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Saturday, 7 August 2021

Liver disease

 

Liver disease

Overview

 

The liver is an organ about the size of a football. It sits just under your rib cage on the right side of your abdomen. The liver is essential for digesting food and ridding your body of toxic substances.

Liver disease can be inherited (genetic). Liver problems can also be caused by a variety of factors that damage the liver, such as viruses, alcohol use and obesity.

Over time, conditions that damage the liver can lead to scarring (cirrhosis), which can lead to liver failure, a life-threatening condition. But early treatment may give the liver time to heal.

 

Liver problems

Liver problems that can occur include fatty liver disease and cirrhosis. The liver and its cells — as seen through a microscope — change dramatically when a normal liver becomes fatty or cirrhotic.

Symptoms

Liver disease doesn't always cause noticeable signs and symptoms. If signs and symptoms of liver disease do occur, the may include:

Skin and eyes that appear yellowish (jaundice)

Abdominal pain and swelling

Swelling in the legs and ankles

Itchy skin

Dark urine color

Pale stool color

Chronic fatigue

Nausea or vomiting

Loss of appetite

Tendency to bruise easily

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. Seek immediate medical attention if you have abdominal pain that is so severe that you can't stay still.

 

The liver

The liver is your largest internal organ. About the size of a football, it's located mainly in the upper right portion of your abdomen, beneath the diaphragm and above your stomach.

Causes

Liver disease has many causes.

Infection

Parasites and viruses can infect the liver, causing inflammation that reduces liver function. The viruses that cause liver damage can be spread through blood or semen, contaminated food or water, or close contact with a person who is infected. The most common types of liver infection are hepatitis viruses, including:

Hepatitis A

Hepatitis B

Hepatitis C

Immune system abnormality

Diseases in which your immune system attacks certain parts of your body (autoimmune) can affect your liver. Examples of autoimmune liver diseases include:

Autoimmune hepatitis

Primary biliary cholangitis

Primary sclerosing cholangitis

Genetics

An abnormal gene inherited from one or both of your parents can cause various substances to build up in your liver, resulting in liver damage. Genetic liver diseases include:

Hemochromatosis

Wilson's disease

Alpha-1 antitrypsin deficiency

Cancer and other growths

Examples include:

Liver cancer

Bile duct cancer

Liver adenoma

Other

Additional, common causes of liver disease include:

Chronic alcohol abuse

Fat accumulation in the liver (nonalcoholic fatty liver disease)

Certain prescription or over-the-counter medications

Certain herbal compounds

Risk factors

Factors that may increase your risk of liver disease include:

Heavy alcohol use

Obesity

Type 2 diabetes

Tattoos or body piercings

Injecting drugs using shared needles

Blood transfusion before 1992

Exposure to other people's blood and body fluids

Unprotected sex

Exposure to certain chemicals or toxins

Family history of liver disease

Complications

Complications of liver disease vary, depending on the cause of your liver problems. Untreated liver disease may progress to liver failure, a life-threatening condition.

Prevention

To prevent liver disease:

Drink alcohol in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Heavy or high-risk drinking is defined as more than eight drinks a week for women and more than 15 drinks a week for men.

Avoid risky behavior. Use a condom during sex. If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop. Seek help if you use illicit intravenous drugs, and don't share needles to inject drugs.

Get vaccinated. If you're at increased risk of contracting hepatitis or if you've already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.

Use medications wisely. Take prescription and nonprescription drugs only when needed and only in recommended doses. Don't mix medications and alcohol. Talk to your doctor before mixing herbal supplements or prescription or nonprescription drugs.

Avoid contact with other people's blood and body fluids. Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids.

Keep your food safe. Wash your hands thoroughly before eating or preparing foods. If traveling in a developing country, use bottled water to drink, wash your hands and brush your teeth.

Take care with aerosol sprays. Make sure to use these products in a well-ventilated area, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the manufacturer's instructions.

Protect your skin. When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask so that chemicals aren't absorbed through your skin.

Maintain a healthy weight. Obesity can cause nonalcoholic fatty liver disease.

Diagnosis

Finding the cause and extent of liver damage is important in guiding treatment. Your doctor is likely to start with a health history and thorough physical examination.

Your doctor may then recommend:

Blood tests. A group of blood tests called liver function tests can be used to diagnose liver disease. Other blood tests can be done to look for specific liver problems or genetic conditions.

Imaging tests. An ultrasound, CT scan and MRI can show liver damage.

Checking a tissue sample. Removing a tissue sample (biopsy) from your liver may help diagnose liver disease and look for signs of liver damage. A liver biopsy is most often done using a long needle inserted through the skin to extract a tissue sample that's sent to a lab for testing.

 

Ultrasound of liver tumor

An ultrasound uses sound waves to create an image. This ultrasound shows a liver tumor.

 

Liver biopsy

A liver biopsy is a procedure to remove a small sample of liver tissue for laboratory testing. Liver biopsy is commonly performed by inserting a thin needle through your skin and into your liver.

Treatment

Treatment for liver disease depends on your diagnosis. Some liver problems can be treated with lifestyle modifications, such as stopping alcohol use or losing weight, typically as part of a medical program that includes careful monitoring of liver function. Other liver problems may be treated with medications or may require surgery.

