Paralysis

Neck massage by barber may damage nerve, cause paralysis (The Times of

India:20170919)

http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=Neck-massage-by-

barber-may-damage-nerve-cause-19092017001064

A haircut at most barber shops in India is followed by a head massage. It often ends with a

`neck-crack', when the barber holds you by the chin and turns the neck sharply to the left and

right.

Like countless Indian men, Ajay Kumar, 54, came away from the salon feeling refreshed

after the haircutand-massage routine last month. Soon, however, he became increasingly

breathless.

It turned out that the neck crack had damaged his phrenic nerves that control the diaphragm,

which in turn controls breathing. Kumar, a PSU employee, had to be put on mechanical

ventilation. “He has been put on non-invasive ventilation for breathing support and may

continue to be on it,“ said Dr Anand Jaiswal, director of respiratory and sleep medicine at

Medanta ­ The Medicity . Jaiswal said Kumar's dia phragm was paralysed and he may need

ventilator support throughout his life because the nerve rarely regenerates spontaneously .

The doctor also cautioned people against getting a neck massage at saloons.

“The neck massage and neck-crack that barbers ritually perform after a haircut can cause

long-term damage to neck joints and surrounding tissues, muscles or nerves or even cause

bilateral diaphragmatic paralysis like in this case,“ the doctor said.

DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DayTuesday 20170919

Breathlessness is often associated with malfunctioning of the heart or lung.When Kumar

came to Medanta with the problem about a month back, doctors said they conducted a series

of tests to diagnose the problem while treating him for other suspected causes.

When the problem persisted, they looked at medical literature for clues.“While examining

him, we noticed Kumar had a paradoxical breathing pattern.His chest was moving inward

instead of expanding.This abnormal chest movement affected the breathing pattern and led to

a drop in his blood oxygen levels,“ Jaiswal explained.

He added, “As we investigated the possible reasons for the paradoxical breathing, a

neurological examination revealed Kumar was suffering from a damaged phrenic nerve.

Because he had no other existing illness to explain it, and literature had some examples about

neck-crack causing such problem, we questioned Kumar and found that his neck massage had

caused the condition.“

In a typical Indian barber shop, it is not uncommon to find customers such as Kumar who like

to end their haircut with a massage and a customary neck-crack.

People get it done because they find it relaxing and believe a neck massage is a good practice

to keep the neck loose.

Dr Shakir Husain, director, stroke and neurovascular clinic at Neo hospital, said these neck

massages can also lead to dissection of the vertebral artery . “If the dissection or tear is

minor, it heals naturally . Blood thinners have to be given for two to three months.But in

some cases, surgery has to be done to clear the aneurysm caused due to the tear,“ he said.

Damage to the artery during neck manipulation is also seen in patients opting for chiropractic

therapy for musculoskeletal problems.“It may lead to disabling stroke or fatality,“ the senior

neurosurgeon said.

Zero Hunger programme

Zero hunger goal to kick off from Oct 16 (The Times of India:20170919)

http://epaperbeta.timesofindia.com/Article.aspx?eid=31808&articlexml=Zero-hunger-goal-

to-kick-off-from-Oct-19092017012020

Gorakhpur, Koraput, Thane To Be Ground Zero

Three districts --Gorakhpur in Uttar Pradesh, Koraput in Odisha and Thane in Maharashtra-

will see the launch of India's ambitious `Zero Hunger' programme through interventions in

farm sector on October 16 (World Food Day).

Though many more districts will eventually be covered under the programme which will

work in sync with UN mandated Sustainable Development Goals (SDGs) to end hunger by

2030, these three will serve as the model for an integrated approach to deal with hunger and

malnutrition by adopting suitable agriculturalhorticultural practices.

“The programme will ensure suitable methods of measuring the impact of intervention. There

will be intensive training programme in order to identify the nutritional maladies in each

district and the appropriate agriculturalhorticultural and animal husbandry remedies“, said

eminent agriculture scientist M S Swaminathan on Monday while speaking about the plan to

initiate the programme in three districts.

The programme will be initiated by the the Indian Council of Agricultural Research in

association with the Indian Council of Medical Research, the M S Swaminathan Research

Foundation and the Biotechnology Industry Research Assistance Council.

The concerned state governments will also be involved in the programme which consists of

organising farming systems for nutrition, setting up genetic gardens for biofortified

plantscrops and initiation of a `Zero Hunger' training. A genetic garden for biofortified

plantscrops contains the germplasm of naturally biofortified crops or such crops through plant

breeding. It has plants and crops that help supp lement micro-nutrient deficiencies, including

iron, iodine, vitamin A and zinc among others. “It is hoped that such an integrated

programme will help us achieve the zero hunger district goal surely and speedily“, said

Swaminathan who is popularly known as father of `green revolution' in India.

