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Showing posts with label smoking. Show all posts
Showing posts with label smoking. Show all posts

Thursday, November 13, 2008

A Simple Guide to Kidney Cancer

A Simple Guide to Kidney Cancer
----------------------------------------

What is Kidney Cancer?
------------------------------

Kidney Cancer is a malignant disease of the kidney.

What are the causes of Kidney Cancer?
-----------------------------------------

1.Hereditary- hereditary kidney cancer is related to the Von Lindau syndrome.

2.Smoking. cigarettes smoke chemicals has been known to damage the Kidney cells

3.Uncontrolled hypertension-damage to kidney cells may contribute to Kidney cancer

4.Obesity has been found to have some causal effect

5.Age - more common in in 50-70 age group

6.Long term dialysis for kidney failure.

What are the symptoms and signs of Kidney Cancer?
-------------------------------------------------------

Symptoms - non-specific and silent.

In the early stage there is no symptoms.

By the the time the symptoms appeared, the cancer is usually in the advanced stage.

1.painless hematuria or blood in urine

2.pain in the renal flanks

3.Fever

4.weight loss

Signs:

1.tenderness in renal area of backs

2.palpable mass in the side of abdomen

How do you diagnose Kidney Cancer?
----------------------------------------------

Diagnosis can usually be made by :

History
-----------

1.hematuria

2.Renal flank pain

3.Weight loss

Liver function tests
---------------------

may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, SGGT and alkaline phosphatase levels) in the absence of liver disease.

Ultrasound or abdominal CT
------------------------------

may be used to identify tumors.

Kidney Biopsy
---------------
biopsy of kidney may be done to determine types of Kidney cancer:

Clear Cell Type: 75%
Papillary type: 20%
Chromophole type: 4%
Others: 1%

What is the treatment of Kidney Cancer?
------------------------------------------------

Treatment of Kidney cancer can be
surgery
chemotherapy
radiotherapy
immunotherapy
biological targeted therapy
depending on the stage of the cancer.

Surgery
--------------

If the cancer is localized within the kidney , then it is surgically resectable and curable.

No treatment after surgery has been proven to prevent recurrence.

Depending on the size of the cancer, the recurrence rate varies from
10% in Stage I
60% in Stage III

Once recurrence occur then the cancer is considered as a Stage IV cancer and therefore incurable.

The aim of treatment then is palliative with emphasis to improve overall survival rates and quality of life.

Immunotherapy
-----------------

High dose immunotherapy such as interleukin may be able to cure less than 5% of the kidney cancer patients.

It is however toxic and potentially life threatening and is used for patients not suitable for surgery.

Low dose immunotherapy such as interferon is better in that it can relieve symptoms and improve quality of life for an average of 3-6 month in 15% of cases treated.

Despite its low dose the side effects can also affects the treatment of the patients such as fever, chills and loss of appetite.

Biological targeted therapy
-------------------------------------

These drugs target the growth of the cancer cells by suppressing the cellular pathways which stimulates the growth of the abnormal tumor blood vessels and the tumor cells .

These treatments have been proven to better in terms of better response and length of the disease control compared to interferon and interleukin.

There has also being an improved overall survival rate with a reduced risk of death by 28%.

Side effects are hypertension, ischemia of heart, fatigue, loss of appetite, diarrhea and loss of weight.

The approved drugs are sorafenib, sumitinib and tensirolimus.

Chemotherapy and radiotherapy
-----------------------------

Chemotherapy and radiotherapy have been found to be ineffective for renal cancer treatment.

What is the Prognosis of Kidney cancer?
-------------------------------------------------

The prognosis of Kidney cancer is poor

1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.

2.Median survival from diagnosis is around 1 year

3.5-year survival is lower than 5%.

4.Kidney cancer has one of the highest mortality of all the cancers.

How to prevent Kidney cancer?
------------------------------------

Avoid smoking

Reduce weight in obese patients

Control high blood pressure to prevent damage to the kidney

Avoid taking toxic substances which may damage or injure the cells of the kidney.

Wednesday, June 18, 2008

A Simple Guide to Pancreatic Cancer

A Simple Guide to Pancreatic Cancer
----------------------------------------


What is Pancreatic Cancer?
------------------------------

Pancreatic Cancer is a malignant disease of the exocrine pancreas. 90% are adenocarcinomas.


What are the causes of Pancreatic Cancer?
-----------------------------------------

1.Smoking. cigarettes smoke chemicals has been known to damage the pancreatic cells

2.Diets rich in red meat- high protein tends to stmulate more enzymes frm pancreas and cause dysfunction in the cells

3.Diabetes mellitus -damage to islets in pancreas may contribute to pancreatic cancer

4.Chronic pancreatitis has been found to have some causal effect

5.Helicobacter pylori infection -known to cause stomach cancer and also pancreatic cancer

6.Occupational exposure to certain chemicals including insecticides

7.Family history -there is a family history in 5-10% of pancreatic cancer patients

8.Obesity - the high fat diet may induce more disease of bile system with blockage of its tract


What are the symptoms and signs of Pancreatic Cancer?
-------------------------------------------------------

Symptoms - non-specific and varied.

1.pain in the upper abdomen that typically radiates to the back

2.pain relieved by leaning forward

3.painless jaundice related to bile duct obstruction (carcinoma of the head of the pancreas)

4.depression is sometimes associated with pancreatic cancer


Signs:

1.tenderness in upper abdomen

2.mass in the abdomen

3.Trousseau sign- Spontaneous blood clots in veins of extremities, or the superficial veins may indicate presence of pancreatic cancer.



How do you diagnose Pancreatic Cancer?
----------------------------------------------

Diagnosis can usually be made by :

History
-----------

1.pain in upper abdomen radiating straight to the back, worse on eating

2.Weight loss severe with anorexia, early satiety, diarrhea, or steatorrhea.

