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Ailmemts & Remedies

Bile duct cancer (cholangiocarcinoma)

Description:
Bile duct cancer (cholangiocarcinoma) occurs when a malignant (cancerous) tumor grows in one of the ducts that transport bile from the liver to the small intestine. It is rare but aggressive type of cancer.

The bile duct system, or ‘biliary’ system, is made up of a series of tubes that begin in the liver and end in the small intestine. Bile is a fluid the digestive system uses to help break down fats and digest foods.

Doctors divide Bile duct cancer into different types based on where the cancer occurs in the bile ducts:

*Intrahepatic Bile duct cancer occurs in the parts of the bile ducts within the liver and is sometimes classified as a type of liver cancer.

*Hilar Bile duct cancer occurs in the bile ducts just outside of the liver. This type is also called perihilar cholangiocarcinoma.

*Distal Bile duct cancer occurs in the portion of the bile duct nearest the small intestine. This type is also called extrahepatic cholangiocarcinoma.

Bile duct cancer is often diagnosed when it’s advanced, making successful treatment difficult to achieve.

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Symptoms:
In most cases, there are no signs of bile duct cancer until it reaches the later stages, when symptoms can include:

*jaundice – yellowing of the skin and the whites of the eyes, itchy skin, pale stools and dark-coloured urine

*Unintentional weight loss/or progressive weakness

*Abdominal pain

*Fever

*Distended gallbladder

Causes:
The exact cause of bile duct cancer is unknown, although some things can increase the risk of developing the condition.

Cancer begins with a change (mutation) in the structure of the DNA in cells, which can affect how they grow. This means that cells grow and reproduce uncontrollably, producing a lump of tissue called a tumour.

If left untreated, cancer can grow and spread to other parts of your body, either directly or through the blood and lymphatic system.

Risk Factors:
Factors that may increase your risk of cholangiocarcinoma include:

*Primary sclerosing cholangitis. This disease causes hardening and scarring of the bile ducts.

*Chronic liver disease. Scarring of the liver caused by a history of chronic liver disease increases the risk of cholangiocarcinoma.

*Bile duct problems present at birth. People born with a choledochal cyst, which causes dilated and irregular bile ducts, have an increased risk of cholangiocarcinoma.

*A liver parasite. In areas of Southeast Asia, cholangiocarcinoma is associated with liver fluke infection, which can occur from eating raw or undercooked fish.

*Older age. Bile duct cancer occurs most often in adults over age 50.

*Smoking. Smoking is associated with an increased risk of Bile duct cancer.

*Diabetes. People who have type 1 or 2 diabetes may have an increased risk of Bile duct cancer.

*Certain inherited conditions. Some DNA changes passed from parents to children cause conditions that increase the risk of Bile duct cancer. Examples of these conditions include cystic fibrosis and Lynch syndrome.

Diagnosis:
To diagnosis the patient may have to undergo one or more of the following tests:

*Liver function tests. Blood tests to measure the liver function can give the doctor clues about what’s causing the signs and symptoms.

*Tumor marker test. Checking the level of carbohydrate antigen (CA) 19-9 in blood may give the doctor additional clues about diagnosis. CA 19-9 is a protein that’s overproduced by bile duct cancer cells.

*A high level of CA 19-9 in blood doesn’t mean the patient has bile duct cancer, though. This result can also occur in other bile duct diseases, such as bile duct inflammation and obstruction.

*A test to examine your bile duct with a small camera. During endoscopic retrograde cholangiopancreatography (ERCP), a thin, flexible tube equipped with a tiny camera is passed down your throat and through the digestive tract to the small intestine. The camera is used to examine the area where the bile ducts connect the small intestine.The doctor may also use this procedure to inject dye into the bile ducts to help them show up better on imaging tests.

*Imaging tests. Imaging tests can help the doctor see internal organs and look for signs of cholangiocarcinoma. Techniques used to diagnose bile duct cancer include ultrasound, computerized tomography (CT) scans and magnetic resonance imaging (MRI) combined with magnetic resonance cholangiopancreatography (MRCP). MRCP is increasingly being used as a noninvasive alternative to ERCP. It offers 3D images without the need for a dye to enhance the images.

*A procedure to remove a sample of tissue for testing. A biopsy is a procedure to remove a small sample of tissue for examination under a microscope.

