India, Russia, China, SA at greater risk of TB

India, China, Russia and South Africa are at an increasiong risk of a tuberculosis crisis if the killer strain of drug resistant bacterias are not controlled, a senior World Health Organization officer has said.

All the four countries are fast developing and have a high percentage of impoverished population with poor hygeine and health care.

Mario Raviglione, who heads WHO’s Stop TB department said, "Scenarios of apocalyptic nature are not, let's say, likely, but they might happen. They are not... impossible."

"Globally speaking about 96 percent of all TB cases are still treatable with the four drugs that we use in the standard regimen, 4 percent are multi-drug resistant ... but the worst case scenario is when this 4 percent becomes 50, 60, 70, 80 pe cent," he said on the sidelines of a TB Conference in Cape Town, South Africa.

He said a new strain of multi drug resistant TB bacteria—MDR-TB and XDR-TB—are immune to all types of present anti-TB drugs and it’s high time strong measures are taken to control the spread of the bacteria. Older types of disease causing bacterias can still be controlled with the available drugs, however, it is the newer types of bacterias for which a new type of drug has to be developed.

Raviglione said some countries in the Commonwealth of Independent States or former Soviet Union have shown an MDR-TB incidence of up to 20 pe cent, while some European states showed resistance to all second-line TB .

He said Russia, China, India and South Africa were the four countries worst-hit with MDR-TB and XDR-TB, accounting for up to 60 per cent of the world's cases.

What has caused panic among health workers is that in some countries, TB patients were also carriers of HIV and this makes the task of treating them absolutely difficult. "The XDR epidemic has simply exposed the limitations of the current tools used to control TB. New diagnostics and hopefully a new vaccine are fundamental items that we have to push through as a global community," Raviglione said

Source : Biospectrumasia

'Early detection of cancer can save your life' by Jeannie Mulford

Original article from http://www.rediff.com/news/2007/oct/26spec.htm

Not everyone is as fortunate as David and I were 28 years ago -- to walk down the aisle of an airplane, glance to my left, take one look at each other and know that in an instant we had found each other after lifetimes of searching. My sister would later say it was the greatest case of destiny she had ever heard of, that we were two stars traveling through time who collided that day and found each other somewhere in the skies between Portland, Oregon, and Chicago, Illinois.
Little did I know that morning when I awakened that that would happen, and little did I know that 26 years later, after 55 years of being blessed with near perfect good health, I would return to the United States from our home in India to have a routine annual mammogram and learn that I had breast cancer. That was two and a half years ago, and the very best part of the journey through those years is what I have learned.
I thought I was afraid of cancer. I learned that I was not.
I learned something I already knew, that David would be my pillar of strength and love.
I actually thought my long hair was important (I had not had short hair since I was eight years old.)
What I learned was that for Lance Armstrong, who went on after brain and testicular cancer to win the Tour de France, it was not about the bike -- and that, certainly, for me was not about the hair.
I learned that we are not always given in life the opportunity to be courageous and strong, and I saw this as my opportunity.
I chose to have a double mastectomy so that I could avoid a possible reoccurrence, begin chemotherapy more quickly, and I would not need radiation. I learned how successful breast reconstruction can be, and I wish more women could know this as well. I feel it would give them comfort when faced with certain outcomes of breast cancer.
During many of the most difficult times, I would actually say to myself: 'How could I possibly be feeling so well, so strong?' I learned that the answer always was that someone somewhere would be thinking of me, saying a prayer, asking the Ambassador how I was doing, lighting a candle, giving him a wave across the parking lot or namaste across the garden -- all of which let him know they were thinking of me.
Every card, e-mail, flower sent, phone call, every word of encouragement, every small kind gesture -- not one went unnoticed, every single gesture was received and appreciated and will be remembered.
I would tell my sisters, my two guardian angels who looked after me when David needed to return to the Embassy in India, that I would suddenly have the feeling of being elevated, somehow lifted by the goodwill, the prayers and thoughts of others and carried through the most difficult times.
At the very beginning of the process I resolved not to spend even one moment thinking a sad thought.
I learned that I could change in an instant a negative thought into a positive thought.
I learned that early detection of cancer can save your life and I encourage all of you, women and men alike, to do your annual exams, learn the early warning signs of some cancers, do self-examination, take the time from your busy schedule, save the money for tests if you must pay yourself, spend it on something that can and will save your life. However unpleasant you think the test is, it is nothing compared to what you could go through if you put if off.
A month after breast surgery I learned that I needed to have open-heart surgery to correct an anomaly that might have interfered with my chemotherapy. I learned that because I had such a squeaky clean heart and had never smoked that I could walk two 14-minute miles a day, only six days after surgery. Two weeks after heart surgery, I was in Washington for the White House State Dinner for Prime Minister Manmohan Singh.
My captive audience of doctors and nurses in Cleveland and New York gave me the chance to tell them of my life here in India and what I have learned that I wish so many more Americans and people worldwide could know, that our Embassy is filled with hard-working, talented, wonderful people, both Americans and Indians working side-by-side on so many fronts of endeavour to improve mankind and our important friendship with this remarkable country.
Four weeks after finishing the chemotherapy on my 56th birthday, I returned to India to welcome the President of the United States George Bush and Mrs Laura Bush to India for their historic visit wearing my wig, and considering myself the most grateful person in the world to be feeling so well and to be back in India.
When David and I sat down to discuss our plan for dealing with my breast cancer, I initially said, 'I am going to do whatever it takes to overcome this and we are not going to tell anyone except my family.' I remember David looking sympathetically but incredulously at me and saying, 'In our present circumstances in India, how do you suggest we do that?'
I understood immediately that it could not be kept a secret. I learned since then that it should not. What I learned was that if I could speak openly about breast cancer, as I have done so today, and if only one woman is moved to have an exam that exposes breast cancer in an early, treatable stage that saves her life, it will have been worth every minute of the journey for me.
(The writer is the wife of the US Ambassador to India David C Mulford. She spoke at a US Embassy briefing to mark the International Breast Cancer Awareness Month on Thursday, October 25, 2007 in New Delhi)

