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Deep Vein Thrombosis

Deep Vein Thrombosis: DVT Causes, Symptoms, and Treatment – Medlife Blog:  Health and Wellness Tips

Deep vein thrombosis (DVT)  can happen to anybody and can cause serious illness, disability, and in some cases, death. The good news is that DVT is preventable and treatable if discovered early.

What is Deep vein thrombosis (DVT)

Deep vein thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein. These clots usually develop in the lower leg, thigh, or pelvis, but they can also occur in the arm.If blood moves too slowly through your veins, it can cause a clump of blood cells called a clot. When a blood clot forms in a vein deep inside your body, it causes what doctors call deep vein thrombosis (DVT). Deep vein thrombosis can cause leg pain or swelling, but also can occur with no symptoms.

Deep vein thrombosis can develop if you have certain medical conditions that affect how your blood clots. It can also happen if you don’t move for a long time, such as after surgery or an accident, or when you’re confined to bed.

Symptoms of DVT :

About half of people with DVT have no symptoms at all. The following are the most common symptoms of DVT that occur in the affected part of the body:

  • throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
  • swelling in 1 leg (rarely both legs)
  • warm skin around the painful area
  • red or darkened skin around the painful area
  • swollen veins that are hard or sore when you touch them

These symptoms also happen in your arm or tummy if that’s where the blood clot is.

Pulmonary embolism

A serious complication associated with deep vein thrombosis is pulmonary embolism.

A pulmonary embolism occurs when a blood vessel in your lung becomes blocked by a blood clot (thrombus) that travels to your lung from another part of your body, usually your leg.

A pulmonary embolism can be life-threatening. It’s important to watch for signs and symptoms of a pulmonary embolism and seek medical attention if they occur. Signs and symptoms of a pulmonary embolism include:

  • Sudden shortness of breath
  • Chest pain or discomfort that worsens when you take a deep breath or when you cough
  • Feeling lightheaded or dizzy, or fainting
  • Rapid pulse
  • Coughing up blood

Postphlebitic syndrome

A common complication that can occur after deep vein thrombosis is known as postphlebitic syndrome, also called postthrombotic syndrome. Damage to your veins from the blood clot reduces blood flow in the affected areas, which can cause:

  • Persistent swelling of your legs (edema)
  • Leg pain
  • Skin discoloration
  • Skin sores

Causes/Risk Factors for DVT?

Many things can raise your chances of getting DVT. Here are some of the most common:

  • Age. DVT can happen at any age, but your risk is greater after age 40.
  • Sitting for long periods. When you sit for long stretches of time, the muscles in your lower legs stay lax. This makes it hard for blood to circulate, or move around, the way it should. Long flights or car rides can put you at risk.
  • Bed rest, like when you’re in the hospital for a long time, can also keep your muscles still and raise your odds of DVT.
  • Pregnancy . Carrying a baby puts more pressure on the veins in your legs and pelvis. What’s more, a clot can happen up to 6 weeks after you give birth.
  • Obesity . People with a body mass index (BMI) over 30 have a higher chance of DVT. This measures how much body fat you have, compared with your height and weight.
  • Serious health issues. Conditions like Irritable bowel disease, cancer, and heart disease can all raise your risk.
  • Certain inherited blood disorders. Some diseases that run in families can make your blood thicker than normal or cause it to clot more than it should.
  • Injury to a vein. This could result from a broken bone, surgery, or other trauma.
  • Smoking makes blood cells stickier than they should be. It also harms the lining of your blood vessels. This makes it easier for clots to form.
  • Birth control pills or hormone replacement therapy. The estrogen in these raises your blood’s ability to clot. (Progesterone-only pills don’t have the same risk.)

Diagnosis:

The diagnosis of superficial thrombophlebitis usually is made by the doctor based upon history, potential risk factors present, and findings from the physical examination.

If the probability of a leg thrombosis is low, a D-Dimer blood test may be ordered.

  • If the D-Dimer is negative, then it is unlikely that a DVT is the diagnosis.
  • If the D-dimer is elevated, then the possibility of a DVT exists and an imaging study, usually ultrasound, is required to look for the DVT

Ultrasound

  • Ultrasound is the standard method of diagnosing the presence of a deep vein thrombosis.
  • Other tests

    • Venography, injecting dye into the veins to look for a thrombus, is not usually performed anymore and has become more of a historical footnote.
    • Other blood testing may be considered based on the potential cause for the deep vein thrombosis.

 

Treatments for DVT and PE

DVT

Medication is used to prevent and treat DVT. Compression stockings (also called graduated compression stockings) are sometimes recommended to prevent DVT and relieve pain and swelling. These might need to be worn for 2 years or more after having DVT. In severe cases, the clot might need to be removed surgically.

PE

Immediate medical attention is necessary to treat PE. In cases of severe, life-threatening PE, there are medicines called thrombolytics that can dissolve the clot.  Other medicines, called anticoagulants, may be prescribed to prevent more clots from forming. Some people may need to be on medication long-term to prevent future blood clots.

Treating DVT at Home

When you return home after DVT treatment, your goals are to get better and prevent another blood clot. You’ll need to:

  • Take medications as directed. After a DVT, you’ll take blood thinners for at least 3 to 6 months.
  • See your doctor often. They’ll let you know if your medications are helping and make adjustments if you need them. If you’re taking warfarin, you’ll get a blood test to see how well your blood is clotting.
  • Make sure you aren’t bleeding too much. This is a side effect of blood thinner medications. Even a small cut can get serious when you’re taking blood thinners.
  • Be safe. Talk to your doctor about things that can lead to bruises or cuts. Try not to bump or injure your legs. Don’t cross your legs.
  • Stay active. Even if you’ve been on bed rest after surgery or for other reasons, get moving. That’s a sure way to prevent more blood clots. Don’t sit or stand still for more than an hour at a time. Change positions often, especially if you’re on a long trip.
  • Wear compression stockings. The most common kinds of these special socks go from the arch of your foot to just below or above your knee. They can relieve the pain and swelling in your legs, and they help prevent more clots. Compression stockings come in different levels of pressure. You can get mild ones over the co

     Preventing DVT.

  • Some simple actions include:
    • Lose weight.
    • Exercise.
    • Don’t stay still for long periods — move every 2 hours or so when you’re on a plane or long car trip.
    • Wear loose clothes and drink lots of water when you travel.

    unter, but you’ll need to get fitted and a prescription for stronger ones. Your doctor will help you figure out what kind you need.

  • You may have to wear them for 2 years or longer after you have DVT.
  • Eat a healthy, low-salt diet. Extra pounds put more pressure on the veins in your pelvis and legs. Salt boosts your blood pressure. Keeping your sodium and cholesterol levels low can help you avoid another blood clot.
  • Work on losing weight if you’re carrying extra pounds.
  • Quit smoking. It affects blood flow and circulation, which can raise your odds of getting another clot.
  • Lift up. Raise the bottom of your bed 6 inches off the ground. You can use blocks, books, or special risers you can find online or at home stores

When Traveling

On flights longer than 4 hours, get up and move around. Take the opportunity to walk and stretch between connecting flights, too.

When you’re traveling by car, stop when you can to walk around.

If you’re stuck in your seat, work the muscles in your legs often throughout your trip:

  • Stretch your legs.
  • Flex your feet.
  • Curl or press your toes down.

Drink plenty of fluids, but avoid coffee and alcohol. They’ll dehydrate you, which makes your veins narrower and blood thicker, so you’re more likely to get a clot.

Don’t wear short, tight socks, and try not to cross your legs a lot. You might want to wear compression stockings. They’ll help your blood flow and keep swelling down.

Take Away

Deep vein thrombosis (DVT)  can happen to anybody and can cause serious illness, disability, and in some cases, death. The good news is that DVT is preventable and treatable if discovered early.

A healthylifestyle is important for preventing DVT and helping to avoid life-threatening complications. Plus, a healthy lifestyle incorporates many of the changes that are necessary to prevent blood clots. This includes moving more, quitting smoking, and losing weight.

You can lower your risk for DVT and blood clots with a healthy diet. Fruits, vegetables, and whole grains deliver essential vitamins and minerals.

Review any vitamins or supplements you take with your doctor and ask about possible interactions with medications. It’s also important you talk with your doctor about any foods or nutrients you should avoid.

 

 

 

Soy Protein: Good or Bad?

The Festival of lights (6)

 

Soy protein is a protein that is isolated from soybeans, offers multiple health benefits(Glycine max) are a type of legume native to eastern Asia. Soy protein has received increased attention in recent years among consumers, researchers, and themedia.Individuals with a habitually health-conscious lifestyle (e.g., individuals who did not eat meat, but did eat fish, or were vegetarians or vegans) were more likely to consume soy foods than the average personSoybeans are healthful and rich in protein, giving them numerous nutritional uses. People can eat them, drink them in milk alternatives, and take them in the form of supplements.They are an important component of Asian diets and have been consumed for thousands of years. Today, they are mainly grown in Asia and South and North America.

Nutrition Facts:

Soybeans are among the best sources of plant-based protein.

Soy protein isolate powder is made from defatted soybean flakes that have been washed in either alcohol or water to remove the sugars and dietary fiber. They’re then dehydrated and turned into a powder.

This product contains very little fat and no cholesterol.

Soy protein powder is used to make infant soy formula, as well as a variety of meat and dairy alternatives.

Soybeans are low in saturated fat and high in protein, vitamin C, and folate. They are also a good source of:

  • calcium
  • iron
  • magnesium
  • phosphorus
  • potassium
  • thiamin

The nutritional content of other soy products may vary based on how manufacturers have processed them and which ingredients they have added.

Benefits

Pregnancy

Use of soy products during pregnancy can be encouraged because expectant women are likely to receive the same health benefits as other women. Fortified milk and fortified soymilk are the only reliable dietary sources of vitamin D  All other dairy products contain little or no vitamin D. While many women will obtain enough vitamin D from exposure to sunlight, soymilk may be an alternative for those who are overly sensitive to the sun or for those who simply are not able to be or do not enjoy being outdoors. Soymilk may also be an alternative for women who do not like regular milk.

Cardiac

Consumption of soy protein in place of animal protein has been found to reduce serum concentrations of total cholesterol, low-density lipoproteins (LDLs), and trigylcerides. Individuals with elevated cholesterol seem to receive the greatest benefit.

Obesity and Diabetes

In recent studies, soy protein contributed to the control of hyperglycemia and reduced body weight, hyperlipidemia, and hyperinsulinemia. These characteristics may be useful to both nondiabetic and diabetic persons in the control of obesity and blood sugar.

Cancer Prevention

Genistein, one of the phytochemicals found in soy, can reduce the risk of cancer.  prevention of breast cancer has received the most attention, and more recent attention has focused on prostate cancer. Genistein blocks cancer development by preventing tumors from creating blood vessels that would provide nourishment for growth .

Vegetarians and Vegans

Vegetarians are individuals who, for various reasons, do not eat meat. Vegans, in comparison, are individuals who do not eat any products from animals, including eggs, milk, and cheese. Vitamin B12 is only found in animal products and, therefore, may be lacking in the diet of vegans. Use of soymilk is one way to obtain this essential vitamin. Cereals and meat substitutes are other options.

Infants

Infants who are not able to tolerate lactose formulas (those based on cow’s milk, casein/whey-based formulas; e.g., Similac, Enfamil, Carnation) may be prescribed soy-based formulas if they are not breastfed

Types and uses

Soybeans are a high protein plant food that people can prepare and eat in a variety of ways.

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Soybeans come in many colors, including:

  • Green soybeans: Young green soybeans are also called edamame. People can steam them and eat them out of the pod as an appetizer. Shelled edamame is also available in salads, stir-fries, and soups.
  • Yellow soybeans: Producers typically use yellow soybeans to make soy milk, tofu, tempeh, and tamari. They also play a role in the production of soy flour for baking.
  • Black soybeans: Several Asian food cultures use simmered or fermented black soybeans in traditional dishes.

Soy milk and cheese are also options for those looking to replace dairy in the diet.