If the suspicious area is located very near where the bile duct joins the small intestine, the doctor may obtain a biopsy sample during ERCP. If the suspicious area is within or near the liver, the doctor may obtain a tissue sample by inserting a long needle through your skin to the affected area (fine-needle aspiration). He or she may use an imaging test, such as an endoscopic ultrasound or CT scan, to guide the needle to the precise area.

How the doctor collects a biopsy sample may influence which treatment options are available to you later. For example, if the bile duct cancer is biopsied by fine-needle aspiration, the patient will become ineligible for liver transplantation.

If the doctor confirms a diagnosis of cholangiocarcinoma, he or she tries to determine the extent (stage) of the cancer. Often this involves additional imaging tests. Your cancer’s stage helps determine the prognosis and the treatment options.

Treatment:
Treatments for cholangiocarcinoma (bile duct cancer) may include:

Surgery. When possible, surgeons try to remove as much of the cancer as they can. For very small bile duct cancers, this involves removing part of the bile duct and joining the cut ends. For more-advanced bile duct cancers, nearby liver tissue, pancreas tissue or lymph nodes may be removed as well.

*Liver transplant. Surgery to remove your liver and replace it with one from a donor (liver transplant) may be an option in certain situations for people with hilar cholangiocarcinoma. For many, a liver transplant can be a cure for hilar cholangiocarcinoma, but there is a risk that the cancer will recur after a liver transplant.

*Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be used before a liver transplant. It may also be an option for people with advanced cholangiocarcinoma to help slow the disease and relieve signs and symptoms. Chemotherapy drugs can be infused into a vein so that they travel throughout the body. Or the drugs can be administered in a way so that they are delivered directly to the cancer cells.

*Radiation therapy. Radiation therapy uses high-powered energy beams from sources such as X-rays and protons to kill cancer cells. Radiation therapy can involve a machine that directs radiation beams at your body (external beam radiation). Or it can involve placing radioactive material inside your body near the site of your cancer (brachytherapy).

*Targeted drug therapy. Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your doctor may test your cancer cells to see if targeted therapy may be effective against your cholangiocarcinoma.

*Immunotherapy. Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process. For cholangiocarcinoma, immunotherapy might be an option for advanced cancer when other treatments haven’t helped.

*Heating cancer cells. Radiofrequency ablation uses electric current to heat and destroy cancer cells. Using an imaging test as a guide, such as ultrasound, the doctor inserts one or more thin needles into small incisions in your abdomen. When the needles reach the cancer, they’re heated with an electric current, destroying the cancer cells.

*Photodynamic therapy. In photodynamic therapy, a light-sensitive chemical is injected into a vein and accumulates in the fast-growing cancer cells. Laser light directed at the cancer causes a chemical reaction in the cancer cells, killing them. You’ll typically need multiple treatments. Photodynamic therapy can help relieve your signs and symptoms, and it may also slow cancer growth. You’ll need to avoid sun exposure after treatments.
Biliary drainage. Biliary drainage is a procedure to restore the flow of bile. It might involve placing a thin tube into the bile duct in order to drain the bile. Other strategies include bypass surgery to reroute the bile around the cancer and stents to hold open a bile duct being collapsed by cancer. Biliary drainage helps relieve signs and symptoms of cholangiocarcinoma.

Because cholangiocarcinoma is a very difficult type of cancer to treat, don’t hesitate to ask about your doctor’s experience with treating the condition. If you have any doubts, get a second opinion.

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Prognosis: The outlook (prognosis) for people with cholangiocarcinoma is usually poor. The five-year survival rate for bile duct cancer that hasn’t spread outside of the bile ducts is 10% to 15%. This rate drops to 2% if the cancer spreads to areas of the body that are far from the bile ducts, such as the lungs. But newer treatments mean these rates will improve over time.

Prevention:
To reduce your risk of cholangiocarcinoma, you can:

*Stop smoking. Smoking is linked to an increased risk of cholangiocarcinoma. If you smoke, stop. If you have tried quitting in the past and haven’t been successful, talk with your doctor about strategies to help you quit.

*Reduce your risk of liver disease. Chronic liver disease is associated with an increased risk of cholangiocarcinoma. Some causes of liver disease can’t be prevented, but others can. Do what you can to take care of your liver.