Treatment for liver disease that causes or has led to liver failure may ultimately require a liver transplant.

Lifestyle and home remedies

Changing certain lifestyle habits can often help improve your liver health. If you've been diagnosed with liver disease, your doctor may recommend that you:

Drink alcohol sparingly, if at all.

Avoid red meat, trans fats, processed carbohydrates and foods with high-fructose corn syrup.

Exercise 30 to 60 minutes around three to four times a week at a moderate intensity.

Cut calories by 500 to 1,000 calories daily, if you're overweight.

Alternative medicine

No alternative medicine therapies have been proved to treat liver disease. Some studies have indicated possible benefits, but further research is needed.

On the other hand, some dietary and herbal supplements can harm your liver. More than a thousand medications and herbal products have been associated with liver damage, including:

Vitamin A

Ma-huang

Germander

Valerian

Mistletoe

Skullcap

Chaparral

Comfrey

Kava

Pennyroyal oil

To protect your liver, it's important to talk to your doctor about the potential risks before you take any complementary or alternative medicines.

Preparing for an appointment

You may be referred to a doctor who specializes in the liver (hepatologist).

What you can do

Be aware of any pre-appointment restrictions, such as not eating solid food on the day before your appointment.

Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.

Make a list of all your medications, vitamins and supplements.

Write down your key medical information, including other conditions.

Write down key personal information, including any recent changes or stressors in your life.

Ask a relative or friend to accompany you, to help you remember what the doctor says.

Write down a list of questions to ask your doctor.

Questions to ask your doctor

What's the most likely cause of my symptoms?

What kinds of tests do I need? Do these tests require any special preparation?

Are my liver problems likely temporary or long lasting?

What treatments are available?

Should I stop taking certain medications or supplements?

Do I need to stop drinking alcohol?

I have other health conditions. How can I best manage these conditions together?

Are my children at risk for liver disease?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may leave time to go over points you want to spend more time on. You may be asked:

When did you first begin experiencing symptoms, and how severe are they? Have your symptoms been continuous or occasional?

Does anything seem to improve your symptoms, or make them worse?

Have you ever had your skin or eyes turn yellow?

What medications and supplements do you take?

How many days of the week do you drink alcohol?

Do you have any tattoos?

Does your job involve exposure to chemicals, blood or body fluids?

Have you ever had a blood transfusion?

Have you been told that you have had liver problems before?

Has anyone in your family ever been diagnosed with liver disease?

 

Friday, 6 August 2021

Some Myths about Nutrition & Physical Activity

 

Some Myths about Nutrition & Physical Activity

Are you overwhelmed by daily decisions about what to eat, how much to eat, when to eat, and how much physical activity you need to be healthy? If so, don’t be discouraged because you’re not alone. With so many choices and decisions, it can be hard to know what to do and which information you can trust.

This information may help you make changes in your daily eating and physical activity habits so that you improve your well-being and reach or maintain a healthy weight.

Food Myths

Myth: To lose weight, you have to give up all your favorite foods.

Fact: You don’t have to give up all your favorite foods when you’re trying to lose weight. Small amounts of your favorite high-calorie foods may be part of your weight-loss plan. Just remember to keep track of the total calories you take in. To lose weight, you must burn more calories than you take in through food and beverages.

TIP: Limiting foods that are high in calories may help you lose weight. The Dietary Guidelines for Americans 2015-2020 External link have estimated daily calorie needs based on a person’s age, sex, and physical activity level.

Myth: Grain products such as bread, pasta, and rice are fattening. You should avoid them when trying to lose weight.

Substituting whole grains for refined-grain products is healthier and may help you feel fuller.

Fact: Grains themselves aren’t necessarily fattening—or unhealthy–although substituting whole grains for refined-grain products is healthier and may help you feel fuller. The Dietary Guidelines for Americans 2015-2020 recommend consuming grains as part of a healthy eating plan External link. At least half of the grains you eat should be whole grains. Examples of whole grains include brown rice and whole-wheat bread, cereal, and pasta. Whole grains provide iron, fiber, and other important nutrients.

TIP: Try to replace refined or white bread with whole-wheat bread and refined pasta with whole-wheat pasta. Or add whole grains to mixed dishes, such as brown instead of white rice to stir fry. Check out ChooseMyPlate for more tips to help you add whole grains External link to your eating plan.

Myth: Choosing foods that are gluten-free will help you eat healthier.

Fact: Gluten-free foods are not healthier if you don’t have celiac disease or are not sensitive to gluten. Gluten is a protein found in wheat, barley, and rye grains. A health care professional is likely to prescribe a gluten-free eating plan to treat people who have celiac disease or are sensitive to gluten. If you don’t have these health problems but avoid gluten anyway, you may not get the vitamins, fiber, and minerals you need. A gluten-free diet is not a weight-loss diet and is not intended to help you lose weight.

TIP: Before you decide to avoid a whole food group, talk with your health care professional if you believe you have problems after you consume foods or drinks with wheat, barley, or rye.

Myth: You should avoid all fats if you’re trying to be healthy or lose weight.

Fact: You do not have to avoid all fats if you’re trying to improve your health or lose weight. Fat provides essential nutrients and should be an important part of a healthy eating plan. But because fats have more calories per gram than protein or carbohydrates, or “carbs,” you need to limit fats to avoid extra calories. If you are trying to lose weight, consider eating small amounts of food with healthy fats, such as avocados, olives, or nuts. You also could replace whole-fat cheese or milk with lower-fat versions. Read about food portions and how much food is enough for you.

