh can

cause the body’s autoimmune system to gradually attack liver cells. This is

believed to lead to autoimmune hepatitis, which can result in death if it

advances or is left untreated. With this in mind, it is suggested that men and

women both who take black cohosh should request liver function tests from their

doctors. It is not a bad idea for men and women who wish to take black cohosh to

discuss its use with a medical professional first.

It is also strongly advised that black cohosh and men should not mix when

prostate cancer is present. The impacts of the herbs can present too many side

issues in this case.

Other potential side effects black cohosh may have on people include such things

as seizures, slowed heart beat and vision problems. Men who experience these

side effects should immediately cease taking black cohosh. It is also extremely

wise to seek medical attention if the major side effects present themselves.

Lesser side effects of taking black cohosh can include dizziness, cramps,

vomiting, weight gain, sweating, headaches and more. It is often suggested that

the use of this herb be discontinued if the lesser effects present, as well.

Black cohosh and men can go together to battle the symptoms of male menopause

and a number of other conditions. The herb is considered very useful in the

treatment of a number of different conditions and has long been used as a

natural alternative to synthetic medicines. There have been some strong signs of

promise when black cohosh is used in extreme moderation. Long-term use remains

unclear in its potential impacts.

Although there are some promising signs for those who treat menopausal symptoms

with black cohosh, there remains a need for much greater study. Since most of

the study to date revolves around women, it is wise for men to proceed with

caution when considering this treatment.

Causes Of Itchy Skin At Night And Solutions

Many people experience itchy skin at night because of different reasons. Itchiness becomes a problem to be addressed when it starts to interfere with a person’s sleep. Insomnia can terribly interfere with the sharpness of mind and concentration. If you are seriously losing your sleep because of the intolerable itch on your skin surface, get some medical help. There are mild and serious causes of this problem. The serious causes are actually illnesses that could be eating away the internal organs of your body.

Liver cirrhosis is one of the major illnesses that cause extreme itchiness to the skin. This happens because of the bile’s end products that are conveyed to the skin and as a result it becomes irritated more evidently at night. This disease is common among men and women who suffer from alcohol addiction. Do you drink a lot? Perhaps the best thing to do now is to see your doctor for a thorough check up.

Psoriasis is a skin infection which causes inflammation at night, mainly. The inflammation follows extreme drinking sessions. It can also be caused by extreme friction from your bedding as you turn and roll during sleep. Are you a woman who is approaching old age? Menopause could be the cause of the itchy skin at night. At this stage of your life, the skin suffers dehydration and if you do not consume enough water or fluids, the skin could become scratchy during sleep.

Allergic or hypersensitive reactions can easily irritate a skin and can be caused by anything that you eat or touch with your skin. If it is happening only during sleep, perhaps there are some chemicals in the bed covers that are not reacting peacefully with your skin. It could be the laundry detergents used to wash the bedding or your sleeping gowns too. Try to change the bedclothes you are using currently and see if the itch will go away.

The tanning rays can irritate your coat in the evening. Are you spending too much time in the sun these days? Try to wear sunscreens, sun hats or something that can shield your lovely skin. This might help you get rid of the scratchy skin at night. Could you be using excess blankets at night? Extreme heat caused by many blankets can make your coating uncomfortable and irritating. In addition, taking a bath right before going to bed can contribute in dehydrating your coat which can in turn be inflamed.

Have you thought of bed bugs? This nasty bug loves human blood and for that reason they sleep right where they can access it easily and quickly. Bed bug bites are itchy. Before visiting your doctor for a liver scan, inspect your bed clothes and the bed itself. There may be blood suckers that pay you a visit in your sleep. If you find bed bugs follow the right steps and measures to eliminate them. Mild itchy skin at night can be alleviated using a number of over the counter creams. In addition, there are prescribed oral medications that can be used to get rid of skin allergic reactions.

Hair Loss Prevention and New Hair Growth Regeneration

There are many factors which can make you lose your hair. In men and women, hair loss can be caused by different lifestyle factors which are numerous to mention here; though a few common causes are listed in the next section. The common denominator of male pattern baldness and hair loss in women is a build up of a chemical known as DHT. You will find that there are dozens of products on the market that promise to be the solution to hair loss prevention from DHT and,  hair regeneration but few really live up to their promise. You can lose a lot of your hard earned money in hair loss prevention products   which do nothing to rectify the real problem of DHT buildup which shortens the lifespan of hair follicles on your scalp.