Soybeans also provide soy oil, which people can use for cooking or as an ingredient. After removing the oil from soybeans, people can use the remaining material to make food for farm animals and pets.

Some manufacturers make protein powder and isoflavone supplements from soy. Isoflavones are plant compounds that have a similar structure to estrogen.

Less processed organic soy is the most healthful option. Some examples include:

  • cooked soybeans
  • edamame
  • soy milk
  • tofu
  • tempeh
  • soy nuts

Risk

Some people have concerns about the consumption of soy. We cover these concerns in more detail in the sections below.

  • Thyroid function

There is some concern that soy intake may interfere with thyroid function.

Researchers found that women with higher soy intake had a higher chance of having elevated levels of thyroid stimulating hormone (TSH).

A high TSH level may signify an underactive thyroid. Researchers did not find the same results in men.

The authors explain that soy is likely to be safe. However, consuming excessive amounts may create health risks in some people, such as those with undiagnosed hypothyroidism.

  • Flatulence and diarrhea

Like most other beans, soybeans contain insoluble fibers, which may cause flatulence and diarrhea in sensitive individuals.If you have IBS, avoiding or limiting the consumption of soybeans may be a good idea.

  • Soy allergy

Food allergy is a common condition caused by a harmful immune reaction to certain components in foods.Soy allergy is triggered by soy proteins — glycinin and conglycinin — found in most soy products. Even though soybeans are one of the most common allergenic foods, soy allergy is relatively uncommon in both children and adults

Take Away

Soy protein is a complete source of protein,offer benefits to women in various life stages. It may aid muscle building, improved diet and cardiovascular status, prevention of certain types of cancer, improved health following menopause, obesity prevention/control, and more options for food variety. Overall, soy is safe for most people and may offer health benefits, including weight loss.If you like the taste or eat plant-based, go ahead and give soy protein a try.

 

Lung Cancer

robina-weermeijer-Pw9aFhc92P8-unsplashThe month of November brings lung cancer into focus and brings awareness to the ways we can all strive to improve our lung health and empower those impacted by the disease.Lung cancer is the most common cause of death due to cancer in both men and women throughout the world. Nearly 9 out of 10 lung cancers are caused by smoking cigarettes.

What Is Lung Cancer?

Cancer is a disease in which cells in the body grow out of control. When cancer starts in the lungs, it is called lung cancer.One of the most common cancers, lung cancer usually occurs when a cancer-causing agent, or carcinogen, triggers the growth of abnormal cells in the lung. These cells multiply out of control and eventually form a tumor. As the tumor grows, it destroys nearby areas of the lung. Eventually, tumor cells can spread (metastasize) to nearby lymph nodes and other parts of the body. These include the

  • liver
  • bones
  • adrenal glands
  • brain.

In most cases, the carcinogens that trigger lung cancer are chemicals found in cigarette smoke. However, more and more lung cancers are being diagnosed in people who have never smoked.

Lung Cancer

Types of Lung Cancer:

Lung cancers are divided into two groups, based on how their cells look under the microscope:

  • Non-small cell lung cancer (NSCLC)
  • Small cell lung cancer.(SCLC)

Non-small cell lung cancer may be localized. This means that it is limited to the lung or that it hasn’t spread beyond the chest. As a result, it can usually be treated with surgery. Small cell lung cancer is rarely localized, even when it is detected early. It is rarely treated with surgery. Knowing whether the cancer has spread is critical, because it affects treatment decisions.

However, even when doctors think that the cancer is localized, it often comes back shortly after surgery. This means cancer cells had started to spread before surgery, but they couldn’t yet be detected.

Non-small cell lung cancer

Non-small cell lung cancer is more likely than small cell cancer to be localized at the time of diagnosis. It also is more likely than small cell cancer to be treatable with surgery. It often responds poorly to chemotherapy (anticancer drugs). However, sophisticated genetic tests can help predict which patients may show favorable responses to particular treatments, including chemotherapy.

Non-small cell lung cancer accounts for about 85% of all lung cancers. These cancers are divided into subgroups, based on how their cells look under a microscope:

  • Adenocarcinoma. This is the most common type of lung cancer. Although it is related to smoking, it is the most common type of lung cancer in nonsmokers. It is also the most common form of lung cancer in women and in people younger than 45. It usually develops near the edge of the lung. It can also involve the pleura, the membrane covering the lung.
  • Squamous cell carcinoma. This type of lung cancer tends to form a mass near the center of the lungs. As the mass gets larger, it can bulge into one of the larger air passages, or bronchi. In some cases, the tumor forms a cavity in the lungs.
  • Large cell carcinoma. Like adenocarcinoma, large cell carcinoma tends to develop at the edge of the lungs and spread to the pleura. Like squamous cell carcinoma, it can form a cavity in the lungs.
  • Adenosquamous carcinoma, undifferentiated carcinoma, and bronchioloalveolar carcinoma.These are relatively rare non-small cell lung cancers. Adenosquamous carcinoma has a worse prognosis compared to either adenocarcinoma or squamous cancer.

Small cell lung cancer 

At the time of diagnosis, small cell lung cancer is more likely than non-small cell cancer to have spread beyond the lung. This makes it almost impossible to cure with surgery. However, it can be managed with chemotherapy or radiation therapy. Small cell cancers account for about 15% of all lung cancers.

Causes and Risk factors:

Risk of all types of lung cancer increase if you:

  • smoke. Smoking cigarettes is by far the leading risk factor for lung cancer. In fact, cigarette smokers are 13 times more likely to develop lung cancer than nonsmokers. Cigar and pipe smoking are almost as likely to cause lung cancer as cigarette smoking.
  •  Exposed to radon gas. Radon is a colorless, odorless radioactive gas formed in the ground. It seeps into the lower floors of homes and other buildings and can contaminate drinking water. Radon exposure is the second leading cause of lung cancer. It’s not clear whether elevated radon levels contribute to lung cancer in nonsmokers. But radon exposure does contribute to lung cancer in smokers and in people who regularly breathe high amounts of the gas at work (miners, for example). You can test radon levels in your home with a radon testing kit.
  • Exposed to asbestos. Asbestos is a mineral used in insulation, fireproofing materials, floor and ceiling tiles, automobile brake linings, and other products. People exposed to asbestos on the job (miners, construction workers, shipyard workers, and some auto mechanics) have a higher-than-normal risk of lung cancer. People who live or work in buildings with asbestos-containing materials that are deteriorating also have an increased risk of lung cancer. The risk is even higher in people who also smoke. Asbestos exposure also increases the risk of developing mesothelioma. It’s a relatively rare and usually fatal cancer that starts in the lining of the lungs.
  • Exposed to other cancer-causing agents at work. These include uranium, arsenic, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust.
  • Passive smoking: Passive smoking or the inhalation of tobacco smoke by non-smokers who share living or working quarters with smokers, also is an established risk factor for the development of lung cancer.
  • Air pollution : Air pollution from vehicles, industry, and power plants can raise the likelihood of developing lung cancer in exposed individuals. Up to 1%-2% of lung cancer deaths are attributable to breathing polluted air, and experts believe that prolonged exposure to highly polluted air can carry a risk for the development of lung cancer similar to that of passive smoking.

  • Exposure to diesel exhaust: Exhaust from diesel engines contains gases and soot (particulate matter). Many occupations, such as truck drivers, tollbooth workers, forklift and other heavy machinery operators, railroad and dock workers, miners, garage workers and mechanics, and some farm workers are frequently exposed to diesel exhaust. Studies of workers exposed to diesel exhaust have shown a small but significant increase in the risk of developing lung cancer.
  • Prior history of lung cancer:  Survivors of lung cancer have a greater risk of developing a second lung cancer than the general population has of developing a first lung cancer. Survivors of non-small-cell lung cancers (NSCLCs) have an additive risk of 1%-2% per year for developing a second lung cancer. In survivors of small-cell lung cancers (SCLCs), the risk for development of second lung cancers approaches 6% per year.

Symptoms:

In some cases, lung cancer is detected when a person with no symptoms has a chest x-ray or computed tomography (CT) scan for another reason. But most people with lung cancer have one or more of these symptoms:

  • a cough that doesn’t go away
  • coughing up blood or mucus
  • wheezing
  • shortness of breath
  • trouble breathing
  • chest pain
  • fever
  • discomfort when swallowing
  • hoarseness
  • weight loss
  • poor appetite.
  • an irregular heart beat if the cancer is located close to the heart

If the cancer has spread beyond the lungs, it can cause other symptoms. For example, you may have bone pain if it has spread to your bones.

Certain small cell lung cancers may secrete chemicals that can alter the body’s chemical composition. For example, levels of sodium and calcium may be abnormal. This can lead to the diagnosis of small cell lung cancer.

Many of these symptoms can be caused by other conditions. See your doctor if you have symptoms so that the problem can be diagnosed and properly treated.

Diagnosis

Your doctor may suspect lung cancer based on

  • your symptoms
  • your smoking history
  • whether you live with a smoker
  • your exposure to asbestos and other cancer-causing agents.

To look for evidence of cancer, your doctor will examine you, paying special attention to your lungs and chest. He or she will order imaging tests to check your lungs for masses. In most cases, a chest x-ray will be done first. If the x-ray shows anything suspicious, a CT scan will be done. As the scanner moves around you, it takes many pictures. A computer then combines the images. This creates a more detailed image of the lungs, allowing doctors to confirm the size and location of a mass or tumor.

You may also have a magnetic resonance imaging (MRI) scan or a positron emission tomography (PET) scanMRI scans provide detailed pictures of the body’s organs, but they use radio waves and magnets to create the images, not x-rays. PET scans look at the function of tissue rather than anatomy. Lung cancer tends to show intense metabolic activity on a PET scan. Some medical centers offer combined PET-CT scanning.

If cancer is suspected based on these images, more tests will be done to make the diagnosis, determine the type of cancer, and see if it has spread. These tests may include the following:

  • Sputum sample. Coughed up mucus is checked for cancer cells.
  • Biopsy. A sample of abnormal lung tissue is removed and examined under a microscope in a laboratory. If the tissue contains cancer cells, the type of cancer can be determined by the way the cells look under the microscope. The tissue is often obtained during a bronchoscopy. However, surgery may be necessary to expose the suspicious area.
  • Bronchoscopy. During this procedure, a tube-like instrument is passed down the throat and into the lungs. A camera on the end of the tube allows doctors to look for cancer. Doctors can remove a small piece of tissue for a biopsy.
  • Mediastinoscopy. In this procedure, a tube-like instrument is used to biopsy lymph nodes or masses between the lungs. (This area is called the mediastinum.) A biopsy obtained this way can diagnose the type of lung cancer and determine whether the cancer has spread to lymph nodes.
  • Fine-needle aspiration. With a CT scan, a suspicious area can be identified. A tiny needle is then inserted into that part of the lung or pleura. The needle removes a bit of tissue for examination in a laboratory. The type of cancer can then be diagnosed.
  • Thoracentesis. If there is fluid build-up in the chest, it can be drained with a sterile needle. The fluid is then checked for cancer cells.
  • Video-assisted thoracoscopic surgery (VATS). In this procedure, a surgeon inserts a flexible tube with a video camera on the end into the chest through an incision. He or she can then look for cancer in the space between the lungs and the chest wall and on the edge of the lung. Abnormal lung tissue can also be removed for a biopsy.
  • Bone scans, MRI scans and CT scans. These imaging tests can detect lung cancer that has spread to the bones, brain, or other parts of the body.

Stages:

After the cancer has been diagnosed, it is assigned a “stage.” The stages differ for non-small cell lung cancer and small cell lung cancer.

Non-small cell lung cancer

Stages of non-small cell lung cancer reflect the tumor’s size and how far the cancer has spread. Stages I through III are further divided into A and B categories.

  • Stage I tumors are small and have not invaded the surrounding tissue or organs.
  • Stage II and III tumors have invaded surrounding tissue and/or organs and have spread to lymph nodes.
  • Stage IV tumors have spread beyond the chest.