TIP: The Dietary Guidelines for Americans 2015-2020 recommend consuming less than 10 percent of your daily calories from saturated fats. Try cutting back on solid-fat foods. Use olive oil instead of butter in cooking.

Myth: Dairy products are fattening and unhealthy.

Fact: Dairy products are an important food group because they have protein your body needs to build muscles and help organs work well, and calcium to strengthen bones. Most dairy products, such as milk and some yogurts, have added vitamin D to help your body use calcium, since many Americans don’t get enough of these nutrients. Dairy products made from fat-free or low-fat milk have fewer calories than dairy products made from whole milk. Learn more about the dairy group External link.

TIP: Adults should have 3 servings a day of fat-free or low-fat dairy products, including milk or milk products such as yogurt and cheese, or fortified soy beverages, as part of a healthy eating plan. If you can’t digest lactose, the sugar found in dairy products, choose fortified soy products, lactose-free or low-lactose dairy products, or other foods and beverages with calcium and vitamin D:

Calcium—soy-based beverages or tofu made with calcium sulfate, canned salmon, or dark leafy greens such as collards or kale

vitamin D—cereals or soy-based beverages

Myth: “Going vegetarian” will help you lose weight and be healthier.

Some research shows that a healthy vegetarian eating plan may be linked to lower obesity levels.

Fact: Some research shows that a healthy vegetarian eating plan, or one made up of foods that come mostly from plants NIH external link, may be linked to lower levels of obesity, lower blood pressure, and a reduced risk of heart disease. But going vegetarian will only lead to weight loss if you reduce the total number of calories you take in. Some vegetarians may make food choices that could lead to weight gain, such as eating a lot of food high in sugar, fats, and calories.

Eating small amounts of lean meats can also be part of a healthy plan to lose or maintain weight. The U.S. Dietary Guidelines 2015-2020 have more information about including meat as part of a healthy eating plan External link.

TIP: If you choose to follow a vegetarian eating plan, be sure you get enough of the nutrients your body needs to be healthy. Read Healthy Eating Tips for Vegetarians External link for more information.

Not all vegetarians are the same.
The types of vegetarian diets eaten in the United States can vary widely. For example, vegans do not consume any animal products, including milk and eggs. Lacto-ovo vegetarians eat milk and eggs along with plant foods. Some people have eating patterns that are mainly vegetarian but may include small amounts of meat, poultry, or seafood. Speak with a registered dietitian External link or health care professional if you are concerned about whether your eating plan is providing all of the nutrients you need.

Physical Activity Myths

Myth: Physical activity only counts if you do it for long periods of time.

Fact: You don’t need to be active for long periods to get the amount of regular physical activity recommended in the Physical Activity Guidelines for Americans, 2nd edition External link, (PDF, 14.2MB)  which is at least 150 minutes, or 2 hours and 30 minutes, of moderate-intensity physical activity each week. An example of moderate-intensity activity is brisk walking. You can spread these sessions out over the week and even do short, 10-minute spurts of activity 3 times a day on 5 or more days a week.

TIP: Find ways to build short bursts of physical activity into your day. While at work, take a 10-minute walking break or have a “walking,” rather than a “sitting” meeting, if work and schedule permit. Use stairs instead of an elevator or escalator. Get off the bus one stop early. Meet a friend for a walk, instead of a meal.

Myth: Lifting weights is not a good way to improve your health or lose weight because it will make you “bulk up.”

Do muscle-strengthening activities at least twice a week.

Fact: Lifting weights or doing other activities 2 or 3 days a week that may help you build strong muscles, such as push-ups and some types of yoga, will not bulk you up. Only intense strength training, along with certain genes, can build large muscles. Like other kinds of physical activity, muscle-strengthening activities will help improve your health and also may help you control your weight by increasing the amount of energy-burning muscle.

TIP: Using large rubber bands, or resistance bands, or doing sit-ups or household or yard chores that make you lift or dig, may help you build strong muscles.

Don’t just sit there!
Americans spend a lot of time sitting: at desks, in cars, and in front of computers, TVs, and other electronic gadgets. Break up your sitting time by getting up and moving around, even if it’s for only 10 minutes at a time. Those minutes will add up over days and weeks.

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials, and are they right for you?

Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. 

 

Two Keys to Losing Weight and Keeping it Off

 

Two Keys to Losing Weight and Keeping it Off

Healthy Moments Episode: July 5, 2021

There are many ways to lose weight, but to keep the pounds off, you need these two keys: physical activity AND healthy eating habits.

Listen Now

Download the MP3 audio file

Transcript

Hi, I’m Dr. Griffin Rodgers, bringing you Healthy Moments from the NIH. I’m the director of the National Institute of Diabetes and Digestive and Kidney Diseases.

There are many ways to lose weight, but to keep the pounds off, you need these two keys: physical activity AND healthy eating habits.

For physical activity, aim for at least 30 minutes of moderate to vigorous activity on most days to control your weight. This could include walking, aerobic dancing, and even household chores.

For healthy eating, your plan should emphasize fruits, vegetables, and whole grains. Include more lean meats and be low in saturated fats and added sugars.