3.Jaundice -initially painless, itchy with dark urine.
Painful jaundice occurs later

4.onset of atypical diabetes mellitus

5.unexplained recent thrombophlebitis

6.past history of pancreatitis

Location of cancer
-----------------------

1.Tumors in the pancreatic body or tail usually present with pain and weight loss

2.Tumors in the head of the gland typically present with steatorrhea, weight loss, and jaundice.

Courvoisier sign
-----------------

presence of jaundice and a painlessly distended gallbladder is suggestive of pancreatic cancer

Liver function tests
---------------------

may show a combination of results indicative of bile duct obstruction (raised conjugated bilirubin, SGGT and alkaline phosphatase levels).

CA19-9 (carbohydrate antigen 19.9)
----------------------------------

is a tumor marker that is frequently elevated in pancreatic cancer.

Ultrasound or abdominal CT
------------------------------

may be used to identify tumors.

Endoscopic ultrasound (EUS) is another procedure that can help visualize the tumor and obtain tissue to establish the diagnosis.


What is the treatment of Pancreatic Cancer?
------------------------------------------------

Treatment of pancreatic cancer can be surgery or chemotherapy depending on the stage of the cancer.

Surgery
--------------

1.Where the head of the pancreas is involved, the Whipple procedure is the most common surgical treatment for pancreatic cancers.
It is a major surgery involving the the resection of the head of pancreas and requres the patient to be fit for the surgery and the tumor to be localised without metastases. Only in small number of cases can the surgery be done.

2.Cancers of the tail of the pancreas can be removes by a technique called distal pancreatectomy

3.localized tumors of the pancreas have been surgically removed using laparoscopy.

4.Surgery may be performed for relief of symptoms especially if the cancer is invading or pressing on the duodenum or colon.

5.Bypass surgery may prevent the obstruction of the pancreatic ducts and improve quality of life.

Chemotherapy
-----------------

is used for patients not suitable for surgery. It can relieve symptoms and improve quality of life

Gemcitabine was approved by the US FDA after a clinical trial reported improvements in quality of life in patients with advanced pancreatic cancer

Gemcitabine may used after surgery to remove tumor tissue remaining in the body. As a result 5-year survival rates has improved.

Other drugs such as oxaliplatin and fluorouracil have also beneficial effect.

Radiation therapy
--------------------

The use of additional radiation therapy follwing surgery has been used in USA while rejected by most doctors in Europe.


What is the Prognosis of pancreatic cancer?
-------------------------------------------------

The prognosis of pancreatic cancer is poor

1.because the cancer usually causes no early symptoms resulting in advanced or metastatic disease at the time of diagnosis.

2.Median survival from diagnosis is around 3-4 months;

3.5-year survival is lower than 5%.

4.Pancreatic cancer has the highest mortality of all the cancers.

5.Pancreatic cancer may sometimes cause diabetes.

How to prevent Pancreatic Cancer?
----------------------------------------

1.a healthy lifesyle

2.increase consumption of fruits, vegetables

3.reduce red meat intake

4.Vitamin D can reduce the risk of pancreatic cancer

5.B vitamins such as B12, B6, and folate in food but not in tablets may reduce the risk of pancreatic cancer

6.Avoid smoking and drinking of alcohol

Monday, June 9, 2008

A Simple Guide to Coughing

A Simple Guide to Coughing
------------------------------


What is Coughing?
----------------------


Coughing is the reflex mechanism in which the body tries to get rid of excessive mucus and phlegm accumulated in the lining membranes of the respiratory tract.

The secretions from the lining of the respiratory tract trap and then flush out the viruses, bacteria and other particles like smoke, haze particles.

It prevents serious infections from entering the lungs and bronchial tubes
.

What are the common causes of cough?
---------------------------------------


Coughing is usually caused by the following:

Infections:
1.bacterial or viral infection of the nose and throat such as the common cold or influenza.(yellow or green phlegm)

2.anaerobic infections of the mouth,

3.Infection of the tonsils, nose and sinuses(postnasal drip)

4.Bacterial infection of the bronchial tubes and lungs(bronchiectasis, bronchitis, pneumonia, sinusitis, or tracheitis).
This often comes with rusty or green mucus.

Dry mouth:
1.Insufficient drinking of water

2.medications especially ACE inhibitors(eg. enapril) can cause dry persistent coughs

Allergies:
1.Certain plants, pollens, chemicals, cosmetics can cause allergic reactions in the throat and bronchial causing cough. (white clear phlegm)

2.Asthma - narrowing of the bronchial tubes due to allergic and other causes usually results in white sticky clear productive phlegm

Smoking:
Cigarettes smokes contains 40 over chemicals which irritates the cells in the lining of the bronchial tubes causing a chronic cough

Stress:
Stress can cause cough due to dryness of mouth during stress or anxiety, causing the saliva to dry up and producing dry unproductive cough.
The cough in stress usually disappears during sleep.

Gastric problems or indigetions
1. Indigestion of food in the stomach can cause the undigested food in the stomach to produce gas in the stomach which goes upwards to the throat drying saliva which then become irritating phlegm in the throat.

2.gastroesophageal reflux of food can also cause the acid and undigested food to travel to the mouth and produce mucus secretions.

Systemic diseases:
1.Congestive heart failure

2.Lower respiratory tract infections

3.Chronic Obstructive Lung Disease

4.Carcinoma lung.


What investigations are needed for cough?
------------------------------------------

1.chest X-ray

2.sputum culture

3.pulmonary function tests

What is the treatment of Coughing?
-------------------------------------

Medications
1.Approprate Antibiotics, antifungal for infections of throat and bonchial tubes

2.Antihistamines for allregic cough

3.Bronchodilators for asthma and Chronic Obstructive Lung Disease

4.cough mixtures - expectorants helps to expel out the phlegm
- suppresant suppress the cough -especially for dry cough and at night to stop the cough

5.Antacids and antiflatulent agents to get rid of gas in stomach and prevent reflux

6.Diuretics for treatment of congestive heart failure especially in the elderly

Healthy Lifestyle:
1.drinking several glasses of water a day prevents dryness of mouth

2.Avoid cold, acidic, spicy and oily food which irritates the throat

3.Proper oral hygience after eating: brushing of teeth and flossing.