He said, “The `Zero Hunger' programme, planned in Koraput, Thane and Gorakhpur districts,

will focus on agriculture, nutrition and health in a symbiotic manner“.

The programme will be launched in addition to the government's other plans to deal with the

issue of malnutrition through various other initiatives under its goal to make India

malnutrition free by 2022.

Under the UN-approved SDGs, which were adopted by countries including India in 2015, the

government is expected to ensure sustainable food production systems and implement

resilient agricultural practices in the country .

Virtual Reality (The Asian Age:20170919)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=9024464

Dental Health (The Asian Age:20170919)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=9024466

Dengue

Dengue cases hit 2000-mark in city (Hindustan Times:20170919)

http://paper.hindustantimes.com/epaper/viewer.aspx

NEWDELHI: Hospitals across Delhi have reported 2,215 cases of dengue this year till

September 16, of which 1,177 patients are residents of Delhi, according to the weekly report

released by the Municipal Corporations of Delhi. One death due to dengue has been recorded.

The total number of cases recorded this year – including patients coming from neighbouring

– is higher than the number of cases recorded during the same period last year (1,378).

“However, this year, the number of cases in Delhi citizens is much less than the number of

cases the two previous years, when there was an outbreak,” said SM Raheja, in-charge of

Delhi government’s dengue control cell.

“Although last year there were more cases of chikungunya, but if we look at both the

mosquito borne diseases together, the number of patients coming with chikungunya

symptoms is about 50% when compared to the previous year. The number of dengue cases

too has become half when compared to 2016,” said Rommel Tickoo, senior consultant,

internal medicine at Max hospital, Saket.

The dengue symptoms too are milder this year. This may be because of the DENV3 strain of

dengue virus that is in circulation, as compared to the deadlier DENV 2 and 4 strains that

were circulating during 2015, which can cause haemorrhagic fever and shock syndrome.

This year, malaria may be more of a challenge than chikungunya. “The herd immunity

(immunity of a population against a disease) against malaria has gone down as there were

very few cases in the last two or three years,” said a civic body official.

Encephalitis

The encephalitis challenge (The Hindu:20170919)

http://www.thehindu.com/opinion/op-ed/the-encephalitis-challenge/article19710503.ece

There must be consensus among major political parties around vital issues like health

Barely a month before the deaths of children in Gorakhpur in Uttar Pradesh, allegedly due to

the disruption of oxygen supply in the BRD Medical College, the U.P. Health Minister had

addressed a consultation in Lucknow organised by the Observer Research Foundation. He

admitted that U.P.’s health system was in the “ICU”, and said he was trying hard to fix it.

Only the local media reported this. It is a fact that U.P. has a problem: many of the children

who died were being treated for acute encephalitis syndrome (AES), including Japanese

encephalitis (JE).

The BRD Medical College, with around 800 beds, provides tertiary health-care services to

Gorakhpur and adjoining districts. It is the only tertiary hospital within a 300-km radius. On

September 4, 2016, it was reported that 224 children had died of encephalitis in the hospital

that year. This hardly made national news. The shocking fact is that if there was no alleged

disruption of oxygen supply, the national media and policy experts would not be discussing

Gorakhpur now.

Research findings

In U.P., an outbreak of JE has occurred almost every year in four districts between 1978 and

2007, according to research published by the World Health Organisation. Various U.P.

governments have set up special wards and set aside specialist doctors for treating the

disease. Studies show that in Gorakhpur, incidence of JE has declined from 1.9 per 100,000

in 2010 to 0.5 per 100,000 in 2012, whereas the incidence of JE-negative AES, which is

causing a majority of the deaths now, has remained relatively stable over the past five years.

From 2006, the Central government has been conducting vaccination drives in endemic areas

of JE. In 2011, the JE vaccine was included in the universal immunisation programme (UIP).

While an indigenous vaccine was licensed in India in 2013, a Chinese variant was made part

of the UIP because of cost considerations. Under the UIP, two doses of JE vaccine are

administered to children. However, a study published in the Indian Journal of Medical

Research showed that only three out of four children in Gorakhpur had received at least one

dose of JE vaccine. The coverage of the second dose was low. Failure to administer the

vaccine simultaneously with other vaccines was the most common reason for the lack of

coverage and has led to many deaths. To expand coverage, adult JE vaccination was

introduced in 2014 in high-burden districts of U.P.

Mass awareness and door-to-door campaigns in districts severely affected by encephalitis,

about the causes of the disease and ways of prevention, should be a priority. A study specific

to Gorakhpur had suggested a possibility of faecal-oral transmission of the virus by

contaminated drinking water. Sanitation, mosquito control, prevention of open defecation,

and ensuring clean drinking water can help prevent an outbreak.