For instance, to reduce your risk of liver inflammation (cirrhosis), drink alcohol in moderation, if you choose to drink. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Maintain a healthy weight. When working with chemicals, follow the safety instructions.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/bile-duct-cancer-cholangiocarcinoma/#causes-of-bile-duct-cancer
https://www.mayoclinic.org/diseases-conditions/cholangiocarcinoma/symptoms-causes/syc-20352408

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Ailmemts & Remedies

Atopic eczema

Description:

Atopic eczema is a condition that causes dry, itchy and inflamed skin. It’s common in young children but can occur at any age. It is long lasting (chronic) and tends to flare sometimes. It can be irritating but it’s not contagious.

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People with atopic eczema are at risk of developing food allergies, hay fever and asthma.

Moisturizing regularly and following other skin care habits can relieve itching and prevent new outbreaks (flares). Treatment may also include medicated ointments or creams.

Symptoms:
This type of eczema can appar anywhere on the body and vary widely from person to person. The symptoms may include:

*Dry, cracked skin
*Itchiness (pruritus)
*Rash on swollen skin that varies in color depending on your skin color
*Small, raised bumps, on brown or Black skin
*Oozing and crusting
*Thickened skin
*Darkness of the skin around the eyes
*Raw, sensitive skin from scratching

Atopic eczema often begins before age 5 and may continue into the teen and adult years. For some people, it flares and then clears up for a time, even for several years.

Causes:
In some people, atopic dermatitis is related to a gene variation that affects the skin’s ability to provide protection. With a weak barrier function, the skin is less able to retain moisture and protect against bacteria, irritants, allergens and environmental factors — such as tobacco smoke.

In other people, this is caused by too much of the bacteria Staphylococcus aureus on the skin. This displaces helpful bacteria and disrupts the skin’s barrier function.

A weak skin barrier function might also trigger an immune system response that causes the inflamed skin and other symptoms.

Atopic eczema is one of several types of dermatitis. Other common types are contact dermatitis and seborrheic dermatitis (dandruff). Dermatitis isn’t contagious.

Risk factors:
The main risk factor is it is very bothersome,having breathing problem,eczimz and fever and restlessness.

Diagnosis:

To diagnose atopic eczima, the doctor will likely talk with the patient about the symptoms, examine his or her skin and review the past medical history. The patient may need tests to identify allergies and rule out other skin diseases.

If certain food caused the child’s rash, then the doctor will determine about potential food allergies.

Patch testing:
The doctor may recommend patch testing of skin. In this test, small amounts of different substances are applied on the skin and then covered. During visits over the next few days, the doctor looks at the skin for signs of a reaction. Patch testing can help diagnose specific types of allergies causing the eczima.

Treatment:
The main treatments for atopic eczema are:

!. Emollients (moisturisers) – used every day to stop the skin becoming dry.

  1. Topical corticosteroids– creams and ointments used to reduce swelling and redness during flare-ups.

Medications:
The Food and Drug Administration requires that these products have a black box warning about the risk of lymphoma. This warning is based on rare cases of lymphoma among people using topical calcineurin inhibitors. After 10 years of study, no causal relationship between these products and lymphoma and no increased risk of cancer have been found.

*Drugs to fight infection. The doctor may prescribe antibiotic pills to treat an infection.

*Pills that control inflammation. For more-severe eczema, your health care provider may prescribe pills to help control your symptoms. Options might include cyclosporine, methotrexate, prednisone, mycophenolate and azathioprine. These pills are effective but can’t be used long term because of potential serious side effects.

*Other options for severe eczema. The injectable biologics (monoclonal antibodies) dupilumab (Dupixent) and tralokinumab (Adbry) might be options for people with moderate to severe disease who don’t respond well to other treatment. Studies show that it’s safe and effective in easing the symptoms of atopic dermatitis. Dupilumab is for people over age 6. Tralokinumab is for adults.

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Prognosis:
There’s no cure, but many children find their symptoms naturally improve as they get older. The main treatments for atopic eczema are: emollients (moisturisers) – used every day to stop the skin becoming dry. topical corticosteroids – creams and ointments used to reduce swelling and redness during flare-ups.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

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Ailmemts & Remedies

Asbestosis (as-bes-TOE-sis)

Description:
Asbestosis is long-term inflammation and scarring of the lungs due to asbestos fibers. It is a chronic lung disease caused by inhaling asbestos fibers. Prolonged exposure to these fibers can cause lung tissue scarring and shortness of breath. Asbestosis symptoms can range from mild to severe, and usually don’t appear until many years after initial exposure.

Asbestos is a natural mineral product that’s resistant to heat and corrosion. It was used extensively in the past in products such as insulation, cement and some floor tiles.