For more information, follow us @NIDDKgov External link. This is Dr. Griffin Rodgers with the NIH.


 

Thursday, 5 August 2021

CANCER TREATMENT

 

Treatment

There are several types of treatment for cancer. The main cancer treatments are surgery, chemotherapy and radiation therapy. Other treatments include hormonal therapy, targeted therapy, immunotherapy and stem cell transplants.

Cancer treatments are given by cancer specialists (oncologists) who specialize in radiation therapy or chemotherapy and other drug therapies. Surgeons use their skill in doing surgery to remove tumours.

The type of treatment you have will depend on many factors, including:

the type of cancer you have

the stage of the cancer

your personal preferences

your age

Treatment plans

Sometimes people who have the same cancer will be given different treatments. Some people will have only 1 treatment but most people will have a combination of treatments such as surgery with chemotherapy or radiation therapy or both.

When a combination of treatments is used, they may be given together or at different times.

First line therapy is the first, most common or preferred (standard) treatment given for a type of cancer. It is also called primary therapy or primary treatment.

Neoadjuvant treatment is given before other treatments such as surgery. It may be given if a tumour is too large to be removed by surgery. It may include chemotherapy, radiation therapy or hormone therapy.

Adjuvant treatment is given to destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (recur).

Treatment goals

Treatment is given for different reasons. Sometimes, the goal of treatment can change over time.

Prevention (prophylaxis)

Treatment is given to prevent the growth of cancer cells or to remove precancerous tissue that could turn into cancer.

Cure

Treatment is given to cure the cancer.

Control

Treatment is given to control the cancer and stop it from growing and spreading. It also reduces the risk of the cancer coming back.

Palliative care

When the cancer can’t be cured or controlled, treatment may be given to relieve pain or ease the symptoms of advanced cancer.

Types of treatment

Treatment can be broadly divided into the following types of therapies.

Local therapy is directed at a specific part of the body and is often used when cancer is only in that area. Radiation therapy and surgery are both local treatments.

Systemic therapy travels through the bloodstream to reach cancer cells throughout the body. Many chemotherapy drugs are systemic treatments that are absorbed by the body’s cells and tissues.

Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells.

Side effects of treatment

Side effects can happen with any type of treatment for cancer, but everyone’s experience is different. Not everyone has side effects or experiences them in the same way. Side effects can occur during or after treatment. They may go away quickly or last for a long time.

 

Heart Attack (Myocardial Infarction)

 

Heart Attack (Myocardial Infarction)

What is a Heart Attack (Myocardial Infarction)?

 

A heart attack occurs when one of the heart's coronary arteries is blocked suddenly or has extremely slow blood flow. A heart attack also is called a myocardial infarction.

The usual cause of sudden blockage in a coronary artery is the formation of a blood clot (thrombus). The blood clot typically forms inside a coronary artery that already has been narrowed by atherosclerosis, a condition in which fatty deposits (plaques) build up along the inside walls of blood vessels.


Slow blood flow in a coronary artery can happen when the heart is beating very fast or the person has low blood pressure. If the demand for oxygen is greater than the supply, a heart attack can happen without formation of a blood clot. People with atherosclerosis are also more likely to have this reason for a heart attack.

Each coronary artery supplies blood to a specific part of the heart's muscular wall, so a blocked artery causes pain and malfunction in the area it supplies. Depending on the location and amount of heart muscle involved, this malfunction can seriously interfere with the heart's ability to pump blood. Also, some of the coronary arteries supply areas of the heart that regulate heartbeat, so a blockage sometimes causes potentially fatal abnormal heartbeats, called cardiac arrhythmias.

The pattern of symptoms that develops with each heart attack and the chances of survival are linked to the location and extent of the coronary artery blockage.

Most heart attacks result from atherosclerosis. The risk factors for heart attack and atherosclerosis are basically the same:

An abnormally high level of blood cholesterol (hypercholesterolemia)

An abnormally low level of HDL (high-density lipoprotein), commonly called "good cholesterol"

High blood pressure (hypertension)

Diabetes

Family history of coronary artery disease at an early age

Cigarette smoking

Obesity

Physical inactivity (too little regular exercise)

In early middle age, men have a greater risk of heart attack than women. However, a woman's risk increases once she begins menopause. This could be the result of a menopause-related decrease in levels of estrogen, a female sex hormone that may offer some protection against atherosclerosis.

Although most heart attacks are caused by atherosclerosis, there are rarer cases in which heart attacks result from other medical conditions. These include congenital abnormalities of the coronary arteries, hypercoagulability (an abnormally increased tendency to form blood clots), a collagen vascular disease, such as rheumatoid arthritis or systemic lupus erythematosus (SLE, or lupus), cocaine abuse, a spasm of the coronary artery, or an embolus (small traveling blood clot), which floats into a coronary artery and lodges there.

Symptoms

The most common symptom of a heart attack is chest pain, usually described as crushing, squeezing, pressing, heavy, or occasionally, stabbing or burning. Chest pain tends to be focused either in the center of the chest or just below the center of the rib cage, and it can spread to the arms, abdomen, neck, lower jaw or neck.

Other symptoms can include sudden weakness, sweating, nausea, vomiting, breathlessness, or lightheadedness. Sometimes, when a heart attack causes burning chest pain, nausea and vomiting, a patient may mistake his or her heart symptoms for indigestion.