The State government needs to allot maximum funds to those districts most affected by

encephalitis. More infrastructure is required in Gorakhpur. Perhaps cost-effective PPP models

could also be explored to not just reach out, but also conduct research. Some studies suggest

that scrub typhus may have some role in JE-negative AES deaths in Gorakhpur; this needs to

be looked into. All this has budget implications. Unfortunately, reports indicate that the

Central government released only 68% of budgeted funds for communicable diseases, and an

even smaller percentage was utilised. Shockingly, the spending capacity of the health system

has proven to be a major bottleneck in U.P. Research shows that in 2015-16, U.P. could

spend only 58% of the approved National Rural Health Mission budget.

Encephalitis is a predictable disaster. Its transmission intensifies during the rainy season,

during the pre-harvest period in paddy-cultivating regions, and in flood-prone districts. U.P.

can learn from other States that have a similar risk profile and that have managed to keep

JE/AES mortality in control.

Any substantial developmental goal that India has to achieve needs to be achieved by U.P.

first, given the size of the State. It is important that the ruling party works towards building a

multipartisan consensus around vital issues like health, so that there is policy focus and such

instances of health system paralysis are minimal. Incidents like Gorakhpur are an acute

manifestation of chronic, systemic problems of the health sector, and the responsibility to

improve things at the earliest lies with the government.

Schizophrenia (The Asian Age:20170919)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=9024465

Smoking

Five ways to quit smoking (Medical News Today:20170919)

https://www.medicalnewstoday.com/articles/319460.php

Quitting smoking can be tough, but we have put together some steps that may help you along

the way.

Deciding that you are now ready to quit smoking is only half the battle. Knowing where to

start on your path to becoming smoke-free can help you to take the leap. We have put

together some effective ways for you to stop smoking today.

Tobacco use and exposure to second-hand smoke are responsible for more than 480,000

deaths each year in the United States, according to the American Lung Association.

Most people are aware of the numerous health risks that arise from cigarette smoking and yet,

"tobacco use continues to be the leading cause of preventable death and disease" in the U.S.

Quitting smoking is not a single event that happens on one day; it is a journey. By quitting,

you will improve your health and the quality and duration of your life, as well as the lives of

those around you.

To quit smoking, you not only need to alter your behavior and cope with the withdrawal

symptoms experienced from cutting out nicotine, but you also need to find other ways to

manage your moods.

With the right game plan, you can break free from nicotine addiction and kick the habit for

good. Here are five ways to tackle smoking cessation.

1. Prepare for quit day

Once you have decided to stop smoking, you are ready to set a quit date. Pick a day that is not

too far in the future (so that you do not change your mind), but which gives you enough time

to prepare.

broken cigarette on a calendar

Choose your quit date and prepare to stop smoking altogether on that day.

There are several ways to stop smoking, but ultimately, you need to decide whether you are

going to:

quit abruptly, or continue smoking right up until your quit date and then stop

quit gradually, or reduce your cigarette intake slowly until your quit date and then stop

Research that compared abrupt quitting with reducing smoking found that neither produced

superior quit rates over the other, so choose the method that best suits you.

Here are some tips recommended by the American Cancer Society to help you to prepare for

your quit date:

Tell friends, family, and co-workers about your quit date.

Throw away all cigarettes and ashtrays.

Decide whether you are going to go "cold turkey" or use nicotine replacement therapy (NRT)

or other medicines.

If you plan to attend a stop-smoking group, sign up now.

Stock up on oral substitutes, such as hard candy, sugarless gum, carrot sticks, coffee stirrers,

straws, and toothpicks.

Set up a support system, such as a family member that has successfully quit and is happy to

help you.

Ask friends and family who smoke to not smoke around you.

If you have tried to quit before, think about what worked and what did not.

Daily activities - such as getting up in the morning, finishing a meal, and taking a coffee

break - can often trigger your urge to smoke a cigarette. But breaking the association between

the trigger and smoking is a good way to help you to fight the urge to smoke.

On your quit day:

Do not smoke at all.

Stay busy.

Begin use of your NRT if you have chosen to use one.

Attend a stop-smoking group or follow a self-help plan.

Drink more water and juice.

Drink less or no alcohol.

Avoid individuals who are smoking.

Avoid situations wherein you have a strong urge to smoke.

You will almost certainly feel the urge to smoke many times during your quit day, but it will

pass. The following actions may help you to battle the urge to smoke:

Delay until the craving passes. The urge to smoke often comes and goes within 3 to 5

minutes.

Deep breathe. Breathe in slowly through your nose for a count of three and exhale through

your mouth for a count of three. Visualize your lungs filling with fresh air.

Drink water sip by sip to beat the craving.

Do something else to distract yourself. Perhaps go for a walk.

Remembering the four Ds can often help you to move beyond your urge to light up.

2. Use NRTs

Going cold turkey, or quitting smoking without the help of NRT, medication, or therapy, is a

popular way to give up smoking. However, only around 6 percent of these quit attempts are

successful. It is easy to underestimate how powerful nicotine dependence really is.

nicotine gum in a packet

NRTs can help you to fight the withdrawal symptoms associated with quitting smoking.

