Asthma

Definition :
Asthma attacks all age groups but often starts in childhood. It is a disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. In an individual, they may occur from hour to hour and day to day.
This condition is due to inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they become easily irritated. In an attack, the lining of the passages swell causing the airways to narrow and reducing the flow of air in and out of the lungs.

Asthma cannot be cured, but could be controlled. The strongest risk factors for developing asthma are exposure, especially in infancy, to indoor allergens (such as domestic mites in bedding, carpets and stuffed furniture, cats and cockroaches) and a family history of asthma or allergy. A study in the South Atlantic Island of Tristan da Cunha, where one in three of the 300 inhabitants has asthma, found children with asthmatic parents were much more likely to develop the condition.
Exposure to tobacco smoke and exposure to chemical irritants in the workplace are additional risk factors. Other risk factors include certain drugs (aspirin and other non-steroid anti-inflammatory drugs), low birth weight and respiratory infection. The weather (cold air), extreme emotional expression and physical exercise can exacerbate asthma.
Urbanization appears to be correlated with an increase in asthma. The nature of the risk is unclear because studies have not taken into account indoor allergens although these have been identified as significant risk factors.
Experts are struggling to understand why rates world-wide are, on average, rising by 50% every decade. And they are baffled by isolated incidents involving hundreds of people in a city, who suffer from allergies such as hay fever but who had never had asthma, suddenly being struck down by asthma attacks so severe they needed emergency hospital treatment.

kids got cought

When to Call Your Child's Doctor if your child got caught

Most childhood coughs are nothing to be concerned about. However, consult a doctor if your child:
+ has trouble breathing or is working hard to breathe
+ is breathing more quickly than usual
+ has a blue or dusky color to the lips, face, or tongue
+ has a high fever (particularly in a young infant or in the absence of congestion or a runny nose; contact your child's doctor for any fever in an infant younger than 3 months)
is an infant (3 months old or younger) who has been coughing for more than a few hours
+ makes a "whooping" sound when she breathes after coughing
+ is coughing up blood
+ has stridor when inhaling
+ has wheezing when exhaling (unless you already have home asthma management instructions from your child's doctor)
+ is listless or cranky

Home Treatment

Home treatments should never take the place of consulting your child's doctor for any of the conditions listed above, but there are several things you can do at home to make your child more comfortable.
+ If your child has asthma, make sure you have received asthma-management instructions from your child's doctor. Monitor your child's progress carefully during a flare-up and give asthma medicines according to the doctor's instructions.
+ If your child wakes up with a "barky" or "croupy" cough in the middle of the night, take him or her into the bathroom, close the door, and let the shower run on hot for several minutes. After the room steams up, sit in the bathroom with your child for about 20 minutes. The steam should help your child breathe more easily. Try reading a book together to keep your child occupied.
+ A cool-mist humidifier in your child's room might help him or her sleep through the night.
Cool beverages like juice can be soothing; avoid carbonated or citrus drinks, however, because carbonation and citric acid can be painful on raw areas.
+ You should not give your child (especially a baby or toddler) OTC cough medicine without specific instructions to do so from your child's doctor.
+ Cough drops, which are fine for older children, are a choking hazard for young children. It's best to avoid them unless your child's doctor says that they are safe to provide to your child.

Avian influenza spread of the virus to new countries

Rapid geographical spread of the virus
The occurrence of the disease in India, reported on 18 February, is part of a recent pattern of rapid geographical spread of the virus in wild and domestic birds. India is one of 13 countries that have reported their first cases of H5N1 infection in birds since the beginning of February. (The 13 countries, listed in order of reporting, are Iraq, Nigeria, Azerbaijan, Bulgaria, Greece, Italy, Slovenia, Iran, Austria, Germany, Egypt, India and France.)
On 20 February, Malaysia reported a fresh outbreak in poultry after having been considered free of the disease for more than a year.
The situation in these recently affected countries varies greatly. Most European countries with good veterinary surveillance have detected the virus in a small number of wild birds only, with no evidence to date of spread to domestic birds.
In Azerbaijan, detection of the virus has coincided with die-offs of domestic birds. In Egypt, outbreaks in domestic poultry have now been confirmed in 10 governorates; deaths have also been reported in exotic zoo birds. In Iraq, presence of the virus in birds was found only after the country confirmed its first human case.
In Nigeria, as in India, the first cases were detected in large commercial farms, where the disease is highly visible and outbreaks are difficult to miss.
Apart from Iraq, none of the countries newly affected during February has reported human cases. Iraq has reported two human cases, both of which were fatal; samples from several other patients are currently undergoing tests.
For human health, experience elsewhere over the past two years has shown that the greatest risk of cases arises when the virus becomes established in small backyard flocks, which allow continuing opportunities for close human contact, exposures, and infections to occur.
All available evidence indicates that the virus does not spread easily from poultry to humans. To date, very few cases have been detected in poultry workers, cullers, or veterinarians. Almost all cases have been linked to close contact to diseased household flocks, often during slaughtering, defeathering, butchering, and preparation of poultry for consumption.
No cases have been linked to the consumption of properly cooked poultry meat or eggs, even in households where disease was known to be present in flocks.who

Diabetes mellitus

Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.
There are two principle forms of diabetes:
Type 1 diabetes (formerly known as insulin-dependent) in which the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted later in life.
Type 2 diabetes (formerly named non-insulin-dependent) which results from the body's inability to respond properly to the action of insulin produced by the pancreas. Type 2 diabetes is much more common and accounts for around 90% of all diabetes cases worldwide. It occurs most frequently in adults, but is being noted increasingly in adolescents as well.