What are some of the causes hair Loss?

There are many different causes of hair loss and symptoms vary from person to person. Some are due to illness and high fevers, serious infections, major operations, menopause in women, and in some cases deep emotional depression or physical stress causes hair loss. Further causes of hair loss include thyroid diseases, low levels of iron in your body, and certain prescriptive drugs given for blood thymes, acne arthritis, and heart disease. Hair loss can also occur in women who take birth control pills, as well as after giving birth. People that suffer from eating disorders like anorexia and bulimia can also suffer extensive hair loss because their bodies will lack the nutrients and vitamins for healthy hair, and also health in general.  In women chemically treated hair dyed hair, and hairstyles that are worn too tight damages the hair follicles that causes the hair to thin and fall out.

Hair Loss Prevention with Provillus

One of the most highly acclaimed products for hair loss prevention for both men and women is certainly Provillus.  Although there are products that will slow down hair loss, what they really lack is the help to regenerate new hair growth. This natural product has all the right ingredients that your hair needs, and with regular use you will most definitely see the difference. What makes Provillus even more desirable is the fact that reputable suppliers will give you a money back guarantee when you purchase it. This is alone gives you peace of mind knowing that Provillus is a real solution for hair loss.

 

All Natural Hair Loss prevention

Provillus is an all natural hair loss prevention treatment without the harsh chemicals like many other hair treatments contain. This formula comes in capsules that can be taken orally for convenience, and you will not experience any side effects at all from using it. It is also possible to purchase this sensational product without a prescription as well, so expensive visits to the doctor are unnecessary. There are two formulations available for men or for women that contain powerful natural ingredients to stave off hair loss and promote new health hair growth.

How does hair loss prevention using Provillus work.

 

Provillus works from within your blood stream, unlike many other formulations that come as shampoos and chemical treatments. Those that have used Provillus for hair loss treatment and prevention have been delighted at the results. Make sure to buy Provillus from a reputable supplier in order to avoid inferior or knock on products. You will see soon enough that Provillus will really make a difference to combat hair loss.

Optimal Health Seekers – Stomach Trouble is Often the Beginning of Disease – 4 Easy Strategies

The digestive system is a critical system in maintain health. One of the first organs of digestion is the stomach.

Those little tummy aches as a child were the first signs of what might result in a chronic malfunction of the entire digestion system. The malfunctioning digestive system may result in almost every disease known to mankind.

Watch a baby: if there is something that doesn’t agree with its stomach, the stomach quickly contracts, squeezing the irritant out one end or the other. Vomiting and diarrhea are two of the body’s acute reactions to get rid of unwanted substances, to maintain homeostasis.

If the stomach which is continually exposed to irritation were to keep vomiting and having diarrhea, the health of the whole body would be put into jeopardy, so the stomach becomes “hardened’. It still reacts to abuse by going into a state of shock, but no longer follows through with complete contraction to the point of actual vomiting and diarrhea. When that is the case we have established one-way communication with the stomach. We eat something and tell the stomach to take it and shut up, so the stomach stops telling us what it feels. This is the way we have gone through life. Thus is the soil readied for many a disease to germinate in.

The stomach is a pretty conscientious character. If we push it past its “hardened” state it will react. Nausea, vomiting, diarrhea, heart burn, indigestion, belching, gas, bloating, appetite disorders, and ulcers are some of the signals that the stomach is having trouble. Rather than stop irritating the stomach so that it will go back to working properly, we often shut the stomach up even more. The biggest-selling drug in the world is Tagamet (cimetadine), which block histamine production by the stomach. Histamine is a chemical produced by tissue to aid inflammation, which is the body’s natural reaction to irritation. Thus Tagamet effectively blocks the stomach’s natural reaction to irritation. But does it stop the irritation?

The quantities of antacids, digestive aids and laxatives sold by pharmacies, health food stores and pyramid systems staggers the imagination. Everything from powerful drugs to foul-tasting herbal concoctions is sold. You would think that there wasn’t a stomach left that worked properly. And you would be closer to the truth than you might suspect.