Fever – Fact Sheet

Fever (also known as pyrexia, or a febrile response from the Latin word febris, meaning fever, and archaically known as ague) is a frequent medical symptom that describes an increase in internal body temperature to levels that are above normal (the common oral measurement of normal human body temperature is 36.8±0.7 °C or 98.2±1.3 °F). Fever is most accurately characterized as a temporary elevation in the body’s thermoregulatory set-point, usually by about 1-2°C. Fever differs from hyperthermia, which is an increase in body temperature over the body’s thermoregulatory set-point (due to excessive heat production or insufficient thermoregulation, or both). Carl Wunderlich discovered that fever is not a disease but a symptom of disease.

The elevation in thermoregulatory set-point means that the previous "normal body temperature" is considered hypothermic, and effector mechanisms kick in. The person who is developing the fever has a cold sensation, and an increase in heart rate, muscle tone and shivering attempt to counteract the perceived hypothermia, thereby reaching the new thermoregulatory set-point.

When a patient has or is suspected of having a fever, that person's body temperature is measured using thermometer. At a first glance, fever is present if:

Ø temperature in the anus (rectum/rectal) or in the ear (otic) is at, or higher than 38 degrees Celsius (100.4 degrees Fahrenheit)

Ø oral temperature (in the mouth) is at, or higher than 37.5 degrees Celsius (99.5 degrees Fahrenheit)

Ø axillary temperature (underarm) is at, or higher than 37.2 degrees Celsius (99 degrees Fahrenheit)

However, there are many variations in normal body temperature, and this needs to be considered when measuring fever. The values given are for an otherwise healthy, non-fasting adult, dressed comfortably, indoors, in a room that is kept at a normal room temperature, during the morning, but not shortly after arising from sleep. Furthermore, for oral temperatures, the subject must not have eaten, drunk, or smoked anything in at least the previous fifteen minutes.

Body temperature normally fluctuates over the day, with the lowest levels at 4A.M. and the highest at 6P.M. Therefore, an oral temperature of 37.5C would strictly be a fever in the morning, but not in the afternoon. Normal body temperature may differ as much as 0.4C (0.7F) between individuals or from day to day. In women, temperature differs at various points in the menstrual cycle, and this can be used for family planning (although it is only one of the variables of temperature). Temperature is increased after meals, and psychological factors (like the first day in the hospital) also influence body temperature.

There are different locations where temperature can be measured, and these differ in temperature variability. Tympanic membrane thermometers measure radiant heat energy from the tympanic membrane (infrared). These may be very convenient, but may also show more variability.

Children develop higher temperatures with activities like playing, but this is not fever because their set-point is normal. Elderly patients may have a decreased ability to generate body heat during a fever, so even a low-grade fever can have serious underlying causes in geriatrics.

Mechanism

Temperature is regulated in the hypothalamus, in response to PGE2. PGE2 release, in turn, comes from a trigger, a pyrogen. The hypothalamus generates a response back to the rest of the body, making it increase the temperature set-point.

Pyrogens

Substances that induce fever are called pyrogens. These are both internal or endogenous, and external or exogenous, such as the bacterial substance LPS.

Endogenous

The cytokines (such as interleukin 1) are a part of the innate immune system, produced by phagocytic cells, and cause the increase in the thermoregulatory set-point in the hypothalamus. Other examples of endogenous pyrogens are interleukin 6 (IL-6), and the tumor necrosis factor-alpha.

These cytokine factors are released into general circulation where they migrate to the circumventricular organs of the brain, where the blood-brain barrier is reduced. The cytokine factors bind with endothelial receptors on vessel walls, or interact with local microglial cells. When these cytokine factors bind, they activate the arachidonic acid pathway.

