Hi Friends, as u all know that I am a Doctor. I am qualified Practitioner of Homoeopathy. If you or anyone of your family, have some health problems and want Homeopathic treatment then you can tell me. I’ll be there for your help.
I will try to post here some information about the diseases or other problems, for your knowledge. I hope you will be like it.
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Nicotine Nicotine is a powerful insecticide and poisonous for the nervous systems. Furthermore, there is enough (50 mg) in four cigarettes to kill a man in just a few minutes if it were injected directly into the bloodstream. Indeed, fatalities have occurred with children after they had swallowed cigarettes or cigarette butts. When diluted in smoke, nicotine reaches the brain in just seven seconds, it stimulates the brain cells and then blocks the nervous impulse. This is where addiction to tobacco arises. Nicotine also causes accelerated heart rate, but at the same time it leads to contracting and hardening of the arteries: the heart pumps more but receives less blood. The result is twice as many coronary attacks. Nicotine thus also increases the consumption of lipids (which is why it has a weight-loss effect) and induces temporary hyperglycaemia (hence the appetite suppressing effect).
Carbon monoxide (CO) This is the asphyxiating gas produced by cars, which makes up 1.5% of exhaust fumes. But smokers inhaling cigarette smoke breathe in 3.2% carbon monoxide – and directly from the source. Oxygen is mostly transported in blood by haemoglobin. When we smoke, however, the carbon monoxide attaches itself to the haemoglobin 203 times more quickly than oxygen does, thereby displacing the oxygen; this in turn asphyxiates the organism. This causes the following cardiovascular complaints: narrowing of the arteries, blood clots, arteritis, gangrene, heart attack, etc. . . . but also a loss of reflexes and visual and mental problems. It takes between six and 24 hours for the carbon monoxide to leave the blood system.
Irritants These substances paralyse and then destroy the cilia of the bronchial tubes, responsible for filtering and cleaning the lungs. They slow down respiratory output and irritate the mucus membranes, causing coughs, infections and chronic bronchitis.
Tars As the cilia are blocked (see paragraph above), the tars in the cigarette smoke are deposited and collect on the walls of the respiratory tract and the lungs, and cause them to turn black. So, just because a smoker is not coughing, it doesn't mean that he or she is healthy! And this fact merely serves to pour water on one of the most common and poorest excuses given by smokers. The carcinogenic action of the tars is well known: they are responsible for 95% of lung cancers. It takes two days at least after cessation of smoking for the cilia to start functioning properly again, albeit only gradually. By smoking one packet of cigarettes every day, a smoker is pouring a cupful of these tars into his or her lungs every year (225 grams on average)!
Chemistry of Tobacco Smoke No less than 4000 irritating, suffocating, dissolving, inflammable, toxic, poisonous, carcinogenic gases and substances and even radioactive compounds (nickel, polonium, plutonium, etc.) have been identified in tobacco smoke. Some of these are listed hereafter: Benzopyrene, dibenzopyrene, benzene, isoprene, toluene (hydorcarbons); naphthylamines; nickel, polonium, plutonium, arsenic, cadmium (metallic constituents); carbon dioxide, methane, ammonia, nitric oxide, nitrogen dioxide, hydrogen sulphide (gases); methyl alcohol, éthanol, glycerol or glycerine, glycol (alcohols and esters); acetaldehyde, acrolein, acetone (aldehydes and ketones); cyanhydric or prussic acid, carboxyl derivatives (acids); chrysene, pyrrolidine, nicoteine, nicotinine, nicoteline, nornicotine, nitrosamines (alkaloids or bases); cresol (phenols), etc.
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HAIR LOSS & ALOPECIA (BALDING) Hair Loss Overview
Hair loss is a common problem and primarily affects men, but can also affect women.
The most common form of hair loss is male pattern balding (androgenetic) and has a strong genetic component (ie. runs in families).
Coming to terms with hair loss is the most practical and cheapest (!) strategy, but many people find this difficult or unacceptable.
Drug treatments for men with hereditary balding include the drugs finasteride and minoxidil.
The main treatment for women is minoxidil because finasteride has little effect and can cause birth defects.
A new topical therapy for alopecia areata is still under investigation.
Hair loss may be distressing and some treatments are available as discussed in this article, but most of them are not as dramatically effective as would be desired by most sufferers.
What is alopecia?
Alopecia is hair loss from the scalp which is also known as male-pattern hair loss or balding in men, or female-pattern hair loss in women.
The most common cause of hair loss is androgenetic alopecia which is thinning of the hair caused by androgens (male hormones) in those who have inherited a genetic tendency towards balding. Another cause is alopecia areata which is an autoimmune disease.
Hair loss can be an extremely distressing condition for men and women but there are now treatments available that can treat some types of hair loss.
People are born with about 100,000 hairs on the scalp. Each day about 100 hairs are shed from the scalp and about the same number enter the growth cycle. With alopecia, the hair growth cycle is shortened, and the follicles produce shorter and finer hairs.
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ANDROGENETIC ALOPECIA
This is the most common cause of hair loss and is due to a genetic susceptibility to balding.
Hair thinning usually begins between the ages of 12 and 40 years of age and about half the population will have experienced some degree of alopecia by the age of 50.
Hair loss is due to a shorter growth cycle of the hair; the follicles become smaller and produce shorter and finer hairs in areas prone to balding.
In male-pattern hair loss, alopecia ranges from a receding hair line, hair loss from the crown, to almost complete baldness. The presence of much finer, shorter hairs which poorly cover the scalp may be noticed.
In female-pattern hair loss, thinning is extensive and more marked on the front, sides and top of the scalp. However, most will keep some hair around the hairline although the scalp will have bald spots.
Treatment of androgenetic alopecia in men:
The aim of treatment is to increase the coverage of hair over the scalp and to prevent further hair thinning.
The best drug treatments for male hair loss is 1 mg of finasteride taken orally once a day, and minoxidil applied directly to the scalp in either 2 or 5 percent solutions twice a day. Both of these drugs increase the size of existing hairs and help prevent further hair loss. However, they still fail to restore all the hair.
Finasteride appears to be more effective than minoxidil at restoring some hair.
The best candidates for treatment are those with early balding and/or fine miniature hairs on bald patches. The drugs do not benefit men with complete baldness or those without finer hair growing in the bald regions.
Both drugs should be used for six to 12 months to improve hair growth, and continued therapy is needed to maintain existing hair.
The most effective treatment for established balding is surgical hair transplants, using plugs of hair taken from back and inserted at the top of the scalp. However, this method is expensive and there are risks of complications. An experienced surgeon is required for the operation.
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Treatment of androgenetic alopecia in women:
Women are thought to be more distressed by hair loss than men, although the use of hair styling and some products can help to disguise their problem.
Women may also need to be investigated for other medical conditions if there are additional signs of an excess of male hormones.
The main treatment for female-pattern baldness is minoxidil. Finasteride is not recommended for women because of the potential for the drug to cause abnormalities in the genitalia of male fetuses.
Finasteride has also been shown to be ineffective in alopecia in postmenopausal women.
Oestrogen therapy has also been tried in women, but with little success.
Women with hair loss should be careful about the type of oral contraceptive they use to ensure they do not aggravate their problem. They should take a combined contraceptive pill with a progestin which has a low androgenic activity such as norgestimate or ethynodiol diacetate. Patients should also avoid testosterone or androgen precursors.