Some people get very severe and dramatic digestive symptoms when they eat, and it’s not hard to convince them that abuse of the stomach is the cause of their problems. There are other patients, who eat with abandon and believe that their digestive systems are like garbage cans. ” I can eat anything and everything,” they say. If they have arthritis, heart attacks, skin problems, allergies, menstrual problems, impotency or cancer, they don’t correlate those problems with their diet or digestion, because they don’t have the obvious digestive symptoms. They do have shocked stomachs however. Stomach malfunction is the cause of the other symptoms as well, even though they may appear to be unrelated.

Here are 4 easy strategies to ensure better stomach functioning:

1. Relax while eating. If you are always in a hurry, at least make the effort to stop or at least slow down at meal time. The digestive system works optimally when in parasympathetic( relaxation) mode.

Put your attention on the process of eating. Don’t read, drive, talk on the phone, work or make love while eating if you can avoid it. Take time to enjoy and digest a meal, rather than catch your food on the run. When your attention is on the eating process, digestion isn’t a distraction, it’s the main event. Try eating in silence and you’ll be amazed at how different your food tastes.

2. Slow down at least at meal time. This allows time for the signals from the senses to get to the brain and stimulate the production of digestive enzymes, muscular contractions and other processes necessary for digestion, before the food arrives. Pavlov’s dogs salivated before the food arrived when their senses told them by association that the food was coming. Take time to look at, smell and savor your meals. Eating slowly will also ensure that your body will signal you back when it’s full and should stop eating, therefore controlling your weight naturally; most of overweight problems in this society are due to over-eating.

3. Maximize your mechanical part of the digestion process. Chew your food until it is baby-food consistency before swallowing. Chewing is the first part of the digestive process: the mechanical part which is responsible for preparation of food for the chemical( enzymatic) part foolowing. Chewing shreds fibers, mashes and macerates food and mixes it with saliva. If the food is not chewed properly, carbohydrate digestion is impeded and digestion may take much longer because the food does not have sufficient surface area exposed to the digestive juices for digestion to occur efficiently. Carnivores who often bolt their meet whole, without chewing, have much stronger digestive juices than human beings do, but for people, chewing is very important.

4. Don’t drink with your foods. Any liquid with your meals dilutes the digestive juices you need. Try to drink liquids between the meals so you won’t feel thirsty during the meal. You should stop drinking 20min. Before a meal, and resume, if necessary, 2.5 hrs. after a meal, depending on its composition.; fruits and veggies take about half an hour to digest, carbohydrates-1.5hrs., proteins-2-2.5hrs.,, mixed foods-3hrs.

Follow these easy-to-do-at home strategies and you’ll soon be on the healthy road of natural digestion on your way to optimal health.

Why House Mice Are Worse Than You Think

Property Loss Due to Infestation

Mice infestation of stored food generates greater loss than simply what the mice eat. In six months a pair of mice will eat about 4 pounds of food. These same mice will produce about 18,000 droppings from what they eat. Food contamination caused by this same pair of mice will be about 10 times the amount of food eaten. Suspected contamination will add to this loss by a significant amount.

Because of the commonplace food contamination, the government actually sanctions a certain amount of rodent hairs and droppings per quantities of food shipped for human consumption. Health inspectors work tirelessly to condemn food stores because of greater than allowable contamination.

House mice infestations also result in significant property damage beyond that of food stores. Fabrics, documents, books, and artwork all fall victim to the incessant gnawing of house mice. These rodents often gnaw at the insulation on electrical wires. This leads to estimated millions of dollars worth of damage in electrical fires each year. Many times these fires go reported as “cause unknown.”

Carriers of Disease

House mice do not cause an impact as great as rats in their disease carrying potential when food contamination is not considered. However, their impact as disease vectors should not be ignored. House mice and the parasites they host are responsible for the transmission of numerous diseases.

Salmonella

Infected rodent feces can contaminate food stores and lead to the spread of a particular type of bacterial food poisoning, called salmonellosis. Mice most likely are more prolific transmitters of this disease than rats.

Rickettsial Pox

Rickettsia akari is a specie of bacteria that causes a chicken pox type rash. This disease is transmitted across mice and then to people through the bite of the house mouse mite that infests them.