There is no specific treatment. Recommendations may include influenza vaccination, pneumococcal vaccination, oxygen therapy, and stopping smoking. Asbestosis affected about 157,000 people and resulted in 3,600 deaths in 2015. Asbestos use has been banned in a number of countries in an effort to prevent disease.

Statistics from the UK’s Health and Safety Executive showed that in 2019, there were 490 asbestosis deaths.

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Symptoms:
The effects of long-term exposure to asbestos typically don’t show up until 10-40 years after initial exposure. Symptoms can vary in severity.

Asbestosis signs and symptoms may include:

*Shortness of breath
*A persistent, dry cough
*Chest tightness or pain
*Dry and crackling sounds in your lungs when you inhale
*Fingertips and toes that appear wider and rounder than usual (clubbing)

Causes:
Asbestosis is caused by breathing in asbestos fibers. It requires a relatively large exposure over a long period of time, which typically only occur in those who directly work with asbestos.

If one is exposed to high levels of asbestos dust over a long period of time, some of the airborne fibers can become lodged within his or her alveoli — the tiny sacs inside the lungs where oxygen is exchanged for carbon dioxide in your blood. The asbestos fibers irritate and scar lung tissue, causing the lungs to become stiff. This makes it difficult to breathe.

As asbestosis progresses, more and more lung tissue becomes scarred. Eventually,the lung tissue becomes so stiff that it can’t contract and expand normally.

Smoking appears to increase the retention of asbestos fibers in the lungs, and often results in a faster progression of the disease.

Risk Factors:
Those who worked in the production, milling, manufacturing, installation, or removal of asbestos products before the late 1970s are at an increased risk of exposure to asbestos. This includes people who worked in these jobs in the United States and Canada. For example:

*Asbestos miners
*Aeronautical and car mechanics
*Boiler operators
*Construction workers
*Electricians
*Railway workers
*Workers who remove asbestos insulation from around a steam vessel in an old building

Construction workers who inhale asbestos from contaminated building materials such paint, spackling, roof shingles, masonry compounds, and drywall may get asbestosis The amount and length of an individual’s exposure to asbestos are the primary factors that determine the level of risk. The longer one is exposed to the substance, the higher their risk of developing lung damage.

Families of exposed workers can be affected because asbestos fibers from clothing and hair can end up in the home. People who live near mines can also be exposed to airborne asbestos fibers.

Diagnosis:.
According to the American Thoracic Society (ATS), the general diagnostic criteria for asbestosis are:

*Evidence of structural pathology consistent with asbestosis, as documented by imaging or histology

*Evidence of causation by asbestos as documented by the occupational and environmental history, markers of exposure (usually pleural plaques), recovery of asbestos bodies, or other means

*Exclusion of alternative plausible causes for the findings

The abnormal chest x-ray and its interpretation remain the most important factors in establishing the presence of pulmonary fibrosis. The findings usually appear as small, irregular parenchymal opacities, primarily in the lung bases. Using the ILO Classification system, “s”, “t”, and/or “u” opacities predominate. CT or high-resolution CT (HRCT) are more sensitive than plain radiography at detecting pulmonary fibrosis (as well as any underlying pleural changes). More than 50% of people affected with asbestosis develop plaques in the parietal pleura, the space between the chest wall and lungs. Once apparent, the radiographic findings in asbestosis may slowly progress or remain static, even in the absence of further asbestos exposure. Rapid progression suggests an alternative diagnosis.

Asbestosis resembles many other diffuse interstitial lung diseases, including other pneumoconiosis. The differential diagnosis includes idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, sarcoidosis, and others. The presence of pleural plaques may provide supportive evidence of causation by asbestos. Although lung biopsy is usually not necessary, the presence of asbestos bodies in association with pulmonary fibrosis establishes the diagnosis. Conversely, interstitial pulmonary fibrosis in the absence of asbestos bodies is most likely not asbestosis. Asbestos bodies in the absence of fibrosis indicate exposure, not disease.