Small Cell Lung Cancer

Many experts divide small cell lung cancers into two groups:

  • Limited stage. These cancers involve only one lung and the nearby lymph nodes.
  • Extensive stage. These cancers have spread beyond the lung to other areas of the chest or to distant organs.

Knowing the type of cancer and its stage helps doctors determine the best treatment. Limited stage cancer, for example, may be treated with surgery and/or chemotherapy. Extensive stage cancer is much less likely to be cured.

However, many doctors now stage small cell lung cancers like non-small cell lung cancers. This more formal method may make the terms limited stage and extensive stage obsolete.

Treatment

After lung cancer has been diagnosed, the type of treatment depends on the type of cancer and how much the tumor has spread i.e, its stage.

Non-small cell lung cancer

Surgery is the main treatment for non-small cell lung cancers that have not spread beyond the chest. The type of surgery will depend on the extent of the cancer. It will also depend on whether other lung conditions, such as emphysema, are present.

There are three types of surgery:

  • Wedge resection removes only a small part of the lung.
  • Lobectomy removes one lobe of the lung.
  • Pneumonectomy removes an entire lung.

Lymph nodes are also removed and examined to see if the cancer has spread.

Some surgeons use video-assisted thoracoscopy (VATS) to remove small, early-stage tumors, especially if the tumors are near the outer edge of the lung. (VATS can also be used to diagnose lung cancer.) Because the incisions for VATS are small, this technique is less invasive than a traditional “open” procedure.

Because surgery will remove part or all of a lung, breathing may be more difficult afterwards, especially in patients with other lung conditions (emphysema, for example). Doctors can test lung function prior to surgery and predict how it might be affected by surgery.

Depending on how far the cancer has spread, treatment may include chemotherapy (the use of anticancer drugs) and radiation therapy. These may be given before and/or after surgery.

When the tumor has spread significantly, chemotherapy may be recommended to slow its growth, even if it cannot cure the disease. Chemotherapy has been shown to ease symptoms and prolong life in cases of advanced lung cancer.

Radiation therapy can relieve symptoms, too. It is often used to treat lung cancer that has spread to the brain or bones and is causing pain. It can also be used alone or with chemotherapy to treat the lung cancer that is confined to the chest.

People who may not withstand surgery due to other serious medical problems may receive radiation therapy, with or without chemotherapy, as an alternative to surgery. Advances in radiation have made it possible for prolonged survival in some people, with results similar to surgery.

In specialized cancer centers, cancerous tissue may be tested for specific genetic abnormalities (mutations). Doctors may then be able to treat the cancer with a “targeted therapy.” These therapies can derail the cancer’s growth by preventing or changing chemical reactions linked to particular mutations. For example, some target therapies prevent cancer cells from receiving chemical “messages” telling them to grow.

Knowing about specific genetic mutations can help predict which therapy will be best. This strategy can be especially helpful in certain patients, such as women with adenocarcinoma of the lung who have never smoked.

Small cell lung cancer

The treatment of small cell lung cancer depends on its stage:

  • Limited stage. Treatments include various combinations of chemotherapy, radiation and, rarely, surgery, with or without radiation to the brain to prevent cancer spread. While small cell lung cancer often responds well to chemotherapy, it very often returns months or even years later.
  • Extensive stage. Treatments include chemotherapy, with or without brain radiation, or radiation treatments to areas of existing metastases in the brain, spine or other bones. Even if the imaging tests show that the cancer has not spread to the brain, many experts suggest treating the brain anyway. That’s because cancer cells may be there even if they haven’t yet shown up on the imaging tests. The question of whether or not to use brain radiation must be considered carefully; many patients experience memory loss afterwards. The decision to use brain radiation is a very crucial one, since many patients may experience a decrease in memory function after radiation therapy, with or without chemotherapy.

Prevention of lung cancer

KEY POINTS

  • Avoiding risk factors and increasing protective factors may help prevent lung cancer.
  • The following are risk factors for lung cancer:
    • Cigarette, cigar, and pipe smoking
    • Secondhand smoke
    • Family history
    • Environmental risk factors
    • Beta carotene supplements in heavy smokers
  • The following are protective factors for lung cancer:
    • Not smoking
    • Quitting smoking
    • Lower exposure to workplace risk factors
    • Lower exposure to radon.

Home remedies for lung cancer symptoms

Home remedies and homeopathic remedies won’t cure cancer. But certain home remedies may help relieve some of the symptoms associated with lung cancer and side effects of treatment.

Ask your doctor if you should take dietary supplements and if so, which ones. Some herbs, plant extracts, and other home remedies can interfere with treatment and endanger your health. Be sure to discuss all complementary therapies with your doctor to make sure they’re safe for you.

Options may include:

  • Massage: With a qualified therapist, massage can help relieve pain and anxiety. Some massage therapists are trained to work with people with cancer.
  • Acupuncture: When performed by a trained practitioner, acupuncture may help ease pain, nausea, and vomiting. But it’s not safe if you have low blood counts or take blood thinners.
  • Meditation: Relaxation and reflection can reduce stress and improve overall quality of life in cancer patients.
  • Hypnosis: Helps you relax and may help with nausea, pain, and anxiety.
  • Yoga: Combining breathing techniques, meditation, and stretching, yoga can help you feel better overall and improve sleep.

Diet

There’s no diet specifically for lung cancer. It is important to get all the nutrients your body needs.

If you’re deficient in certain vitamins or minerals, your doctor can advise you which foods can provide them. Otherwise, you’ll need a dietary supplement. Don’t take supplements without talking to your doctor because some can interfere with treatment.

Here are a few dietary tips:

  • Eat whenever you have an appetite.
  • If you don’t have a major appetite, try eating smaller meals throughout the day.
  • If you need to gain weight, supplement with low sugar, high-calorie foods and drinks.
  • Use mint and ginger teas to soothe your digestive system.
  • If your stomach is easily upset or you have mouth sores, avoid spices and stick to bland food.
  • If constipation is a problem, add more high-fiber foods.

As you progress through treatment, your tolerance to certain foods may change. So can your side effects and nutritional needs. It’s worth discussing nutrition with your doctor often. You can also ask for a referral to a nutritionist or dietician.

There’s no diet known to cure cancer, but a well-balanced diet can help you fight side effects and feel better.

Lung Cancer and Survival rate:

Once cancer enters the lymph nodes and bloodstream, it can spread anywhere in the body. The outlook is better when treatment begins before cancer spreads outside the lungs.

Other factors include age, overall health, and how well you respond to treatment. Because early symptoms can be easily overlooked, lung cancer is usually diagnosed in later stages.

Survival rates and other statistics provide a broad picture of what to expect. There are significant individual differences, though. Your doctor is in the best position to discuss your outlook.

Current survival statistics don’t tell the whole story. In recent years, new treatments have been approved for stage 4 non-small cell lung cancer (NSCLC). Some people are surviving much longer than previously seen with traditional treatments.

The following are the estimated five-year survival rates for NSCLC by SEER stage:

  • Localized: 60 percent
  • Regional: 33 percent
  • Distant: 6 percent
  • All SEER stages: 23 percent

Small-cell lung cancer (SCLC) is very aggressive. For limited stage SCLC, the five-year survival rate is 14 percentTrusted Source. Median survival is 16 to 24 months. Median survival for extensive stage SCLC is six to 12 months.

Long-term disease-free survival is rare. Without treatment, median survival from diagnosis of SCLC is only two to four months.

The relative five-year survival rate for mesothelioma, a type of cancer caused by asbestos exposure, is 5 to 10 percent.

Outlook

Lung cancer is the most common cancer in the world. This disease carries a higher risk of death than breast, colon, and prostate cancer combined if not detected and treated early. It is also largely preventable through not smoking. Lung cancer is more treatable if diagnosed in its early stages.

The prognosis and outlook for lung cancer depend upon the cancer type and the spread. People should talk to their doctor who can provide a more accurate prognosis, taking into account the individual’s overall health and the extent of their cancer.

Takeaway

Lung cancer is  the most common, serious and potentially deadly disease that affects a person’s ability to breath.

However, early diagnostic screening of individuals who are at high risk for lung cancer can help them receive treatment in earlier and more treatable stages. Treatment options include surgery to remove sections or all of the lung, chemotherapy, and radiation therapy, as well as targeted drug therapy.

If a person has concerns that they could be at risk for lung cancer, they should consult a doctor immediately.

Stroke

A stroke is a medical emergency, and prompt treatment is very important. Early detection & action can reduce brain damage and other complications leading to permanent disability or uncommon death.

What is Stroke?www.gtsmeditour.com (2)

Stroke is a cerebrovascular disease. This means that it affects the blood vessels that feed the brain oxygen. If the brain does not receive enough oxygen, damage may start to occur.

A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.

Although many strokes are treatable, some can lead to disability or death.

Remember “Be Fast”  when you spot a stroke:www.gtsmeditour.com

  • Sudden Loss of Balance
  • Loss of vision in one or both Eyes
  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call  medical emergency

Risk factors:

Risk factors for narrowed blood vessels in the brain are the same as those that cause narrowing blood vessels in the heart and heart attack  these includes:

  • High blood pressure/Hypertension
  • High cholesterol
  • Diabetes & Smoking

Symptoms:

The sooner a person having a stroke gets care, the better their outcome is likely to be. For this reason, it’s helpful to know the signs of a stroke so you can act quickly. Stroke symptoms can include:

  • Confusion, including difficulty speaking and understanding speech
  • A Head ache, possibly with altered consciousness or vomiting
  • Numbness or an inability to move parts of the face, arm, or leg, particularly on one side of the body
  • Vision problems in one or both eyes
  • Difficulty walking, including dizziness and a lack of coordination.

What are the different types of strokes?

There are three main types of stroke:

  • transient ischemic attack
  • ischemic stroke
  • hemorrhagic stroke.

Transient ischemic attack (TIA):

Doctors also call a transient ischemic attack (TIA) a warning or ministroke. Anything that temporarily blocks blood flow to your brain causes a TIA. The blood clot and TIA symptoms last for a short period of time.

Ischemic stroke

An ischemic stroke occurs when a blood clot keeps blood from flowing to your brain. The blood clot is often due to atherosclerosis, which is a buildup of fatty deposits on the inner lining of a blood vessel. A portion of these fatty deposits can break off and block blood flow in your brain. The concept is similar to that of a heart attack, where a blood clot blocks blood flow to a portion of your heart.

An ischemic stroke can be embolic, meaning the blood clot travels from another part of your body to your brain. An estimated 15 percent of embolic strokes are due to a condition called atrial fibrillation, where your heart beats irregularly.

A thrombotic stroke is an ischemic stroke caused by a clot forming in a blood vessel in your brain.

Unlike a TIA, the blood clot that causes an ischemic stroke won’t go away without treatment.

Hemorrhagic stroke

A hemorrhagic stroke results when a blood vessel in your brain ruptures or breaks, spilling blood into the surrounding tissues.

There are three main types of hemorrhagic strokes: The first is an aneurysm, which causes a portion of the weakened blood vessel to balloon outward and sometimes rupture. The other is an arteriovenous malformation, which involves abnormally formed blood vessels. If such a blood vessel ruptures, it can cause a hemorrhagic stroke. Lastly, very high blood pressure can cause weakening of the small blood vessels in the brain and result in bleeding into the brain as well.

Diagnosis of stroke

Your doctor will ask you or a family member about your symptoms and what you were doing when they arose. They’ll take your medical history to find out your stroke risk factors. They’ll also:

  • ask what medications you take
  • check your blood pressure
  • listen to your heart

You’ll also have a physical exam, during which the doctor will evaluate you for:

  • balance
  • coordination
  • weakness
  • numbness in your arms, face, or legs
  • signs of confusion
  • vision issues.

Treatment:

Proper medical evaluation and prompt treatment are vital to recovering from a stroke.