Meningitis

A viral infection of house mice, known as lymphocytic choriomeningitis, can also infect people. It is transmitted through contaminated feces or dust.

Leptospirosis (Weil’s Disease)

Weil’s Disease is a bacterial infection caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals. All though more commonly transmitted to humans by rats, house mice are serious carriers of this disease.

Dermatitis

The bite of house mice mites can transmit a disease to humans that results in uncomfortable skin irritation and itching. The cause of this irritation is frequently mistaken for heat rash, fleas, allergies and other causes. These mites are capable of spreading through an entire house stricken by mouse infestation during certain times of seasons.

Rat-bite fever, Ray Fungus, and Ringworm

These diseases and others are commonly transmitted from house mice. Infections can result from mouse droppings, carried through the mice themselves, or transmitted to pets and then passed on to humans.

Summary

House mice cause millions in property damage and food contamination every single year. It remains one of the most costly drains in the rodent population on the nations economy. While they do so less frequently then rats, house mice role in the transmission of diseases to human beings should not be understated. Comprehensive mice control procedures are essential in successfully limiting the impact on human dwellings and their severe economic effects.

Bone Cancer: Causes, Symptoms, Diagnosis, Treatment and Prognosis

Bone cancer is rare and accounts for less than 1% of all new tumors. Not all bone tumors are fatal in fact benign (non cancerous) abnormalities are more common than malignant ones. Most bone cancers are secondary and have been spread from another site. Primary bone cancer which starts in the bone is quite rare constituting less than one per cent of all malignant tumors. They are more common in males, especially in children and adolescents. The most common type of primary bone cancer is osteosarcoma. This type of carcinoma usually affects young adults. It can affect any bone, but the arms, legs and pelvis are more commonly affected. Other less common forms of primary bone cancer include Ewing sarcoma, malignant fibrous histiocytoma and chondrosarcoma.

Primary Bone Cancer
The causes of primary bone tumours are not known; however, adults who have Pagets disease (a bone disease) may have an increased risk.

Secondary bone cancer
Secondary bone cancer is the most common bone cancer. It is a carcinoma that starts somewhere else in the body and spreads (metastasises) to the bone. The most common cancers that spread to the bone originate in the breast, prostate, lung, kidney and thyroid.

Reticulum cell sarcoma of the bone
A cancerous tumor of the bone marrow presenting in more males than females.

Leukaemia
Cancer of the blood, which starts in the bone marrow

Symptoms of bore cancer
Symptoms tend to develop slowly and depend on the type, location, and size of the tumor. The signs and symptoms of bone cancer include: painful bones and joints, swelling of bones and joints, problems with movement, susceptibility to fractures. Less common symptoms include: unexplained weight loss, tiredness, fever and sweating.

Remember bone cancer is very rare so if you have any of these symptoms it is likely to be caused by another condition. Always see your doctor if you have for a diagnosis.

Causes
Although bone cancer does not have a clearly defined cause, researchers have identified several factors that increase the likelihood of developing these tumors. A small number of bone cancers are due to heredity.

Diagnosis
Bone cancer can present itself in any of the bones of the body, but it is diagnosed most often in the long bones of the arms and legs.

Diagnosing bone cancer involves a number of tests, including: X-rays and bone scans to show the exact location and size of the cancer (these are always done prior to biopsy), bone biopsy where a small sample of the cancer is removed from the bone and examined in the laboratory for the presence of malignant cells, Magnetic Resonance Imaging (MRI) scan similar to a CT scan but uses magnetism instead of x-rays to build three-dimensional pictures of your body.

Treatment
The treatment and prognosis of bone cancer depend upon multiple factors including the type and extent of the cancer, the patient’s age and overall health status. Tumors may be treated with surgery, radiation therapy, chemotherapy, or a combination of these.

Primary bone cancers:
The tumor, surrounding bone tissue and nearby lymph nodes are surgically removed. In severe cases, the affected limb may need to be amputated, but this is rare. Treatment may also include radiotherapy (x-rays to target and kill the cancer cells) and chemotherapy (anti-cancer drugs). These may be given before surgery, to shrink the cancer and/or afterwards to destroy any remaining cancer cells.

Secondary bone cancer:
Treatment depends on the treatment for the original tumor, but usually includes chemotherapy, radiotherapy or hormone therapy. Surgery may be needed to strengthen the affected bone.