Treatment:
There is no cure available for asbestosis. Oxygen therapy at home is often necessary to relieve the shortness of breath and correct underlying low blood oxygen levels. Supportive treatment of symptoms includes respiratory physiotherapy to remove secretions from the lungs by postural drainage, chest percussion, and vibration. Nebulized medications may be prescribed in order to loosen secretions or treat underlying chronic obstructive pulmonary disease. Immunization against pneumococcal pneumonia and annual influenza vaccination is administered due to increased sensitivity to the diseases. Those with asbestosis are at increased risk for certain cancers. If the person smokes, quitting the habit reduces further damage. Periodic pulmonary function tests, chest x-rays, and clinical evaluations, including cancer screening/evaluations, are given to detect additional hazards.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Asbestosis
https://www.mayoclinic.org/diseases-conditions/asbestosis/symptoms-causes/syc-20354637

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Ailmemts & Remedies

Acute lymphoblastic leukaemia. (ALL)

Description:

Acute lymphoblastic leukaemia is a type of blood cancer that affects white blood cells. Cancer starts in the bone marrow, the spongy tissue inside the bones where blood cells are produced
It is a cancer of the lymphoid line of blood cells characterized by the development of large numbers of immature lymphocytes. Symptoms may include feeling tired, pale skin color, fever, easy bleeding or bruising, enlarged lymph nodes, or bone pain. As an acute leukemia, ALL progresses rapidly and is typically fatal within weeks or months if left untreated.

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The underlying mechanism involves multiple genetic mutations that results in rapid cell division. The excessive immature lymphocytes in the bone marrow interfere with the production of new red blood cells, white blood cells, and platelets. Diagnosis is typically based on blood tests and bone marrow examination.

ALL affected about 876,000 people globally in 2015 and resulted in about 111,000 deaths. It occurs most commonly in children, particularly those between the ages of two and five. In the United States it is the most common cause of cancer and death from cancer among children. ALL is notable for being the first disseminated cancer to be cured. Survival for children increased from under 10% in the 1960s to 90% in 2015. Survival rates remain lower for babies (50%) and adults (35%).

Symptoms:
Initial symptoms can be nonspecific, particularly in children. Over 50% of children with leukemia had one or more of five features: a liver one can feel (64%), a spleen one can feel (61%), pale complexion (54%), fever (53%), and bruising (52%). Additionally, recurrent infections, feeling tired, arm or leg pain, and enlarged lymph nodes can be prominent features. The B symptoms, such as fever, night sweats, and weight loss, are often present as well.

Central nervous system (CNS) symptoms such as cranial neuropathies due to meningeal infiltration are identified in less than 10% of adults and less than 5% of children, particularly mature B-cell ALL (Burkitt leukemia) at presentation.

Signs and symptoms of acute lymphocytic leukemia may include:

*Bleeding from the gums
*Bone pain
*Fever
*Frequent infections
*Frequent or severe nosebleeds
*Lumps caused by swollen lymph nodes in and around the neck, armpits, abdomen or groin
*Pale skin
*Shortness of breath
*Weakness, fatigue or a general decrease in energy

Causes:
In most cases, the cause is unknown. Genetic risk factors may include Down syndrome, Li–Fraumeni syndrome, or neurofibromatosis type 1. Environmental risk factors may include significant radiation exposure or prior chemotherapy. Evidence regarding electromagnetic fields or pesticides is unclear. Some hypothesize that an abnormal immune response to a common infection may be a trigger.

The cancerous cell in ALL is the lymphoblast. Normal lymphoblasts develop into mature, infection-fighting B-cells or T-cells, also called lymphocytes. Signals in the body control the number of lymphocytes so neither too few nor too many are made. In ALL, both the normal development of some lymphocytes and the control over the number of lymphoid cells become defective.

ALL emerges when a single lymphoblast gains many mutations to genes that affect blood cell development and proliferation. In childhood ALL, this process begins at conception with the inheritance of some of these genes. These genes, in turn, increase the risk that more mutations will occur in developing lymphoid cells. Certain genetic syndromes, like Down Syndrome, have the same effect. Environmental risk factors are also needed to help create enough genetic mutations to cause disease. Evidence for the role of the environment is seen in childhood ALL among twins, where only 10–15% of both genetically identical twins get ALL. Since they have the same genes, different environmental exposures explain why one twin gets ALL and the other does not.

Infant ALL is a rare variant that occurs in babies less than one year old. KMT2A (formerly MLL) gene rearrangements are most common and occur in the embryo or fetus before birth. These rearrangements result in increased expression of blood cell development genes by promoting gene transcription and through epigenetic changes. In contrast to childhood ALL, environmental factors are not thought to play a significant role. Aside from the KMT2A rearrangement, only one extra mutation is typically found. Environmental exposures are not needed to help create more mutations.