NRT can reduce the cravings and withdrawal symptoms you experience that may hinder your

attempt to give up smoking. NRTs are designed to wean your body off cigarettes and supply

you with a controlled dose of nicotine while sparing you from exposure to other chemicals

found in tobacco.

The U.S Food and Drug Administration (FDA) have approved five types of NRT:

skin patches

chewing gum

lozenges

nasal spray (prescription only)

inhaler (prescription only)

If you have decided to go down the NRT route, discuss your dose with a healthcare

professional before you quit smoking. Remember that while you will be more likely to quit

smoking using NRT, the goal is to end your addiction to nicotine altogether, and not just to

quit tobacco.

Contact your healthcare professional if you experience dizziness, weakness, nausea,

vomiting, fast or irregular heartbeat, mouth problems, or skin swelling while using these

products.

3. Consider non-nicotine medications

The FDA have approved two non-nicotine-containing drugs to help smokers quit. These are

bupropion (Zyban) and varenicline (Chantix).

white tablets falling from a container

Bupropion and varenicline are non-nicotine medications that may help to reduce cravings and

withdrawal symptoms.

Talk to your healthcare provider if you feel that you would like to try one of these to help you

to stop smoking, as you will need a prescription.

Bupropion acts on chemicals in the brain that play a role in nicotine craving and reduces

cravings and symptoms of nicotine withdrawal. Bupropion is taken in tablet form for 12

weeks, but if you have successfully quit smoking in that time, you can use it for a further 3 to

6 months to reduce the risk of smoking relapse.

Varenicline interferes with the nicotine receptors in the brain, which results in reducing the

pleasure that you get from tobacco use, and decreases nicotine withdrawal symptoms.

Varenicline is used for 12 weeks, but again, if you have successfully kicked the habit, then

you can use the drug for another 12 weeks to reduce smoking relapse risk.

Risks involved with using these drugs include behavioral changes, depressed mood,

aggression, hostility, and suicidal thoughts or actions.

4. Seek behavioral support

The emotional and physical dependence you have on smoking makes it challenging to stay

away from nicotine after your quit day. To quit, you need to tackle this dependence. Trying

counseling services, self-help materials, and support services can help you to get through this

time. As your physical symptoms get better over time, so will your emotional ones.

group of people at support meeting

Individual counseling or support groups can improve your chances of long-term smoking

cessation.

Combining medication - such as NRT, bupropion, and varenicline - with behavioral support

has been demonstrated to increase the chances of long-term smoking cessation by up to 25

percent.

Behavioral support can range from written information and advice to group therapy or

individual counseling in person, by phone, or online. Self-help materials likely increase quit

rates compared with no support at all, but overall, individual counseling is the most effective

behavioral support method.

The National Cancer Institute (NCI) provide help to anyone who wants to stop smoking

through their support services:

smoking helpline: 1-877-44U-QUIT (1-877-448-7848)

local and state quitlines: 1- 800-QUIT-NOW (1-800-784-8669)

LiveHelp online chat

Smokefree website

SmokefreeTXT text messaging service

Twitter

Facebook

Instagram

Support groups, such as Nicotine Anonymous (NicA), can prove useful too. NicA applies the

12-step process of Alcoholics Anonymous to tobacco addiction. You can find your nearest

NicA group using their website or by calling 1-877-TRY-NICA (1-877-879-6422).

5. Try alternative therapies

Some people find alternative therapies useful to help them to quit smoking, but there is

currently no strong evidence that any of these will improve your chances of becoming smoke-

free, and, in some cases, these methods may actually cause the person to smoke more.

Some alternative methods to help you to stop smoking might include:

man comparing e-cigarette and cigarettes

E-cigarettes have had some promising research results in helping with smoking cessation.

filters

smoking deterrents

electronic cigarettes (e-cigarettes)

tobacco strips and sticks

nicotine drinks, lollipops, straws, and lip balms

hypnosis

acupuncture

magnet therapy

cold laser therapy

herbs and supplements

yoga, mindfulness, and meditation

E-cigarettes

E-cigarettes are not supposed to be sold as a quit smoking aid, but many people who smoke

view them as a method to give up the habit.

E-cigarettes are a hot research topic at the moment. Studies have found that e-cigarettes are

less addictive than cigarettes, that the rise in e-cigarette use has been linked with a significant

increase in smoking cessation, and that established smokers who use e-cigarettes daily are

more likely to quit smoking than people who have not tried e-cigarettes.

How to give up smoking: Ten tips

Here, we provide even more tips on how to successfully quit smoking.

The gains from using e-cigarettes may not be risk-free. Studies have suggested that e-

cigarettes are potentially as harmful as tobacco cigarettes in causing DNA damage and are

linked to an increase in arterial stiffness, blood pressure, and heart rate.