You may go through various tests to further help your doctor determine if you’ve had a stroke, or to rule out another condition. These tests include:

Blood tests

Your doctor might draw blood for several blood tests. Blood tests can determine:

  • your blood sugar levels
  • if you have an infection
  • your platelet levels
  • how fast your blood clots

MRI and CT scan

You may undergo either or both a magnetic resonance imaging (MRI) scan and a computerized tomography (CT) scan.

The MRI will help see if any brain tissue or brain cells have been damaged. A CT scan will provide a detailed and clear picture of your brain that shows any bleeding or damage in the brain. It may also show other brain conditions that could be causing your symptoms.

EKG

Your doctor may order an electrocardiogram (EKG), too. This simple test records the electrical activity in the heart, measuring its rhythm and recording how fast it beats. It can determine if you have any heart conditions that may have led to stroke, such as a prior heart attack or atrial fibrillation.

Cerebral angiogram

Another test your doctor may order to determine if you’ve had a stroke is a cerebral angiogram. This offers a detailed look at the arteries in your neck and brain. The test can show blockages or clots that may have caused symptoms.

Carotid ultrasound

A carotid ultrasound, also called a carotid duplex scan, can show fatty deposits (plaque) in your carotid arteries, which supply the blood to your face, neck, and brain. It can also show whether your carotid arteries have been narrowed or blocked.

Echocardiogram

An echocardiogram can find sources of clots in your heart. These clots may have traveled to your brain and caused a stroke.

These stroke types are caused by a blood clot or other blockage in the brain. For that reason, they’re largely treated with similar techniques, which include:

Antiplatelet and anticoagulants

Over-the-counter aspirin is often a first line of defense against stroke damage. Anticoagulant and antiplatelet drugs should be taken within 24 to 48 hours after stroke symptoms begin.

Clot-breaking drugs

Thrombolytic drugs can break up blood clots in your brain’s arteries, which still stop the stroke and reduce damage to the brain.

One such drug, tissue plasminogen activator (tPA), or Alteplase IV r-tPA, is considered the gold standard in ischemic stroke treatment. It works by dissolving blood clots quickly, if delivered within the first 3 to 4.5 hours after symptoms of your stroke began. People who receive a tPA injection are more likely to recover from a stroke, and less likely to have any lasting disability as a result of the stroke.

Mechanical thrombectomy

During this procedure, the doctor inserts a catheter into a large blood vessel inside your head. They then use a device to pull the clot out of the vessel. This surgery is most successful if it’s performed 6 to 24 hours after the stroke begins.

Stents

If your doctor finds where artery walls have weakened, they may perform a procedure to inflate the narrowed artery and support the walls of the artery with a stent.

Surgery

In the rare instances that other treatments don’t work, your doctor may perform surgery to remove a blood clot and plaques from your arteries. This may be done with a catheter, or if the clot is especially large, your doctor may open an artery to remove the blockage.

Hemorrhagic stroke

Strokes caused by bleeds or leaks in the brain require different treatment strategies. Treatments for hemorrhagic stroke include:

Medications

Unlike with an ischemic stroke, if you’re having a hemorrhagic stroke, the treatment goal is to make your blood clot. Therefore, you may be given medication to counteract any blood thinners you take.

You may also be prescribed drugs that can reduce blood pressure, lower the pressure in your brain, prevent seizures, and prevent blood vessel constriction.

Coiling

During this procedure, your doctor guides a long tube to the area of hemorrhage or weakened blood vessel. They then install a coil-like device in the area where the artery wall is weak. This blocks blood flow to the area, reducing bleeding.

Clamping

During imaging tests, your doctor may discover an aneurysm that hasn’t started bleeding yet or has stopped. To prevent additional bleeding, a surgeon may place a tiny clamp at the base of the aneurysm. This cuts off blood supply and prevents a possible broken blood vessel or new bleeding.

Surgery

If your doctor sees that an aneurysm has burst, they may do surgery to clip the aneurysm and prevent additional bleeding. Likewise, a craniotomy may be needed to relieve the pressure on the brain after a large stroke.

Recovery And  Rehabilitation:

It’s important that recovery and rehabilitation from a stroke start as soon as possible. In fact, stroke recovery should begin in the hospital. There, a care team can stabilize your condition, assess the effects of the stroke, identify underlying factors, and begin therapy to help you regain some of your affected skills.

Stroke recovery focuses on four main areas:

Speech therapy

A stroke can cause speech and language impairment. A speech and language therapist will work with you to relearn how to speak. Or, if you find verbal communication difficult after a stroke, they’ll help you find new ways of communication.

Cognitive therapy

After a stroke, many survivors have changes to their thinking and reasoning skills. This can cause behavioral and mood changes. An occupational therapist can help you work to regain your former patterns of thinking and behavior and to control your emotional responses.

Relearning sensory skills

If the part of your brain that relays sensory signals is affected during the stroke, you may find that your senses are “dulled” or no longer working. That may mean that you don’t feel things well, such as temperature, pressure, or pain. A therapist can help you learn to adjust to this lack of sensation.

Physical therapy

Muscle tone and strength may be weakened by a stroke, and you may find you’re unable to move your body as well as you could before. A physical therapist will work with you to regain your strength and balance, and find ways to adjust to any limitations.

Rehabilitation may take place in a rehabilitation clinic, a skilled nursing home, or your own home.

Preventive Measures:

In addition to emergency treatment,Recovery and Rehab  healthcare providers will also advise you on ways to prevent future strokes.

  • Quit smoking.
  • Consume alcohol in moderation.
  • Keep weight in check
  • Regular Checkups

Taking all these measures will help put you in better shape to prevent stroke.

Conclusion/ Take away

If you suspect or experiencing symptoms of a stroke, it’s crucial  you seek emergency medical treatment. Clot-busting medication can only be provided in the first hours after the signs of a stroke begin, (i.e, first 3hrs- 4.5hrs are said to be golden period) and early treatment is one of the most effective ways to reduce your risk for long-term complications and disability.

Prevention is possible, whether you’re preventing a first stroke or trying to prevent a second. Medications can help reduce the risk of blood clots, which lead to strokes. Speakup with your doctor to find a prevention strategy that works for you, including medical intervention and lifestyle changes.

 

Breast Cancer Awareness

Global Hand Wash Day (13)October is termed as Breast cancer Awareness month across the globe.After skin & lung cancer, breast cancer is the most common cancer diagnosed in women and rarely in men. Breast cancer is cancer that forms in the cells of the breasts.Its treatment depends on the stage of cancer. It may consist of chemotherapy, radiation, hormone therapy and surgery.

On average, 1 in 8 women will develop breast cancer in their lifetimes. About two-thirds of women with breast cancer are 55 or older. Most of the rest are between 35 and 54.

Fortunately, breast cancer is very treatable if you spot it early. Localized cancer (meaning it hasn’t spread outside your breast) can usually be treated before it spreads.

Once the cancer begins to spread, treatment becomes more complicated. It can often control the disease for years.

What is Breast Cancer?

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.

A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body.

Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. Instead, 85-90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.

Causes Of Breast Cancer: How Did This Happen?

When you’re told that you have breast cancer, it’s natural to wonder what may have caused the disease. But no one knows the exact causes of breast cancer. Doctors seldom know why one woman develops breast cancer and another doesn’t, and most women who have breast cancer will never be able to pinpoint an exact cause. What we do know is that breast cancer is always caused by damage to a cell’s DNA.

Symptoms:

Different people have different symptoms of breast cancer. Some people do not have any signs or symptoms at all.

Few warning signs of breast cancer are—

  • New lump in the breast or underarm (armpit).
  • Thickening or swelling of part of the breast.
  • Irritation or dimpling of breast skin.
  • Redness or flaky skin in the nipple area or the breast.
  • Pulling in of the nipple or pain in the nipple area.
  • Nipple discharge other than breast milk, including blood.
  • Any change in the size or the shape of the breast.
  • Pain in any area of the breast.

Keep in mind that these symptoms can happen with other conditions that are not cancer.

Stages:

A doctor stage cancer according to the size of the tumor and whether it has spread to lymph nodes or other parts of the body.

There are different ways of staging breast cancer. One way is from stage 0–4, with subdivided categories at each numbered stage. Descriptions of the four main stages are listed below, though the specific substage of a cancer may also depend on other specific characteristics of the tumor, such as HER2 receptor status.

  • Stage 0: Known as ductal carcinoma in situ (DCIS), the cells are limited to within the ducts and have not invaded surrounding tissues.
  • Stage 1: At this stage, the tumor measures up to 2 centimeters (cm) across. It has not affected any lymph nodes, or there are small groups of cancer cells in the lymph nodes.
  • Stage 2: The tumor is 2 cm across, and it has started to spread to nearby nodes, or is 2–5 cm across and has not spread to the lymph nodes.
  • Stage 3: The tumor is up to 5 cm across, and it has spread to several lymph nodes or the tumor is larger than 5 cm and has spread to a few lymph nodes.
  • Stage 4: The cancer has spread to distant organs, most often the bones, liver, brain, or lungs.

    Risk Factors:

    UnControlable:

  • Age. Women over 50 are more likely to get breast cancer than younger women.
  • Race: African American women are more likely than white women to get breast cancer before  menopause.
  • Dense breasts. If your breasts have more connective tissue than fatty tissue, it can be hard to see tumors on a mammogram.
  • Personal history of cancer. Your odds go up slightly if you have certain benign breast conditions. They go up more sharply if you’ve had breast cancer before.
  • Family history. If a first-degree female relative (mother, sister, or daughter) had breast cancer, you’re two times more likely to get the disease. Having two or more first-degree relatives with a history of breast cancer increases your risk at least three times. This is especially true if they got cancer before menopause or if it affected both breasts. The risk can also rise if your father or brother was diagnosed with breast cancer.
  • Genes. Changes to two genes, BRCA1 and BRCA2, are responsible for some cases of breast cancer in families. About 1 woman in 200 has one of these genes. While they make you more likely to get cancer, they don’t mean you definitely will. If you have a BRCA1 or BRCA2 mutation, you have a 7 in 10 chance of being diagnosed with breast cancer by age 80. These genes also raise your odds of ovarian cancer, and they’re linked to pancreatic cancer and male breast cancer. Other gene mutations linked to breast cancer risk include mutations of the PTEN gene, the ATM gen, the TP53 gene, the CHEK2 gene, the CDH1 gene, the STK11 gene, and the PALB2 gene. These carry a lower risk for breast cancer development than the BRCA genes.
  • Menstrual history. Your breast cancer odds go up if:
    • Your periods start before age 12.
    • Your periods don’t stop until after you’re 55.
  • Radiation. If you had treatment for cancers like Hodgkin’s lymphoma before age 40, you have an increased risk of breast cancer.
  • Diethylstilbestrol (DES). Doctors used this drug between 1940 and 1971 to prevent miscarriage. If you or your mother took it, your breast cancer odds go up.

    Controlable:

  • Physical activity The less you move, the higher your chances.
  • Weight and diet. Being overweight after menopause raises your odds.
  • Alcohol. Regular drinking — especially more than one drink a day — increases the risk of breast cancer.
  • Reproductive history.

You have your first child after age 30.

You don’t breastfeed.

You don’t have a full-term pregnancy.

  • Taking hormones. Your chances can go up if you:

Use hormone replacement therapy that includes both estrogen and progesterone during menopause for more than 5 years. This increase in breast cancer risk returns to normal 5 years after you stop treatment.

Use certain birth control methods including birth control pills, shots, implants, IUDS, skin patches, or vaginal rings that contain hormones.

  • Still, most women who are at high risk for breast cancer don’t get it. On the other hand, 75% of women who develop breast cancer have no known risk factors.

Types:

There are several different types of breast cancer, including:

  • Ductal carcinoma: This begins in the milk duct and is the most common type.
  • Lobular carcinoma: This starts in the lobules.

Invasive breast cancer occurs when the cancer cells break out from inside the lobules or ducts and invade nearby tissue. This increases the chance of cancer spreading to other parts of the body.

Noninvasive breast cancer develops when the cancer remains inside its place of origin and has not yet spread. However, these cells can sometimes progress to invasive breast cancer.