4.Gargle mouth after every meal.

4.Avoid smoking

6.Avoid frequent usage of the voice and throat - do not talk too much

6.Treat underlying condition such as asthma, diabetes, liver, kidney and other conditions.

Thursday, February 28, 2008

A Simple Guide to Stomatitis

A Simple Guide to Stomatitis
-----------------------------------


What is Stomatitis?
--------------------------


Stomatitis means inflammation of the mouth

What are the Causes of Stomatitis?
---------------------------------------------


There are many many disorders which can cause Stomatitis:

1.Bacteria, viruses, fungus

2.avitaminosis

3.leukemia,agranulocytosis

4.Dental problems,poor fitting denture, poor dental hygience

5.smoking

6.medicines: phenytoin, iodides, barbiturates

7.stress


What are the Symptoms of Stomatitis?
----------------------------------------------


Stomatitis usually appear on the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums.

It may begin with a tingling or burning sensation, followed by a red hyperemia of the inside of the lining of the cheek, gums or tongues.

The inflamed surfaces may develop into ulcers

Occasionally, a severe occurrence may be accompanied by fever,lymphadenopathy and lethargy.

Most mouth inflammation is not infectious except bacterial,fungal and viral infections.

Oral mucosal smears may be necessary to determine those with bacterial or fungal infections.

What is the Treatment of Stomatitis?
-------------------------------------------


The exact treatment will depend on the cause of the Stomatitis.
Sometimes all that is required is to remove the cause of the Stomatitis such as an ill fitting denture.

The following measures may help to reduce pain from Stomatitis:
Proper oral hygience:
---------------------


1.keep your mouth clean at all times,

2.avoid foods that are spicy, acidic, salty or particularly hot or cold, which can make the symptoms worse,

3.eat a healthy diet that includes fresh fruit and vegetables,

4.gargle with warm salt water,

5.use a diluted chlorhexidine mouthwash once a day to help reduce the length of time the stomatitis last.

6.sprays and rinses are also available for pain relief.


Medical treatment:
-------------------


The main treatment of the Stomatitis is application of topical corticosteroids (Kenalog in orabase or Oracorte E), or other soothing preparations.

Where bacteria are present the appropriate antibiotic will treat the Stomatitis.

Antifungal agents are used to treat fungal infection.


Vitamin B replacements are important in cases due to deficiency of the vitamins.

Underlying condition:
-------------------


Treatment of systemic condition causing the Stomatitis such as leukemia,

What are the Prevention measures in Stomatitis?
---------------------------------------------------------


Good oral hygiene may help in the prevention of some types of stomatitis or complications from stomatitis.

This includes brushing the teeth at least twice per day, flossing at least daily, and going for regular dental checkup and cleaning.

Try to avoid getting run down by making sure you eat a balanced diet, take regular exercise and learn to manage stress.

What is the prognosis of the Stomatitis?
---------------------------------------------


The outlook for most stomatitis is good.

Those with underlying condition such as leukemia will improve with treatment of the illness.

Monday, December 24, 2007

A Simple Guide to Stroke 2

A Simple Guide to Stroke 2
--------------------------------


What is the treatment of Stroke?
--------------------------------


Stroke is an emergency.

Purpose of treatment is to:

1. preserve life

2. limit the amount of brain damage

3. lessen the extent of disability and deformity

4. prevent recurrence of a stroke.

Admission to hospital is necessary to determine

1. the cause of the stroke

2. the extent of damage to the brain using MRI of the brain

3. immediate treatment with medicines(usually anticoagulant,blood circulation,nerve vitamins).

4. whether Surgery is necessary to stop bleeding or remove a blood clot

5. risk factors for stroke are investigated and treated (diabetes, high blood pressure etc
)

During the acute phase of stroke:
1. A clear airway must be maintained

2. Sufficient fluid and electrolyte intake must be maintained

3. Adequate nutrition in the form of glucose, proteins and calories must be given

4. Adequate nursing care is provided to prevent bed sores etc

5. Proper medicines are given


Once the stroke is stable:
The stroke patient is started on a rehabilitation programme.


This will include
a.exercises to strenthen his muscles,

b.speech training for patients with dysphasia (difficulty in talking)

c.training on how to carry out his daily activities.

d.advice about his diet

Immediate care improves the chance of a complete recovery.

How to care for a Stroke Patients?
----------------------------------------


A stroke can be very devastating and depressing for a patient.

He will feel that part of his body and brain function is incapacitated.

Therefore he need all the support from everyone involved in the treatment of his condition:
1.doctors,
2.nurses,
3.physiotherapist,
4.speech therapist
5.occupational therapists
6.family members and friends


Family members can provide the most important means of support.
They should be familiar with his disabilities and help him accordingly:

Please do:
--------------
1.be understanding and patient.

2. keep the patient cheerful and hopeful

3.learn how to help him with the diet, daily exercises and other care necessary for him

4.allow the person more time to do any task

5.encourage and praise the patient to do as much as possible for himself at his own pace.

6.involve the person in family discussions and activities.

7.be encouraging and praise his daily efforts.

8.encourage the person to look at, touch, and move his affected limbs.

Do not:

----------
1.ignore him or treat him like a child .

2.encourage the person to do things using the good side only.

3.pull on the affected arm or leg as it can be extremely painful.

4.interrupt or speak up for him.

5.make discouraging remarks.

6.allow the person to squeeze rubber balls as this may tighten his hand muscles.