Exogenous

One model for the mechanism of fever caused by exogenous pyrogens includes lipopolysaccharide (LPS), which is a cell wall component of gram-negative bacteria. An immunological protein called Lipopolysaccharide-Binding Protein (LBP) binds to LPS. The LBP-LPS complex then binds to the CD14 receptor of a nearby macrophage. This binding results in the synthesis and release of various endogenous cytokine factors, such as interleukin 1 (IL-1), interleukin 6 (IL-6), and the tumor necrosis factor-alpha. In other words, exogenous factors cause release of endogenous factors, which, in turn, activate the arachidonic acid pathway.

PGE2 release

PGE2 release comes from the arachidonic acid pathway. This pathway (as it relates to fever), is mediated by the enzymes phospholipase A2 (PLA2), cyclooxygenase-2 (COX-2), and prostaglandin E2 synthase. These enzymes ultimately mediate the synthesis and release of PGE2.

PGE2 is the ultimate mediator of the febrile response. The set-point temperature of the body will remain elevated until PGE2 is no longer present. PGE2 acts on neurons in the preoptic area (POA) through the EP3 subtype of PGE receptors and the EP3-expressing neurons in the POA innervate the dorsomedial hypothalamus (DMH), the rostral raphe pallidus nucleus in the medulla oblongata (rRPa) and the paraventricular nucleus of the hypothalamus (PVN). Fever signals sent to the DMH and rRPa lead to stimulation of the sympathetic output system, which evokes non-shivering thermogenesis to produce body heat and skin vasoconstriction to decrease heat loss from the body surface. It is presumed that the innervation from the POA to the PVN mediates the neuroendocrine effects of fever through the pathway involving pituitary gland and various endocrine organs.

Hypothalamus response

The brain ultimately orchestrates heat effector mechanisms. These may be

Ø increased heat production by increased muscle tone, shivering and hormones like epinephrine.

Ø prevention of heat loss, such as vasoconstriction.

The autonomic nervous system may also activate brown adipose tissue to produce heat (=non-exercise associated thermogenesis, also known as non-shivering thermogenesis), but this seems mostly important for babies. Increased heart rate and vasoconstriction contribute to increased blood pressure in fever.

Types

Pyrexia (fever) can be classed as

Ø low grade: 38 - 39 °C (100.4 - 102.2 °F)

Ø moderate: 39 - 40 °C (102.2 - 104 °F)

Ø high-grade: > 40 °C (> 104 °F)

Ø Hyperpyrexia: > 42 °C (> 107.6 °F)

The last is clearly a medical emergency because it approaches the upper limit compatible with human life.

Most of the time, fever types can not be used to find the underlying cause. However, there are specific fever patterns that may occasionally hint the diagnosis:

Ø Pel-Ebstein fever is a specific kind of fever associated with Hodgkin's lymphoma, being high for one week and low for the next week and so on. However, there is some debate whether this pattern truly exists.

Ø Continuous fever: temperature remains above normal throughout the day and does not fluctuate more than 1 degree C in 24 hours. Eg: lobar pneumonia, typhoid, urinary tract infection, brucellosis, typhus, etc. Typhoid fever may show a specific fever pattern, with a slow stepwise increase and a high plateau.

Ø Intermittent fever: temperature is present only for some hours of the day and becomes normal for remaining hours.Eg: malaria, kala-azar, pyaemia, septicemia etc In malaria, there may be a fever with a periodicity of 24 hours (quotidian) 48 hours (tertian fever) or 72 hours (quartan fever, indicating Plasmodium vivax). These patterns may be less clear in travelers.

Ø Remittent fever: temperature remains above normal throughout the day and fluctuates more than 1 degree C in 24 hours.Eg: infective endocarditis etc

Febricula is a mild fever of short duration, of indefinite origin, and without any distinctive pathology.

Causes

Fever is a common symptom of many medical conditions:

Ø infectious disease, e.g. influenza, common cold, HIV, malaria, infectious mononucleosis, gastroenteritis, etc..

Ø Various skin inflammations such as boils, pimples, acne, abscess, etc.

Ø Immunological diseases like lupus erythematosus, sarcoidosis, inflammatory bowel diseases, etc..

Ø Tissue destruction, which can occur in hemolysis, surgery, infarction, crush syndrome, rhabdomyolysis, cerebral hemorrhage, etc..

Ø Drug fever

1. directly caused by the drug (e.g. lamictal, progesterone, chemotherapeutics causing tumor necrosis)

2. as an adverse reaction to drugs (e.g. antibiotics, sulfa drugs, etc.)

3. after drug discontinuation, like with heroin withdrawal

Ø Cancers such as Hodgkin disease (with Pel-Ebstein fever)

Ø Metabolic disorders like gout, porphyria, etc..

Ø Thrombo-embolic processes (i.e. pulmonary embolism, deep venous thrombosis)

Persistent fever which cannot be explained after repeated routine clinical inquiries, is called fever of unknown origin.

Usefulness of fever

There are arguments for and against the usefulness of fever, and the issue is controversial. There are studies using warm-blooded vertebrates and humans in vivo, with some suggesting that they recover more rapidly from infections or critical illness due to fever.

