Symptoms of Liver Problem – Hepatitis C

Symptoms of Liver Problem – Hepatitis C
Hepatitis C is inflammation of the liver caused by hepatitis C virus (HCV)and generally considered to be among the most serious of these viruses.About eight out of 10 people infected with HCV develop permanent (chronic) infection. It is estimated that anywhere between 1.5 to 3.5 per cent people in India are suffering from the disease.

Doctors say that Hepatitis C results in the death of liver cells. It is uncertain whether the virus kills the cells or if it is the immune system’s response to invasion by the virus. At present it is thought that it is probably a combination of the two, but that the immune system’s response is what causes the most damage. In most cases of HCV infection, the body’s immune system is not able to get rid of the virus by itself.

How Hepatitis C affects you
1.    High Blood Sugar

Hepatitis C makes it hard for your body’s cells to take in sugar from the food you eat. And over the course of time, the body will stop responding to the insulin, leading it to diabetes 2.

2.    Cancers

Hepatitis C, a virus that inflames the liver, is one of the main causes of primary liver cancer, or “hepatocellular” cancer.

3.    Kidney Disease

People with hepatitis C are about 40% more likely to get the long-term kidney disease than those who are not infected.

4.    Osteosclerosis
It is a type of bone disorder that causes bones in the body to become abnormally hard and dense.This painful but rare condition mostly affects your feet and legs.

Symptoms
Symptoms of Liver diseaseare not easily recognizable, thus, most people infected with the hepatitis C virus (HCV) show no symptoms. In fact, most people don't know they have the hepatitis C infection until the liver damage shows up.

•    Bleeding easily
•    Bruising easily
•    Fatigue
•    Poor appetite
•    Yellow discoloration of eyes (jaundice)
•    Dark-colored urine
•    Itchy skin
•    Fluid buildup in your abdomen (ascites)
•    Swelling in your legs
•    Weight loss
•    Confusion, drowsiness and slurred speech (hepatic encephalopathy)
•    Spiderlike blood vessels on the skin (spider angiomas)

Acute hepatitis C infection doesn't always become chronic. In studies of people diagnosed with acute HCV, rates of spontaneous viral clearance have varied from 15% to 25%.

Causes
The HCV virus causes hepatitis C. The virus is transmitted through blood-to-blood contact.
The nation's health protection agency,Centers for Disease Control have identified the factors that lead to the greatest risk of HCV exposure. These include:
•    being born between 1945 and 1965
•    receiving transfusions or organ transplants before 1992
•    using or having used injectable drugs
•    hemophilia
•    long-term hemodialysis
•    exposure to a needle stick, especially for those who work in healthcare sector
•    HIV
•    getting a tattoo in an unregulated setting
•    risky sexual behaviors, such as unprotected intercourse with an intravenous drug user
•    being born to a mother having HCV infection
•    being incarcerated
•    a history of long-term daily alcohol use
•    unexplained liver disease
•    snorting drugs
It is important to know that HCV is not transmitted through casual contact, respiratory droplets, sharing food, kissing, or mosquito bites.

Prevention

Unfortunately, there is no vaccine discovered to prevent hepatitis C. To reduce your risk of getting hepatitis C, follow the below advices.

•    Injection drug use is the most common way by which people get hepatitis C. Thus, avoid injecting drugs to reduce your risk. Avoid reusing and sharing.
•    Avoid sharing the personal care items that might have blood on them (razors, toothbrushes, nail clippers).
•    If you are a health care or public safety worker, follow universal blood/body fluid precautions & safely handle needles.
•    Consider the risks if you are thinking about tattooing, body piercing, or acupuncture to make sure the instruments are properly sterilized.
•    If you’re having sex with more than one partner, use latex condoms correctly and every time, to prevent the spread of STDs, including hepatitis C.
Most local liver hospitals in India have a public health unit that can also supply information and advice.It is very important to get a full explanation of the condition from the best Gastro doctor. 