7.let him be depressed

8.let him develop bed sores. Try to turn his body regularly.

In order to help the person be as independent as possible, there are
special aids(such as tripod walking cane) and
appliances(wheelchairs) which can be used to help him with his daily activities.

There are also special clothes and shoes which uses velcro instead of buttons or zips.

Make the home a safe place with non-slipmats and grab bars

How to Prevent Stroke?
----------------------


Prevention of a stroke is the same as the prevention of a heart attack as both involve the avoiding the blockage or bleeding of a major artery to the brain or heart.

1.Control the Blood Pressure
Have your blood pressure checked at least once a year from the age of 40 years.
If there is high blood pressure, lifelong treatment with monthly checkups will keep it under control.

2.Control the Diabetes
Check for diabetes starting from the age of 40 years.
If there are risk factors for diabetes, screening should start earlier.
If there is diabetes, take the medicine or injections regularly.
Monitor the sugar levels daily.
Control the diet.
Check with the doctor regularly
.

2.Watch Your Diet
Reduce consumption of fat, high-cholesterol food, sugar and salt.
Take more fruit, vegetables and moderate servings of carbohydrates.
Eat more beancurd, dried peas, dried beans, fish and chicken instead of red meat.
Drink low-fat milk.
Avoid full cream milk.
Avoid alcohol.
Drink less coffee, tea and cola drinks.

3.Don't Smoke
Stop smoking immediately.
Don't start smoking if you are not a smoker.

4.Physical Activity
Regular exercise is good for you.
Do moderate intensity physical activity for 30 minutes such that you sweat and breathe deeply without getting breathless.

Examples include brisk walking, swimming, cycling.

6.Learn To Relax
Have adequate rest especially when you feel tense or tired.
Take up a hobby.
Do relaxation exercises such as yoga or deep breathing exercises.
Time management is important
.

Sunday, November 25, 2007

A Simple Guide to Laryngitis

A Simple Guide to Laryngitis
----------------------------------

What is Laryngitis?
------------------------

Laryngitis
is the inflammation of the mucous membranes of the Laryngx which produces the sound of the voice.

What causes the Laryngitis?
---------------------------------

Laryngitis is caused by
1.bacterial or viral infections of the larynx.

2.excessive use of voice

3.inhalation of irritants such as cigarette smoke

Laryngitis is also associated with
1.bronchitis

2.pneumonia

3.whooping cough

4.diphtheria

What are the Symptoms of the Laryngitis?
--------------------------------------------------

Laryngitis produces mild but uncomfortable symptoms:

1.hoarseness of voice

2.loss of voice

3.pain on speaking

4.Fever low grade rare

How is the diagnosis of Laryngitis confirmed?
------------------------------------------------------

1.Symptoms of hoarseness or loss of voice

2.Physical examination of the throat may showed the presence of redness and swelling of the vocal cords with some pus discharge.

The movement of the vocal cords may be impeded.

Sometimes nodules may be found on the vocal cord due to excessive usage of voice.

What are the investigations done in Laryngitis?
-----------------------------------------------------------

1.nasal and throat swabs
to determine the type of infection

2.Xray of the chest and neck to determine any pressure of other organs pressing on the larynx

3.A biopsy of the nodules on the vocal cords if present to exclude malignancy

What is the Treatment of Laryngitis?
---------------------------------------------

1.Rest the voice. A rested patient will recover faster.

2.Adequate warm fluids helps to keep the mucus membranes moist

3.Steam inhalations may help

4.Antibiotics if there is suspicion of bacterial infection.

5.Gargles and decongestants may help to soothe the throat and vocal cords

6.Avoid smoking.

What is the prognosis of Laryngitis?
------------------------------------------

Acute laryngitis usually clears up within 10 days.

Very rarely chronic laryngitis may cause hoarseness of voice for months or years.

Thursday, October 11, 2007

A Simple Guide to Chronic Obstructive Lung Disease

A Simple Guide to Chronic Obstructive Lung Disease
-----------------------------------------------------------

What is Chronic Obstructive Lung Disease?
------------------------------------------------

Chronic Obstructive Lung Disease (COLD) is a disease of the lungs characterised by the obstruction to the air flow in the airways of the lungs.

The narrowing of the airways together with distension of the air sacs beyond the terminal bronchioles with destruction of the alveolar walls over the course of many years damages the air sacs reducing the surface area left for the exchange of oxygen and carbon dioxide.

As a result the patient become increasingly short of breath.

What is the cause of Chronic Obstructive Lung Disease?
-------------------------------------------------------------

Chronic Obstructive Lung Disease is associated with
1.Chronic bronchitis .
Chronic bronchitis is an ongoing inflammation of the lining of the breathing tubes (the bronchi), which is caused by bacterial infection or cigarette smoke irritation.

As the inflammation progresses, the bronchi fill up with mucus resulting in a chronic cough, as the body attempts to rid itself of the excess mucus that is irritating the lungs. The excess mucus in the bronchi also makes the diameter of the bronchi narrower and reduces the amount of air that can pass through. There is obstruction to air flow and hence breathlessness.

Smoking is the main culprit here.

2.Chronic asthma-
the narrowing of the airtubes caused by spasm of the muscles of the lining the airtubes triggered off by the allergens can cause permanent damage to the airtubes causing obstruction to airflow and hence difficulty in breathing.

3.Emphysema -
here the narrowing of the airway extends to the smaller airways or bronchioles with damage and overdistension of the air sacs resulting in obstruction and less air getting through to the lungs.

4.Chronic infection of the lungs like pneumoconiosis and tuberculosis may cause damage to the lungs with difficulty in breathing and poor air flow.

In all cases of the above conditions air flow is impeded and there is hyper inflation of the lungs.

What are the Symptoms of Chronic Obstructive Lung Disease?
--------------------------------------------------------

Symptoms include:
1.Cough is usually the first symptom to develop.
It is usually a wet cough with phlegm(sputum).
Initially the cough is intermittent but becomes persistent as the condition progresses.