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ALOPECIA AREATA
This is an autoimmune disease which affects about two percent of the population, and affects both sexes equally. It occurs more frequently in children and young adults.
In this condition the hair is lost in small, round patches, and it can cause total baldness.
The hair may spontaneously grow back, but regrowth may take months to years. The hair follicles remain alive so there is always the potential for hair to return.
Treatment is more effective in milder cases, and no therapy is particularly effective for total hair loss.
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ALCOHOL ABUSE, ADDICTION & DEPENDENCY
Alcohol may be good for your heart if taken in moderation.
Teetotalers and heavy drinkers have higher death rates than moderate drinkers do
There is controversy over what moderate drinking means
More than three drinks a day for men and over two for women is considered too much
One in 13 people are believed to be alcoholics
Heavy drinking has been linked to suicide, fatal accidents and fatal diseases
Alcohol can harm unborn children
Drinkers are advised to have alcohol free days
There is a wide range of alcohol treatment programmes available
What are the issues?
Many drinkers have been heartened in recent years by the news from several studies that alcohol may actually be good for you. However, it must be stressed that drinking alcohol is only beneficial if it's done in moderation.
The majority of the population drinks alcohol, only about 10 percent are teetotalers.
Alcohol dependency is one of the most common drug problems all over the world. One person in 13 is believed to be an alcoholic. Several million more people drink too much and are at risk of alcohol abuse.
Alcohol addiction is a serious issue. Alcohol consumption is linked to 80 percent of suicides, 50 percent of murders, 30 percent of fatal road crashes, and 15 percent of drownings. It is also a factor in one in three divorces, and one in three cases of child abuse.
Drinking alcohol can increase the likelihood of cirrhosis of the liver, harm an unborn child, and has been linked to breast cancer in women and cancer of the mouth, oesophagus, pharynx, larynx, and liver.
Heavy drinking has also been associated with poor sexual performance, dementia and muscle degeneration.
On the other hand moderate drinking in middle age has been shown to reduce deaths from heart disease by about one third. An Australian study shows the heart attack risk is lowest among men who report one to four drinks daily on five or six days a week and for women who have two standard drinks a day, five or six days a week.
Infrequent drinkers and teetotalers are not advised to drink more because they may run the risk of developing an alcohol problem.
What is moderate drinking?
There is controversy over what moderate drinking is. A common guideline is one standard drink a day for women and two for men, and no heavy drinking sessions at all. Another recommendation is three or four small drinks for men, three or four times a week and two or three small drinks for women, three or four times a week. UK health authorities suggest a limit of 14 drinks a week for women and 21drinks a week for men.
Many people fall outside these guidelines and some could have an alcohol problem.
The definition of a standard drink also varies, but a general guide is one can of beer, one small glass of wine, and one nip of spirits.
There is no strong evidence that wine drinking is any better than drinking beer or spirits.
Women need to drink less than men because they have less fluid in their bodies so alcohol has a stronger effect. They are also smaller than men.
People with low body weight and a small frame should drink less than others.
What are the warning signs of a drinking problem?
Some of the early signs of problem drinking include:
Drinking faster than others. Thinking of ways to get extra drinks when socialising with others Spending too much money on alcohol Denying the problem and understating how much you are drinking Feeling guilt or remorse about drinking Memory loss while drinking Promising to drink less Drinking to cope with normal stress
The CAGE questionnaire is commonly used for people to find out if they have an alcohol problem. Answer the questions honestly:
Have you ever felt you should Cut down on your drinking? Have people Annoyed you by criticising your drinking? Have you ever felt bad or Guilty about your drinking? Have you ever had an "Eye opener" - a drink first thing in the morning to steady your nerves?
Just one yes answer indicates a possible drinking problem. Yes to more than one question suggests a likely drinking problem. Even if you answered no to all the questions but your drinking is causing problems with relationships, your job, or the law, you should seek help.
When does problem drinking become alcoholism?
There is no standard definition of alcoholism. However, it is generally linked to an uncontrollable urge to drink, needing to drink more to feel the effects, and chronic intoxication.
A strong craving for alcohol, not being able to stop drinking and suffering withdrawal symptoms such as shakiness when sober are all symptoms of alcoholism.
The need for alcohol may become as strong as the desire for food or water. The majority of alcoholics cannot stop drinking without treatment and support.
People who cannot go without a drink for three days in a row may be alcoholics.
It is not unusual for heavy drinkers to deny they have problem.
Men who drink more than six drinks a day and women who have more than four drinks a day are drinking too much and run the risk of illness or alcohol-related problems.
What are the effects of alcohol on unborn children?
Women are advised to abstain from alcohol when they become pregnant or are trying for a baby.
Exposing the fetus to alcohol can cause birth defects known as fetal alcohol syndrome (FAS).
The condition is normally found in babies of mothers who drank excessively during pregnancy. However, studies have also shown it can occur with mothers having just one drink a day.
Infants with FAS may be born small, have problems with eating and sleeping, seeing and hearing, following directions, paying attention at school and making friends.
In serious cases the child may need medical care all their lives and need special-aide teachers.
What can be done to help?
If you think you drink too much try to limit your intake. Alcoholics are advised to give up drinking altogether.
Write down your reasons for cutting down. You may want to do it for health reasons, to sleep better or wake up in the morning without a hang over.
Decide before drinking how many drinks will have and stick to it. Reward yourself with a treat for keeping to your limit.
Team up with a friend and help support each other to drink less.
Avoid rounds because this can make you drink more. Put your glass down between sips to stop drinking as fast.
Pace your drinks by having a non-alcoholic drink in between alcoholic ones.
If you are worried about how much you are drinking go and do something else, go and dance or take time out for five minutes.
It may pay to avoid people and places that make you drink while you are cutting down.
Try to have three alcohol free days a week. Learn how to say no to a drink.
Don't give up if you are not successful the first time. Many people need a few trial runs before reaching their goal.
Seek help from a treatment programme. Most heavy drinkers cannot give up without professional guidance.
Medicines are also available which cause nasty side effects when alcohol is consumed.
How can alcohol abuse be prevented?
Many people are believed to inherit a drinking addiction from their parents. If your parent was or is a heavy drinker then you could be at risk. You need to watch the amount you drink.
People can control their drinking by having three alcohol free days a week, and by not drinking more than four alcoholic beverages in one sitting.
Switch to low alcohol beer and mix drinks with non-alcoholic drinks like lemonade.
QUEEN VICTORIA
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CIRRHOSIS -
What is it?
Cirrhosis is a liver condition characterized by scar formation in the liver, accompanied by regeneration (new growth) of tissue. These changes in the liver is the result of repetitive damage to the liver, usually over a prolonged period of time. As a result, the liver becomes hardened, nodular, and may shrink. At a later stage the functioning of the liver may decline.
The most important causes are:
1. Alcohol (prolonged and excessive use)
2. Viral hepatitis -hepatitis B, hepatitis C, other viruses.
4. Drugs and Toxins - methotrexate, isoniazid, methlydopa, arsenic.
5. Biliary cirrhosis.
6. Chronic heart failure (cardiac cirrhosis).
What are the consequences?