Diagnosis

Your doctor will ask you to describe your chest pain and any other symptoms. Ideally, a family member or close friend should accompany you when you go for medical treatment. This person can help to provide your doctor with valuable information about your symptoms and medical history if you are unable to do so.

It is also important to give your doctor a list of the names and dosages of the prescription and nonprescription medications that you are taking. If you don't have a list already prepared, just scoop the medicines into a nearby bag or purse and bring them with you to the hospital.

Your doctor will suspect that you are having a heart attack based on your symptoms, your medical history and your risk factors for cardiovascular disease. To confirm the diagnosis, he or she will do:

An electrocardiogram (EKG)

A physical examination, with special attention to your heart and blood pressure

Blood tests for serum cardiac markers — chemicals that are released into the blood when the heart muscle is damaged. The blood test that doctors order most frequently to diagnose a heart attack is called troponin.

Additional tests may be needed, including:

An echocardiogram — A painless test that uses sound waves to look at the heart muscle and heart valves.

Radionuclide imaging — Scans that use special radioactive isotopes to detect areas of poor blood flow in the heart

Expected Duration

How long heart attack symptoms last varies from person to person. In about 15% of cases, the patient never reaches a hospital for treatment and dies quickly after symptoms begin.

Prevention

You can help to prevent a heart attack by:

Exercising regularly

Eating healthfully

Maintaining a healthy weight

Not using tobacco products

Controlling your blood pressure

Lowering your LDL cholesterol.

Treatment

The treatment of a heart attack depends on how stable the person's condition is and his or her immediate risk of death. As soon as possible, the person will receive an aspirin and often other medicines that help prevent unwanted blood clotting in the coronary arteries.

The person also will be given oxygen to breathe, pain medication (usually morphine) for chest pain, beta-blockers to reduce the heart's demand for oxygen, nitroglycerin to help blood flow into heart muscle cells, and a cholesterol-lowering statin drug. The person may be started on heparin in addition to aspirin for more potent anti-clotting action.

During the initial evaluation, the person will be considered for reperfusion therapy. The goal is to restore blood flow to the injured heart muscle as soon as possible to limit permanent damage.

Reperfusion is best done mechanically. The patient is taken to the cardiac catheterization laboratory in the hospital. A catheter is threaded through a large blood vessel toward the heart. Dye is injected to locate the blockage in the coronary artery.

The next step is percutaneous transluminal coronary angioplasty (PTCA). In PTCA, a different catheter that has a small deflated balloon is threaded past the blockage, and the balloon is inflated to crush the clot and plaque. Most balloon catheters also have a wire mesh, called a stent, over the balloon. After the balloon is inflated to unclog the blocked artery, the stent remains in place to keep the artery open.

In addition to aspirin, a second anti-platelet drug is given. The ones used most commonly are clopidogrel (Plavix, generic versions), prasugrel (Effient) and ticagrelor (Brilinta).

Reperfusion therapy can also be done with clot-dissolving drugs called thrombolytic agents, such as tissue plasminogen activator (tPA). This drug is used if it would take too long to transfer a patient to a hospital where an angioplasty could be performed.

Much of the additional treatment for heart attack depends on whether the patient developed any complications. For example, additional drugs may be needed to treat dangerous cardiac arrhythmias (abnormal heartbeats), low blood pressure, and congestive heart failure.

While in the hospital, daily medications usually include aspirin, a beta-blocker, an ACE (angiotensin-converting enzyme) inhibitor to help the heart work more efficiently, primarily by lowering blood pressure, a statin and a second anti-clotting drug.

When To Call A Professional

Seek emergency help immediately if you have chest pain, even if you think it is just indigestion or that you are too young to be having a heart attack. Prompt treatment increases your chance of limiting heart muscle damage. That's because reperfusion measures work best if they are started as soon as possible after symptoms start.

Prognosis

Survival from a heart attack has improved dramatically over the last two decades. However, some people experience sudden death and never make it to the hospital. For most people that do reach the hospital soon after the onset of symptoms, the prognosis is very good. Many people leave the hospital feeling well with limited heart damage.


 

Wednesday, 4 August 2021

LIST OF DELHI GOVT. HOSPITALS

 LIST OF DELHI GOVT. HOSPITALS

                                                   
S.NONAME OF HOSPITALADDRESSCONTACT NO

UNDER DELHI GOVT

1Aruna Asaf Ali Govt. HospitalRajpur Road,Delhi.11005423965532,23831524 Fax-23922333
2Acharyaashree Bhikshu HospitalMoti Nagar New Delhi-11001525423011 Fax- 25448806
3Attar Sain Jain HospitalLawrence Road, New Delhi-11003527153357 Fax- 27106441
4Baba Saheb Ambedkar HospitalSector 6, Rohini, New Delhi.-11008527055585, Fax-27058108
5Bhagwan Mahavir HospitalPitamPura, Delhi-11003427034535, Fax-27033948
6Babu Jagjivan Ram HospitalJahangir Puri, New Delhi11003327631810, Fax- 27631610
7Central Jail HospitalJail Road, Hari Nagar, Delhi-11006428520012
8Chacha Nehru Bal ChikitsalayaGeeta Colony, Delhi-11003121210215,2120216 Fax-21210203
9Dadadev Mother & Child HospitalNasirpur Near Dabrimore Janakpuri New Delhi-11001825395536 Fax-25395542
10Deen Dayal Upadhyay HospitalHari Nagar, New Delhi-11006425494337 Fax-25494264
11Deep Chand Bandhu HospitalKokiwala Bagh,Ashok Vihar,Phase-IV,New Delhi27305953
12Delhi State Cancer InstitutionGTB Hospital Complex, Shahadara, Delhi - 95