Diagnosis:

If you feel a lump or if something shows up on a mammogram, your doctor will begin the breast cancer diagnosis process.

They’ll ask about your personal and family healthy history. Then, they’ll do a breast exam and order tests that include:

Imaging tests. Your doctor will use these to learn more about your breast.

  • Ultrasound. This test uses sound waves to make a picture of your breast.
  • Mammogram. This detailed X-ray gives doctors a better view of lumps and other problems.
  • Magnetic resonance imaging (MRI). This body scan uses a magnet linked to a computer to create detailed images of the insides of your breasts.
  • Biopsy. For this test, the doctor removes tissue or fluid from your breast. They look at it under a microscope to check for if cancer cells and, if they’re there, learn which type they are. Common procedures include:
    • Fine-needle aspiration. This is for easy-to-reach lumps or those that might be filled with fluid.
    • Core-needle biopsy. This type uses a bigger needle to remove a piece of tissue.
    • Surgical (open) biopsy. A surgeon removes the entire lump along with nearby breast tissue.
    • Lymph node biopsy. The doctor removes a part of the lymph nodes under your arm to see if the cancer has spread.
    • Image-guided biopsy. The doctor uses imaging to guide the needle.The doctor can test your biopsy sample for:
      • Tumor features. Is it invasive or in situ, ductal, or lobular? Has it spread to your lymph nodes? The doctor also measures the margins or edges of the tumor and their distance from the edge of the biopsy tissue, which is which is called margin width.
      • Estrogen receptors (ER) and progesterone receptors (PR). This tells the doctor if the hormones estrogen or progesterone make your cancer grow. This affects how likely it is that your cancer will come back and what type of treatment is most likely to prevent that.
      • HER2. This test looks for the gene human epidermal growth factor receptor 2. It can help cancer grow more quickly. If your cancer is HER2-positive, targeted therapy could be a treatment option for you.
      • Grade. This tells the doctor how different the cancer cells look from healthy cells and whether they seem to be slower-growing or faster-growing.
      • Oncotype Dx. This test evaluates 16 cancer-related genes and five reference genes to estimate the risk of the cancer coming back within 10 years of diagnosis.
      • Breast Cancer Index. This test can help your doctor decide how you need endocrine therapy.
      • MammaPrint. This test uses information from 70 genes to predict the risk of the cancer coming back.
      • PAM50 (Prosigna). This test uses information from 50 genes to predict if the cancer will spread.

      You might get blood tests including:

      • Complete blood count (CBC). This measures the number of different types of cells, like red and white blood cells, in your blood. It lets your doctor know if your bone marrow is working like it should.
      • Blood chemistry. This shows how well your liver and kidneys are working.
      • Hepatitis tests. These are sometimes done to check for hepatitis B and hepatitis C. If you have an active hepatitis B infection, you may need medication to fight the virus before you get chemotherapy. Without it, chemo can cause the virus to grow and damage your liver.

Treatment:

Treatment will depend on several factors, including:

  • the type and stage of the cancer
  • the person’s sensitivity to hormones
  • the age, overall health, and preferences of the individual

The main treatment options include:

radiation therapy

  • surgery
  • biological therapy, or targeted drug therapy
  • hormone therapy
  • chemotherapy

Factors affecting the type of treatment a person has will include the stage of the cancer, other medical conditions, and their individual preference.

Surgery

If surgery is necessary, the type will depend on both the diagnosis and individual preference. Types of surgery include:

Lumpectomy: This involves removing the tumor and a small amount of healthy tissue around it.

A lumpectomy can help prevent the spread of the cancer. This may be an option if the tumor is small and easy to separate from its surrounding tissue.

Mastectomy: A simple mastectomy involves removing the lobules, ducts, fatty tissue, nipple, areola, and some skin. In some types, a surgeon will also remove the lymph nodes and muscle in the chest wall.

Sentinel node biopsy: If breast cancer reaches the sentinel lymph nodes, which are the first nodes to which a cancer can spread, it can spread into other parts of the body through the lymphatic system. If the doctor does not find cancer in the sentinel nodes, then it is usually not necessary to remove the remaining nodes.

Axillary lymph node dissection: If a doctor finds cancer cells in the sentinel nodes, they may recommend removing several lymph nodes in the armpit. This can prevent the cancer from spreading.

Reconstruction: Following mastectomy, a surgeon can reconstruct the breast to look more natural. This can help a person cope with the psychological effects of breast removal.

The surgeon can reconstruct the breast at the same time as performing a mastectomy or at a later date. They may use a breast implant or tissue from another part of the body.

Radiation therapy

A person may undergo radiation therapy around a month after surgery. Radiation involves targeting the tumor with controlled doses of radiation that kill any remaining cancer cells.

Chemotherapy

A doctor may prescribe cytotoxic chemotherapy drugs to kill cancer cells if there is a high risk of recurrence or spread. When a person has chemotherapy after surgery, doctors call it adjuvant chemotherapy.

Sometimes, a doctor may choose to administer chemotherapy before surgery to shrink the tumor and make its removal easier. Doctors call this neoadjuvant chemothera

Hormone blocking therapy

Doctors use hormone blocking therapy to prevent hormone sensitive breast cancers from returning after treatment. Hormone therapy may be used to treat estrogen receptor (ER)-positive and progesterone receptor (PR)-positive cancers.

They usually administer hormone blocking therapy after surgery but might sometimes use it beforehand to shrink the tumor.

Hormone blocking therapy may be the only option for people who are not suitable candidates for surgery, chemotherapy, or radiotherapy.

Doctors may recommend a person has hormone therapy for 5–10 years after surgery. However, the treatment will not affect cancers that are not sensitive to hormones.

Examples of hormone blocking therapy medications may include:

  • tamoxifen
  • aromatase inhibitors
  • ovarian ablation or suppression
  • Goserelin, which is a luteinizing hormone-releasing agonist drug that suppresses the ovaries

Hormone treatment may affect fertility.

Biological treatment

Targeted drugs can destroy specific types of breast cancer. Examples include:

  • trastuzumab (Herceptin)
  • lapatinib (Tykerb)
  • bevacizumab (Avastin)

Treatments for breast and other cancers can have severe adverse effects. When deciding on a treatment, people should discuss the potential risks with a doctor and look at ways to minimize the side effects.

Facts to know about Breasts

  1. Breasts contain fat cells, not muscles
  2. Breast size cannot be altered by any excercise. it can only  be altered by painful surgery.
  3. Breast size depends upon a lot of factors such as harmonalchanges, bodyfat, genetics etc.
  4. Most of the time when body gains or losses fat, breast size changes.

Conclusion

There are steps every person can take to help the body stay as healthy as possible, such as eating a balanced diet, maintaining a healthy weight, not smoking, limiting alcohol, and exercising regularly . While these may have some impact on your risk of getting breast cancer, they cannot eliminate the risk.

Developing breast cancer is not your or anyone’s fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.

Regular checks and screening can help detect symptoms early. Women should discuss their options with a doctor.There is no way to prevent breast cancer. However, certain lifestyle decisions can significantly reduce the risk of breast cancer as well as other types.

 

Middle East Respiratory Syndrome (MERS)

Image result for mers virus

Middle East Respiratory Syndrome (MERS) is viral respiratory illness that is new to humans. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries, including the United States.Middle East Respiratory Syndrome (MERS) is an illness caused by a virus (more specifically, a coronavirus) called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Most MERS patients developed severe respiratory illness with symptoms of fever, cough and shortness of breath. About 3 or 4 out of every 10 patients reported with MERS have died.

Symptoms:

Most people confirmed to have MERS-CoV infection have had severe respiratory illness with symptoms of:

  • fever
  • cough
  • shortness of breath
  • Some people also had diarrhea and nausea/vomiting.
  • For many people with MERS, more severe complications followed, such as pneumonia and kidney failure.

Most of the people who died had a pre-existing medical condition that weakened their immune system, or an underlying medical condition that hadn’t yet been discovered. Medical conditions sometimes weaken people’s immune systems and make them more likely to get sick or have severe illness.

Pre-existing conditions among people who got MERS have included

diabetes
cancer
chronic lung disease
chronic heart disease
chronic kidney disease
Some infected people had mild symptoms (such as cold-like symptoms) or no symptoms at all.

The symptoms of MERS start to appear about 5 or 6 days after a person is exposed, but can range from 2 to 14 days.

Transmission

MERS-CoV, like other coronaviruses, likely spreads from an infected person’s respiratory secretions, such as through coughing. However, we don’t fully understand the precise ways that it spreads.

MERS-CoV has spread from ill people to others through close contact, such as caring for or living with an infected person. Infected people have spread MERS-CoV to others in healthcare settings, such as hospitals. Researchers studying MERS have not seen any ongoing spreading of MERS-CoV in the community.

All reported cases have been linked to countries in and near the Arabian Peninsula. Most infected people either lived in the Arabian Peninsula or recently traveled from the Arabian Peninsula before they became ill. A few people have gotten MERS after having close contact with an infected person who had recently traveled from the Arabian Peninsula. The largest known outbreak of MERS outside the Arabian Peninsula occurred in the Republic of Korea in 2015 and was associated with a traveler returning from the Arabian Peninsula.

Diagnosis:
Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) testing of upper and lower respiratory secretions and serum
MERS should be suspected in patients who have an unexplained acute febrile lower respiratory infection and who have had either of the following within 14 days of symptom onset:

Travel to or residence in an area where MERS has recently been reported or where transmission could have occurred
Contact with a health care facility where MERS has been transmitted
Close contact with a patient who was ill with suspected MERS
MERS should also be suspected in patients who have had close contact with a patient with suspected MERS and who have a fever whether they have respiratory symptoms or not.

Testing should include real-time RT-PCR testing of upper and lower respiratory secretions, ideally taken from different sites and at different times. Serum should be obtained from patients and from all, even asymptomatic close contacts, including health care workers (to help identify mild or asymptomatic MERS). Serum is obtained immediately after MERS is suspected or after contacts are exposed (acute serum) and 3 to 4 weeks later (convalescent serum). Testing is done at state health departments.

Treatment:
Treatment of MERS is supportive. To help prevent spread from suspected cases, health care practitioners should use standard, contact, and airborne precautions.

There is no vaccine.

Prevention:
There is currently no vaccine to protect people against MERS. But scientists are working to develop one.

We can help reduce the risk of getting respiratory illnesses:

  • Wash your hands often with soap and water for at least 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Cover your nose and mouth with a tissue when you cough or sneeze, then throw the tissue in the trash.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid personal contact, such as kissing, or sharing cups or eating utensils, with sick people.
  • Clean and disinfect frequently touched surfaces and objects, such as doorknobs.

People Who May Be at Increased Risk for MERS:

  • Recent Travelers from the Arabian Peninsula

If you develop a fever and symptoms of respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in or near the Arabian Peninsula, you should call ahead to a healthcare provider and mention your recent travel.

  • Close Contacts of an Ill Traveler from the Arabian Peninsula

If you have had close contact with someone within 14 days after they traveled from a country in or near the Arabian Peninsula, and the traveler has/had fever and symptoms of respiratory illness, such as cough or shortness of breath, you should monitor your health for 14 days, starting from the day you were last exposed to the ill person.

  • Healthcare Personnel Not Using Recommended Infection-Control Precautions

Healthcare personnel who had close contact*** with a confirmed case of MERS while the case was ill, if not using recommended infection control precautions (e.g., appropriate use of personal protective equipment), are at increased risk of developing MERS-CoV infection. These individuals should be evaluated and monitored by a healthcare professional with a higher index of suspicion.

  • Close Contacts of a Confirmed Case of MERS

f you have had close contact with someone who has a confirmed MERS-CoV infection, you should contact a healthcare provider for an evaluation. Your healthcare provider may request laboratory testing and outline additional recommendations, depending on the findings of your evaluation and whether you have symptoms.

  • People with Exposure to Camels

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Direct contact with camels is a risk factor for human infection with MERS-CoV.