Cirrhosis can lead to:
1. Liver failure with jaundice and confusion (hepatic encephelopathy)
2. Portal hypertension (increases pressure in the vessels that drain the liver). This can cause severe bleeding, particularly from dilated veins (varices) in the oesophagus. It may also cause an enlarged spleen.
3. Ascites (fluid in the abdominal cavity). This results from decreases protein production by the liver, as well as portal hypertension.
4. Bleeding due to decreased production by the liver of clotting factors.
5. Spontaneous bacterial peritonitis - this is an infection in the ascites, which can be very serious.
6. Renal failure (hepato-renal syndrome)
7. Liver cancer (hepatoma)
Diagnosis:
Diagnosis requires a careful history, particularly relating to alcohol intake, as well as a clinical examination. Blood tests can usually identify abnormalities in liver function, as well as identify the different viruses which cause hepatitis. Radiological scanning (ultrasound, CT or MRI) of the liver shows evidence of scarring. In some cases a biopsy of the liver is required, so that a piece of tissue can be examined under the microscope.
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ALLERGIC RHINITIS
Allergic rhinitis is inflammation of the nasal lining.
It causes chronic sneezing, runny nose or a blocked nose.
Seasonal allergic rhinitis is also known as hay fever.
It is caused by allergies to various types of pollen.
Perennial allergic rhinitis is caused by allergies to things like dust mites, chemicals and cats.
Skin prick tests can help identify what substance a sufferer is allergic to.
The rate of allergic rhinitis varies from 1.4 percent to 40 percent around the world.
There is evidence the prevalence of the condition is increasing.
What is allergic rhinitis?
Rhinitis means inflammation of the nasal lining or mucosa. It is characterised by chronic or recurrent sneezing, rhinorrhea (runny nose), itchy and blocked nose, which may be labeled as allergic when an allergen is identified. The most well known form of rhinitis is the common cold, which is infectious rhinitis due to a virus.
The hallmark of allergic rhinitis is the relationship of symptoms on exposure to an allergen. Your nose is not the only organ that may be affected in allergic rhinitis. You may have itching of your eyes (allergic conjunctivitis), throat and ears.
There are two types of allergic rhinitis:
Seasonal allergic rhinitis or hay fever - when symptoms are experienced only during spring and/or summer. It is usually due to various types of pollen, which are carried by the wind and easily breathed into the nose. When most people talk about hay fever it usually means seasonal allergic rhinitis.
Perennial allergic rhinitis - when symptoms are experienced all year round. It is usually caused by allergens such as house dust mite, particles from the family pets known as animal dander, or mould spores which are carried in the air.
Other causes of perennial rhinitis
Occupational: vets working with furred animals, bakers allergic to flour, health workers allergic to latex, etc.
Drugs: Oral contraceptives, hormone replacement therapy, aspirin & other nonsteroidal anti-inflammatory drugs and anti-hypertensives can all cause rhinitis.
How common is allergic rhinitis?
Allergic rhinitis is estimated to have a prevalence of up to 40% in the New Zealand and Australian populations.
A recent ISAAC study of 460,000 children aged 13 to 14 years found the prevalence of allergic rhinitis varies from 1.4 percent to 39.7 percent in countries around the world.
The lowest rates were found in parts of Eastern Europe, south and central Asia. The highest rates were found in regions in Canada, Australia, New Zealand, the United States and the United Kingdom.
The overall rate was 13.9 percent and nearly half of the children studied also asthma or eczema. Areas with low rates of allergic rhinitis also had low rates of asthma and eczema.
There is mounting evidence of a rise in the prevalence of allergic diseases, including rhinitis, over recent decades. Lifestyle factors may be important given the high prevalence of rhinitis and other allergic diseases found in westernised English-speaking countries.
What is the mechanism of allergic rhinitis?
Allergic rhinitis is a hypersensitivity response to specific allergens in sensitised patients that are mediated by IgE antibodies. Sensitised patients with allergic rhinitis have IgE antibodies for specific allergen(s) bound to receptors on the surface of mast cells. On re-exposure to the specific allergen(s), cross-linking of adjacent IgE molecules occurs, and mast cell degranulation (rupture) takes place, releasing a variety of chemical mediators that may be performed (histamine) or newly synthesized (leukotrienes, prostaglandins).
Histamine causes the cardinal symptoms of allergic rhinitis including sneezing, nasal itching, and runny nose. The nasal congestion is more due to leukotrienes than to histamine. Hence antihistamines are not very good at relieving nasal congestion.
A large number of patients with allergic rhinitis will have an increase in sensitivity to allergens after repeated daily exposure; an effect called "priming". At the start of the pollen season, comparatively large doses of pollens are needed to trigger an allergic response but toward the middle and end of the season, patients become extremely reactive to even small amounts of pollen.
QUEEN VICTORIA
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JET LAG - a patient's guide
Jet lag occurs after crossing more than three time zones.
Symptoms include insomnia, irritability, and altered bowel habits.
In general, flying on west-bound flights is easier on the body.
Get a good nights sleep before travelling.
Medical treatment involves the use of sleeping tablets, melatonin and stimulants.
New recommendations indicate jet lag can be treated with short spells of bright light.
What is jet lag?
Jet lag is when the body's own time clock is out of sync with the country they are visiting.
Jet lag occurs when you fly over at least three time zones. There are 24 time zones around the world - one for each hour in the day.
In these cases a traveller cannot immediately adjust to the time zone of the country they are visiting. For example it may be 7am when you arrive but you will feel more like sleeping than having breakfast.
Symptoms of jet lag include insomnia, fatigue and altered bowel habits. Other problems include irritability, dehydration, problems concentrating and sometimes nausea.
Advice for minimising jet lag during air travel
Long flights can be hard on your body, but you can limit the undesirable affects of fatigue by taking the following advice:
Travel from east to west when flying to and from Europe. You will spend more time in darkness, making it easier to sleep.
In general, travelling north to south is least likely to give you jet lag because you may be able to stay in the same time zone. Otherwise, travelling west is considered best because you gain time in that direction - not lose it.
If possible, make some adjustments to your body clock before you leave so it has less adjustments to make on arrival.
Get a good sleep the night before you leave.
Stop over in another country for two days during the trip if you are crossing more than six time zones.
Drink plenty of water on the flight to avoid dehydration. Don't drink too much alcohol. And avoid coffee during the flight and on arrival.
Avoid overeating, this may give you indigestion.
Exercise your legs by taking a walk around the aircraft.
Take short-acting sleeping tablets to avoid a hungover feeling when they wear off. An eye mask and earplugs may also help you sleep.
Wear loose clothing for comfort. Your feet may swell during the flight so also wear lose fitting shoes or slippers.
See your doctor if you get a heavy cold before you leave. Pressure on your ears during descent can be extremely painful.
Airsickness is now unusual, but anti-airsickness tablets are available if you are worried about nausea.
Advice for adjusting to new time zones on arrival:
Take a short nap on arrival and then go to bed at night.
Try to keep the day on arrival free to rest if you are crossing more than six time zones.
For the first three days do most of your activities in the morning if you have travelled from east to west, and in the afternoons if you have flown from west to east.
Try not to use sleeping pills, but if you need to, use them only on the first two or three nights and them stop taking them so you do not get addicted.
Taking a long-acting sleeping pill may be better for travellers following west-bound flights because of problems with early-morning waking after those flights.