22110505,22110303

13Dr. Hedgewar Arogya SansthanKarkardooma, Delhi-110032 20822305, 20822313
14Dr. N.C. Joshi HospitalKarol Bagh New Delhi-11000523611786, Fax-23523677
15Govind Ballabh Pant Hospital (G.B.P.H.)Jawahar Lal Nehru Marg,Delhi.-11000223238109,23237254 Fax-23239442
16Guru Govind Singh Govt. HospitalRaghubir Nagar New Delhi-11002725984549,25988532 Fax- 25989417
17Guru Nanak Eye CenterMaharaja Ranjit Singh Marg, New Delhi-223236931 Fax-23230033
18Guru Teg Bahadur Hospital (G.T.B.H.)Shahdara,Delhi.11009522581730 Fax-22581928
19Institute of Liver & Biliary Sciences (I.L.B.S.)Vasant Kunj, Delhi-11005746300000
20Institute of Human Behaviour and Allied Sciences (I.H.B.A.S.)Shahdara,Delhi-110095 22112136,PBX No 22114021,22114029, 22583056, 22583322
21Janakpuri Super Speciality HospitalJanakpuri, Delhi-11005825552023
22Lal Bahadur Shastri Hospital (L.B.S.)Khichri Pur New Delhi-11009122774145 Fax-22786808
23Lok Nayak HospitalJawahar Lal Nehru Marg,Delhi.11000223236000, 23232400, Fax-23232870
24Maharishi Balmiki HospitalPooth Khurd, New Delhi-11003927761521, Fax- 27761522
25Pt. Madan Mohan Malviya HospitalMalviya Nagar New Delhi-11001726680603, 26674757
26Maulana Azad Institute of Dental SciencesM.A.M.C. J.L. Nehru Marg, New Delhi-11000223233925, 23239271-76
27Poor House HospitalBeggers Home G.T.B.Ngr Delhi-11000923965532,23831524
28Rajiv Gandhi Super Speciality HospitalTahirpur, New Delhi-11006465252480
29Rao Tula Ram Memorial HospitalJaffar pur, New Delhi-11007325318444, Fax-25318012 25318070
30Sardar Vallabh Bhai Patel HospitalPatel Nagar New Delhi-11000825885944 Fax-25881396
31Satyawadi Raja Harish Chandra HospitalNarela, Delhi-11004027787304; 27787305(Fax)
32Sanjay Gandhi Memorial HospitalMangol Puri,Delhi.-11008327921117 Fax-27924403
33Jag Parvesh Chander HospitalShastri Park, Delhi-11003122184453 Fax-22184455
34Ayurvedic & Unani Tibbia College & HospitalAjmal Khan Park, Karol Bagh, New Delhi-0523629013
35B R Sur Homeopathic Medical CollegeNanakpura, Moti Bagh, Delhi-11002124105298
36Nehru Homeopathic Medical CollegeB-Block, Defence Colony, New Delhi-2424331193
37Chaudhary Brahm Prakash Ayurved Charak SansthanVill. Khera Dabar, Najafgarh, New Delhi - 7365172030

Asthma

 

What is asthma?

Asthma is a lung disease that makes breathing difficult. Chronic inflammation and reactions to triggers narrow the airways in the lungs. Asthma can become life-threatening if it is not managed

What is cough-variant asthma?

Cough-variant asthma is a type of asthma that causes a dry cough that keeps coming back. A dry cough may be your only symptom, or you may also have chest tightness. These symptoms may be caused by exercise or exposure to odors, allergens, or respiratory tract infections. Cough-variant asthma is treated the same way as typical asthma.

What are the signs and symptoms of asthma?

Coughing

Wheezing

Shortness of breath

Chest tightness

What may trigger an asthma attack?

A cold, the flu, or a sinus infection

Exercise

Weather changes, especially cold, dry air

Smoking or secondhand smoke

Fumes from chemicals, dust, air pollution, or other small particles in the air

Pets, pollen, dust mites, or cockroaches

How is asthma diagnosed?

Your healthcare provider will examine you and listen to your lungs. He or she will ask how often you have symptoms and what makes them worse. Tell him or her if you have trouble sleeping, exercising, or doing other activities because of shortness of breath. Your provider will ask about your allergies and past colds, and if anyone in your family has allergies or asthma. Tell your healthcare provider about medicines you take, including over-the-counter drugs and herbal supplements. You may need a chest x-ray to check for lung problems, or a lung function test. Lung function tests show how well you can breathe.

How is asthma treated?

Medicines may be used to decrease inflammation, open airways, and make it easier to breathe. Medicines may be inhaled, taken as a pill, or injected. Short-term medicines relieve your symptoms quickly. Long-term medicines are used to prevent future asthma attacks. Other medicines may be needed if your regular medicines are not able to prevent attacks.