Theoretically, fever has been conserved during evolution because of its advantage for host defense. There are certainly some important immunological reactions that are sped up by temperature, and some pathogens with strict temperature preferences could be hindered. The overall conclusion seems to be that both aggressive treatment of fever and too little fever control can be detrimental. This depends on the clinical situation, so careful assessment is needed.

Fevers may be useful to some extent since they allow the body to reach high temperatures. This causes an unbearable environment for some pathogens. White blood cells also rapidly proliferate due to the suitable environment and can also help fight off the harmful pathogens and microbes that invaded the body.

Treatment

Fever should not necessarily be treated. Fever is an important signal that there's something wrong in the body, and it can be used for follow-up. Moreover, not all fevers are of infectious origin.

Even when treatment is not indicated, however, febrile patients are generally advised to keep themselves adequately hydrated, as the dehydration produced by a mild fever can be more dangerous than the fever itself. Water is generally used for this purpose, but there is always a small risk of hyponatremia if the patient drinks too much water. For this reason, some patients drink sports drinks or products designed specifically for this purpose.

Most people take medication against fever because the symptoms cause discomfort. Fever increases heart rate and metabolism, thus potentially putting an additional strain on elderly patients, patients with heart disease, etc. This may even cause delirium. Therefore, potential benefits must be weighed against risks in these patients. In any case, fever must be brought under control in instances when fever escalates to hyperpyrexia and tissue damage is imminent.

Treatment of fever should be based primarily on lowering the setpoint, but facilitating heat loss may also contribute. The former is accomplished with antipyretics. Wet cloth or pads are also used for treatment, and applied to the forehead. Heat loss may be an effect of (possibly a combination of) heat conduction, convection, radiation or evaporation (sweating, perspiration). This may be particularly important in babies, where drugs should be avoided. However, if water that is too cold is used, it induces vasoconstriction and prevents adequate heat loss.

New Diseases Arise as Environments Destroyed, Says UN

Changes to the environment that are sweeping the planet are bringing about a rise in infectious diseases, the United Nations Environment Program (UNEP) has warned.

Loss of forests; the building of roads and dams; urban growth; the clearing of natural habitats for agriculture; mining; and pollution of coastal waters are promoting conditions under which new and old pathogens can thrive, according to research published today in UNEP's Global Environment Outlook Year Book for 2004/2005.

Ailments previously unknown in human beings are appearing, such as the Nipah virus, which until recently was found normally in Asian fruit bats, according to the report.

Nipah's emergence in the late 1990s as an often fatal disease in humans has been linked to a combination of forest fires in Sumatra and the clearance of natural forests in Malaysia for palm plantations. In searching for fruit, bats were forced into closer contact with domestic pigs, giving the virus its chance to spread to humans.

Climate change in particular may aggravate the threats of infectious diseases in three ways, the report suggests. First, by increasing the temperatures under which many diseases and their carriers flourish.

Second, by further stressing and altering habitats. For example, the geographic range and seasonality of two of the world's most serious mosquito-borne infections, malaria and dengue fever, are very sensitive to changes in climate. Also, Neissseria meningitidis, a common cause of meningitis, can be spread many miles in the dusty conditions that occur following prolonged drought in the Sahel.

Third, climate change may increase the number of environmental refugees who are forced to migrate to other communities, or even countries. This in turn will also favor the spread of diseases from one location to another. Overall, it seems that intact habitats and landscapes tend to keep infectious agents in check.

The issue of environmental degradation and a rise of many new and old infectious diseases is a complex, sometimes subtle one that is causing increasing concern among scientists and disease specialists.

Many scientists are now convinced that ecological disruption, dramatic environmental change, and poor handling of human and animal wastes are playing an important part in the spread of diseases such as malaria, bilharzia, Japanese encephalitis, and dengue haemorrhagic fever.

The report is based on research by some of the leading specialists. They include Tony McMichael of the Australian National University, Bernard Goldstein of the University of Pittsburgh and Jonathan Patz of the University of Wisconsin

Source : http://www.commondreams.org/headlines05/0222-02.htm

CEREBRAL PALSY

This article comes here because I read an article which had been forwarded by my friend; it shows the some photos of a man attacked by Cerebral Palsy. So let us know the thing.