QUEEN VICTORIA
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BEE STINGS - a patient's guide
Bee stings are serious for those who are allergic to them. A bee sting leaves a stinger which looks like a splinter and pumps venom in the body. It is best to remove stingers as fast as you can rather than slowly and carefully. Check anyone who has been stung by a bee for an allergic reaction. Symptoms of an allergic reaction include headache, fever, loss of consciousness, and severe swelling of the face, tongue, lips and body, rash and possible difficulty breathing.
What is it?
Bee stings are very common and very serious for five percent of the population who are allergic to them.
There is an increased risk of bee stings during spring.
Once you have been stung by a bee, it leaves a stinger which will continue to pump venom into your body for up to 20 minutes unless it is removed.
A bee sting will cause a red swollen welt on the skin.
Other insects which sting include hornets, bumble bees, wasps and hornets.
What can be done?
The first thing to do is to look for the stinger which looks like a small splinter. If there have been multiple stings check the head, neck and chest first. Remove the stingers as quickly as possible.
Studies show it is better to remove the stinger as fast as you can. In the past, tweezers were recommended to remove stingers but this advice is now outdated because this can squeeze more venom into the site.
Use your thumb and forefinger and grab the stinger as close to the skin as possible and then pull it out.
Wash the sting area with soap and water or alcohol wipes.
Apply ice to the area or use a cloth that has been soaked in cold water. This will help to limit the inflammation.
Bee sting allergies
Some people suffer from hives or stomach cramps following a bee sting and others have a more serious reaction which requires immediate medical attention. In some cases a bee sting can be fatal due to airway obstruction or shock.
Anyone who is stung by a bee should be asked if they are allergic. If unsure the victim should be observed for an allergic reaction. Symptoms include headache, fever, loss of consciousness, severe swelling of the face, tongue, lips and body, muscle cramps, and difficulty breathing.
A person who has received multiple stings should also be observed for signs of an allergic reaction.
An allergic reaction will usually occur within one hour of a sting.
People who have suffered an allergic reaction to a sting have a 60 percent chance of another reaction if they are stung again.
Those allergic to bee stings should wear a medic allergic bracelet to alert others about the allergy and carry an anaphylaxis kit which includes adrenaline and a needle and syringe and an antihistamine. It should also have an instruction kit to explain to others how to use the treatment.
Venom immunotherapy treatment is also an option for people who have suffered an allergic reaction to bee stings. This involves administering traces of venom until the person becomes immune to it. Venom immunotherapy is more than 90 percent effective. However, it may not be necessary in children who are more likely to grow out of the allergy.
This can be a difficult area and advice of an allergy specialist is advisable
Bee sting prevention
The best way to avoid a bee sting is to stand still and even let it land on you. In most cases it will simply fly away.
Other prevention measures include:
Keep soft drinks and sweet foods covered Avoid wearing perfume or hair spray outside Avoid wearing bright clothes because these can attract bees Wear trousers and long sleeved shirts and avoid bare feet Be particularly cautious when you are gardening or doing work around the house
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MOTION SICKNESS-A Guide for Travellers
About 90 percent of people suffer from motion sickness at some time in their lives
Symptoms include nausea, dizziness, headache, disorientation, and vomiting
Several measures can be taken to help limit motion sickness such as staring at the horizon and breathing fresh air
Medication can be helpful
What is it?
Motion sickness is experienced by about 90 percent of people at some time in their lives.
It is caused by the brain receiving conflicting messages from the balance organs in the ears and the focus of your sight. For example if you are reading while traveling your sight is detecting little movement, but your balance centre can still feel movement. This can confuse your brain, leading to motion sickness.
The problem is more common in children than adults and most will grow out if it.
However, some people suffer from it throughout their lives.
The problem is encountered on long car journeys, air travel and on boats and ships.
What are the symptoms?
Common symptoms include:
Nausea
Vomiting
Dizziness
Headache
Disorientated
A cold sweat
What can be done?
Several measures can be taken to help limit motion sickness:
Avoid eating a heavy meal for dinner or breakfast before leaving on a journey
Don't drink alcohol the night before a trip
Don't look at moving objects such as waves or scenery Keep your focus at 45 degrees above the horizon. Put children in a car seat so they can see the horizon
Sit in the place with the least motion; the front seat of the car, over the wings of the aircraft or in the middle of the ship
Face forward in a large ship
Breath fresh air if you can
Avoid strong odours from tobacco, food or fumes while traveling
Avoid reading, or watching a video or movie
Trying to sleep can help. Put your seat in the recline position if you are in an aircraft
Anti-motion sickness medications are useful in some cases
One study has found ginger taken before a journey can help limit motion sickness
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Smoking Facts and Smoking Statistics on The Dangers of Smoking Hazards: The Hazards of Smoking
Here are established shocking smoking facts and smoking statistics about the hazards of smoking, the dangers of smoking cigarette smoking hazards and other known smoking hazards. There are more than 4,000 chemicals in cigarette smoke, including 43 known cancer-causing (carcinogenic) compounds and 400 other toxins. Some of these smoking hazards are also in wood varnish, the insect poison DDT, arsenic, nail polish remover, and rat poison. Clear and present dangers of smoking. The soot, tar, gases, and other poisons in cigarettes harm your body over time. These are smoking facts. These dangers of smoking damage your heart and lungs. They also make it harder for you to taste, smell, and fight infections. More shocking smoking facts and smoking statistics... Smoking accounts for more than 30% of all deaths from cancer, almost 90% of deaths from lung cancer, and has replaced breast cancer as the leading cause of death due to cancer, for Canadian women. Smoking is the leading cause of lung cancer and chronic lung diseases. Smoking has been linked to about 90 percent of all lung cancer cases. It's a smoking fact that smoking is responsible for about a quarter of heart attack deaths. A strong link has also been discovered between smoking and cancer of the pancreas, kidney, and urinary bladder. About 75% of deaths from chronic bronchitis and emphysema are attributed to smoking. These smoking statistics and smoking facts reveal the shocking truth about smoking hazards and the real dangers of smoking. Smoking is associated with cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, ureter, and bladder. The overall rates of death from cancer are twice as high among smokers as among nonsmokers, with heavy smokers having rates that are four times greater than those of nonsmokers. On average, smoking removes 15 years from a smoker's expected life span. Second hand smoking has also shown to be a major risk factor is the development of disease in non-smokers. The US Environmental Protection Agency (EPA) has classified environmental tobacco smoke as a class A (known human) carcinogen along with asbestos, arsenic, benzene and radon gas. Smoking Facts About Smokers Cough Mucus clearance from your lungs is accomplished by cilia, tiny hairlike projections lining the inside of the lungs which constantly move dirt, bacteria, and other irritants up into the throat where they can be swallowed. Cilia beat at about 16 times per second. A decrease in this rate impairs mucociliary clearance. It's a smoking fact that cigarette smoke paralyzes the cilia it contacts in the sinuses and lungs for twenty-minutes. Cigarette smoke, even second hand smoke, causes the lungs to become clogged with thick secretions of mucus, containing bacteria and primarily dead white blood cells. This thick build up of mucus also interferes with cilia pulsation, decreasing mucus clearance still further. Multiple dangers of smoking and smoking hazards. Cilia regain their function during cigarette-free sleep, and must work overtime to gather all of the mucus that have built up, which can be up to 2 liters per day. When smokers awake, they cough because their lungs are attempting to clear this mucus. When cilia are repeatedly exposed to smoke over a long period of time, their action is permanently destroyed. And another smoking fact is that smokers' lungs will then be more exposed to dangers of smoking and hazards of smoking than before.