Allergy testing may find allergies that trigger an asthma attack. You may need allergy shots or medicine to control allergies that make your asthma worse.

How can I manage my symptoms and prevent future attacks?

Follow your Asthma Action Plan (AAP). This is a written plan that you and your healthcare provider create. It explains which medicine you need and when to change doses if necessary. It also explains how you can monitor symptoms and use a peak flow meter. The meter measures how well your lungs are working.

Manage other health conditions , such as allergies, acid reflux, and sleep apnea.

Identify and avoid triggers. These may include pets, dust mites, mold, and cockroaches.

Do not smoke or be around others who smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Ask about the flu vaccine. The flu can make your asthma worse. You may need a yearly flu shot.

When should I seek immediate care?

You have shortness of breath, even after you take your short-term medicine as directed.

Your lips or nails turn blue or gray.

When should I call my doctor?

You run out of medicine before your next refill is due.

Your symptoms get worse.

You need to take more medicine than usual to control your symptoms.

You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Garlic

 

Garlic

 What is garlic?

Garlic is an herb also known as Ail, Ajo, Allii Sativi Bulbus, Allium, Allium sativum, Camphor of the Poor, Da Suan, Lasun, Lasuna, Nectar of the Gods, Poor Man's Treacle, Rason, Rust Treacle, or Stinking Rose.

Garlic is a commonly used food and flavoring agent. When used as a food product, garlic is not likely to produce health benefits or side effects. When used as a medicinal product, garlic may produce both desired and unwanted effects on the body.

Garlic products sold as health supplements may vary widely in amount of allicin, the active ingredient in garlic. Allicin is unstable and can be reduced in garlic products that are aged to reduce odor. Odorless garlic may contain little to no allicin. The lower the amount of allicin, the less effective a garlic product might be.

Garlic taken orally (by mouth) has been used in alternative medicine as a possibly effective aid in treating high blood pressure, coronary artery disease (hardened arteries), stomach cancer, colon cancer or rectal cancer, and in preventing tick bites. Garlic applied to the skin may also be possibly effective in treating fungal skin infections such as ringworm, jock itch, or athlete's foot.

Garlic has also been used to treat high cholesterol, stomach ulcers caused by H. pylori, cancer, or circulation problems in the legs. However, research has shown that garlic may not be effective in treating these conditions.

Other uses not proven with research have included preventing the common cold, and improving urination problems caused by an enlarged prostate.

It is not certain whether garlic is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Garlic should not be used in place of medication prescribed for you by your doctor.

Garlic is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Garlic may also be used for purposes not listed in this product guide.

Warnings

Follow all directions on the product label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use garlic if you are allergic to it.

Ask a doctor, pharmacist, or other healthcare provider if it is safe for you to use this product if you have:

a stomach ulcer;

problems with digestion; or

a bleeding or blood clotting disorder such as hemophilia.

Ask a doctor before using garlic if you are pregnant or breastfeeding.

The use of garlic as a flavoring agent in foods is considered safe during pregnancy.

Do not give any herbal/health supplement to a child without medical advice. Garlic taken by mouth in large doses may be harmful to children.

How should I take garlic?

When considering the use of herbal supplements, seek the advice of your doctor. You may also consider consulting a practitioner who is trained in the use of herbal/health supplements.

If you choose to use garlic, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider. Do not use more of this product than is recommended on the label.

Do not use different forms (cloves, tablets, oil, etc) of garlic at the same time without medical advice. Using different formulations together increases the risk of an overdose.

Do not crush, chew, or break an enteric coated pill. Swallow it whole. The pill has a special coating to protect your stomach. Breaking the pill will damage this coating.

Call your doctor if the condition you are treating with garlic does not improve, or if it gets worse while using this product.

Garlic can affect blood-clotting and may increase your risk of bleeding. If you need surgery, dental work, or a medical procedure, stop taking garlic at least 2 weeks ahead of time.

Store at room temperature away from moisture, heat, and light, or as directed on the package.

What happens if I miss a dose?

Skip the missed dose and take the next regularly scheduled dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention 

What should I avoid while taking garlic?

Avoid taking fish oil or vitamin E while you are taking garlic.

Also avoid using garlic together with other herbal/health supplements that can also affect blood-clotting. This includes angelica (dong quai), capsicum, clove, danshen, ginger, ginkgo, horse chestnut, panax ginseng, poplar, red clover, turmeric, and willow.

Garlic side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Although not all side effects are known, garlic is thought to be possibly safe when taken for a short period of time.

Stop using garlic and call your healthcare provider at once if you have:

redness, swelling, or blistering (when applied to the skin); or

easy bruising or bleeding (nosebleeds, bleeding gums).

Common side effects (especially when eating raw garlic) may include:

unpleasant breath or body odor;

heartburn, burning in your mouth or throat;

nausea, vomiting, gas or

diarrhea.

This is not a complete list of side effects and others may occur. 

Garlic side effects (more detail)

What other drugs will affect garlic?