2. Excessive sputum or mucus is produced by the damaged airways.
This results in excessive production of phlegm

3.Chronic shortness of breath or shortness of breath occurs with mild exertion.
As the illness continues, breathlessness occurs even when sitting and can be very distressing to the patient.

4.There may even be breathing difficulty when lying down.

5.Wheezing may occur due to the sound of the air trying to squeeze through narrow airways.

6.Bluish coloration of the skin due to lack of oxygen

7.Dizziness can occur if the brain does not receive enough oxygen

8.Fatigue also occur when the body does not receive enough oxygen

Besides these main symptoms, other symptoms are:
1. Nasal flaring and bulging eyes

2.Vision abnormalities

3.Anxiety, stress, and tension

4.Ankle, feet, and leg swelling

5.Unintentional weight loss

6.Headache (especially in the morning)

7.Excessive daytime sleepiness

8.Insomnia

How is the diagnosis of Chronic Obstructive Lung Disease made?
----------------------------------------------------------

1. medical history of cough, excessive sputum, breathlessness and their duration.
Any history of smoking,asthma, exposure to environmental toxins.

2. Physical examination for barrel-shaped chest and flattened diaphragm.

3. Pulmonary (lung) Function Testing-
this is a very important tool used to confirm COLD.
The patient is asked to into a machine called the spirometer which measures the amount of air the patient is able to blow out from his lungs.
The readings from the spirometer will confirm the diagnosis of COLD and assess the severity.
It is also used to monitor the patient's progress.

4. Chest X-ray is useful as an aid in the diagnosis of COLD(hyperinflated lungs and depressed diaphragm is typical).
It is also useful to rule out other conditions besides COLD.
It also detects any complications of COLD.

What is the Treatment of Chronic Obstructive Lung Disease?
-------------------------------------------------------

There is no cure for COLD.

Medications and lifestyle changes may help in the relief of symptoms and preventing the progression of the disease.

Lifestyle Changes:
1.Stop Smoking is the most important step for a COLD sufferer.
While the damage to to the lungs cannot be reversed, stopping smoking will help prevent the progression of the condition.

2. Avoid air pollution and second hand smoke in the workplace and wear a mask if the air pollution index is high

3.Pulmonary Rehabilation- this involved a structured programme which includes education, exercise training,psychosocial support and instruction proper breathing techniques.
Benefits include improvement in the ability to exercise, reduced breathlessness and fatigue resulting in improvement in the quality of life.

4.Nutrition- eat a well balanced diet.
If chewing and swallowing interfere withbreathing, take small frequent meals.

5. Rest, meditation,adequate sleep are factors which will help improve your quality of life.

Medications:
1.Bronchodilators are medicines that relax the muscles aound the airways in your lungs, It opens the airways allowing air flow in and out of the lungs to improve. Bronchodilators may be taken orally or in inhalers.

2. Corticosteroids helps reduce airway inflammation and decrease the mucus production. Again these medicines can be taken orally or in inhalers.
Side effects are less with inhalers.

3. Antibiotics are taken to treat any underlying infection.

4. Vaccinations:
a.Yearly influenza vaccination is given if there is a higher risk of pneunomia if you suffer from influenza.
b.Pneumoccal vaccination for protection against pneumococcal infection.

Oxygen Therapy:Those wth severe symptoms may benefit from a regime of oxygen therapy for at least 15 hours a day.

Surgery:
Sometime removal of section of lung which has collapsed may improve symptoms. Sometimes a few may be considered for lung transplantation.

What are the Complications of Chronic Obstructive Lung Disease?
-----------------------------------------------------------

Most patients ends up with pneumonia and death because of the chronic progression of the disease.

Many if treated are able to live a long time before succumbing to pneumonia.

Other advice:

Air travel may be possible if the doctor deem that you are fit to travel.

Sometimes arrangement for oxygen and medications during the air flight may be necessary.

Thursday, September 27, 2007

A Simple Guide to Stomach Cancer


A Simple Guide to Stomach Cancer
----------------

What is Stomach Cancer?
-----------------

Stomach cancer (also called “gastric cancer”) is the growth of abnormal cells in the lining and wall of the stomach which mutates and proliferates giving rise to the stomach cancer .
Stomach Cancer can spread to the surrounding organs like liver,pancreas and colon.
Once in the blood stream it can spread to the brain, bones and kidneys.

Who is at risk of getting Stomach Cancer?
-------------------------------------------------

1. Chronic Helicobacter pylori bacteria infection. This bacteria is found in the stomach and has been found to cause gastric ulcers and stomach cancer.

2. family history of stomach cancer

3. frequent consumption of preserved or smoked food such as salted vegetables,fish,meat. Cancer causing nitrosamines are released when these food are cooked.

4.previous stomach surgery with partial removal of stomach (gastric ulcers or polyps)

5. Pernicious anaemia- a rare blood disorder affecting the red blood cells

6. Smoking

7. Men are affected more than women

8. Age above 50 years of age

9.People with blood group A has a higher incidence

What are the symptoms of Stomach Cancer?
----------------------------------------------------

In the early stages, stomach cancer may have no symptoms.

As it spread it can cause the following symptoms:

1.Indigestion, stomach discomfort or heartburn

2.A fullness feeling or bloating after eating a small meal

3. loss of appetite

4.Nausea or belching

5. Feeling tired

When the cancer is larger, it can cause the following symptoms:

1.Stomach pain

2.Vomiting

3.Blood in your stool or black tarry stools

4.Unexplained weight loss

5.pallour due to anaemia from loss of blood

Many of these symptoms can be caused by other conditions besides cancer.
So the earlier stomach cancer is found, the better are the chances of it being cured.

How do you diagnose Stomach Cancer?
----------------------------------------------

1.medical history and complete physical exam.