What is CEREBRAL PALSY

Cerebral Palsy is often referred to as CP. Damage to the muscles or nerves does not cause cerebral palsy, but damage to the motor area or improper development in the brain does. Development of the brain starts during pregnancy and continues till the age of three. When the brain is damaged or hurt during pregnancy, during birth or after birth of the baby, then cerebral palsy may result. We all know that the brain controls all our actions and hence the movements of the muscles. If the brain is injured or not properly developed, the messages which allow the child to walk, talk, stand, and sit are not properly conveyed and the child experiences difficulty in movement. Hence, the conditions could range from very slight awkwardness in movement or muscle control to total loss of muscle control. The muscles that are affected could be confined to one side of the body or the entire body. Muscles become stiff (spasticity) and reflex movements are absolutely uncontrolled. Unfortunately, the damage is permanent. There is no cure as such for cerebral palsy but Therapy and training can help the child to lead a better life. It is not a disease in the strict sense of the word and hence is not contagious or hereditary in nature. Although C.P. is a non-progressive condition ---that is the damage to the brain does not worsen with the passage of time, the effects of cerebral palsy may change. Body movement and muscle coordination may deteriorate with the aging process or in some cases the condition may actually improve. Cerebral Palsy need not necessarily incapacitate the child entirely. Since the learning and thinking centers are controlled by a different part of the brain, loss of motor control is not necessarily accompanied by a loss in thinking or the ability to learn. In fact many children with cerebral palsy have average intelligence. Depending on which areas of the brain have been damaged, the child will encounter muscle spasms, involuntary movement, difficulty with walking and running (gross motor skills), difficulty with writing (fine motor skills) or experience difficulty in perception and sensation and may have difficulty even in swallowing. Unfortunately the effects of cerebral palsy may bring along with it other associated problems which may lead to difficulties in feeding, developmental delay and seizures which are more difficult to handle. Spastic hemiplegia is said to occur when one side is affected---either the right or left side. In spastic quadriplegia all four limbs are affected and in paraplegia only the legs are affected. Children with cerebral palsy need special education from special schools, which focus on speech therapy, improvement of motor skills, and more importantly cater to their individual needs because no two children suffering from CP are alike. Symptoms of cerebral palsy Indications of cerebral palsy are often noticed first by the parents. These symptoms manifest usually before the child is 18 months old, but if it is a severe case of cerebral palsy, indications are visible even before three months. Motor skills may be affected to the extent that the common "developmental milestones" like sitting, crawling, rolling over, smiling and walking are all delayed. Some children are impassive; others do not react to noises while some children experience difficulty in following the movement of objects. Irregular breathing, difficulty in sucking and feeding and limited range of motion is also evident. A few children are mentally retarded while some have superior intellect. Because there is no control of the muscles in the throat and mouth, there could be an abnormality in speech. As the motor areas are most likely to be affected, even swallowing saliva could be very difficult. When swallowing is affected, eating is a problem and the risk of inhaling liquids into the lungs is great. Behavioral, learning and reading problems are also triggered off by cerebral palsy and the situation could become really difficult. Children tend to throw more tantrums than usual and could become violent and difficult to control. While motor movements are affected there could also be a loss in muscle tone. Hypotonia refers to loose and flaccid muscles while hypertonia refers to muscles that tend to become stiff and rigid. In both conditions, the muscles cannot be used optimally. Sometimes it is very hard to detect CP. The muscles on one side only may function so well that the defect on the other side goes unnoticed for a very long time. Walking on the toes could also be indicative of CP. Uncoordinated and uncontrolled jerky motions of limbs, clenched fists; unusual postures may also be seen. Changing from one position to another is also difficult for the child. In some cases, muscle tone is affected to such an extent that the feet are turned inwards while walking. Since the limbs cross at the knees, the gait is often referred to as "scissors gait". It is often found that the limbs are shorter on one side and non-intervention could lead to curvature of the spine itself. Difference in muscle tone on both sides could lead to unequal pressures on joints, which could later stiffen. Most children with cerebral palsy experience seizures, but these seizures are not evident because of so many other abnormalities. Defects in tooth enamel and an inability to brush their teeth properly make the children with cerebral palsy prone to dental cavities. Thus children suffering from cerebral palsy could have different symptoms. On an average it is seen that no two children experience the same symptoms. There is no cure for cerebral palsy, but with early detection of CP, it can be made more manageable. Causes of cerebral palsy As cerebral palsy is a consequence of damage to a developing brain, it can occur anytime during pregnancy, during labor, just before birth, during birth, in a newborn child or in early childhood. If the pregnant woman contracts rubella, herpes simplex, or other types of infection, it could affect the development of the fetal brain and cause cerebral palsy. Placental abnormalities could deprive the brain tissue of the much-needed oxygen for proper growth. Malnutrition deprives the fetus of the essential nutrients and the use of drugs, alcohol or tobacco could pose hazards to the fetal brain. Untreated high blood pressure and high blood sugar levels and blood type incompatibly are risk factors. Multiple births (twins or triplets) would mean that the weight of each infant is less and is more vulnerable. . During birth: Positioning of the baby in a breech or transverse manner which makes delivery difficult, small pelvic structure of the woman or the use of anesthetics and analgesics during birth, rupture of the amniotic membranes leading to infection, compression of the umbilical cord, untreated seizures, problems with the heart are all contributory factors. Children who do not cry within the first five minutes of birth or have to be kept on a ventilator for a few weeks are also prone to CP. In early childhood: CP may occur if the brain is damaged by meningitis, hemorrhages, head injuries resulting from accidents or falls, and asphyxia (lack of oxygen during drowning) or poisoning. These however are not the only causes of cerebral palsy. There are a number of cases where it is actually very difficult to determine the actual cause. Some children have congenital defects in the heart, kidney or spine and they are very vulnerable to Cerebral Palsy. Although we do know much about CP than we did a decade ago, it is not possible to identify a particular pattern of symptoms, which could result in CP. Cerebral palsy treatment There is no cure for cerebral palsy, as the damage to the brain cannot be reversed. What can be done however is that it can be managed. There are limitations to the amount of improvement that can be brought about, so the best thing that can be done is to teach children to achieve their maximum potential. This is easier said than done, for it requires patience on the part of the parents and children and the cooperation of doctors, nurses and therapists. Motivation is a key factor and this has got to stem from within. To make that happen there has to be external motivation. Play, outdoor games are an important factor which children enjoy. The dual benefit of learning and having fun at the same time can be achieved. Almost all cases of cerebral palsy require physiotherapy in some form or the other. The parts of the body that are not affected need to be exercised regularly to increase their function and the parts which are affected have to be exercised to optimize their functioning capacity. Vocation and occupational therapy have got to be an integrated part of any management program, for it caters to the daily needs of the individual. Brushing, dressing, practicing to hold objects, listening to music and nursery rhymes and doing daily chores help the children to have a sense of independence. Speech Language Therapy is essential for constructive communication. Where the muscles of the tongue, mouth and throat are affected, swallowing is a problem. Speech is also difficult. Speech therapy can help to make it less difficult. Educational Therapies In order to fit in with the real world, education in some form is a must. Conductive education focuses on all aspects of learning--- Developing motor skills, and acquiring social and emotional skills. The BOBATH therapy is aimed at optimizing co-coordinated movements. The FELDENKARAIS therapy is a form of somatic education that focuses on improving coordination between the muscles. Drugs are an inevitable part of managing cerebral palsy. They could be in the form of anticonvulsant drugs, muscle relaxants or anticholinergic drugs are used to control bladder movements. Acupressure, acupuncture and massage, help in controlling muscle spasms. When the child experiences difficulties because of muscle contractions, surgery may be resorted to. The nature of surgery would be to lengthen the tendons or to transfer tendons from one area to another. The elbows, backs of the heel or the shoulders are areas of the body where this procedure is done. In cases where the child cannot eat, liquid feeding tubes are inserted. As a prerequisite to treatment, prevention and early diagnosis are key factors that reduce the incidence of cerebral palsy. Nullifying Blood incompatibility in pregnant women, adequate prenatal care, treating jaundice in newborns with photo therapy and educating parents on protecting children from brain injury. CAT scans and MRI help to identify lesions in the brain of children and this helps to diagnose cerebral palsy early. In spite of doing all this, it takes months or years sometimes to diagnose a case of cerebral palsy.