Mental Health: Diagnosing and dealing with Depression

Everyone remembers the days when we have felt sad, lethargic and disinterested in the daily activities happening around us. When such symptoms occur once in a way, they are understandable. It is when they persist for months together that a red-flag needs to be raised – depression.

As per the WHO, globally more than 300 million suffer from depression, considered a common mental disorder affecting persons of all ages. Some fast facts on depression:

·        More women than men suffer from it.

·        Left untreated, depression can trigger suicide.

·        Almost 800,000 persons commit suicide annually.

·        Among 15 to 29-year-olds, suicide is the second-biggest cause of death.

·        It’s the leading cause of disability worldwide, contributing majorly to the overall disease burden.

Fortunately, effective psychological and medical regimens are available to treat depression.But for timely treatment, it is necessary to first identify the symptoms of depression. A person could be suffering from depression if someof the following signs or symptoms persist for more than a fortnight:

·        Feeling anxious, sad or purposeless.

·        Feeling pessimistic or hopeless.

·        Feeling guilty, worthless, or helpless.

·        No longer enjoying activities previously enjoyed.

·        Lack of concentration, memory or decision-making.

·        Rising or falling appetite.

·        Gaining or losing weight without dietary intervention.

·        Restlessness or irritability.

·        Suicidalthoughts or a death wish.

·        Insomnia (difficulty in sleeping) or hypersomnia (excessive sleeping).

·        Recurring thoughts about death or suicide, or an attempt at suicide.

In the case of depression, the above symptoms may not be passing ones but persist for more than six to eight months. But it is imperative to consult a psychiatrist or mental health specialist to diagnose the precise causes of depression for safe and effective therapy. For example, feelings of intense grief arising from the death of a close family member may not mean depression if these emotions don’t persist for months. On the other hand, bereavement can lead to depression if the victim is unable to overcome the deep sense of loss, loneliness and despair. In such instances, it is termed ‘complicated bereavement’.

Although depression’s causes aren’t understood fully, these won’t arise from a single source. A complex combination of causes could be at play, including:

·        Genetic

·        Biological – changes at the neurotransmitter level

·        Environmental

·        Psychological and social (psychosocial)

Some persons may be predisposed to depression, with the risk factors including:

·        Personality: Those unable to cope with stress, or previous life trauma, may be more susceptible.

·        Genetic factors:Close relatives suffering depression increases the risk.

·        Childhood trauma.

·        Life events: These may include bereavement, professional issues, divorce, relationships with family and friends, financial issues, medical problems, or acute stress.

·        Specific prescription drugs: Some corticosteroids, interferon, beta-blockers and other prescribed drugs can cause depression.

·        Past head injury.

·        Recreational drugs:Overdependence on alcohol, amphetamines and other drugs are linked to depression.

·        One episode of major depression:A single episode enhances the risk of a subsequent one.

·        Chronic pain syndromes:Pain and other chronic conditions, such as diabetes, chronic obstructive pulmonary disease, and cardiovascular ailments make depression more likely.

As mentioned earlier, depression can be treated. The three components in managing depression:

·        From discussing the relevant stress factors and practical solutions to educating family members, a support system helps in managing depression.

·        Psychotherapy(also termed talking therapies), such as cognitive behavioural therapy.

·        Drug treatment, particularly antidepressants.

Psychotherapy

In treating depression, psychological or talking therapies include cognitive behavioural therapy, interpersonal psychotherapy as well as problem-solving treatment. In mild cases, psychotherapies comprise the first treatment option; in moderate or severe cases, they can be used along with other treatment. Interpersonal therapy helps victims identify emotional problems affecting relationships and communication and how these, in turn, impact their mood and can be changed.

Antidepressant drugs

These are drugs available on prescription from a doctor to combat depression. Although these can be used for moderate to severe depression, they are not meant for children and are only prescribed with caution for adolescents since they can be counterproductive in such cases. Each type of antidepressant acts on a different neurotransmitter. As prescribed by the doctor, these drugs should be continued even after symptoms improve in order to prevent relapse.