Prognosis
Overall, the chance of recovery (prognosis) for bone cancers has improved significantly since the development of modern chemotherapy. The chance of recovery will depend on a variety of influences; if the cancer has spread, the type of bone cancer, the size of the tumour, location, the person’s general health and other individual factors.

If the tumor is very small and localized, the five-year survival rate is close to 90 percent. If the cancer has begun to spread, however, survival becomes more difficult. The five-year survival rate is only about 60 percent, and the prognosis is poor once the cancer spreads.

Bone cancer in cats and dogs
Bone carcinoma in dogs and cats can be a challenging disorder. Osteosarcoma is by far the most common bone tumour if dogs, usually striking the leg bones of larger breeds. Chemotherapy significantly prolongs the survival of animals with osteosarcoma when used in conjunction with surgery. For dogs Cisplatin alone or in combination with doxorubicin markedly improves survival time to a median of 8-10 months with the percentage of dogs alive after11 months at 50%.

Feline Osteosarcoma unlike its canine counterpart it has a much lower rate of metastasis and longer term survival can be expected with complete excision. Median survival for cats with osteosarcoma is approximately 2 years with many cats outreaching that.

The Top 10 Digestive Parasites

Digestive parasites cause very unpleasant symptoms. My own experience of having H pylori and Blastocystis hominis was particularly unpleasant, with digestive issues & energy problems. In fact, they are the root cause of many chronic health problems. Unfortunately western medicine does not acknowledge parasites as a problem.

Parasites are easily passed from person to person or picked up in contaminated food and water or day care centres and municipal swimming pools. The following ten parasites are regularly seen in patients’ stool samples:

#1 Helicobacter pylori

H pylori is not really a parasite, it is a bacterium. It buries into the stomach and small intestine causing heartburn, reflux, gastritis, bad breath, bloating and other digestive symptoms. It is known to cause 80% of stomach ulcers and 90% of duodenal ulcers. It can also lead to stomach cancer and possibly heart disease.

#2 Blastocystis homins

‘Blasto’ can cause practically any digestive symptom and has been linked with arthritis and weight gain. It is the most common protozoan found in stool samples with at least 10% of the western population carrying the parasite.

#3 Cryptosporidium

‘Crypto’ is also a very common parasite. It is one of the classic diarrhoea-causing parasites and there have been significant outbreaks recently in Milwaukee, Sydney (Australia) and Daventry (UK). Long term Cryptosporidium infections can be very damaging as they lead to intestinal destruction and nutritional deficiencies.

#4 Giardia lamblia

Giardia can cause the same or similar symptoms as Cryptosporidium. Foul smelling, greasy stools, wind, bloating and diarrhoea are common. This parasite can cause long term symptoms such as chronic fatigue.

#5 Entamoeba histolytica

‘E. histo’ causes amoebic dysentery. It is a very nasty bug. Severe diarrhoea, fever and vomiting are often self -limiting, but the parasite has the ability to migrate out of the GI tract and invade the liver and other organs, where it causes abscesses. Chronic symptoms include mood problems, chronic fatigue, poor blood sugar control and liver dysfunction.

#6 Dientamoeba fragilis

D. fragilis is another diarrhoea-causing infection. Although it is not usually as severe as E. histo, it can cause a multitude of chronic symptoms.

#7 Strongyloides (threadworm)

I see threadworm quite regularly in client’s stool tests. Adults live in the upper part of the small intestine. Larvae get into the body through the skin then migrate to the lungs where they may cause respiratory symptoms such as coughing and mucus. The larvae are coughed up and enter the GI tract where they mature. Adult worms cause similar symptoms to H pylori and are often misdiagnosed as ulcer disease and GERD.

#8 Trichuris trichiura (whipworm)

Whipworm is relatively common and may cause similar symptoms to any of the parasites listed above, such as bloating, diarrhoea and constipation.

#9 Enterobius vermicularis (pinworm)

Pinworm is usually thought of as a childhood infection, but it is also frequently seen in adults. It does not often cause significant symptoms, but rectal itching is common.

#10 Necator americanus (hookworm)

In my experience, hookworm infections can be very nasty. Although the worms are only very small, because they attach and hook to the intestinal wall, they can cause significant damage to digestion and cause a great deal of stress on the body.