Quitting smoking requires planning and commitment - not luck. Decide on a personal plan to

stop tobacco use and make a commitment to stick to it.

Weigh up all your options and decide whether you are going to join a quit-smoking class, call

a quitline, go to a support meeting, seek online support or self-help guidance, or use NRTs or

medications. A combination of two or more of these methods will improve your chances of

becoming smoke-free.

In addition to trying out these steps, you could check out our selection of the best apps for

quitting smoking.

Alzheimer's disease

Alzheimer's disease: New genetic culprit found (Medical News Today:20170919)

https://www.medicalnewstoday.com/articles/319456.php

The genetic narrative behind Alzheimer's disease may need to be adjusted, according to a

new study.

So far, the consensus among scientists has been that the ApoE4 gene is the main marker of

Alzheimer's disease and many other dementias. But new research adds another key player

into the mix: the so-called TOMM40 gene.

The ApoE gene is instrumental in forming lipoproteins, which are molecules that carry

cholesterol and other fats through our bloodstream.

ApoE has several slightly different versions, and one of them, called e4, has been strongly

associated with the risk of developing Alzheimer's disease.

Moreover, the ApoE4 gene is linked to the buildup of amyloid plaque, which is a clumpy

protein found in the brain tissue of Alzheimer's patients.

These data have led researchers to agree, by and large, that ApoE4 is the main genetic culprit

behind Alzheimer's disease. But a new study published in the journal PLOS ONE reverses

this narrative, suggesting that another gene may be "orchestrating" the cognitive decline

typical of dementia.

The research was conducted by scientists at the University of Southern California (USC) in

Los Angeles, in collaboration with those at the University of Manchester in the United

Kingdom.

The study's first author is Thalida Em Arpawong, a postdoctoral fellow in the USC Dornsife

College of Letters, Arts, and Sciences Department of Psychology. The senior investigator is

Carol A. Prescott, who is a professor of psychology at the USC Dornsife College.

Arpawong summarizes the findings, saying, "Typically, ApoE4 has been considered the

strongest known genetic risk factor for cognitive decline, memory decline, Alzheimer's

disease, or dementia-related onset."

"[But our] study found that a TOMM40 variant was actually more influential than ApoE4 on

the decline in immediate memory - the ability to hold onto new information."

Studying memory and genetics

Prof. Prescott and team set out to examine two kinds of memory ability: immediate and

delayed recall. She explains the difference between these two types of memory, saying, "An

example of immediate recall is someone tells you a series of directions to get somewhere, and

you're able to repeat them back."

"Delayed recall is being able to remember those directions a few minutes later, as you're on

your way," she adds.

Alzheimer's disease: Scientists close in on how it starts and how to stop it

Two new potential drug targets have also been discovered.

The researchers studied how these abilities change over time, together with genetic markers.

Prof. Prescott and her colleagues used the verbal memory test results from two nationally

representative surveys: the United States Health and Retirement Survey (HRS) and the

English Longitudinal Study of Ageing (ELSA).

The former interviewed participants once every 2 years between 1996 and 2012, and the

latter did so between 2002 and 2012.

For the test of immediate recall, the participants were read a list of 10 nouns and were asked

to say them back to the interviewer immediately. But for the delayed recall test, the

interviewer waited 5 minutes before asking participants to repeat the list.

The two memory types were ranked on a scale from 0 to 10. Too large a difference between

the scores from one type of memory and the other may be a sign of Alzheimer's disease or

another dementia.

As Prof. Prescott explains, "You would be more worried about a person who has scores of 10

and 5 than a person with scores of 6 and 4." In these tests, participants scored 5.7 for the

immediate recall and 4.5 for the delayed recall, on average.

To avoid population bias, the researchers focused on participants of European descent. They

also excluded participants who said that they had been diagnosed with "Alzheimer disease,

dementia, senility, or serious memory-related problem."

In total, the researchers examined 20,650 HRS participants and 11,391 ELSA participants, all

aged 50 and above. They adjusted the data for age and sex. Prof. Prescott and colleagues also

examined the genetic data from 7,486 HRS participants and 6,898 ELSA participants.

TOMM40 strongly linked to memory decline

Overall, the scientists examined 1.2 million genetic variations in the human genome, looking

for associations between these gene variations and the results of the memory tests.

Only TOMM40 was found to be strongly associated with a decline in immediate and delayed

recall. The results also showed an association with the "traditional" genetic culprit, ApoE4,

but the link was not as strong.

Additionally, the analysis revealed that the e3 variant of the ApoE gene was also associated

with a low memory score, when found in conjunction with the TOMM40 gene.

These results suggest that TOMM40 may affect memory decline independently of the e4

version of the ApoE gene. "Our findings indicate that TOMM40 plays a larger role,

specifically, in the decline of verbal learning after age 60," say the authors. "Other studies

may noy have detected the effects of TOMM40," adds Prof. Prescott.