Risk factors:
Factors that may increase the risk of acute lymphocytic leukemia include:

1.Previous cancer treatment. Children and adults who’ve had certain types of chemotherapy and radiation therapy for other kinds of cancer may have an increased risk of developing acute lymphocytic leukemia.

  1. Toomuch exposure to radiation. People exposed to very high levels of radiation, such as survivors of a nuclear reactor accident, have an increased risk of developing acute lymphocytic leukemia.

3.Genetic disorders. Certain genetic disorders, such as Down syndrome, are associated with an increased risk of acute lymphocytic leukemia.

Diagnosis:
The doctor may ask for the following tests:

*Blood tests. Blood tests may reveal too many or too few white blood cells, not enough red blood cells, and not enough platelets. A blood test may also show the presence of blast cells — immature cells normally found in the bone marrow.

*Bone marrow test. During bone marrow aspiration and biopsy, a needle is used to remove a sample of bone marrow from the hipbone or breastbone. The sample is sent to a lab for testing to look for leukemia cells.

Doctors in the lab will classify blood cells into specific types based on their size, shape, and other genetic or molecular features. They also look for certain changes in the cancer cells and determine whether the leukemia cells began from B lymphocytes or T lymphocytes. This information helps your doctor develop a treatment plan.

*Imaging tests. Imaging tests such as an X-ray, a computerized tomography (CT) scan or an ultrasound scan may help determine whether cancer has spread to the brain and spinal cord or other parts of the body.

*Spinal fluid test. A lumbar puncture test, also called a spinal tap, may be used to collect a sample of spinal fluid — the fluid that surrounds the brain and spinal cord. The sample is tested to see whether cancer cells have spread to the spinal fluid.

Treatment:

In general, treatment for acute lymphocytic leukemia falls into separate phases:

Induction therapy. The purpose of the first phase of treatment is to kill most of the leukemia cells in the blood and bone marrow and to restore normal blood cell production.
Consolidation therapy. Also called post-remission therapy, this phase of treatment is aimed at destroying any remaining leukemia in the body.
Maintenance therapy. The third phase of treatment prevents leukemia cells from regrowing. The treatments used in this stage are usually given at much lower doses over a long period of time, often years.

Preventive treatment to the spinal cord. During each phase of therapy, people with acute lymphocytic leukemia may receive additional treatment to kill leukemia cells located in the central nervous system. In this type of treatment, chemotherapy drugs are often injected directly into the fluid that covers the spinal cord.
Depending on your situation, the phases of treatment for acute lymphocytic leukemia can span two to three years.

Treatments may include:

*Chemotherapy. Chemotherapy, which uses drugs to kill cancer cells, is typically used as an induction therapy for children and adults with acute lymphocytic leukemia. Chemotherapy drugs can also be used in the consolidation and maintenance phases.

*Targeted therapy. Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your leukemia cells will be tested to see if targeted therapy may be helpful for you. Targeted therapy can be used alone or in combination with chemotherapy for induction therapy, consolidation therapy or maintenance therapy.

*Radiation therapy. Radiation therapy uses high-powered beams, such as X-rays or protons, to kill cancer cells. If the cancer cells have spread to the central nervous system, your doctor may recommend radiation therapy.

*Bone marrow transplant. A bone marrow transplant, also known as a stem cell transplant, may be used as consolidation therapy or for treating relapse if it occurs. This procedure allows someone with leukemia to reestablish healthy bone marrow by replacing leukemic bone marrow with leukemia-free marrow from a healthy person.

A bone marrow transplant begins with high doses of chemotherapy or radiation to destroy any leukemia-producing bone marrow. The marrow is then replaced by bone marrow from a compatible donor (allogeneic transplant).

*Engineering immune cells to fight leukemia. A specialized treatment called chimeric antigen receptor (CAR)-T cell therapy takes your body’s germ-fighting T cells, engineers them to fight cancer and infuses them back into your body.

CAR-T cell therapy might be an option for children and young adults. It might be used for consolidation therapy or for treating relapse.

Clinical trials. Clinical trials are experiments to test new cancer treatments and new ways of using existing treatments. While clinical trials give you or your child a chance to try the latest cancer treatment, the benefits and risks of the treatment may be uncertain. Discuss the benefits and risks of clinical trials with your doctor.
Treatment for older adults:
Older adults, such as those older than 65, tend to experience more complications from treatments. And older adults generally have a worse prognosis than children who are treated for acute lymphocytic leukemia.