Certain genetic markers have been shown to increase the risk of developing Type 1 diabetes. Type 2 diabetes is strongly familial, but it is only recently that some genes have been consistently associated with increased risk for Type 2 diabetes in certain populations. Both types of diabetes are complex diseases caused by mutations in more than one gene, as well as by environmental factors.
Diabetes in pregnancy may give rise to several adverse outcomes, including congenital malformations, increased birth weight and an elevated risk of perinatal mortality. Strict metabolic control may reduce these risks to the level of those of non-diabetic expectant mothers.
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) refer to levels of blood glucose concentration above the normal range, but below those which are diagnostic for diabetes. Subjects with IGT and/or IFG are at substantially higher risk of developing diabetes and cardiovascular disease than those with normal glucose tolerance. The benefits of clinical intervention in subjects with moderate glucose intolerance is a topic of much current interest.

Symptoms
The symptoms of diabetes may be pronounced, subdued, or even absent.
In Type 1 diabetes, the classic symptoms are excessive secretion of urine (polyuria), thirst (polydipsia), weight loss and tiredness.
These symptoms may be less marked in Type 2 diabetes. In this form, it can also happen that no early symptoms appear and the disease is only diagnosed several years after its onset, when complications are already present.

Prevalence
Recently compiled data show that approximately 150 million people have diabetes mellitus worldwide, and that this number may well double by the year 2025. Much of this increase will occur in developing countries and will be due to population growth, ageing, unhealthy diets, obesity and sedentary lifestyles.
By 2025, while most people with diabetes in developed countries will be aged 65 years or more, in developing countries most will be in the 45-64 year age bracket and affected in their most productive years.

Diagnosis
WHO has published recommendations on diagnostic values for blood glucose concentration. The diagnostic level of fasting blood glucose concentration was last modified in 1999.

Treatment
The mainstay of non-pharmacological diabetes treatment is diet and physical activity.
About 40% of diabetes sufferers require oral agents for satisfactory blood glucose control, and some 40% need insulin injections. This hormone was isolated by Frederic Banting and Charles Best in 1921 in Canada. It revolutionized the treatment of diabetes and prevention of its complications, transforming Type 1 diabetes from a fatal disease to one in which long-term survival became achievable.
People with Type 1 diabetes are usually totally dependent on insulin injections for survival. Such people require daily administration of insulin. The majority of people suffering from diabetes have the Type 2 form. Although they do not depend on insulin for survival, about one third of sufferers needs insulin for reducing their blood glucose levels.
Insulin is unavailable and unaffordable in many poor countries, despite being listed by WHO as an essential drug. Access to insulin by those who require it is a subject of special concern to international health agencies and national health authorities.

Complications associated with diabetes mellitus
+Diabetic retinopathy is a leading cause of blindness and visual disability. Diabetes mellitus is associated with damage to the small blood vessels in the retina, resulting in loss of vision. Findings, consistent from study to study, make it possible to suggest that, after 15 years of diabetes, approximately 2% of people become blind, while about 10% develop severe visual handicap. Loss of vision due to certain types of glaucoma and cataract may also be more common in people with diabetes than in those without the disease.
+Good metabolic control can delay the onset and progression of diabetic retinopathy. Loss of vision and blindness in persons with diabetes can be prevented by early detection and treatment of vision-threatening retinopathy: regular eye examinations and timely intervention with laser treatment, or through surgery in cases of advanced retinopathy. There is evidence that, even in developed countries, a large proportion of those in need is not receiving such care due to lack of public and professional awareness, as well as an absence of treatment facilities. In developing countries, in many of which diabetes is now common, such care is inaccessible to the majority of the population.
+Diabetes is among the leading causes of kidney failure, but its frequency varies between populations and is also related to the severity and duration of the disease. Several measures to slow down the progress of renal damage have been identified. They include control of high blood glucose, control of high blood pressure, intervention with medication in the early stage of kidney damage, and restriction of dietary protein. Screening and early detection of diabetic kidney disease are an important means of prevention.
+Heart disease accounts for approximately 50% of all deaths among people with diabetes in industrialized countries. Risk factors for heart disease in people with diabetes include smoking, high blood pressure, high serum cholesterol and obesity. Diabetes negates the protection from heart disease which pre-menopausal women without diabetes experience. Recognition and management of these conditions may delay or prevent heart disease in people with diabetes.
+Diabetic neuropathy is probably the most common complication of diabetes. Studies suggest that up to 50% of people with diabetes are affected to some degree. Major risk factors of this condition are the level and duration of elevated blood glucose. Neuropathy can lead to sensory loss and damage to the limbs. It is also a major cause of impotence in diabetic men.
+ Diabetic foot disease, due to changes in blood vessels and nerves, often leads to ulceration and subsequent limb amputation. It is one of the most costly complications of diabetes, especially in communities with inadequate footwear. It results from both vascular and neurological disease processes. Diabetes is the most common cause of non-traumatic amputation of the lower limb, which may be prevented by regular inspection and good care of the foot.

Prevention
Large, population-based studies in China, Finland and USA have recently demonstrated the feasibility of preventing, or delaying, the onset of diabetes in overweight subjects with mild glucose intolerance (IGT). The studies suggest that even moderate reduction in weight and only half an hour of walking each day reduced the incidence of diabetes by more than one half.
Diabetes is a serious and costly disease which is becoming increasingly common, especially in developing countries and disadvantaged minorities. However, there are ways of preventing it and/or controlling its progress. Public and professional awareness of the risk factors for, and symptoms of diabetes are an important step towards its prevention and control.