Do not take garlic without medical advice if you are using any of the following medications:

acetaminophen (Tylenol);

birth control pills;

chlorzoxazone;

cyclosporine;

theophylline;

warfarin (Coumadin, Jantoven);

HIV or AIDS medicines--delavirdine, efavirenz, nevirapine, saquinavir;

medicine used to prevent blood clots, such as alteplase, clopidogrel, dipyridamole, ticlopidine, and urokinase; or

NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

Do not take garlic without medical advice if you are using a medication to treat any of the following conditions:

any type of infection (including HIV, malaria, or tuberculosis);

anxiety or depression;

asthma or allergies;

cancer;

erectile dysfunction;

heartburn or gastroesophageal reflux disease (GERD);

high blood pressure, high cholesterol, or a heart condition;

migraine headaches;

psoriasis, rheumatoid arthritis, or other autoimmune disorders;

a psychiatric disorder; or

seizures.

This list is not complete. Other drugs may affect garlic, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.


Further information

Consult with a licensed healthcare professional before using any herbal/health supplement. Whether you are treated by a medical doctor or a practitioner trained in the use of natural medicines/supplements, make sure all your healthcare providers know about all of your medical conditions and treatments.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

 

Tuesday, 3 August 2021

Pain

 

Pain

Summary

Pain is a signal in your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your backabdomenchestpelvis, or you may feel pain all over.

Pain can be helpful in diagnosing a problem. If you never felt pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment.

There are two types of pain: acute and chronic. Acute pain usually comes on suddenly, because of a disease, injury, or inflammation. It can often be diagnosed and treated. It usually goes away, though sometimes it can turn into chronic pain. Chronic pain lasts for a long time, and can cause severe problems.

Pain is not always curable, but there are many ways to treat it. Treatment depends on the cause and type of pain. There are drug treatments, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

 


What Is Heartburn?

 

What Is Heartburn?

Heartburn is an irritation of the esophagus -- the tube that connects your throat and stomach. It's caused by stomach acid. This leads to a burning discomfort in your upper belly or below your breastbone.

Despite its name, heartburn has nothing to do with the heart. But some of the symptoms are similar to those of a heart attack or heart disease.

Heartburn Symptoms

Heartburn feels just like its name: a burning sensation behind your sternum, or breastbone, in the middle of your chest. You might also feel it in your throat. You may also:

Feel pain in your chest when you bend over or lie down

Have a hot, acidic, bitter, or salty taste in the back of your throat

Find it hard to swallow

 

How long does heartburn last?

It can vary. For some folks, it can last just a few minutes. Sometimes it can last for several hours.

Heartburn happens about once a week for up to 20% of Americans and is common in pregnant women.

Heartburn Causes and Risk Factors

Heartburn symptoms can start up because of a problem with a muscular valve called the lower esophageal sphincter (LES). It's located where the esophagus meets the stomach -- below the rib cage and slightly left of center.

Normally, with the help of gravity, the LES keeps stomach acid right where it should be -- in your stomach. When it's working right, the LES opens to allow food into your stomach or to let you belch, then closes again. But if the LES opens too often or doesn't close tightly enough, stomach acid can seep into the esophagus and cause a burning sensation.

If your LES doesn't tighten as it should, there are often two things that contribute to the problem. One is overeating, which puts too much food in your stomach. Another is too much pressure on your stomach, often due to obesity, pregnancy, or constipation.

Certain foods can relax your LES or increase stomach acid, including:

Tomatoes

Citrus fruits

Garlic and onions

Chocolate

Coffee or caffeinated products

Alcohol

Peppermint

Meals high in fats and oils (animal or vegetable) often lead to heartburn, as do certain medications. Stress and lack of sleep can raise how much acid your stomach makes and can cause heartburn.

If you're pregnant, the hormone progesterone can relax your LES and lead to heartburn. Smoking also relaxes the LES and increases stomach acid.



 


Heartburn Diagnosis

If your heartburn goes on for a long time, it may be a sign of a more serious condition known as gastroesophageal reflux disease (GERD). Your doctor may be able to tell if GERD is the cause of your heartburn from your symptoms. But to tell how serious it is, they may do several tests, including:

X-ray: You’ll drink a solution called a barium suspension that coats the lining of your upper GI (gastrointestinal) tract -- your esophagus, stomach, and upper small intestine. This coating lets doctors see defects that could mean a problem in your digestive system.

Endoscopy: A small camera on a flexible tube is put down your throat to give a view of your upper GI tract.

Ambulatory acid probe test (esophageal pH monitoring): An acid monitor is put into your esophagus and connected to a small computer that you can wear on a belt or shoulder strap. It measures when stomach acid backs up into your esophagus and for how long.

Esophageal motility testing (esophageal manometry): A catheter is put into your esophagus and measures pressure and movement.

Heartburn Treatment

Usually, you can treat heartburn with over-the-counter medicines, including:

Antacids: These medications lessen the acid in your stomach to ease heartburn pain. They can also sometimes help with stomach pains, indigestion, and gas.

Acid blockers and proton pump inhibitors: These drugs lessen the amount of acid your stomach makes. They can also calm symptoms of acid indigestion.

If OTC medicines don’t work for you, your doctor may give you a prescription version of these types of medicines.

Heartburn Complications

Occasional heartburn isn't dangerous. But GERD can sometimes lead to serious problems, such as:

A long-term cough

Laryngitis

Inflammation or ulcers of the esophagus

Problems swallowing because of a narrow esophagus

Barrett's esophagus, a condition that can make it more likely to get esophageal cancer

 

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