QUEEN VICTORIA
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ASTHMA -
What is asthma?
Asthma is an inflammatory condition of the breathing tubes (or bronchi). The inflammation causes airway irritability and results in airway narrowing (called bronchospasm).
Now, to explain that in a little more detail, let's go back a few steps.
How the lungs work
Our breathing "equipment" is made up of two parts: a set of breathing tubes - similar to the trunk and branches of a tree, except that our breathing tubes, of course, are hollow. At the end of the finest branches of a tree there are leaves. In our bodies, instead of leaves, our lungs are made up of a sponge tissue.
Inhaled air travels down the breathing tubes, out to the finest branches, which are in close communication with blood vessels containing blood. The blood takes the oxygen from the air and carbon dioxide travels in the other direction, from the blood stream back into the airways, where it is breathed out.
The process of gas exchange occurs in the sponge tissue of the lung. The job of the breathing tubes is to get the air in and the carbon dioxide out.
What is different about the lungs in asthma?
In asthma, the sponge tissue works well. The problem lies in the breathing tubes.
The breathing tubes (bronchi) have an inner lining, which is similar to the lining of your mouth. In the middle of the airway wall is a layer of muscle. In asthma, this muscle layer is very irritable or "twitchy" so that a wide variety of trigger factors cause it to tighten. This causes narrowing of the breathing tubes, making it harder to breathe, and also causing chest tightness, wheezing and coughing.
Why is the muscle layer in the breathing tubes so irritable? By far the main reason for this is inflammation. An example of inflammation elsewhere in the body is sunburn. Inflamed tissues are red and swollen. In asthma the lining of the breathing tubes are inflamed.
a) Inflamed tissue contains a large number of white blood cells and these are like tiny chemical factories. The substances they release have a number of harmful effects. They cause blood vessels to become leaky so that fluid seeps out into the tissues - the tissues then become swollen.
b) Other chemicals or substances from the white blood cells attack the inner lining layer of the breathing tubes, causing it to become so damaged that, under the microscope, it looks as though the lining layer has been attacked with sandpaper. Because of this damage, infections and irritating substances we breathe in can affect the breathing tubes more easily and cause problems.
c) Some chemicals released by the white blood cells act like a signal, calling in more white blood cells into the area. Because of this, the inflammation in asthma "has a life of its own" - there is an inbuilt mechanism by which the process keeps itself going on and on.
d) We will talk about asthma medicines later, but one of the most important actions of inhaled steroids is to calm down the white blood cells, reducing the release of chemicals from them, and thus allowing the asthma process to settle down.
A third part of the asthma process is the production of sticky mucus from the inner lining layer of the breathing tubes. Asthma mucus tends to be a pale lemon-yellow colour.
In summary, the key to things to remember about asthma is that it is essentially an inflammatory condition of the airways resulting in over-sensitive breathing tubes, which then react to things which don't cause problems for normal airways.
QUEEN VICTORIA
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What are the symptoms of asthma?
Typical asthma symptoms include a tight feeling across the upper chest, cough, breathlessness and wheezing.
A wheeze is a noise - a high pitched noise which comes from within the chest. Anyone can mimic this wheezing sound by tightening their throat muscles and breathing out forcibly. The wheezing in asthma is similar to this, but comes from within the chest, not the throat.
Asthma symptoms may be brought on by head colds, exercise, exposure to pollens or dust to which the person is allergic, or a whole host of other factors.
Not everyone with asthma has these typical symptoms. For instance, a frequent or persistent cough might be the only obvious feature of underlying asthma.
Conditions which can be confused with asthma
Occasionally, people who are elderly are told they have emphysema when, in fact, there may be at least some asthma present.
Hyperventilation - that is, "overbreathing" caused by an abnormal breathing pattern - can mimic asthma. Sometimes people have a combination of asthma and hyperventilation, both of which cause breathing difficulties and chest tightness.
Vocal cord spasm is another condition which is less common, but can also mimic asthma. Here, change in the quality of the voice is usually present, and the wheezes which are heard are generated from the throat, rather than from breathing tubes in the chest.
What causes asthma?
This is not properly understood. In most cases there is no obvious reason why one person develops asthma.
Asthma can be inherited or have a genetic cause, but this is only a factor in about 50% of people with asthma.
We also know that viral infections which attack the breathing tubes can, at times, set off asthma in someone who has never had asthma before. If this type of asthma is recognised in time (within, say, a couple of months) and fairly intensive treatment is given (usually with inhaled steroid and steroid tablets) good treatment has an excellent chance of producing a cure from this form of asthma.
In the work place there are a few substances recognised as causing asthma in people who have never had it before. Toluene di-isocyanate (TDI) is the best known. TDI is found in 2-pot paints (used by car body paint sprayers), and in a number of glues where two components have to be mixed together to form the glue. Persistent exposure to sawdust from Western red cedar can also cause asthma: here the offending substance is plicatic acid, which is a natural chemical found in this particular wood.
There is an important distinction between "causes" of asthma (two of which we have just discussed), and asthma "triggers", which make existing asthma worse.
Asthma triggers
Asthma triggers are things that make asthma worse. The most common asthma triggers include head colds, cigarette smoke, exercise, fumes, allergic substances (such as pollens, pets and dust), weather factors (weather change, cold or humid weather), and change in emotions (such as stress or excitement). Food factors may be important in some individuals but not others.
It is important to know about asthma triggers and to look out for those triggers that affect you. Regularly using a peak flow meter, with recordings morning and night, can help you track down triggers. If you are suspicious of a particular possible trigger factor, measuring the peak flow before and after exposure can help determine if that factor is important or not.
Though many trigger factors cause asthma soon after exposure, some only affect asthma hours later. Another complication is the fact that it sometimes takes a combination of several triggers to make asthma worse, with the individual triggers themselves not causing problems.
Tracking down asthma triggers is important, but it may be an exercise in frustration. You need to decide for yourself how much effort you want to put into finding things that make your asthma worse. Just remember, though, trigger avoidance is a fundamental aspect of good asthma care.
Asthma attacks
Surprisingly, it is not easy to define what is an asthma attack. What the medical profession regard as an asthma attack is worsening of asthma, with an important degree of respiratory distress, or with an important degree of fall in lung function.
Asthma attacks can be sudden and severe, in which case it is important to take extra medication straight away and to get medical attention. At other times, asthma can be mildly, but persistently worse over a period of days, or even weeks, with gradual deterioration. Thus, asthma attacks can have a sudden onset or a slow onset. Either way, when asthma becomes worrying, or distressing, it is time to get help.
Asthma attacks are important because they can result in death if they are not managed properly. Typically, people who are too busy, or just keep on putting off getting medical attention, are the ones who wind up in trouble. "A stitch in time saves nine" - early treatmentof attacks saves trouble; it saves lives.
Looking after asthma
1. How you feel about asthma is important
Most people with asthma can live normal lives if they look after asthma conscientiously. Up to 10% of people with asthma have problems which cause some interference with their life despite good treatment. But this interference can be minimised with good treatment.