2.Abdominal X-ray for any other condition in the abdomen causing pain or swelling in the abdomen

3.Gastroscopy:
a thin, lighted tube is put into your mouth and passed down to your stomach.

4.Biopsy:
During gastrocopy, a small piece of your suspicious stomach tissue is taken to check for cancer cells. This is called a biopsy sample which is then examined under a microscope for cancer cells.

How is stomach cancer treated?
-------------------------------------

Treatment for stomach cancer may include surgery, chemotherapy or radiation therapy, or a combination of these treatments. The choice of treatment depends on whether the cancer is just in the stomach or if it has spread to other places in the body. A person’s age and overall health will also affect the choice of treatment.

Surgery
Surgery is still the best form of treatment for stomach cancer.
For smaller cancers -partial removal of the stomach is done.
In early stages cure rate is about 90%.
For later stages of cancer, the whole stomach including the spleen and surrounding tissues may be removed.

Chemotherapy
Chemotherapy is used in conjunction with surgery in later stges of cancer.

Radiotherapy:
Radiation can help to kill the cancer cells surrounding the stomach cancer as well as to relieve pain.

Can I prevent stomach cancer?
------------------------------------

There is no way to prevent stomach cancer.
However, you can help reduce your risk of getting stomach cancer by:
Living a healthy lifestyle

Not drinking a lot of alcohol or smoking.

Avoid preserved food

Treat H.pyrori infections of the stomach early.

Eat a diet high in fresh fruits and vegetables, and vitamin C.
Vitamin C is found in foods such as oranges, grapefruit and broccoli.

AS IN ALL CANCERS, EARLY DETECTION IS THE BEST CURE!!

Wednesday, September 26, 2007

A Simple Guide to Liver Cancer




A Simple Guide to Liver Cancer
----------------


What is Liver Cancer?
---------------


Liver Cancer develops when the liver cells undergo abnormal changes to form cancer cells.
Most Primary cancer of the liver begins as mutated hepatocytes(liver cells).
Secondary cancer of the liver is due to spread from the stomach, colon, breast, lungs, ovaries etc

What is the incidence of Liver Cancer?
----------------------------------------------


Liver cancer is one of the most common cancer.
It occurs in men more than women.
It is more common in the 40s and 50s age groups.

What are the Risk Factors of Liver Cancer?
--------------------------------------------------


The main risk factor for liver cancer is
1.Hepatitis B infection.

Other important risk factors include
2.Hepatitis C infection

3.alcoholic liver disease (disease of the liver caused by heavy alcohol consumption).

4.family history of liver cancer

5.Chemicals exposures such as nitrites,solvents, hydrocarbons,viny chloride

6.poisons (e.g. aflatoxin present in some spoilt or mouldy peanuts).

7.inherited liver diseases (alpha-1 anti-trypsin deficiency)

8.Drug abuse eg heroin


What are the Signs and Symptoms of Liver Cancer?
------------------------------------------------------------


During the early stages, most people with liver cancer do not show any signs or symptoms.
Signs and symptoms, when they do appear, include:

1.loss of appetite and weight

2.discomfort or swelling in the upper part of the abdomen on the right side

3.weakness and fatigue

4.nausea and vomiting

5.jaundice - yellowness of the skin and eyes

6.dark color urine

7.Persistent or swinging fever

How is the Diagnosis of Liver Cancer confirmed?
--------------------------------------------------------


1. full medical history especially history of Hepatitis B and alcohol

2. full examination especially of the liver

3.an ultrasound scan of the liver and gallbladder, if possible the whole abdomen.
4.CT scan or MRI of the liver and surrounding tissues


5.blood tests (a protein present in blood called the alpha- fetoprotein or AFP may be found to be raised in liver cancer)

6.needle liver biopsy into the liver swelling as detected by ultrasound or MRI (to confirm the liver cancer).

With the diagnosis confirmed, the doctor will proceed with further tests to find out how advanced the liver cancer is. This will help the doctor to plan the treatment.

What is the Treatment of Liver Cancer?
---------------------------------------------


As in all cancers, treatment includes surgery, radiation therapy, chemotherapy.

In Liver cancer percutaneous ethanol (alcohol) injection is injected directly into the tumour, by means of a small needle, to kill the cancerous cells.

Liver transplant can also be carried out in selected cases where the size of the cancer is not too massive but surgery is not feasible due to the patient's limited liver reserve(provided a suitable liver donor can be found).

Treatment depends on the the stage of the cancer as well as health of the affected person.

The goal of treatment is complete cure.

However, where this is not possible, treatment is aimed at
preventing the tumour from spreading or growing.
Helping to
eliminate uncomfortable symptoms is also an important aspect of liver cancer treatment.

How to Protect yourself from Liver Cancer?
---------------------------------------------------


Prevention from getting liver cancer is by taking steps to reduce your risk factors.

1. Reduce your risk of Hepatitis B by getting vaccinated. The Hepatitis B vaccine is safe and effective.
Both Hepatitis B and C are spread through infected blood or sexual fluids as well as intravenous drug abuse. It is therefore important to avoid activities that put you at risk:

2.Avoid multiple sex partners and having sex with commercial sex workers, strangers or anyone with multiple sex partners.

3.Do not abuse drugs or share injection needles.

4.Never share personal items like razors, toothbrushes or other items that may cause breaks in the skin.

5.Visit only reliable operators for ear/body piercing, tattooing or acupuncture.

6.It is also important that you limit your consumption of alcohol as excessive drinking can give rise to liver disease and increase your risk of liver cancer.

The liver is one of the largest and most important organs in your body. It performs many essential functions including:
making and storing of essential nutrients
making important hormones and enzymes
breaking down harmful substances.

Do not abuse Your LIVER by excessive drinking or taking drugs!