Types and Symptoms of Mesothelioma

Mesothelioma is a form of cancer that develops in the lining around the lungs (the “pleura”), abdomen (the “peritoneum”), or heart (the “pericardium”).

Mesothelioma is almost always caused by exposure to asbestos. In contrast, lung cancer refers to a malignancy of the lung itself.

This section is not intended as a tool for self-diagnosis, nor is it intended to be a substitute for consulting with a doctor who specializes in the diagnosis and treatment of mesothelioma. This section is merely designed to help you learn about mesothelioma.

Pleural Mesothelioma

Pleural mesothelioma, also known as mesothelioma of the pleura, is a tumor of the lining surrounding the lungs. The pleura is a thin tissue around the lungs and the inside of the chest. In order to protect the lungs, the pleura produces a small amount of fluid which helps cushion the lungs, making the lungs move more smoothly during breathing.

Benign (Non-Cancerous) pleural mesothelioma

Benign pleural mesothelioma is a non-cancerous tumor that has not spread to other organs of the body. If the tumor is large, it may squeeze the lung itself and cause shortness of breath and pain.

Malignant Pleural Mesothelioma

Malignant Pleural mesothelioma is cancerous and can spread to other parts of the body. This rare form of cancer is found in the pleural sac lining of the lung. Exposure to asbestos is considered the primary cause of pleural mesothelioma.

Symptoms

Pleural mesothelioma may include shortness of breath, chest pain, back pain, pain in the rib cage, fluid build-up in the lung lining, hoarseness, coughing up blood, swelling of the face and arms, muscle weakness, paralysis and sensory loss.

Peritoneal Mesothelioma

Peritoneal mesothelioma, also known as cancer of the peritoneum, is a cancer of the abdominal lining.

One way doctors diagnose peritoneal mesothelioma is by looking inside the abdominal cavity with an instrument called a peritoneoscope. In this procedure, a cut is made through the abdomen wall and the peritoneoscope is placed into the abdomen. This test, called a peritoneoscopy, is usually performed in the hospital.

Some patients develop excessive fluid in the abdomen. This is called an effusion or ascites. A doctor may take a sample of such fluid to diagnose peritoneal mesothelioma. Fluid in the abdomen might also be drained to relieve symptoms of peritoneal mesothelioma. The procedure for drawing out this fluid is called “paracentesis”.