"The results from this study provide more evidence that the causes of memory decline are

even more complicated than we thought before, and they raise the question of how many

findings in other studies have been attributed to ApoE4 that may be due to TOMM40 or a

combination of TOMM40 and ApoE4."

Prof. Carol A. Prescott

Further studies, the researchers note, should focus on the link between ApoE3 and TOMM40,

in order to show how their conjugated effect impacts memory and cognitive decline.

Pneumonitis

Pneumonitis: Symptoms, causes, and treatments (Medical News Today:20170919)

https://www.medicalnewstoday.com/articles/319451.php

Pneumonitis is a disorder where a person has an allergic reaction in their lungs caused by

certain inhaled substances. The condition is also referred to as hypersensitivity pneumonitis.

The reaction they have to these substances can cause air sacs in one or both lungs to become

inflamed. If untreated, the condition can cause long-term damage to the lungs. However,

pneumonitis can be completely reversed if action is taken quickly.

In this article, we take a look at the symptoms, causes, and treatments of pneumonitis. We

also examine the differences between the condition and the more familiar pneumonia.

Contents of this article:

Symptoms

Causes

When to see a doctor

Diagnosis

Treatment and self-management

Prevention

The difference between pneumonitis and pneumonia

Outlook

Symptoms

Shirtless male patient coughing while female doctor listens to his breathing using a

stethoscope on his back.

Symptoms of pneumonitis include shortness of breath, rattling sounds in the lungs, and

coughing.

The symptoms of pneumonitis can vary in intensity, frequency, and the areas of the body that

they affect.

The symptoms can include the following:

fevers, chills, and headaches

muscle or joint pain

coughing or a rattling sound in the lungs

shortness of breath

severe weight loss

fatigue

clubbing of fingers or toes

Any fluid filling the lungs can be a deadly complication of pneumonitis if it is not caught

early and treated. So people should look out for any of these symptoms if they suspect

someone might be suffering from pneumonitis.

Certain complications of pneumonitis or severe flares of symptoms in the lungs can cause

respiratory issues. Tissue in the lungs can become scarred, which may stop the lungs from

working properly. Furthermore, the amount of oxygen reaching the bloodstream may also be

reduced.

If left untreated, pneumonitis can be life-threatening, as it makes it harder for the heart to

pump blood through the lungs.

Pneumonia: Symptoms, causes, and treatments

Causes

Pneumonitis tends to occur when an irritating substance of any kind is introduced to the

lungs. When this happens, tiny air sacs in the lungs become inflamed, making it difficult to

breathe and causing other symptoms.

In most cases, the irritants that cause pneumonitis in the first place are never identified.

Lifestyle factors, such as occupation, location, gender, and age can all contribute to the risk

of pneumonitis. Someone who works with harsh chemicals or irritants is more likely to

develop pneumonitis than others, for example.

The causes behind pneumonitis vary and can include:

molds and bacteria

radiation treatment, usually when targeting the chest area

drugs and antibiotics, including some used in chemotherapy or to control the heartbeat

exposure to birds, bird feathers, or excrement

Risk factors

Woman holding a cigarette.

Smoking may increase the risk of developing pneumonitis as well as many other lung

conditions.

Pneumonitis has many risk factors associated with it.

Due to the ease with which it can develop, pneumonitis is often linked to some specific risk

factors. These vary but largely come down to the location and living conditions of an

individual.

A person who works with birds for a living, or someone who deals with harsh chemicals, can

be more at risk than someone who works in an office, for example.

Risk factors include:

lifestyle habits, such as smoking

genetics

age, as it usually affects those between 50-55 years of age

environment and job, such as working around irritants or large public crowds

sex, as the condition may be slightly more common in women than men

bird-handling

hot tubs and humidifiers

certain cancer treatments

When to see a doctor

Someone should go and see their doctor, as soon as any symptoms worsen or become severe.

In particular, any flu-like symptoms or signs of water in the lungs should be referred to a

doctor immediately.

If the factors that are causing the pneumonitis symptoms cannot be removed, adjusted or

avoided, a doctor should also be seen for different treatment options.

As explained early, pneumonitis can cause permanent damage to the lungs if it is not treated

early. As a result, it is best to see a doctor before symptoms become severe or impossible to

treat with self-care.

Diagnosis

Pneumonitis causes similar symptoms to many other lung conditions. As such, it may take

several tests before a definitive diagnosis is made, as the doctor will need to rule out these

other possibilities first.

A doctor will try to establish if the person has come into contact with any of the substances

that can cause pneumonitis. To do so, they will begin by taking a medical history and

carrying out a physical exam.