Tuesday, September 25, 2007

A Simple Guide to Bladder Cancer


A Simple Guide to Bladder Cancer
-----------------

What is Bladder Cancer?

-----------------

Bladder cancer is a growth of abnormal cells forming a malignant tumour in the bladder. Most bladder cancers start in the inner lining of the bladder.


What are the different types of Bladder Cancer?

-----------------------------------------------

There are 2 main types of Bladder Cancer:

1.superficial cancer

the cancer is contained on the inner lining of the bladder.

They may occur as a small, wart-like growths on the inside of the bladder, which can be removed in a simple operation and usually will never recur.

2.invasive cancer

where the cancer has spread into the muscle wall of the bladder.

Examples are:

a.large growth in the muscle wall of the bladder, which requires major surgery to remove.

b.mushroom-like growths( papillary cancers)on the inside lining of the bladder. They have a short stem attached to the lining of the bladder and can spread into the wall of the bladder.

Treatment is different for these two types of bladder cancer.

What are the causes of Bladder Cancer?

-----------------------------------------------

There are a few factors which increase the risk of getting bladder cancer:

1.Smoking

chemicals in a cigarette have been found to contribute to bladder cancer. The more cigarettes smoked, the greater the risk.

2.Exposure to harmful, cancer-causing chemicals

Certain chemicals at the workplace, for example, those used in dye factories, rubber, gasworks, plastics and other chemical industries, can cause a higher risk of contracting bladder cancer in workers.

It can take about 25 years after exposure to these chemicals before bladder cancer develops.These chemicals may have been banned in some countries.

3.Frequent bouts of cystitis

Cystitis caused by repeated bacterial infections and bladder stones can lead to the development of bladder cancer.

4.Age and Gender

Bladder cancer occurs mostly among people aged between 50 - 70 years.

It is twice as common in men as in women.

It is rare in people below age 40.


What are the symptoms of Bladder Cancer?

---------------------------------------------------

The most common symptom is

1.blood in the urine which usually occurs suddenly and is generally not painful.

The blood may not be present constantly but eventually it does recur.

In some cases, blood clots can form and these may cause painful muscle spasms in the bladder. The amount of blood present is however not related to the extent of the cancer.

2. burning feeling when they pass urine.

3. frequency of urination.

While these are also symptoms of bladder irritation, further tests would be necessary if they persist and do not clear with antibiotics.

How can Bladder Cancer be treated?

------------------------------------------

The treatment for bladder cancer depends on the type of cancer, the stage and grade.

It also depends on the health of the patient.

Superficial cancers:

Superficial cancers, which can be single or multiple, are usually removed using a cystoscope. Anti-cancer drugs (chemotherapy or immunotherapy) may be instilled into the bladder to try to prevent the cancer recurring.

Invasive cancers

the options are as follows:

Surgery

The most common treatment method is surgery to remove a part of the bladder.

A new bladder is sometimes constructed if it has to be removed.

Radiotherapy

Radiotherapy may be used instead of surgery to avoid removal of the bladder. Radiotherapy may also be used before surgery in cases of large tumours to facilitate the tumour removal or if there is a high risk of cancer cells left behind after surgery.

Chemotherapy

In some cases, chemotherapy is given before surgery or radiotherapy to shrink the tumour so that it can be treated more effectively. Chemotherapy is also applied after surgery to reduce the recurrence of the tumour.The drug can be instilled into the bladder to maximise contact with the cancer cells.

Once the cancer has spread outside the bladder, the main treatment is chemotherapy.

Removal of bladder

------------------------

In a small proportion of people with bladder cancer, the bladder may completely removed.

The surgeon will then give the patients an urostomy - an artificial opening from the urinary tract.The opening is usually formed on the abdomen, to the right of the navel. Wrinkles, scars and prominent underlying bones must be avoided, as placing the opening near them may cause problems with leakage later on.

Ensure that the bag is emptied and changed as often as necessary.

At first the opening will be slightly swollen.

It may take several weeks for it to reduce to its normal size.

There may also be mucus (a thick white substance) from the opening. The amount of mucus will gradually reduce over time but will never disappear completely.
Most people with an urostomy live a normal life. Many return to their jobs and take up their favourite pastimes again, including swimming.
Now with advancement of plastic surgery a new bladder can be constructed easily and the days of urostomy may be over.

Sunday, September 23, 2007

A Simple Guide to Nasopharyngeal Cancer


A Simple Guide to Nasopharyngeal Cancer
----------------------------

What is Nasopharyngeal Cancer ?
------------------------

Nasopharyngeal cancer, commonly referred to as NPC, occurs when the cells lining the nasopharynx(area behind the nose and above the back of the throat) become abnormal and proliferates giving rise to cancer cells.
It affects more men than women.

What are the causes of Nasopharyngeal Cancer?
--------------------------------------------------------

Various causes may be involved:
1.Genes. -males between the ages of 20-50 from southern China and Southeast Asia are at higher risk.

2.Diet. such as preserved foods ( salted fish, vegetables and meat) can cause a higher risk of NPC. Cooking of such food releases toxic substances called nitrosamines into the fumes that we breathe.
Many NPC patients consumed much less fresh fruit and vegetables.

3.Virus. There is evidence that NPC patients have higher levels of the Epstein-Barr virus in their blood. The Epstein-Barr virus activating substances have been detected in a number of these preserved foods.

4.Smoking. People who smokes have a higher risk

What are the signs and symptoms of Nasopharyngeal Cancer?
------------------------------------------------------------------------

The following are symptoms of nasopharyngeal cancer:

1.A painless lump in the neck-usually a lymph node infiltrated by cancer cells

2.Nosebleed or blood stained sputum

3.Blocking of one or both nostrils

4.Loss of hearing, or ringing in the ear

5.Discharge from the ear

6.Blurred or double vision

7.Difficulty in breathing or speaking

8.Persistant Sore throat

9.Paralysis of one side of the face

10.Headaches

How can Nasopharyngeal Cancer be detected?
-----------------------------------------------------

Examination of the upper part of the nose for swelling or lumps.
An endoscope is inserted into the nose. The ENT specialist may extract tissue(biopsy) which can be sent for testing, to confirm if there is a cancerous growth.