The World Health Organization considers certain groups to be at high risk for severe MERS. These groups include people with diabetes, kidney failure, or chronic lung disease, and people who have weakened immune systems. The World Health Organization recommends that these groups take additional precautions:

  1. Avoid contact with camels
  2. Do not drink raw camel milk or raw camel urine
  3. Do not eat undercooked meat, particularly camel meat

We’re sure, you now have a fair idea of what MERS-CoV is all about and the way it could impact your life. Please seek immediate medical attention at the nearest healthcare centre if you find the MERS-CoV. symptoms, don’t ignore the symptoms as there is no medicine available at present.

suggested reading COVID -19

Coronavirus disease (COVID-19) outbreak

 

Image result for coronavirus prevention chart

Coronavirus disease (COVID-19) that was first reported from Wuhan, China, on 31 December 2019Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.

Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Detailed investigations found that SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans. Several known coronaviruses are circulating in animals that have not yet infected humans.

Common Symptoms:

Common signs of infection include

  •  fever
  • cough
  • shortness of breath
  • breathing difficulties.
  •  infection causing pneumonia,
  • severe acute respiratory syndrome
  • kidney failure.

Prevention of COVID – 19

Till date, there is no specific medicine recommended to prevent or treat the new coronavirus (2019-nCoV), those infected with the virus should receive appropriate care to relieve and treat symptoms, and those with severe illness should receive optimized supportive care.

However Following  simple hygiene steps will keep us safe  & healthy against the virus:

  • Wash your hands often
  • Covering mouth and nose when coughing and sneezing.
  • Thoroughly cooking meat and eggs.
  • Avoid close contact sick people
  • Wear a mask  when you are coughing & sneezing
  • Avoid crowded places like  bus stations, railway stati

Few Myths Busters

Can pets at home spread the new coronavirus (2019-nCoV)?
According to WHO research at present, there is no evidence that companion animals/pets such as dogs or cats can be infected with the new coronavirus. However, it is always a good idea to wash your hands with soap and water after contact with pets. This protects you against various common bacteria such as E.coli and Salmonella that can pass between pets and humans.

Do vaccines against pneumonia protect you against the new coronavirus?
No. Vaccines against pneumonia, such as pneumococcal vaccine and Haemophilus influenza type B (Hib) vaccine, do not provide protection against the new coronavirus.

The virus is so new and different that it needs its own vaccine. Researchers are trying to develop a vaccine against 2019-nCoV, and WHO is supporting their efforts.

Although these vaccines are not effective against 2019-nCoV, vaccination against respiratory illnesses is highly recommended to protect your health.

Are antibiotics effective in preventing and treating the new coronavirus?
No, antibiotics do not work against viruses, only bacteria.

The new coronavirus (2019-nCoV) is a virus and, therefore, antibiotics should not be used as a means of prevention or treatment.

However, if you are hospitalized for the 2019-nCoV, you may receive antibiotics because bacterial co-infection is possible.

COVID-19 virus can be transmitted in areas with hot and humid climates
From the evidence so far, the COVID-19 virus can be transmitted in ALL AREAS, including areas with hot and humid weather. Regardless of climate, adopt protective measures if you live in, or travel to an area reporting COVID-19. The best way to protect yourself against COVID-19 is by frequently cleaning your hands. By doing this you eliminate viruses that may be on your hands and avoid infection that could occur by then touching your eyes, mouth, and nose.

We’re sure, you now have a fair idea of what CORONA VIRUS  disease  is all about and the way it could impact your life. Please seek  immediate medical attention at the nearest healthcare centre if you find the COVID -19 symptoms, don’t ignore the symptoms as there is no medicine available at present.

 

Alzheimer’s Disease

 

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Alzheimer’s disease is a neurological disorder in which the death of brain cells causes memory loss and cognitive decline.Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.Alzheimer’s disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently.

The disease is named after Dr. Alois Alzheimer. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. Her symptoms included memory loss, language problems, and unpredictable behavior. After she died, he examined her brain and found many abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles).

These plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. Another feature is the loss of connections between nerve cells (neurons) in the brain. Neurons transmit messages between different parts of the brain, and from the brain to muscles and organs in the body. Many other complex brain changes are thought to play a role in Alzheimer’s, too.

This damage initially appears to take place in the hippocampus, the part of the brain essential in forming memories. As neurons die, additional parts of the brain are affected. By the final stage of Alzheimer’s, damage is widespread, and brain tissue has shrunk significantly.

Understanding Alzheimer’s and dementia

Alzheimer’s is the most common cause of dementia, a general term for memory loss and other cognitive abilities serious enough to interfere with daily life. Alzheimer’s disease accounts for 60 percent to 80 percent of dementia cases.Learn more about dimentia

Sign & Symptoms of Alzheimer

The most common early symptom of Alzheimer’s is difficulty remembering newly learned information.

the person must have experienced a decline in cognitive or behavioral function and performance compared with how they were previously. This decline must interfere with their ability to function at work or in usual activities.

Reduced ability to take in and remember new information, which can lead, for example,

  • repetitive questions or conversations
  • misplacing personal belongings
  • forgetting events or appointments
  • getting lost on a familiar route

Impairments to reasoning, complex tasking, and exercising judgment, for example:

  • poor understanding of safety risks
  • inability to manage finances
  • poor decision-making ability
  • inability to plan complex or sequential activities

If symptoms begin or worsen over the course of hours or days, you should seek immediate medical attention, as this could indicate an acute illness.

Alzheimer’s is most likely when memory loss is a prominent symptom, especially in the area of learning and recalling new information.

Language problems can also be a key early symptom, for example, struggling to find the right words.

If visualization deficits are most prominent, these would include:

inability to recognize objects and faces
difficulty comprehending separate parts of a scene at once
difficulty with reading text, known as alexia
The most prominent deficits in executive dysfunction would be to do with reasoning, judgment, and problem-solving.

Causes
Scientists believe that for most people, Alzheimer’s disease is caused by a combination of genetic, lifestyle and environmental factors that affect the brain over time.

The exact causes of Alzheimer’s disease aren’t fully understood, but at its core are problems with brain proteins that fail to function normally, disrupt the work of brain cells (neurons) and unleash a series of toxic events. Neurons are damaged, lose connections to each other and eventually die.

The damage most often starts in the region of the brain that controls memory, but the process begins years before the first symptoms. The loss of neurons spreads in a somewhat predictable pattern to other regions of the brains. By the late stage of the disease, the brain has shrunk significantly.

Researchers are focused on the role of two proteins:

Plaques. Beta-amyloid is a leftover fragment of a larger protein. When these fragments cluster together, they appear to have a toxic effect on neurons and to disrupt cell-to-cell communication. These clusters form larger deposits called amyloid plaques, which also include other cellular debris.
Tangles. Tau proteins play a part in a neuron’s internal support and transport system to carry nutrients and other essential materials. In Alzheimer’s disease, tau proteins change shape and organize themselves into structures called neurofibrillary tangles. The tangles disrupt the transport system and are toxic to cells.

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Stages
The progression of Alzheimer’s can be broken down into three main stages:

Alzheimer’s disease typically progresses slowly in three general stages — mild (early stage), moderate (middle stage), and severe (late stage). Since Alzheimer’s affects people in different ways, the timing and severity of dementia symptoms varies as each person progresses through the stages of Alzheimer’s differently.

Mild Alzheimer’s disease (early stage)
In the early stage of Alzheimer’s, a person may function independently. He or she may still drive, work and be part of social activities. Despite this, the person may feel as if he or she is having memory lapses, such as forgetting familiar words or the location of everyday objects.

Friends, family or others close to the individual begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration. Common difficulties include:

Problems coming up with the right word or name
Trouble remembering names when introduced to new people
Challenges performing tasks in social or work settings.
Forgetting material that one has just read
Losing or misplacing a valuable object
Increasing trouble with planning or organizing

Moderate Alzheimer’s disease (middle stage)
Moderate Alzheimer’s is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer’s will require a greater level of care.

During the moderate stage of Alzheimer’s, the dementia symptoms are more pronounced. A person may have greater difficulty performing tasks, such as paying bills, but they may still remember significant details about their life.

You may notice the person with Alzheimer’s confusing words, getting frustrated or angry, or acting in unexpected ways, such as refusing to bathe. Damage to nerve cells in the brain can make it difficult to express thoughts and perform routine tasks.
At this point, symptoms will be noticeable to others and may include:

Forgetfulness of events or about one’s own personal history

Feeling moody or withdrawn, especially in socially or mentally challenging situations

Being unable to recall their own address or telephone number or the high school or college from which they graduated

Confusion about where they are or what day it is

The need for help choosing proper clothing for the season or the occasion

Trouble controlling bladder and bowels in some individuals

Changes in sleep patterns, such as sleeping during the day and becoming restless at night

An increased risk of wandering and becoming lost

Personality and behavioral changes, including suspiciousness and delusions or compulsive, repetitive behavior like hand-wringing or tissue shredding

Severe Alzheimer’s disease (Final stage)

In the final stage of this disease, dementia symptoms are severe. Individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, significant personality changes may take place and individuals need extensive help with daily activities.

Diagnosis
There is no single test for Alzheimer’s disease, so doctors will look at the signs and symptoms, take a medical history, and rule out other conditions before making a diagnosis.

They may also check the person’s neurological function, for example, by testing their balance, senses, and reflexes.

Other assessments may include a blood or urine test, a CT or MRI scan of the brain, and screening for depression.

Sometimes the symptoms of dementia are related to an inherited disorder such as Huntington’s disease, so genetic testing may be done.

After ruling out other possible conditions, the doctor will carry out cognitive and memory tests, to assess the person’s ability to think and remember.

Risk factors

  • Age
  • Family History
  • Genetics
  • Down syndrome
  • Sex
  • life style & heart health
  • Past Head Trauma
  • poor sleep patterns

Treatment
There is no known cure for Alzheimer’s. The death of brain cells cannot be reversed.

However, there are therapeutic interventions that can make it easier for people to live with the disease.

According to the Alzheimer’s Association, the following are important elements of dementia care:

effective management of any conditions occurring alongside the Alzheimer’s
activities and day-care programs
involvement of support groups and services
Drug therapy
No disease-modifying drugs are available for Alzheimer’s disease, but some options may reduce the symptoms and help improve quality of life.

Prevention
Alzheimer’s disease is not a preventable condition. However, a number of lifestyle risk factors for Alzheimer’s can be modified. Evidence suggests that changes in diet, exercise and habits — steps to reduce the risk of cardiovascular disease — may also lower your risk of developing Alzheimer’s disease and other disorders that cause dementia. Heart-healthy lifestyle choices that may reduce the risk of Alzheimer’s include the following:

Exercise regularly
Eat a diet of fresh produce, healthy oils and foods low in saturated fat
Follow treatment guidelines to manage high blood pressure, diabetes and high cholesterol
If you smoke, ask your doctor for help to quit smoking
Studies have shown that preserved thinking skills later in life and a reduced risk of Alzheimer’s disease are associated with participating in social events, reading, dancing, playing board games, creating art, playing an instrument, and other activities that require mental and social engagement.

How Long Can a Person Live with Alzheimer’s Disease?
The time from diagnosis to death varies—as little as 3 or 4 years if the person is older than 80 when diagnosed, to as long as 10 or more years if the person is younger.Although treatment can help manage symptoms in some people, currently there is no cure for this devastating disease.

 

We’re sure, you now have a fair idea of what Alzheimer’s disease is is all about and the way it could impact your life. Please feel free to contact us  query@gtsmeditour.com if you’d like to take a second opinion on your condition or undergo treatment for the same.

 

Obesity

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Obesity is a chronic condition defined by an excess amount of body fat. A certain amount of body fat is necessary for storing energy, heat insulation, shock absorption, and other functions.

The foods we eat every day contribute to our well-being. Foods provide us with the nutrients we need for healthy bodies and the calories we need for energy. If we take in more calories than we burn, the extra food turns to fat and is stored in our bodies. If we overeat regularly, we gain weight, and if we continue to gain weight, we may become obese.