Some people may choose to forgo treatment for the cancer, instead focusing on treatments that improve their symptoms and help them make the most of the time they have remaining.

Prognosis:
Prior to the development of chemotherapy regimens and hematopoietic stem cell transplant, children were surviving a median length of 3 months, largely due to either infection or bleeding. Since the advent of chemotherapy, the prognosis for childhood leukemia has improved greatly and children with ALL are estimated to have a 95% probability of achieving a successful remission after 4 weeks of initiating treatment. People in pediatric care with ALL in developed countries have a greater than 80% five-year survival rate. It is estimated that 60–80% of adults undergoing induction chemotherapy achieve complete remission after 4 weeks, and those over the age of 70 have a cure rate of 5%

However, there are differing prognoses for ALL among individuals depending on a variety of factors:

*Gender: Females tend to fare better than males.

*Ethnicity: Caucasians are more likely to develop acute leukemia than African-Americans, Asians, or Hispanics. However, they also tend to have a better prognosis than non-Caucasians.

*Age at diagnosis: children 1–10 years of age are most likely to develop ALL and to be cured of it. Cases in older people are more likely to result from chromosomal abnormalities (e.g., the Philadelphia chromosome) that make treatment more difficult and prognoses poorer. Older people are also likely to have co-morbid medical conditions that make it even more difficult to tolerate ALL treatment.

*White blood cell count at diagnosis of greater than 30,000 (B-ALL) or 100,000 (T-ALL) is associated with worse outcomes

*Cancer spreading into the Central nervous system (brain or spinal cord) has worse outcomes.

*Morphological, immunological, and genetic subtypes
Person’s response to initial treatment and longer length of time required (greater than 4 weeks) to reach complete remission

*Early relapse of ALL

*Minimal residual disease

*Genetic disorders, such as Down syndrome, and other chromosomal abnormalities (aneuploidy and translocations)

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Acute_lymphoblastic_leukemia
https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/symptoms-causes/syc-20369077

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Ailmemts & Remedies

Benign paroxysmal positional vertigo (BPPV)

Common Name: BPPV

Description:
Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that some one spinning or that the inside of head is spinning.

BPPV causes brief episodes of mild to intense dizziness. It is usually triggered by specific changes in one’s head position. This might occur when he or she tips head up or down, when lie down, or when turn over or sit up in bed.

Although BPPV can be bothersome, it’s rarely serious except when it increases the chance of falls. One can receive effective treatment for BPPV during a doctor’s office visit.

BPPV can affect people of all ages but is most common in people over the age of 60.
Most patients can be effectively treated with physical therapy. In rare cases, the symptoms can last for years.

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Symtoms:
People with BPPV can experience a spinning sensation — vertigo — any time there is a change in the position of the head.

The symptoms can be very distressing. People can fall out of bed or lose their balance when they get up from bed and try to walk. If they tilt their head back or forward while walking, they may even fall, risking injury. Vertigo can cause the person to feel quite ill with nausea and vomiting tendensis.

While the hallmark of BPPV is vertigo associated with changes in head position, many people with BPPV also feel a mild degree of unsteadiness in between their recurrent attacks of positional vertigo.

The onset of BPPV may be abrupt and frightening. People may think they are seriously ill; for example, they may fear they are having a stroke. A doctor’s diagnosis of BPPV can be reassuring, especially when people understand that help is available to relieve their symptoms.

Without treatment, the usual course of the illness is lessening of symptoms over a period of days to weeks, and sometimes there is spontaneous resolution of the condition. In rare cases, the person’s symptoms can last for years.

In many people, especially older adults, there is no specific event that causes BPPV to occur, but there are some things that may bring on an attack:

*Mild to severe head trauma

*Keeping the head in the same position for a long time, such as in the dentist chair, at the beauty salon or during strict bed rest

*Bike riding on rough trails

*High intensity aerobics

*Other inner ear disease (ischemic, inflammatory, infectious)

Causes:
BPPV occurs when tiny calcium crystals called otoconia come loose from their normal location on the utricle, a sensory organ in the inner ear.

If the crystals become detached, they can flow freely in the fluid-filled spaces of the inner ear, including the semicircular canals (SCC) that sense the rotation of the head. Otoconia will occasionally drift into one of the SCCs, usually the posterior SCC given its orientation relative to gravity at the lowest part of the inner ear.