How you feel about your asthma and the treatment is important. Some people feel angry because they have asthma, become frustrated because they can't stop problems occurring, and hate having to take medication. While these feelings are natural and normal, it is a fact that they are a source of unhappiness. More than this, these feelings about asthma can produce a significant amount of stress which, in turn, can make the asthma worse.
Behind all these negative feelings, I suspect that there lies a fear, or probably a number of fears. It may be that these fears become mixed up with a wider pattern of fears about other issues. If this feels familiar to you, it may be worth taking steps to manage stress, fear or anger, for instance, by reading books, attending courses, or considering a counsellor, for instance.
Be determined, calm and responsible in looking after asthma. The problems associated with the condition can be considered to be tests and trials to be overcome. If you are interested in developing yourself into a stronger, more effective person, asthma could be an ideal training ground! Surrendering to anger, annoyance or stress isn't the answer. Good help is available, good medications are available. Success in looking after asthma should be expected - there are plenty of people who can help.
2. Trigger avoidance
In the section on asthma triggers, it was made clear that trigger avoidance is one of the cornerstones of good asthma care. Some of the following may be appropriate for you:
At the first sign of a cold or flu, increase your preventer treatment (usually this will be the inhaled steroid - see below).
Don't smoke - this is the worst thing you can do if you have asthma, even if the asthma seems trivial.
Don't tolerate being a passive smoker - consider making a rule for your home (and work place): "No Smoking Here". If you just can't get away from smokers, try and sit in a smoke-free area or near an open window.
If exercise makes your asthma worse, take your reliever inhaler 10-20 minutes before exercise. Exercise is one trigger that needs to be controlled, rather than avoided, if at all possible. Warm up exercises may also reduce exercise-induced asthma.
House dust allergy is caused by tiny mites which eat the skin we shed. House dust mites are unavoidable in modern life, but exposure to house dust must be minimised. Here are some tips for avoiding them and other asthma triggers:
Put bedding items in direct sunlight every couple of weeks - direct sunlight kills the dust mite. Wash bedding in warm water regularly.
Either avoid using sheepskins and electric blankets, or air them frequently in sunlight. Sheepskin can also be washed.
Vacuum frequently (perhaps twice a week) using a vacuum which doesn't expel dust into the air through its exhaust system.
Don't use a feather duster - use a damp cloth to dust other surfaces.
Don't allow pets into the bedroom and, if possible, keep them outside. Pets carry dust and dirt; it's not just allergy to their dander that is important.
Take extra medicine during the pollen season if pollens affect you.
Damp houses are associated with worsened asthma - keep your house warm and dry. Clean away mould straight away, checking wardrobes and cupboards.
Foods and drinks can be important trigger factors - metabisulphite and monosodium glutamate (MSG), as well as the colouring agent tartrazine, should be avoided.
Aspirin and the class of pain relievers called NSAIDS affect about 5% of people with asthma, making their asthma worse. If you are sensitive to them, they should be avoided. (If you change doctors, remember to let the new one know).
Principles of good asthma care
Trigger avoidance.
Don't ignore symptoms: when asthma gets worse, extra treatment is required. If it gets much worse, see your doctor.
Preventer treatment should be taken regularly - usually this means twice a day. Preventers reduce airway inflammation, which is the fundamental problem in asthma.
When you stop your preventer treatment inflammation automatically starts getting worse.
See your doctor and obtain an action plan. This will help you recognise an asthma attack and know what to do about it.
Have regular check ups with your doctor. The more troublesome the asthma, the more frequent the check-ups. Even people with very well-controlled asthma should see their family doctor at least twice a year.
QUEEN VICTORIA
Age: 124
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MOUTH ULCERS
What is a mouth ulcer?
A mouth ulcer is a breach or break in the mucous membrane which lines the inside of the mouth. It usually looks like a depression in the mucous membrane and usually has a yellow or white colour. The size may vary from a millimetre or less in diameter to several centimetres. It is often painful.
What are the most common types of mouth ulcers?
There are many different types of mouth ulcers. The two most common types are
1) ulcers caused by minor injuries and
2) aphthous ulcers.
1. Ulcers caused by minor injuries:
If a person has a sharp edge on a tooth (for example, because the tooth is chipped), or poorly fitting dentures, the mucosal lining of the mouth may be injured and this may result in an ulcer. These ulcers usually heal rapidly if the source of the injury is removed (for example, if poorly fitting dentures are removed or replaced).
2. Aphthous ulcers:
Most people probably get aphthous mouth ulcers at some time in their life. Usually the first attack occurs in adolescence or young adulthood. These ulcers are usually small (less than 5 mm in diameter) and painful. There may be just one or two at a time, or there may be very numerous ulcers in the mouth. People with this condition usually feel fairly well apart from the pain in their mouth. The ulcers usually heal in 1 to 2 weeks but they tend to recur at intervals over the course of many years. In some cases recurrences can be so frequent that mouth ulcers may be constantly present for prolonged periods.
Occasionally, aphthous ulcers can be much larger (more than a centimetre in diameter), and then they can take months to heal. These large ulcers are called 'major aphthous ulcers'.
People may feel pain or tingling in the mouth for a day or two before aphthous ulcers break out. It's best to start treatment at this time if possible.
The exact cause of aphthous ulcers is unknown but it is thought that they may result from the body's own immune system attacking the mucosal lining of the mouth. They may occur after minor injury to the inside of the mouth. Aphthous ulcers are more likely to occur at times of stress. They may occasionally occur after eating certain foods. They may be more common when certain hormones circulate; they tend to be more common round about the time of a menstrual period but less common during pregnancy. Sometimes aphthous ulcers can be caused by deficiency in vitamin B12, folic acid or iron. In rare instances, aphthous ulcers may be caused by coeliac disease (coeliac disease is a condition caused by an inability to tolerate gluten in the diet). A blood test can be used to test for coeliac disease.
Viral infections causing mouth ulcers:
Several different types of viral infections can result in ulcers forming in the mouth and throat.
The herpes simplex virus can cause an illness known as primary herpetic gingivostomatitis. This illness is most common in children. Numerous small painful ulcers occur on the lips, in the mouth and in the throat. There is usually a fever and the glands in the neck are enlarged. The child is usually miserable and may have difficulty eating and drinking because of the pain.
Another viral infection called hand, foot and mouth disease is most common in preschool children. Small ulcers occur in the mouth and little blisters also occur on the hands and feet of the child.
Healthy people with normal immunity recover rapidly from most viral infections in the mouth and throat; people suffering from the viral illnesses described above usually recover completely after a week or two.
QUEEN VICTORIA
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Mouth cancer:
Most mouth ulcers are caused by relatively harmless conditions. However, an ulcer in the mouth may sometimes be the first sign of a mouth cancer. Any sore or ulcer in the mouth which is unexplained and not healing should be checked carefully by a general practitioner or specialist in case it might be a cancer. This is particularly important for older people and smokers, because mouth cancer is more common in these groups.
What are the other causes of mouth ulcers?
There are a great many other conditions which can cause mouth ulcers. These can include infections; abnormalities of the blood; adverse reactions to medications; and skin conditions in which rashes or ulcers may occur on other parts of the body too, not only in the mouth. People who suffer from intestinal conditions such as ulcerative colitis or Crohn's disease may also get mouth ulcers.