Other therapies

·        Aerobic exercise can help combat mild depression as it raises endorphin levels and stimulates the neurotransmitter norepinephrine, which is related to moods.

·        Brain stimulation therapies (such as electroconvulsive therapy) are also useful in treating depression. Repetitive transcranial magnetic stimulation (which transmits magnetic pulses to the brain) may be effective in treating major depressive disorder.

·        Electroconvulsive therapymay be beneficial in severe cases of depression that do not respond to drug treatment; this is particularly effective for psychotic depression.

Whatever the case, it is best to consult with doctor at best hospital if depression is suspected.

Treating Painful Knees via High Tibial Osteotomy Surgery

In many persons, misaligned knees can lead to debilitating pain, restricting function and mobility. In such cases, two surgical avenues are available for addressing this problem: realignment osteotomies and joint replacements. In certain patients, particularly the youth(given their age and activity levels), realignment osteotomies – viz., high tibial osteotomy (HTO) – are an appropriate option.

Introduced in 1958, HTO was first used in correcting primary knee deformities and, later, in treating osteoarthritis of the knee. HTO may be recommended for people with painful arthritic knees and/or unstable knee joints. Osteotomy refers to cutting and reshaping a bone so it’s aligned with a joint. In knee osteotomies, the cuts are usually in the top of the tibia, therefore the term ‘high tibial osteotomy’. 

When some patients suffer arthritis (thinning or damage to the cartilage/meniscus) or instability (giving away or buckling of the knee due to ligament damage), their condition can be improved by realigning the knee. High Tibial Osteotomy surgery can prevent or delay the need for either partial or total knee replacement because it helps preserve damaged joint tissue.

Some elaboration is necessary on how the knee functions. When you take a single step, a force equivalent to three to eight times the body weight travels between your femur (thighbone) and tibia (shin bone) in the knee. Two menisci located on the inner and outer knee then soften these forces even as the bone ends remain shielded by articular cartilage.

But patients with osteoarthritis (or degenerative arthritis) of the knee are subjected to successive wear-outof the menisci and articular cartilage, which may later develop tears. As these tissues degenerate, the ability of the knee in gliding smoothly is limited, resulting in catching, clicking, popping, locking and pain. In such a condition – called mal-alignment – the unbalanced forces exert excessive pressure on either the inner (medial) or outer (lateral) part of the knee. In a repetitive damage cycle due to degenerative arthritis and mal-alignment, the protective tissues of the knee wear out more on one side than the other.

If the knee joint is damaged beyond repair, your orthopaedic surgeon may recommend knee replacement surgery. In some cases, however, a high tibial osteotomy will be better in relieving pressure on the damaged side by reconfiguring the knee joint. Weight-bearing is then shifted onto the healthier tissue from the damaged/worn tissue. Since HTO benefits only last for about a decade or so, it is typically considered when a young patient seeks to postpone knee replacement for as long as possible.

Ultimately, however, this surgery can be beneficial for young patients because there are no activity restrictions after a person recovers completely from the HTO procedure, which can take up to a year. 

 

The Perils of Lung Cancer

Fast facts about lung cancer:

·         It’s the number one cause of cancer deaths in men and women worldwide.

·         Cigarette smoking is the main risk factor.

·         Exposure to second-hand smoke (passive smoking) can also cause lung cancer.

·         There are two types of lung cancer: small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC), which grow and spread differently.

·         The most aggressiveand rapidly growing, SCLC constitute around 20% of lung cancers.

·         Treatment can involve a combination of surgery, radiation,chemotherapy, targeted therapy and immunotherapy.

·         Its general prognosis is poor because doctors find lung cancer only at an advanced stage.

·         Five-year survival is around 54% for early-stage lung cancer localized to the lungs, but only about 4% in advanced, inoperable lung cancer.