All  you need to know about – Body mass index (BMI) 

Body mass index best defines obesity. A person’s height and weight determines his or her body mass index. The body mass index (BMI) equals a person’s weight in kilograms (kg) divided by their height in meters (m) squared (more information will be found later in the article). 

Body Mass Index Chart

BMI Weight Status
Below 18.5 Underweight
18.5 – 24.9 Normal
25.0 – 29.9 Overweight
30 or greater Obese


Being a little overweight may not cause many noticeable problems. However, once you are obese, you may develop symptoms that affect your daily life.

Obesity is a chronic medical disease that can lead to diabetes, high blood pressure, obesity associated cardiovascular disease such as heart disease, gallstones, and other chronic illnesses.

Most common causes of obesity

The balance between calorie intake and energy expenditure determines a person’s weight. If a person eats more calories than he or she burns (metabolizes), the person gains weight (the body will store the excess energy as fat). If a person eats fewer calories than he or she metabolizes, he or she will lose weight. Therefore, the most common causes of obesity are overeating and physical inactivity. Ultimately, body weight is the result of genetics, metabolism, environment, behavior, and culture.

  • Physical inactivity
  • Overeating.
  • Genetics.
  • A diet high in simple carbohydrates

Risk factors

Obesity usually results from a combination of causes and contributing factors:

Family History

The genes you inherit from your parents may affect the amount of body fat you store, and where that fat is distributed. Genetics may also play a role in how efficiently your body converts food into energy, how your body regulates your appetite and how your body burns calories during exercise.

Obesity tends to run in families. That’s not just because of the genes they share. Family members also tend to share similar eating and activity habits.

Lifestyle choices

Unhealthy diet. A diet that’s high in calories, lacking in fruits and vegetables, full of fast food, and laden with high-calorie beverages and oversized portions contributes to weight gain.

Liquid calories. People can drink many calories without feeling full, especially calories from alcohol. Other high-calorie beverages, such as sugared soft drinks, can contribute to significant weight gain.

Inactivity. If you have a sedentary lifestyle, you can easily take in more calories every day than you burn through exercise and routine daily activities. Looking at computer, tablet and phone screens is a sedentary activity. The number of hours you spend in front of a screen is highly associated with weight gain.

Certain diseases and medications

In some people, obesity can be traced to a medical cause, such as Prader-Willi syndrome, Cushing syndrome and other conditions. Medical problems, such as arthritis, also can lead to decreased activity, which may result in weight gain.

Some medications can lead to weight gain if you don’t compensate through diet or activity. These medications include some antidepressants, anti-seizure medications, diabetes medications, antipsychotic medications, steroids and beta blockers.

Social and economic issues

Social and economic factors are linked to obesity. Avoiding obesity is difficult if you don’t have safe areas to walk or exercise. Similarly, you may not have been taught healthy ways of cooking, or you may not have access to healthier foods. In addition, the people you spend time with may influence your weight — you’re more likely to develop obesity if you have friends or relatives with obesity.

Age

Obesity can occur at any age, even in young children. But as you age, hormonal changes and a less active lifestyle increase your risk of obesity. In addition, the amount of muscle in your body tends to decrease with age. Generally, lower muscle mass leads to a decrease in metabolism. These changes also reduce calorie needs, and can make it harder to keep off excess weight. If you don’t consciously control what you eat and become more physically active as you age, you’ll likely gain weight.

Other factors

Pregnancy. Weight gain is common during pregnancy. Some women find this weight difficult to lose after the baby is born. This weight gain may contribute to the development of obesity in women. Breast-feeding may be the best option to lose the weight gained during pregnancy.

Quitting smoking. Quitting smoking is often associated with weight gain. And for some, it can lead to enough weight gain to qualify as obesity. Often, this happens as people use food to cope with smoking withdrawal. In the long run, however, quitting smoking is still a greater benefit to your health than is continuing to smoke. Your doctor can help you prevent weight gain after quitting smoking.

Lack of sleep. Not getting enough sleep or getting too much sleep can cause changes in hormones that increase your appetite. You may also crave foods high in calories and carbohydrates, which can contribute to weight gain.

Stress. Many external factors that affect your mood and well-being may contribute to obesity. People often seek more high-calorie food when experiencing stressful situations.

Microbiome. Your gut bacteria are affected by what you eat and may contribute to weight gain or difficulty losing weight.

Previous attempts to lose weight. Previous attempts of weight loss followed by rapid weight regain may contribute to further weight gain. This phenomenon, sometimes called yo-yo dieting, can slow your metabolism.

Even if you have one or more of these risk factors, it doesn’t mean that you’re destined to develop obesity. You can counteract most risk factors through diet, physical activity and exercise, and behavior changes.

Symptoms

Although gaining a few extra pounds may seem insignificant as far as a person’s overall health is concerned, weight gain can quickly escalate to a serious medical condition. Symptoms for Adults

Symptoms of obesity can negatively impact one’s daily life.

For adults, symptoms include:

  • Excess body fat accumulation (particularly around the waist)
  • Shortness of breath
  • Sweating (more than usual)
  • Snoring
  • Trouble sleeping
  • Skin problems (from moisture accumulating in the folds of skin)
  • Inability to perform simple physical tasks (that one could easily perform before weight gain)
  • Fatigue (from mild to extreme)2
  • Pain (commonly in the back and joints)
  • Psychological impact (negative self-esteem, depression, shame, social isolation)

Common symptoms of childhood obesity may include:

  • Eating disorders
  • Fatty tissue deposits (may be noticeable in the breast area)
  • The appearance of stretch marks on the hips and back
  • Acanthosis nigricans (dark velvety skin around the neck and other areas)
  • Shortness of breath with physical activity4
  • Sleep apnea4
  • Constipation 
  • GI reflux
  • Poor self-esteem4
  • Early puberty in girls/delayed puberty in boys
  • Orthopedic problems (such as flat feet or dislocated hips)

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Diagnosis

Diagnosing obesity involves much more than simply stepping onto a scale. In fact, a thorough evaluation of a person’s weight status is a complex procedure that involves taking into consideration many different factors and the use of various tools and diagnostic tests, including body mass index (BMI), waist circumference measurement, physical exams, and lab tests to check for comorbidities.

Self-Checks/At-Home Testing

The most commonly used scale that healthcare providers use to diagnose obesity, is called the body mass index or BMI.

Labs and Tests

It’s important to understand the significance of seeking professional help when it comes to diagnosing childhood, adolescent or adult obesity.

Diagnostic testing for obesity and overweight conditions may involve some lab tests to evaluate the extent of how severely the condition has impacted a person’s overall health and to check for signs of an underlying disease. The lab tests that the healthcare provider will order depend on many factors, such as an individual’s risk factors to obesity-related diseases and current symptoms

Lab tests may include:

Cholesterol levels: Low good cholesterol (HDL) and high bad cholesterol (LDL) levels are commonly associated with obesity

Fasting blood sugar to check for signs of early diabetes

A thyroid test to observe for signs of thyroid disease, commonly linked with obesity

Liver function tests to screen for the potential of fatty liver disease, which often accompanies obesity

Other tests may be ordered by the physician or other healthcare provider to evaluate the overall impact that obesity has on the body. One such test is an electrocardiogram, used to look for signs of heart disease.

Diagnosing Childhood Obesity

To diagnose childhood obesity, the healthcare provider will use a growth chart to evaluate how a child’s weight and height compare to other kids of the same age and sex. For example, a child who is considered in the 90th percentile means that compared with other kids the same age and sex, 90% have a lower weight and BMI.

Because the growth pattern and body frame can differ drastically from one child to the next, pediatricians take several factors into consideration when diagnosing a child’s weight status, these include:

  1. Growth charts
  2. Family history of obesity
  3. Eating habits
  4. Activity level
  5. Psychosocial history (includes sleep pattern, mood disorders such as depression, social interactions, and factors such as being bullied)

Other health conditions

Lab tests that may be ordered when a child is suspected of being overweight include:

A cholesterol test

A blood sugar test

Blood tests to check for hormone imbalances

Blood tests to check for obesity-linked conditions

Treatment

The goal of obesity treatment is to reach and stay at a healthy weight. This improves your overall health and lowers your risk of developing complications related to obesity. You may need to work with a team of health professionals — including a dietitian, behavioral counselor or an obesity specialist — to help you understand and make changes in your eating and activity habits.

The initial treatment goal is usually a modest weight loss — 5% to 10% of your total weight. That means that if you weigh 200 pounds (91 kg) and have obesity by BMI standards, you would need to lose only about 10 to 20 pounds (4.5 to 9 kg) for your health to begin to improve. However, the more weight you lose, the greater the benefits.

All weight-loss programs require changes in your eating habits and increased physical activity. The treatment methods that are right for you depend on your obesity severity, your overall health and your willingness to participate in your weight-loss plan.

Dietary changes

Reducing calories and practicing healthier eating habits are vital to overcoming obesity. Although you may lose weight quickly at first, steady weight loss over the long term is considered the safest way to lose weight and the best way to keep it off permanently.

There is no best weight-loss diet. Choose one that includes healthy foods that you feel will work for you. Dietary changes to treat obesity include:

Cutting calories The key to weight loss is reducing how many calories you take in. The first step is to review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back.

Feeling full on less. Some foods — such as desserts, candies, fats and processed foods — contain a large amount of calories for a small portion. In contrast, fruits and vegetables provide a larger portion size with fewer calories.

Making healthier choices. To make your overall diet healthier, eat more plant-based foods, such as fruits, vegetables and whole-grain carbohydrates. Also emphasize lean sources of protein — such as beans, lentils and soy — and lean meats. If you like fish, try to include fish twice a week. Limit salt and added sugar. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as olive, canola and nut oils.

Restricting certain foods. Certain diets limit the amount of a particular food group, such as high-carbohydrate or full-fat foods. Ask your doctor which diet plans have been found effective and which might be helpful for you.

Meal replacements. These plans suggest that you replace one or two meals with their products — such as low-calorie shakes or meal bars — and eat healthy snacks and a healthy, balanced third meal that’s low in fat and calories.

Exercise and activity

Increased physical activity or exercise is an essential part of obesity treatment. Most people who are able to maintain their weight loss for more than a year get regular exercise, even simply Behavior changes

A behavior modification program can help you make lifestyle changes and lose weight and keep it off. Steps to take include examining your current habits to find out what factors, stresses or situations may have contributed to your obesitywalking.

Weight-loss medication

Losing weight requires a healthy diet and regular exercise. But in certain situations, prescription weight-loss medication may help.

Keep in mind, though, that weight-loss medication is meant to be used along with diet, exercise and behavior changes, not instead of them. The main purpose of weight-loss medications, also known as anti-obesity medications, is to help you to stick to a low-calorie diet by stopping the hunger and lack of fullness signals that appear when trying to lose weight.

Your doctor may recommend weight-loss medication if other diet and exercise programs haven’t worked and you meet one of these criteria:

Your body mass index (BMI) is 30 or greater

Your BMI is greater than 27, and you also have medical complications of obesity, such as diabetes, high blood pressure or sleep apnea

Before selecting a medication for you, your doctor will consider your health history, as well as possible side effects. Some weight-loss medications can’t be used by women who are pregnant or by people who take certain medications or have chronic health conditions.

Endoscopic procedures for weight loss

These types of procedures don’t require any incisions in your skin. After you receive anesthesia, flexible tubes and tools are inserted through your mouth and down your throat into your stomach.

There are several different types of endoscopic procedures used for weight loss. One procedure involves placing stitches in your stomach to reduce its size and the amount of food you can comfortably consume. In another endoscopic procedure, doctors insert a small balloon into your stomach. The balloon is filled with water to reduce the amount of space available in your stomach. This helps you feel fuller faster.

These procedures are usually approved for people with BMIs of 30 or above when diet and exercise alone have not been successful. The expected weight loss varies among procedures from 5% to 20% of total body weight loss.

In some people, weight-loss surgery, also called bariatric surgery, is an option. Weight-loss surgery limits the amount of food you’re able to comfortably eat or decreases the absorption of food and calories, or it does both. While weight-loss surgery offers the best chance of losing the most weight, it can pose serious risks.