Ulcers can sometimes occur after radiotherapy to the head and neck region.
Summary
Most mouth ulcers are not due to serious illness. Occasionally they can be associated with poor immunity or other medical conditions.
Ulcers that so not heal should always be checked by a doctor.
QUEEN VICTORIA
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HIGH BLOOD PRESSURE (HYPERTENSION)
Hypertension is a major risk factor for stroke and heart attacks
The risk can be substantially reduced by attention to lifestyle issues
Medication has been shown to be safe and effective at reducing complications if pressures remain elevated.
Undetected and under-treated hypertension remains unfortunately common.
What is blood pressure?
Everyone has a blood pressure - in fact it is this pressure which makes the blood circulate through the bodies arterial system. Blood pressure fluctuates throughout the course of the day - it goes up during exercise and intense activity and is lower at rest and particularly lower during sleep.
How is it measured?
It is important that you are feeling rested and not rushed or stressed when having your blood pressure recorded.
A cuff is inflated over the arm and blown up; the pressure on the arm blocks the arterial pulse. As the pressure is let down, jets or blood start getting through the artery (this is heard through the stethoscope).
The point at which these sounds are first heard is called the systolic blood pressure and is the reading on the top. The pressure is recorded in millimeters of mercury as this is what is in the column that measures the pressure reading.
As the pressure in the cuff goes lower, the pulsing sounds get fainter and fade away; the point at which they fade away totally is known as the diastolic blood pressure and is the bottom reading.
Both the top and bottom readings are important in determining the risks of high blood pressure.
For example a pressure of 120/80 means the systolic pressure is 120 and the diastolic is 80.
It is important that the correct sized cuff is used - if you have a bigger arm a larger cuff is needed, otherwise a reading may be falsely too high.
Because blood pressure varies so much, it is important to have itchecked several times. If the pressure is high, it should be rechecked several times over a period of time.
If it is very high (e.g. 180/110), it should be checked sooner (within days or weeks), but if it is only just above normal (e.g. 145/95), it is fine to check it in a few months.
Automated home blood pressure machines are also increasingly used. If these are used it is important that they are reliable and accurate (your doctor may be able to guide you).
Increasingly, ambulatory blood pressure monitoring may be used to gain a better picture of what a blood pressure is actually doing. A cuff is worn for 24 hours and a series of recordings is made, including during sleep. It is particularly useful in cases where blood pressure is very labile (up and down) and where it is in a borderline category (where treatment decisions may be more difficult).
It may also be useful to help establish which patients may just be getting an "alarm response" (pressure goes up when being measured).
High blood pressure should not be diagnosed until there have been consistent high measurements on several occasions.
What is normal?
Levels around 130/80 and below are absolutely fine. Doctors are generally concerned when levels are consistently greater than 140/90, as this is the level above which blood pressure starts significantly contributing to the long term risk of increased cardiovascular problems (strokes and heart attacks).
Depending on the exact classification used, pressures around 140-150/90-100 would be called mild hypertension. Pressures around 150-170/100-110 would be called moderate, and pressures higher, e.g. 200/120 would be considered fairly severe.
In reality blood pressure is a continuum, and it is sometimes difficult to be categoric about exactly what category a person is in. The higher the pressure is, the greater the risk that it will lead to further problems.
Causes of high blood pressure
The exact cause of most (90-95%) cases of high blood pressure remain unclear. It is probably caused by a mixture of lifestyle and dietary factors in people who have a genetic tendency.
In a smaller group of patients, a single underlying condition may be responsible - this is more likely to be the case in a young person with very high blood pressure and none of the usual lifestyle risk factors. Such cases are referred to as secondary hypertension. They can usually be identified by careful examination and additional tests if indicated.
QUEEN VICTORIA
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Important factors in Essential Hypertension
The following factors all play a role in essential hypertension and correcting them as far as possible, plays a very important role in the lifestyle treatment of high blood pressure.
Genetic Factors
The tendency to high blood pressure runs in families. If you have a parent with high blood pressure, it is important to make lifestyle changes from a young age and have your blood pressure checked regularly every few years. Often it may only start increasing from middle age onwards.
African Americans seem particularly prone to hypertension and its effects.
Diet
This is probably one of the main areas where lifestyle changes can be most effective and lead to substantial improvements in blood pressure levels.
Obesity
There is no doubt that being overweight may bring on hypertension. The exact mechanism is unclear but may involve increased peripheral resistance and metabolic changes.
Salt
A high salt diet may increase the tendency to hypertension in some people - this is thought to be a factor in approximately 40% of people with hypertension. The exact mechanism is unclear.
Potassium
There is some evidence suggesting that a high dietary potassium intake will reduce the risk of hypertension. Fruit tends to have a high potassium content and is the best source of dietary potassium.
Calcium
A good calcium intake has been linked to hypertension and recent research has showed a high calcium diet (low fat dairy food) may help reduce high blood pressure.
The renin-angiotensin system
It is thought that abnormalities in the hormonal system in the kidney may lead to the production of chemicals (angiotensin) which brings on hypertension.
The exact mechanism remains unclear as does its importance in individual patients.
Alcohol
Excess alcohol (e.g. greater than 2-3 drinks a day) is a very important factor in many cases of high blood pressure. The exact mechanism by which alcohol increases blood pressure is uncertain, but it is believed to be a major factor in a substantial portion people with essential hypertension. It also leads to difficulty controlling it and resistance to the effects of medication.
Very modest drinking (1-2 drinks a day) may be beneficial for the heart - the key is the amount that is drunk!
QUEEN VICTORIA
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Secondary Hypertension
This includes specific medical conditions which lead to hypertension as a result of the underlying illness/condition and include the following. Secondary causes account for only about 5% of cases of hypertension, but they are worth considering as they may be cured by treating the underlying cause. A secondary cause may be more likely in a young person with very high blood pressure.
Kidney problems
Conditions which damage the kidneys, such as previous infection/reflux, polycystic kidneys may lead to hypertension.
Increasingly, renal artery stenosis (narrowing of the kidney artery) is being recognised as an important cause of hypertension.
Hormonal syndromes
Hyperthyroidism - an overactive thyroid gland may cause raised blood pressure.
Phaeochromocytoma - this is a very rare problem, where adrenaline-like chemicals are secreted by a tumour in the adrenal gland; some cases are associated with headache, sweating and palpitations.
Hyperaldosteronism - this results from the secretion of a chemical called aldosterone by the adrenal gland. A clue to this condition may be a low potassium level in the blood.
Cushing's syndrome - this is from a variety of conditions which result in an increased production of cortisol (a steroid, either from tumours or problems in the adrenal gland). Features include truncal obesity, striae (stretch marks in skin), hirsuitism (excess hair).
Sleep apnoea
This is characterised by loud snoring, which may be followed by apnoea (no breathing) and then gasping or snorting. The changes and stress this puts on the body may lead to high blood pressure. Daytime sleepiness may be a feature and morning headaches.
Special sleep studies (a polysomnograph) is needed to diagnose it.
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Why is high blood pressure so important?
Although high blood pressure usually causes no symptoms at all, it acts as a major cardiovascular risk factor over time. Having high blood pressure substantially increases the risk of having a stroke or heart attack in the future.