If a tumour is found, magnetic resonance imaging (MRI) can be used to assess its size.

Patients may also be tested for the presence of the Epstein-Barr virus in their systems. This is used to indicate the likelihood of contracting NPC.

How can NPC be prevented?
--------------------------------

No one can be fully protected from NPC.
However, you can modify your lifestyle practices to reduce your chances of contracting NPC.
Avoid preserved foods at an early age.
Eat fresh fruit and vegetables. Studies ave found that citrus fruits (rich in Vitamin C) and orange-coloured vegetables (eg, carrots and sweet potatoes), tomatoes, and dark green vegetables (all rich in carotenoids) also help lower the chances of contracting NPC.
Don't smoke. Smoking increases the risk of NPC by two to four times. Those who smoke, can still lower their risk by cutting down on the number of cigarettes smoked a day. Better still, quit smoking.

How can Nasopharyngeal Cancer be treated?
----------------------------------------------------

Radiotherapy.
This is the most common treatment. This involves the use of radiation to attack cancer cells, stopping them from growing or multiplying.

Chemotherapy.
This involves the use of anti-cancer medication to treat the cancer.
For both methods, the patient may experience side-effects such as tiredness and nausea.

Surgery
Surgery is seldom used because of the danger of cutting tissues too close to the brain.

Early treatment is recommended as it increases the patient's chances of survival.
Delayed action could result in the cancer spreading to other parts of the body, making it more difficult to treat.

Sunday, August 19, 2007

A Simple Guide to Sinusitis


A Simple Guide to Sinusitis
-----------------

What is sinusitis?
----------------

Sinusitis is a condition in which the lining of your sinuses becomes inflamed.

The sinuses are the air chambers in the bone behind your cheeks, eyebrows and jaw.
They produce mucus, a fluid that cleans bacteria and other particles out of the air you breathe. Tiny hairs called cilia sweep mucus out of your sinuses so it can drain out through your nose.
The paranasal sinuses are in direct communication with the nose.
The sinuses are normally sterile.

If the sinus openings may become blocked, the mucus becomes congested in the sinuses, resulting in stagnation of secretion and finally bacterial growth.

What causes sinusitis?
---------------------------

Anything that causes swelling in your sinuses or keeps the cilia from moving mucus can cause sinusitis.
This can occur because of changes in temperature or air pressure,
Using decongestant nasal sprays too much,
Smoking, and
Swimming or diving.
Some people have growths called polyps that block their sinus passages.
When sinusitis is caused by a bacterial or viral infection, you get a sinus infection.

Sinus infections sometimes occur after you've had a cold.
The cold virus attacks the lining of your sinuses, causing them to swell and become narrow.
Your body responds to the virus by producing more mucus, but it gets blocked in your swollen sinuses.
This built-up mucus makes a good place for bacteria to grow.
The bacteria can cause a sinus infection.

Acute sinusitis is usually bacterial in origin.
Haemophilus influenzae and Streptococcus pneumoniae are the organisms most commonly found in adults.
In children, similar organisms are seen, with the addition of Moraxella catarrhalis.
In older children and young adults, Staphylococcus aureus is an occasional finding.
In systemically impaired hosts, Candida, Aspergillus, and Phycomycetes may be the cause.

Risk factors include the following: diabetes mellitus, cancer, hepatic disease, renal failure, burns, extreme malnutrition, and immunosuppressive diseases.

What are the signs of acute sinusitis?
-------------------------------------------


Presentation of sinusitis is often nonspecific.

Patients may present with a persistent cold.
A cold that starts to get better and then gets worse may be a sign of acute sinusitis.

Pain or pressure in some areas of the face (forehead, cheeks or between the eyes) is often a sign of blocked sinus drainage and can be a sign of acute sinusitis.

Pain in your forehead that starts when you lean forward can also be a sign.

Other symptoms may include a stuffy nose.

Some patients complain of dental pain or alteration in smell.

Fever is seen in fewer than 2% of individuals with sinusitis.

Facial tenderness to palpation is present.

Complete opacification of sinus on transillumination is present.

An X-ray of the paranasal sinuses usually confirms the presence of sinusitis as opacity in the sinuses.

How is acute sinusitis treated?
------------------------------------

Your doctor may prescribe an antibiotic.
You may take an antibiotic for 10 to 14 days, but you will usually start feeling better a couple of days after you start taking it. It is important to take this medicine exactly as your doctor tells you and to continue taking it until it is gone, even after you're feeling better.

If you have sinus pain or pressure, your doctor may prescribe or recommend a decongestant to help your sinuses drain.

Painkillers may be prescribed if there is severe pain.

How to take care of sinusitis?
-----------------------------------

1.Get plenty of rest.

2.Lying down can make your sinuses feel more congested, so try lying on the side that lets you breathe the best.

3.Drink plenty of fluids.

4.Apply moist heat by holding a warm, wet towel against your face or breathing in steam through a cloth or towel.

5.Rinse your sinus passages with a saline solution.

How is chronic sinusitis treated?
---------------------------------------

In cases where the acute sinus infection does not cleared or become chronic, a sinus washout may be necessary to remove the mucus stucked in the sinuses.

This involves syringing of antiseptic solution through a hole in the septum separating the maxillary sinuses from the nose.
Sometimes syringing of frontal sinuses can be done through a tube inserted into the sinuses.

In severe case of chronic sinusitis, endoscopy surgery may be done to strip the lining of the maxillary sinuses and clean the cavity of the sinuses.

A new therapy is the use of phage therapy where bacterial viruses are used to cause bacterila lysis in the sinuses.

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