The doctor may also request checks, including:

blood tests to evaluate the levels of white blood cells in the body

CT or computed tomography scans or X-rays to test for fluid or inflammation in the lungs

a spirometry to see how well the lungs are able to breathe in and out

an oximetry to test how much oxygen is in the bloodstream

bronchoalveolar lavage where fluid is collected from the lungs and tested for white blood

cells

lung biopsies to check the tissue in the lungs for any changes that indicate pneumonitis

To examine the lungs and collect samples of tissue or fluid, a doctor may use a device called

a bronchoscopy. This thin, flexible tube can be passed down the throat into the lungs. It has a

light and a camera attached to it, allowing the user to look inside the lungs.

Treatment and self-management

Woman wearing a pollution mask over her mouth on seafront.

Measures to prevent pneumonitis include removing or avoiding the source of irritation, and

wearing a face mask that covers the mouth and nose.

In most cases, a doctor will recommend removing the irritant that caused or is causing the

pneumonitis so a person is no longer exposed to the contaminant.

Avoiding the irritant is often enough to prevent the pneumonitis from reoccurring or getting

worse. This may not always be possible, however, especially if the case is related to

chemotherapy or radiation treatments.

To help manage the risk of developing pneumonitis, it is important to take preventive

measures when dealing with irritants. This can include wearing a face mask when dealing

with birds, bacteria, or mold of any kind, and avoiding chemical irritants, as much as

possible.

In more severe cases of pneumonitis, a doctor might prescribe corticosteroids. These drugs

work by reducing inflammation in the lungs by weakening the immune system. However,

weakening the immune system leaves a person at risk of developing infections or brittle

bones, so corticosteroids can be dangerous.

Doctors might also offer oxygen therapy with an oxygen mask if someone is finding it

difficult to breathe. While some people only need oxygen therapy when they sleep, others

may need it constantly if their case is severe.

Prevention

Unlike pneumonia, where several preventative vaccinations are available, pneumonitis is

largely prevented by avoiding the irritants that can cause the condition.

Routine checking that heating, air-conditioning, and ventilation units are clean and working

properly may help prevent airborne irritants from causing pneumonitis.

People should always be aware of any allergies they might have, and the possible allergens

that can be found in areas they visit frequently. Any areas where allergens could be found

should be avoided or visited with caution.

Pneumonitis vs. pneumonia

Pneumonitis is a general term that describes inflammation in the lungs.

When it is noninfectious inflammation, doctors will refer to the problem as pneumonitis.

Pneumonia is a kind of pneumonitis as it causes inflammation. However, pneumonia is

caused by an infection by bacteria, a fungus or viruses.

As a result, pneumonia can be spread from person to person while pneumonitis cannot.

Outlook

Pneumonitis can lead to severe complications if it is not treated, so people should be aware of

the symptoms.

Fortunately, someone should be able to prevent the condition if they are aware of what

substances could cause them to have an allergic reaction

If anyone is experiencing the symptoms of pneumonitis and notices them getting worse at any

point, they should contact their doctor.

Lung Cancer

Lung cancer and cough: What is the connection? (Medical News Today:20170919)

https://www.medicalnewstoday.com/articles/319449.php

Everyone has experienced a nagging cough after a cold or needed to cough while in a quiet

room.

Despite these problems, coughing actually serves a very valuable and useful purpose.

Coughing is a protective action, helping the lungs clear out potential germs or harmful

objects.

Sometimes, however, that cough is not linked to a cold or infection and can linger for weeks

to months at a time. This may lead people to wonder or worry that their cough is a sign of

something more serious, such as lung cancer.

This article takes a look at the connection between coughing and lung cancer, including when

someone should see a doctor.

Contents of this article:

Coughing and lung cancer

Lung cancer symptoms

Causes of coughing

When to see a doctor

Treatment options

Outlook

Coughing and lung cancer

A cough associated with lung cancer may be either dry or wet.

Not every cough signifies the presence of lung cancer. However, many people do complain of

a chronic cough or a "cough that just won't go away" at the time of their diagnosis.

If a cough is associated with other symptoms, such as those in the list below, it warrants a trip

to the doctor to get checked out:

coughing up blood or rust-colored phlegm

shortness of breath

chest pain

A cough that is associated with lung cancer can be either dry or wet. It can occur at any time,

and even be so severe that it interferes with sleep at night.

Lung cancer symptoms

There are many symptoms other than persistent or worsening coughing that are associated

with lung cancer. Some of these symptoms include:

ongoing chest pain

coughing up blood

shortness of breath

wheezing or hoarseness of the voice

problems swallowing

loss of appetite

losing weight

fatigue and tiredness

frequent lung infections, such as pneumonia or bronchitis

Stages of lung cancer: Symptoms, changes, and outlook

What are the different stages of lung cancer? Learn about their signs and symptoms here.

Causes of coughing

Man in field of yellow flowers coughing and blowing his nose.

Allergies such as hay fever may cause short-term coughing. A long-term cough that does not

clear up a few weeks, or that gets worse, may have a more serious cause.