As a high proportion of people will eventually suffer from some form of cardiovascular disease, it is an important public health issue to try and reduce the risk of this.
The actual risk of an actual problem occurring in a younger person is usually small, but if blood pressure remains elevated, it will continue increasing the risk of future events such as heart attacks and strokes.
The risk associated with high blood pressure increases with age and is further increased in the presence of other risk factors such as smoking, high cholesterol and diabetes.
The following specific conditions are specifically related to high blood pressure:
Coronary heart disease
Hypertension is an important risk factor for heart attacks. Having high blood pressure may double the risk of a heart attack. The risk of heart attacks is further increased if other risk factors are present. Treating high blood pressure reduces the risk of heart attacks substantially (approximately 20 %). This risk is further reduced if other risk factors are also treated.
The reasons that treating high blood pressure does not lead to as great a reduction of heart attacks and stroke, are not well understood.
In patients who have already had a heart attack, it is vitally important to gain good control of blood pressure to try and help reduce the risk of further problems.
Congestive heart failure
Many elderly people develop congestive heart failure - this may be as a result of heart attacks damaging the heart muscle, or as a result of years of uncontrolled hypertension placing undue stress on the heart muscle.
Stroke
Hypertension is a major risk factor for all types of stroke, and effectively treating it can reduce the risk by approximately 30-40 percent.
Kidney problems
Hypertension may lead to kidney damage. If there is already a kidney problem (e.g. due to diabetes), hypertension will accelerate the damage.
In the presence of kidney failure or even mild kidney impairment, it is vitally important to control hypertension, to minimise ongoing kidney damage.
Eyes
The small vessels at the back of the eyeball can sometimes be damaged by raised blood pressure leading to visual problems.
What symptoms does high blood pressure cause?
The vast majority of people with hypertension have no symptoms at all and in fact would have no idea at all that their blood pressure was raised, unless it was measured. This is why it is sometimes referred to as the "silent killer".
Feelings of tension and stress are not automatically linked to high blood pressure and many people with high blood pressure are in fact perfectly calm and relaxed.
This is why some people may find it difficult to accept that there may be a potential problem, as they feel absolutely normal.
Very rarely a condition called malignant hypertension is associated with extremely high pressures and headache may be a feature of this.
For the vast majority of people with high blood pressure, headaches are not a feature of the condition.
However, a painful headache (like anything painful) may cause a slight increase in blood pressure.
Often the symptoms are of complications of the long term effects of hypertension e.g. angina, strokes and heart failure.
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Examination
Examination is usually geared towards confirming the blood pressure on several occasions. The heart and general circulation needs to be examined well and signs of rare conditions will usually be checked for by doctors. This is especially so in cases of very high blood pressure in young patients, who will be more likely to have an underlying cause (secondary hypertension).
Investigations and tests
These are important to check for other risk factors such as diabetes (sugar) and high cholesterol (lipids).
Other blood tests are needed to exclude kidney problems and other hormonal problems mentioned.
Urine tests - testing of the urine is needed to exclude an underlying kidney problem.
An ECG (electrocardiogram) and chest X-ray are often ordered as part of diagnosing an enlarged heart or other underlying heart problems.
An echocardiogram (echo) is a useful test to tell accurately whether the heart muscle is enlarged or thickened (this may indicate a need for specific or more urgent treatment).
Treatment
The aim of treatment is not just to simply lower blood pressure, but to actually substantially reduce the risk of heart attacks and strokes and other circulation problems and make the person live a longer healthier life. If the best results are to be achieved, it is vital that all the vascular risk factors are treated e.g. lowering cholesterol and giving up smoking will add a substantial further benefit to any blood pressure treatment.
In general, lifestyle measures should be tried first before considering medication. For example a young person (say around 40) with mild hypertension (of around 143/92) and no other risk factor would be advised to vigorously try lifestyle changes for possibly up to a year, before considering medication.
If there were other problems such as a previous heart attack, diabetes or very high cholesterol, a move to medication would likely be advised earlier.
Regardless of whether medication is tried either initially or later, lifestyle changes have a great impact and should be continued.
Lifestyle
Stopping smoking. This is probably the most important, as smoking is such a powerful vascular risk factor (for both heart attack and stroke) and greatly increases the risks associated with high blood pressure.
Diet. The key issue is to have a healthy low fat diet which results in a gradual weight loss. The help of a dietitian should not be underestimated to help with a programme and support to achieve this. A very high proportion (over 50 %) of overweight patients may be able to control blood pressure with weight loss alone. As a general rule of thumb, each pound of weight loss can result in a 1mm Hg reduction of blood pressure. This means many overweight people could avoid the need for medication altogether by achieving a modest weight loss of 10-15 pounds.
Achieving as close to possible a normal weight is highly desirable.
Sodium. Very low salt diets are not very well tolerated, but it is wise to have moderate salt restriction. For example do not add a lot of salt and avoid very salty foods. Most dietary sodium comes from meats (including poultry and fish), grains and dairy foods, so being overly restrictive could have adverse effects on overall nutritional needs and is probably not necessary.
Potassium - in practice this means eating plenty of fruit (aim for five pieces per day and vegetables).
Exercise - regular exercise has been shown to lower blood pressure and will also help with weight loss. If you are not used to exercise, it is best to start gradually and increase slowly. Exercise can be gentle and yet still beneficial - aim for the equivalent of 30-45 minutes per day on most or all days of the week.
It is wise to be evaluated carefully if there are risk factors before undertaking any vigorous programme of exercise, particularly if you are over the age of 40. An exercise test may be advised as a precaution in some cases.
Medication
If blood pressure levels remain elevated despite lifestyle changes, medication may be needed and discussed with your doctor. There is pretty unanimous agreement amongst doctors that drugs should be used if blood pressure is severely elevated e.g. 160/100 at age 20, 160/110 at age 50.
In fact there is good evidence that treating even mild hypertension with medication is beneficial e.g.160/95 at age 50 is effective in reducing complications like stroke.
In patients at greater risk because of other risk factors, medication may be started at relatively lower levels e.g. 140/90.
Such patients may include those with diabetes, previous heart attack or stroke, high cholesterol and heart failure: In such patients, the baseline risk of further problems is much higher, so treatment is relatively more beneficial.
It has been shown that it is beneficial to treat isolated systolic hypertension (e.g.165/85), where only the top level is elevated.
Trials have also confirmed that it is beneficial to treat hypertension in older people as well. In fact it may be particularly beneficial as the risk of problems increases with age.
The aim of medication is to reduce blood pressure with minimal side effects and inconvenience. All medications may take a month or two to exert their full effect, so most doctors will "start low" and "go slow" until the desired blood pressure level is reached.
There are a number of suitable and effective medications for safely lowering blood pressure and reducing the risk of complications.
The most studied over many trials include thiazide diuretics and B-blockers, which have been convincingly shown to reduce complications.
Unless there is a reason not to, most doctors will choose one of these when starting therapy.
Other classes of medications which have been shown to safely and effectively lower blood pressure include ACE inhibitors, calcium channel blockers and alpha blockers.
All these medications have pros and cons and need to be chosen for their potential benefits in a given patient.
Often a second or even occasionally a third medication may be required to achieve adequate control.