If you have unexplained, chronic symptoms of any kind, suspect that parasites are playing a role, even if you do not have digestive symptoms. Click on the link below to discover how to get tested.

The Top 10 Digestive Parasites

Digestive parasites cause very unpleasant symptoms. My own experience of having H pylori and Blastocystis hominis was particularly unpleasant, with digestive issues & energy problems. In fact, they are the root cause of many chronic health problems. Unfortunately western medicine does not acknowledge parasites as a problem.

Parasites are easily passed from person to person or picked up in contaminated food and water or day care centres and municipal swimming pools. The following ten parasites are regularly seen in patients’ stool samples:

#1 Helicobacter pylori

H pylori is not really a parasite, it is a bacterium. It buries into the stomach and small intestine causing heartburn, reflux, gastritis, bad breath, bloating and other digestive symptoms. It is known to cause 80% of stomach ulcers and 90% of duodenal ulcers. It can also lead to stomach cancer and possibly heart disease.

#2 Blastocystis homins

‘Blasto’ can cause practically any digestive symptom and has been linked with arthritis and weight gain. It is the most common protozoan found in stool samples with at least 10% of the western population carrying the parasite.

#3 Cryptosporidium

‘Crypto’ is also a very common parasite. It is one of the classic diarrhoea-causing parasites and there have been significant outbreaks recently in Milwaukee, Sydney (Australia) and Daventry (UK). Long term Cryptosporidium infections can be very damaging as they lead to intestinal destruction and nutritional deficiencies.

#4 Giardia lamblia

Giardia can cause the same or similar symptoms as Cryptosporidium. Foul smelling, greasy stools, wind, bloating and diarrhoea are common. This parasite can cause long term symptoms such as chronic fatigue.

#5 Entamoeba histolytica

‘E. histo’ causes amoebic dysentery. It is a very nasty bug. Severe diarrhoea, fever and vomiting are often self -limiting, but the parasite has the ability to migrate out of the GI tract and invade the liver and other organs, where it causes abscesses. Chronic symptoms include mood problems, chronic fatigue, poor blood sugar control and liver dysfunction.

#6 Dientamoeba fragilis

D. fragilis is another diarrhoea-causing infection. Although it is not usually as severe as E. histo, it can cause a multitude of chronic symptoms.

#7 Strongyloides (threadworm)

I see threadworm quite regularly in client’s stool tests. Adults live in the upper part of the small intestine. Larvae get into the body through the skin then migrate to the lungs where they may cause respiratory symptoms such as coughing and mucus. The larvae are coughed up and enter the GI tract where they mature. Adult worms cause similar symptoms to H pylori and are often misdiagnosed as ulcer disease and GERD.

#8 Trichuris trichiura (whipworm)

Whipworm is relatively common and may cause similar symptoms to any of the parasites listed above, such as bloating, diarrhoea and constipation.

#9 Enterobius vermicularis (pinworm)

Pinworm is usually thought of as a childhood infection, but it is also frequently seen in adults. It does not often cause significant symptoms, but rectal itching is common.

#10 Necator americanus (hookworm)

In my experience, hookworm infections can be very nasty. Although the worms are only very small, because they attach and hook to the intestinal wall, they can cause significant damage to digestion and cause a great deal of stress on the body.

If you have unexplained, chronic symptoms of any kind, suspect that parasites are playing a role, even if you do not have digestive symptoms. Click on the link below to discover how to get tested.

Treatment Options for Pneumonia

Pneumonia is the inflammatory condition of lungs. It is often characterized by the inflammation of parenchyma of lungs and alveolar filling with fluid.

The alveoli are the microscopic air sacs present in lungs responsible for gas exchange.

Pneumonia can result from variety of infections. Some of the common causes of pneumonia are as follows.