There are many reasons why someone might be coughing. A short-term cough can be caused

by:

an infection, such as a cold, pneumonia, or bronchitis

an allergy, such as hay fever

inhaled dust, smoke, or debris

a long-term respiratory condition, such as asthma or COPD

Sometimes, a short-term cough can develop into a chronic or a persistent cough. When this

happens, it may be caused by one of the following factors:

Long-term respiratory infection, such as chronic bronchitis or pneumonia.

Asthma, which causes shortness of breath, tightening of the chest, and wheezing.

Allergies, such as hay fever.

Smoking. Chronic coughing in a smoker is also known as a "smoker's cough" and is the result

of smoke and other debris irritating the airways.

Bronchiectasis, which is a widening of the airways in the lungs.

Postnasal drip, which is mucus dripping down the throat and triggering a cough. This is

usually associated with a cold or allergy.

Gastroesophageal reflux disease (GERD), where stomach acid flows back into the food pipe.

The throat gets irritated by the acid and triggers a cough.

Medications, such as ACE inhibitors, which are used to treat high blood pressure and heart

disease.

When to see a doctor

Most coughs clear up within a few days to a few weeks.

It is important to see the doctor if the cough is persistent or occurs along with other

symptoms, such as coughing up blood or chest pain.

Seeing a doctor promptly can help to determine the cause of a cough and ensure that nothing

more serious is going on.

Diagnosis

Firstly, the doctor will take a thorough medical history and perform a physical exam. In

addition to asking about family and personal medical history, the doctor will ask about the

history of coughing, shortness of breath, and other symptoms.

During the physical exam, the doctor will listen to the heart and lungs, and look for other

potential causes of the coughing, such as signs of an infection or postnasal drip.

Depending on the findings from the history and physical, the doctor may order additional

testing. This may include imaging tests, such as:

a chest X-ray

CAT scan

PET scan

MRI

If lung cancer is suspected based on these results, the doctor will likely want to take a biopsy

of the suspicious cells. A doctor can do this by passing a needle into the lung tissue through

the skin.

Another way is by bronchoscopy, where a small tube is inserted down the nose and into the

lungs. A small sample is removed through the tube and analyzed.

A specialist called a pathologist will look at the cell samples under the microscope to

determine if there is cancer. If cancer is present, they will also work out the type, and how far

it has advanced.

If lung cancer is diagnosed, the doctor may want to order additional testing to see if it has

spread beyond the lungs.

Researchers have also found some genetic markers that can impact how a cancer behaves.

This includes whether it is aggressive or spreads quickly, or is responsive to certain

hormones.

Some doctors will order genetic testing to look for these genetic markers. Positive results can

sometimes help with making treatment decisions, as there are new medications that can be

more effective than traditional therapies.

Treatment options

Senior mans hand in chair as he receives chemotherapy.

Chemotherapy is a common treatment option for lung cancer, although complete removal of

the tumor is usually preferable.

The best treatment for lung cancer is complete removal of the tumor and unhealthy cells

surrounding it.

Removal is usually only an option when the growth is small and contained, or has only

spread to the nearby tissues.

Radiation or chemotherapy is sometimes also given to ensure that all of the cancerous cells

have been removed or destroyed.

Once a tumor has spread significantly, it may no longer be removable or curable. The doctor

may recommend radiation or palliative care to prevent further complications and treat

symptoms.

New targeted therapies may be more successful in certain groups of people or with particular

types of cancers. These include female non-smokers or carriers of certain genetic markers.

The doctor can help work out whether someone may benefit from these types of treatments.

Outlook

The outlook for someone diagnosed with lung cancer depends on the stage of the cancer

when it is diagnosed.

In general, someone with a small cancer that has not spread to other parts of the body has a

much better outlook than someone who has an aggressive form of cancer that has spread.

Early diagnosis and treatment are very important in increasing the odds of surviving lung

cancer. There is no screening test, which can make early detection more difficult.

The best way to prevent lung cancer is to live a healthful lifestyle and avoid cigarette smoke

whenever possible. In addition to not smoking, or quitting smoking, avoiding secondhand

smoke is essential.

Someone with a high risk of developing lung cancer, based on either family history or history

of smoking, should discuss any unusual symptoms with their doctor as soon as possible.

These symptoms include a persistent cough that occurs with chest pain, shortness of breath,

or blood.

Vaccine (Dainik Jagran:20170919)

http://epaper.jagran.com/ePaperArticle/19-sep-2017-edition-National-page_14-2329-20988-

262.html

Cancer (Hindustan:20170919)

http://epaper.livehindustan.com/story.aspx?id=2217911&boxid=60103794&ed_date=2017-

09-19&ed_code=1&ed_page=2

Malnutrition (Hindustan:20170919)

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09-19&ed_code=1&ed_page=2