For more information about the diagnosis of this disease, click here

Symptoms

The symptoms of this cancer may include stomach pain, weight loss, nausea, vomiting, hernia, fluid in the abdominal cavity or a mass in the abdomen.

Pericardial Mesothelioma

Pericardial mesothelioma is also known as mesothelioma of the pericardium or cancer of the sac that holds the heart.

Your doctor may diagnose this cancer using a thoracoscope to perform a thoracoscopy, which might also involve opening up the chest cavity to remove the tumor.

Patients who develop excessive fluid around the heart, called an effusion, may have a sample of the fluid taken to diagnose pericardial mesothelioma. Fluid might also be drained to relieve symptoms of pericardial mesothelioma. The procedure for drawing out this fluid is called “pericardiocentesis.”

For more information about the diagnosis of this disease, click here.

Symptoms

Symptoms can include chest pain and shortness of breath. The tumor and/or fluid that accumulates between the heart and the sac can compress the heart, causing such symptoms

Cell Types of Mesothelioma

A patient’s doctor or medical records may refer to the “cell type” of the malignant mesothelioma. This refers to the type of tissue where the cancer first developed. For example, “epithelial” malignant mesothelioma refers to cancerous cells that develop in the “epithelium,” which is the membrane lining of the lung, heart, or abdomen. In contrast, “sarcomatous” malignant mesothelioma arises in connective tissue. “Biphasic” refers to malignant mesothelioma that arises in two different cell types. Other cell types of malignant mesothelioma are lymphohistiocytoid and desmoplastic.

Who's At Risk

The use of asbestos has exposed thousands of unsuspecting workers and their families to this toxic substance. The United States Occupational Safety and Health Administration (OSHA) has stated that it is aware of no instance in which exposure to a toxic substance has more clearly demonstrated deleterious health effects than has asbestos exposure. From 1940 through 1970, approximately 27.5 million individuals had potential asbestos exposure at work. Such a figure is not surprising when one considers that by one estimate, 1.2 billion square feet of asbestos-containing insulation can be found in 190,000 buildings in the United States. It has also been estimated that the number of workers exposed as a consequence of asbestos brake and clutch work is about 900,000.

Workers may be exposed to asbestos in a wide range of job sites and trades, ranging from milling and mining to manufacturing and consumer industries. According to one estimate from the Asbestos Information Association, there are over 3,000 discrete uses of asbestos. These uses have resulted in exposures to through the mining and milling process, in primary and secondary manufacturing of asbestos-containing products, in shipbuilding and repair, and in construction.

Hazardous exposures to asbestos may have also occurred from off-site releases from the mining, milling and manufacture of asbestos products. Such releases may have exposed residents in nearby communities. According to estimates, off-site release from construction sites has resulted in environmental asbestos levels approximately 100 times greater than the levels that naturally occur in the environment.

Additionally, contamination of homes may occur by employees bringing home asbestos contaminated clothing from the workplace. This may expose innocent members of the worker’s family to asbestos. Some believe that the most important current source of non-occupational exposure is the release of fibers from existing asbestos-containing surface materials, such as those in schools, residences and public buildings.

Age Groups

Mesothelioma cancer can have a long latency period between the time of exposure to asbestos fibers and the onset of the actual injury or disease. The latency period can be anywhere between 15 and 50 years, and sometimes even longer. There are also documented cases of mesothelioma cancer with latency periods of less than 15 years. So, a person only recently diagnosed with mesothelioma was probably exposed to asbestos fibers many years ago.

As reported by the National Cancer Institute, there are about 3,000 cases per year of malignant mesothelioma being reported in the USA. The occurrence of mesothelioma appears to be increasing. Mesothelioma is detected in three times as many men than women. For men, the incidence is 10 times higher for men between the ages of 60 and 70 as compared to men between the ages of 30 and 40. Job site exposure to asbestos in America is estimated to have occurred in about eight million workers over the last five decades.

For further details http://lifeanddiseases.blogspot.com/2007/09/mesothelioma-killer-disease.html

ORAL CANCER

What is Oral Cancer?

Oral cancer is a type of malignancy that begins in the oral cavity, which includes the lips, the inside of the lips and cheek, teeth and gums, the front portion of the tongue, the floor and roof of the mouth below the tongue, the bony roof of the mouth (hard palate), and the area behind the wisdom teeth.

Throat cancer (also called oropharyngeal cancer), develops in the area behind the mouth called the oropharynz. Often oral and throat cancer are discussed together because both the oral cavity and throat are involved in both breathing and eating. Saliva glands in both the mouth and throat help us digest the food we eat.

Types of Oral Cancer

Both cancers of the mouth (oral cancer) and throat (oropharyngeal cancer) can derive from different tissues that contain different types of cells in both the mouth and throat. These cell types can affect treatment and recovery.

Squamous cell carcinomas account for 90 percent of all oral and oropharyngeal cancers. Squamous cells make up the epithelium or lining of the mouth and throat. These cancers can spread beyond the top layer of epithelial tissue to become an invasive cancer. About 5 percent of squamous cell carcinomas of the mouth and throat are called verrucous cancer and rarely spread or metastasize beyond the original tumor site.