·         Smoking cessation is critical in preventing its development.

·         Lung cancer tumours can be benign or malignant (cancerous).

·         Benign tumours can usually be removed and don’t spread to other body parts.

·         But malignant tumours often grow aggressively locally where they emerge.

·         Tumour cells can also enter the bloodstream or lymphatic system, then spreading to other sites in the body (metastasis).

·         Since lung cancer spreads or metastasizes very early after forming, it is one of the most difficult cancers to treat and extremely life-threatening.

·         While lung cancer can spread to any organ, certain areas – the adrenal glands, liver, brain, and bones – are most vulnerable.

·         Primarily a disease of the elderly, almost 70% of those with lung cancer are 65-plus, with less than 3% occurring in people under 45 years. The median diagnosis age: 70 years.

·         Uncommon before the 1930s, it rose dramatically after tobacco smoking soared.

Lung cancer causes and risk factors:

Smoking

·         Around 90% of cases arise from tobacco abuse.

·         Tobacco smoke has 4,000-plus chemical compounds, many carcinogenic (cancer-causing).

Passive smoking

Inhalation of tobacco smoke by non-smokers (living or working with smokers) is an established risk factor leading to a 24% rise in risk for developing lung cancer.

Asbestos fibres

These are silicate fibres that can persist in lung tissue for a lifetime after exposure to asbestos.

Familial predisposition

All smokers don’t eventually develop lung cancer,indicating other factors(e.g. individual genetic susceptibility) may play a role in causing lung cancer.

Lung diseases

Having certain lung diseases (notably chronic obstructive pulmonary disease or COPD) is linked with ahigher risk for developing lung cancer even after excluding the effects of concomitant cigarette smoking.

Prior history

Lung cancer survivors run a higher risk of developing a second lung cancer than the general population has of developing a first lung cancer.

Air pollution

Vehicular, industrial, and power plant pollution inflates the chances of developing lung cancer in exposed persons.

Diesel exhaust

Diesel engine exhaust contains carcinogenic gases and soot (particulate matter).

Signs and symptoms

Symptoms are varied depending on the location and tumour spread. Warning signs are not always present or easy to spot. In some cases, there may be no pain or other symptoms. A lung cancer victim may have:

No symptoms: In up to 25% of cases, lung cancer is first discovered on a routine chest X-ray or CT scan as a solitary small mass.Such patients often report no symptoms when the cancer is found.

Cancer-related symptoms: The cancer growth may interfere with breathing, leading to symptoms such as cough, shortness of breath, wheezing, chest pain, and coughing up blood (haemoptysis). If cancer invades nerves, it can cause shoulder pain or paralysis of the vocal cords leading to hoarseness. Invasion of the esophagus may lead to difficulty swallowing (dysphagia).

Metastasis-related symptoms: Lung cancer spreading to the bones may produce excruciating pain at the sites. Cancer spreading to the brain may cause neurologic symptoms,including blurred vision, headache, seizures, or symptoms of stroke such as weakness or loss of sensation in some body parts.

Non-specific symptoms:These include weight loss, weakness and fatigue. Depression and mood changes are also common.

When to consult a doctor

Consult a Doctor of Cancer if symptoms associated with lung cancer exist, particularly if there is:

·         A new persistent cough or worsening of an existing chronic cough

·         Blood in the sputum

·         Persistent bronchitis or chronic respiratory infections

·         Chest pain

·         Unexplained weight loss and/or fatigue

·         Breathing difficulties (shortness of breath or wheezing).

Treatment and prevention

This mainly involves surgeryto remove the cancer, chemotherapy, or radiation, as well as combinations of the treatments. Targeted therapies and hypnotherapy are used as well. The treatment mode will depend on the location and extent of the tumour, besides the patient’s overall health. Considering the gravity of the disease, prevention is best. Avoiding tobacco products and exposure to second-hand smoke is crucial. Screenings for early detection may be advised for high-risk individuals.
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