Weight-loss surgery for obesity may be considered if you have tried other methods to lose weight that haven’t worked and:

You have extreme obesity (BMI of 40 or higher)

Your BMI is 35 to 39.9, and you also have a serious weight-related health problem, such as diabetes or high blood pressure

You’re committed to making the lifestyle changes that are necessary for surgery to work

Weight-loss surgery helps some people lose as much as 35% or more of their excess body weight. But weight-loss surgery isn’t a miracle obesity cure.

It doesn’t guarantee that you’ll lose all of your excess weight or that you’ll keep it off long term. Weight-loss success after surgery depends on your commitment to making lifelong changes in your eating and exercise habits.

Common weight-loss surgeries include:

Gastric bypass surgery. In gastric bypass (Roux-en-Y gastric bypass), the surgeon creates a small pouch at the top of your stomach. The small intestine is then cut a short distance below the main stomach and connected to the new pouch. Food and liquid flow directly from the pouch into this part of the intestine, bypassing most of your stomach.

Adjustable gastric banding. In this procedure, your stomach is separated into two pouches with an inflatable band. Pulling the band tight, like a belt, the surgeon creates a tiny channel between the two pouches. The band keeps the opening from expanding and is generally designed to stay in place permanently.

Biliopancreatic diversion with duodenal switch. This procedure begins with the surgeon removing a large part of the stomach. The surgeon leaves the valve that releases food to the small intestine and the first part of the small intestine (duodenum). Then the surgeon closes off the middle section of the intestine and attaches the last part directly to the duodenum. The separated section of the intestine is reattached to the end of the intestine to allow bile and digestive juices to flow into this part of the intestine.

Gastric sleeve. In this procedure, part of the stomach is removed, creating a smaller reservoir for food. It’s a less complicated surgery than gastric bypass or biliopancreatic diversion with duodenal switch.

Preventing weight regain after obesity treatment

Unfortunately, it’s common to regain weight no matter what obesity treatment methods you try. If you take weight-loss medications, you’ll probably regain weight when you stop taking them. You might even regain weight after weight-loss surgery if you continue to overeat or overindulge in high-calorie foods or high-calorie beverages.

One of the best ways to prevent regaining the weight you’ve lost is to get regular physical activity. Aim for 45 to 60 minutes a day.

Keep track of your physical activity if it helps you stay motivated and on course. As you lose weight and gain better health, talk to your doctor about what additional activities you might be able to do and, if appropriate, how to give your activity and exercise a boost.

Complications

People with obesity are more likely to develop a number of potentially serious health problems:

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Heart disease and strokes. Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.

Type 2 diabetes. Obesity can affect the way your body uses insulin to control blood sugar levels. This raises your risk of insulin resistance and diabetes.

Certain cancers. Obesity may increase your risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.

Digestive problems. Obesity increases the likelihood that you’ll develop heartburn, gallbladder disease and liver problems.

Gynecological and sexual problems. Obesity may cause infertility and irregular periods in women. Obesity also can cause erectile dysfunction in men.

Sleep apnea. People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.

Osteoarthritis. Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.

Quality of life

Obesity can diminish your overall quality of life. You may not be able to do things you used to do, such as participating in enjoyable activities. You may avoid public places. People with obesity may even encounter discrimination.

 

Other weight-related issues that may affect your quality of life include:

  1. Depression
  2. Disability
  3. Sexual problems
  4. Shame and guilt
  5. Social isolation
  6. Lower work achievement

Prevention

Whether you’re at risk of obesity, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems. Not surprisingly, the steps to prevent weight gain are the same as the steps to lose weight: daily exercise, a healthy diet, and a long-term commitment to watch what you eat and drink.

Exercise regularly. You need to get 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.

Follow a healthy-eating plan. Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables and whole grains. Avoid saturated fat and limit sweets and alcohol. Eat three regular meals a day with limited snacking. You can still enjoy small amounts of high-fat, high-calorie foods as an infrequent treat. Just be sure to choose foods that promote a healthy weight and good health most of the time.

Know and avoid the food traps that cause you to eat. Identify situations that trigger out-of-control eating. Try keeping a journal and write down what you eat, how much you eat, when you eat, how you’re feeling and how hungry you are. After a while, you should see patterns emerge. You can plan ahead and develop strategies for handling these types of situations and stay in control of your eating behaviors.

Monitor your weight regularly. People who weigh themselves at least once a week are more successful in keeping off excess pounds. Monitoring your weight can tell you whether your efforts are working and can help you detect small weight gains before they become big problems.

Be consistent. Sticking to your healthy-weight plan during the week, on the weekends, and amidst vacation and holidays as much as possible increases your chances of long-term success.

We’re sure, you now have a fair idea of what Obesity is all about and the way it could impact your life. Please feel free to contact us  query@gtsmeditour.com if you’d like to take a second opinion on your condition or undergo treatment for Obesity.

 

 

Glaucoma

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Glaucoma is known as the “silent thief of sight” as it is a symptom less disease, and people usually do not realize that they are suffering from glaucoma unless they visit the ophthalmologist or have reached an advanced stage of disease. If undiagnosed and untreated, glaucoma can lead to irreversible loss of vision and even cause blindness. Though the disease is not curable, the progress of glaucoma can be halted and total blindness can be prevented if it is detected early.

What is Glaucoma?

Glaucoma is a serious eye disease where the optic nerve that carries signals from the eye to the brain gets damaged due to unhealthy fluid pressure inside your eye.The intraocular pressure rises due to an alteration in the drainage system of the eye, which is either blocked or offers resistance to the normal drainage.Since the optic nerve is the primary carrier of visual stimulus to the brain, damage to it could actually result in significant loss of vision. Glaucoma generally affects both the eyes, although the pressure inside each eye could be different,the estimated number of cases of glaucoma in India is 12 million. This is around one fifth of global burden of glaucoma.

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Glaucoma – Symptoms of this disease?

There are no early symptoms associated with Glaucoma.and hence a routine eye check up after the age of 40 is usually advisable to rule out glaucoma.

However, most Glaucoma patients visit a doctor due to one or more of the following symptoms:

  • Frequent changes of glasses, especially for near work, but none is satisfactory,
  • Rainbow colored rings around lights (seeing halos),
  • Blurred or foggy vision
  • Loss of side vision.
  • Redness of the eye

TYPES OF GLAUCOMA

The different types of glaucoma include

  • Primary open angle glaucoma – is the most common type of glaucoma. In this type of glaucoma, the part of the eye through which the fluid of the eye flows out is open, permitting the outflow of fluid, but the patient still has high pressure. This type of glaucoma develops slowly without any symptoms. Initially it affects the peripheral or side vision and very gradually progresses to the centre. This is the reason why many people are not aware that they have the condition until they have significant vision loss affecting central vision.

Risk factors for primary open angle glaucoma are:

  1. Age more than 40 years
  2. Race – African Americans
  3. Family history of glaucoma
  4. Systemic diseases such as diabetes mellitus, hypertension, heart disease
  5. Injuries to the eye
  6. High myopia
  • Angle closure glaucoma or closed angle glaucoma –is a less common type of glaucoma which occurs due to narrow drainage channels in the eye. Gradual closing of the angle is called chronic angle closure and if the drainage angle closes suddenly, it causes an acute angle closure attack. Acute angle closure glaucoma usually presents as an emergency.  A patient who is in an acute angle closure attack will have symptoms of eye pain, nausea, vomiting, redness and blurred vision due to a rapid increase in the eye pressure. In such cases the patient needs immediate treatment by an eye specialist.

Risk factors for angle closure glaucoma:

  1. Age more than 40 years
  2. Race – East Asians
  3. Family history of glaucoma
  4. Women
  5. High hypermetropia or those with a high plus power
  • Normal tension glaucoma /Low tension glaucoma –In this type of glaucoma the optic nerve can get affected even though the pressure in the eye is normal. Although its cause is not entirely known or understood, normal tension glaucoma is believed to occur either because of an extremely fragile optic nerve that can get damaged even though the pressure in the eye is normal, or because of reduced blood flow to the optic nerve. Because of its silent nature, people usually do not have any visual complaints until a very advanced stage of the disease.

Risk factors for normal tension glaucoma are:

  1. Family history of normal tension glaucoma
  2. Race – Japanese ancestry
  3. Thinner corneas
  4. Heart disease
  5. Migraine and peripheral vascular disease
  • Secondary glaucoma –There are certain other types of glaucoma where there is an identifiable cause for increased eye pressure resulting in optic nerve damage and vision loss. These are called secondary glaucoma. It may be caused by prolonged, indiscriminate use of steroids, severe diabetic retinopathy, injuries to the eye, inflammation of the eye (uveitis) or advanced cases of cataract.

If you believe you have any of these risk factors get an eye examination done. Always remember to inform your eye doctor about the risk factors that you have. This will help your doctor decide how often you need to get your eyes examined.

Glaucoma may also occur in children (congenital glaucoma) after trauma or with inflammation.

Diagnosis & Treatment

Initial glaucoma workup involves the measurement of the intraocular pressure (IOP) with the help of a Goldmann’s Applanation tonometer, evaluation of the angle of the eye with a Goldmann goniolens , examination of the optic nerve head by slit lamp bio microscopy and the measurement of the central corneal thickness using a pachymeter. Ultrasound biomicroscopy helps us to further assess angle details and dimensions and actively intervene based on the findings

The Visual Field test is a method of measuring your peripheral or side vision (which is affected first by glaucoma), through which your doctor can diagnose and monitor glaucoma. The data from the test is used to determine the severity of your glaucoma, level of vision loss, damage to the visual pathways of the brain, and other optic nerve diseases.

Ophthalmoscopy

 Treatment:

  •  Medication

Glaucoma can be treated with external medication or surgery. The medication generally involves the usage of eye drops to reduce the secretion of the fluid (aqueous humor).

  • Surgery:
  1. Trabeculectomy (TRAB) 

 A surgery helps to open up the blocks in the drainage pipe to enable the outflow of the fluid. This can be performed by a procedure called Trabeculectomy (TRAB)

 

       2.  LASER Treatment

3. Glaucoma drainage valve implant placements are performed by qualified surgeons

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Further, in cases of congenital glaucoma surgery is opted.

Glaucoma – prevention, Diet, 

There’s actually nothing you can do to prevent Glaucoma. However, with early detection, you could reduce the impact on the optic nerve, as the damage once done is irreversible. 

The best way to tackle this disease is through regular eye check-ups.

Get glaucoma screening done if you have a family history of glaucoma, diabetes, hypertension, heart disease, asthma, arthritis, migraine, thyroid disease, using minus or plus powered glasses, any history of trauma to eye. If detected in the early stage, the disease can be arrested and existing vision can be retained.

Babies born with whitish coloured eyes or bigger than normal eyes, or babies with severe watering and difficulty in opening their eyes at birth, should be screened for congenital glaucoma.

Ophthalmic consultation is a must for everyone over the age of 40, in an eye hospital rather than getting tested for near vision at an optical shop.

Avoid-Lifting of heavy weights is known to cause a temporary increase in the intraocular pressure. Hence, patients who already suffer from glaucoma are advised to avoid lifting very heavy weights. Yoga, which is a very popular form of exercise includes various ‘asanas’ or positions. Some of these asanas, particularly those with the head – down position (sheershasana) have been proven to cause an increase in the eye pressure. Therefore, patients with glaucoma are advised to avoid such positions.

Diet – Foods which are rich in trans-fats, the kind found in deep fried food, prevent the optimal functioning of omega 3- fatty acids and increases eye pressure. Such food should be avoided.Habit forming substances – such as caffeine, alcohol, tobacco and marijuana are known to have a negative effect on eye pressure. Caffeine, which is consumed widely, is known to cause a temporary increase in the eye pressure.

We’re sure, you now have a fair idea of what Glaucoma is all about and the way it could impact your life. Please feel free to contact us  query@gtsmeditour.com if you’d like to take a second opinion on your condition or undergo treatment for glaucoma.

 

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