Cancer of salivary glands and lymph nodes of the mouth and throat and not included in oral cancers and are treated differently.

Statistics

Approximately 34,360 Americans will be diagnosed with oral cancer (including pharyngeal) cancer in 2007, and 7,550 are estimated to die from the diseases.

The five-year survival rate is 60 percent for those with oral cancer, though it rises to 84 percent when detected early enough.

The incidence of oral and oropharyngeal cancer has dropped 5 percent in each of the last two years.

Men are twice as likely to suffer from oral cancer as women.

Prevention

You can lower you risk of getting oral cancer by making certain lifestyle choices. The steps outlines below can serve as a guide to healthy living that may aid in preventing several cancers, including oral cancer.

Avoid any type of tobacco. About 90 percent of people with oral cavity and oropharyngeal cancer have used tobacco.

Avoid excessive alcohol use or the combination of tobacco and alcohol. Oral cancer is about six times more common in drinkers than in non-drinkers. And the combination of the two habits increased risk significantly.

Avoid being outdoors during the middle of the day, when the sun's ultraviolet rays are strongest. Use lip balms containing a sunscreen of SPF 15 or more to protect against sunlight.

Increase dietary intake of fruits and vegetables and whole grain foods.

Have an annual oral cancer screening by your dentist or health care professional.

Risks

You are at greater risk if you:

Chew and/or smoke tobacco: About 90 percent of people with oral cavity and oropharyngeal cancer use tobacco. The risk of developing these cancers increases exponentially with the amount of tobacco smoked or chewed and also with the length people have used tobacco. Smokers are six times more likely than nonsmokers to develop these cancers.

Abuse alcohol: About 75 to 80 percent of all patients with oral cancer drink a lot of alcohol. These cancers are about six times more common in drinkers than in nondrinkers.

Are age 40 and older: Half of all patients are over age 65.

Are a man: Oral and oropharyngeal cancer is twice as common in men as in women. This may be because men are more likely to use tobacco and alcohol.

Are an African-American man .

Are exposed to sunlight for long periods of time: More than 30 percent of patients with cancers of the lip have outdoor occupations associated with prolonged exposure to sunlight.

Maintain a diet low in fruits and vegetables.

Have human papillomavirus (HPV): The types of HPV found in cervical cancer are found in about 20 to 30 percent of oral cancers, but are also found in just a little more than 10 percent of samples of normal oral tissue. People with oral cancer associated with HPV infection have a better outlook than those without HPV. They are also less likely to be smokers and drinkers.

Have a vitamin A deficiency

Symptoms

In the early stages of oral cancer, there are usually no symptoms. Others may experience any of the following symptoms:

• A white or red lesion on the gum, tongue or mouth lining
• A lump or mass, which can be felt inside the mouth or neck
• Pain or difficulty chewing, swallowing or speaking
• Hoarseness lasting for a long time
• Numbness of the tongue or other areas of the mouth
• Swelling of the jaw
• Loosening of the teeth
• Pain in the mouth that doesn't go away
• Persistent bad breath
• Weight loss

Early Detection

To help detect oral cancer in its earliest stages conduct a monthly self-examination by looking in a mirror to check for any of the symptoms. Have regular dental checkups that include an examination of the entire mouth. And a sk your primary health care professional to examine your mouth and throat as part of a routine cancer-related checkup.

A thorough oral examination should include looking at the roof and floor of the mouth, back of the throat and insides of the cheeks and lips. Your tongue should be pulled gently out and your health care professional should check both the sides and underneath of the tongue. All lymph nodes in your neck should also be checked.

If an exam shows an abnormal area, a biopsy will be performed in which a small sample of tissue is and examined for cancer cells.

New early detection tools are being studied, including the use of fiber optics and dietary compounds from black raspberries.

Treatment

Several types of surgery are used to treat oral cancer. The type of procedure depends on the location and stage of the cancer. Oral cancer is characterized in stages from Stage 1 (the cancer is no more than 2 cm and has not spread to lymph nodes) through Stage IV (the cancer has spread to tissues around the lip and oral cavity and/or has spread to lymph nodes on one or both sides of the neck).

There are several types of surgical procedures used – surgery aims to remove as much of the cancer as possible and help restore the appearance and function of the tissues affected by the cancer. A primary tumor resection removes the tumor and surrounding tissue to prevent cancer cells from remaining. Other procedures include a full or partial mandible resection in which part of the jaw bone is removed when cancer is present, a maxillectomy, which involves removal of part of the roof of the mouth, or Moh's surgery, which is used on cancers of the lip to remove the tumor in thin slices. Other procedures are performed if the cancer has moved to the larynx or to lymph nodes in the neck.

External radiation (high energy x-rays kill cancer cells when aimed on the outside of the body) or internal radiation (use of a radioactive materials put directly on or near the cancerous tissue) and chemotherapy alone or in combination may follow surgery. Frequently plastic surgery is performed to restore speech and the ability to eat more normally.