Causes of Pneumonia:

Pneumonia is caused by inhalation of infected micro organisms spread through contact of infected person. If the body resistance is low, the natural process of fighting off the disease is weakened and the micro organisms are free to spread in the lungs. The sir sacs are filled with fluid and pus from the infectious agents making it more difficult to get oxygen hence resulting in sickness. The main causes of pneumonia are

  • Bacteria
  • Viruses
  • Fungi
  • Parasites
  • Chemical or Physical Injury to Lungs

Symptoms:

The normal symptoms of pneumonia are

  • Cough
  • Chest Pain
  • Fever
  • Difficulty in Breathing

The treatment of pneumonia depends on the type of cause. The bacterial pneumonia is treated with antibiotics. Pneumonia is the common disease occurring in the persons having weak immune system. There are various vaccines available for preventing and treating pneumonia.

Medical Treatment of Pneumonia:

The treatment of pneumonia depends on the cause and type of pneumonia. The treatments for different types of pneumonia are listed below.

Bacterial Pneumonia: It is treated with penicillin, ampicillin clavulanate and erythromycin. Pneumonia caused by influenza bacteria is treated with antibiotics like cefuroxime, ofloxacin and trimethoprim sulfanethoxazole.

Viral Pneumonia: This pneumonia doesn’t responds to antibiotics. If the lungs are infected with secondary bacterial infection, doctors prescribe the appropriate antibiotic for eliminating bacterial infection.

Mycoplasma Pneumonia: It is treated with antibiotics like erythromycin, clarithromycin, tetracycline and azithromycin.

Along with the medical prescription, doctors will also recommend bed rest, intake of fluids, breathing exercises, proper diet and pain relievers. In severe cases, artificial ventilation and oxygen therapy may be required.

Home Treatment for Pneumonia:

  • Pneumonia can be treated in early stage by having the tea prepared from the leaves of fenugreek seeds. Have four cups of tea every day. Reduce the intake rate, once the condition improves.
  • Garlic is the most important component in curing pneumonia. Adding garlic in the food of the patient can be helpful. Garlic paste can also be applied on the chest of the patient to improve respiration and pulse.
  • Crush 15 gms of sesame seeds and add it in 250 ml water. Mix it with one tablespoon of honey and linseed. Add a pinch of salt to it and consume the mixture. This is much effective in treating pneumonia.
  • The combination of carrot juice and beet with cucumber juice or spinach juice is also beneficial in curing pneumonia.
  • Apply the turpentine oil over the patient’s rib cage and cover the area with warm cloth.
  • Take the juice of 5 to 6 holy Basil leaves and add some black pepper to it. Consume this every 6 hours. This can relieve you from the pains.

Most causes of pneumonia can be treated at home. However, if the symptoms last for many days, approach the doctor as soon as possible.

A Few Facts About Heart Murmurs

To begin with, what are heart murmurs? They can be described as unusual sounds heard while the heart beats. A stethoscope helps your doctor to hear them. To your knowledge, most murmurs are not dangerous or life-threatening. They often resolve on their own and even if they don’t and stick around, they will cause no serious health problem.

Stated simply, murmurs are caused by blood flow through a damaged heart valve. As a result, the efficiency of the heart to pump blood will be reduced, which if not treated properly, may even cause a congestive heart failure. When this happens your venous blood pressure will be increased causing swelling and edema in the lower part of your legs (Ankle Edema). Apart from that, the excess fluid that builds up may also induce breathing difficulty. This means that you will have restrictions in doing the things you normally love to do and your style of life will be affected.

Apart from the brain, the heart is undoubtedly the most important organ in our body. The main function of heart is to pump blood to all parts of the body so that all our organs and tissues can get sufficient amount of oxygen and nutrients which are required for optimum health.

When you first visit your doctor, the first thing he will do is listening to your lungs and heart using a stethoscope. He will listen to both normal and abnormal sounds such as a murmur. There may be various causes for such a heart murmur. They may be genetic in nature or may have occurred due to a serious defect in the heart present at birth. Apart from these, damages to a heart valve can also occur from a bacterial or viral infections, or due to poor lifestyle habits such as cigarette smoking or alcohol consumption.

Keep in mind that when taken alone, a cardiac murmur is not a disease but an indicator of a more serious underlying disease. To be exact, there are mainly 2 classes of heart murmurs. The first type is called an innocent heart murmur which rarely requires treatment. The second type is called an abnormal murmur. These types of murmurs occur usually due to some other serious heart conditions which require ongoing and immediate treatment.

if your doctor suspects an abnormal heart murmur, he will order a series of blood tests as well as ultrasound examination of the heart (Echocardiogram).