The otoconia will not cause a problem when located in an SCC until the person’s head changes position, such as when looking up or down, going from lying to seated or lying to seated in bed, or when rolling over in bed. The otoconia move to the lowest part of the canal, which causes the fluid to flow within the SCC, stimulating the balance (eighth cranial) nerve and causing vertigo and jumping eyes (nystagmus).

Risk factors:
Benign paroxysmal positional vertigo occurs most often in people age 60 and older, but can occur at any age. BPPV is also more common in women than in men. A head injury or any other disorder of the balance organs of your ear may make you more susceptible to BPPV.

Complications:
Although BPPV is uncomfortable, it rarely causes complications. The dizziness of BPPV can make a person unsteady, which may put him or her at greater risk of falling.

Diagnosis:
The doctor may do a series of tests to determine the cause of your dizziness. During a physical exam, the doctor will likely look for:

*Signs and symptoms of dizziness that are prompted by eye or head movements and then decrease in less than one minute

*Dizziness with specific eye movements that occur when you lie on your back with your head turned to one side and tipped slightly over the edge of the examination bed

*Involuntary movements of the person’s eyes from side to side

*Inability to control the eye movements

If the doctor can’t find the cause of your signs and symptoms, he or she may order additional testing, such as:

*Electronystagmography (ENG) or videonystagmography (VNG). The purpose of these tests is to detect abnormal eye movement. ENG (which uses electrodes) or VNG (which uses small cameras) can help determine if dizziness is due to inner ear disease by measuring involuntary eye movements while your head is placed in different positions or your balance organs are stimulated with water or air.

*Magnetic resonance imaging (MRI). This test uses a magnetic field and radio waves to create cross-sectional images of your head and body. Your doctor can use these images to identify and diagnose a range of conditions. MRI may be performed to rule out other possible causes of vertigo.

Treatments:
Benign paroxysmal positional vertigo may go away on its own within a few weeks or months. But, to help relieve BPPV sooner, the doctor, audiologist or physical therapist may treat the person with a series of movements known as the canalith repositioning procedure.

Canalith repositioning:

This can be performed in doctor’s office, the canalith repositioning procedure consists of several simple and slow maneuvers for positioning your head. The goal is to move particles from the fluid-filled semicircular canals of inner ear into a tiny baglike open area (vestibule) that houses one of the otolith organs in the ear, where these particles don’t cause trouble and are more easily resorbed.

Each position is held for about 30 seconds after any symptoms or abnormal eye movements stop. This procedure usually works after one or two treatments.

The doctor will likely teach the person how to perform the procedure on oneself so that he or she can do it at home if needed.

Surgical alternative:
In rare situations when the canalith repositioning procedure doesn’t work, the doctor may recommend a surgical procedure. In this procedure, a bone plug is used to block the portion of the inner ear that’s causing dizziness. The plug prevents the semicircular canal in the ear from being able to respond to particle movements or head movements in general. The success rate for canal plugging surgery is about 90%.

But the sergical option is needed in very very rare cases.

Medication:
The use of medication in treating vestibular disorders depends on whether the vestibular system dysfunction is in an initial or acute phase (lasting up to 5 days) or chronic phase (ongoing). Pharmacological treatments may be used to control symptoms, accelerate central compensation, and diminish psychological comorbidity.

AYURVEDIC TREATMENT: Some effective herbs tried in vertigo: Ginger Coriander Lemongrass – helps to treat nausea and dizziness, effective in vertigo. Herbal tea prepared with lemongrass is highly effective. It will relieve the symptoms within few minutes of onset. Cayenne – contains a chemical called capsaicin which helps enhance blood flow in your brain.

CLICK TO SEE AYURVEDIC WAY TO CURE VERTIGO

Exercises:
The home Epley maneuver is a type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV).One can do this exercise at home. BPPV is caused by a problem in your inner ear.

Semont Maneuver:
*Sit on the edge of your bed. Turn your head 45 degrees to the right.

*Quickly lie down on your left side. Stay there for 30 seconds.

*Quickly move to lie down on the opposite end of your bed. …

*Return slowly to sitting and wait a few minutes.

*Reverse these moves for the right ear.

Yoga therapy :
There are several types of yoga poses, or asanas: meditative, cultural, and therapeutic poses.

Meditation helps to calm the mind and reduce anxiety. Because stress is a trigger for many vestibular patients, reducing stress can also help to minimize symptoms like dizziness and vertigo. Controlled breathing, or pranayama, is a tool that can help you control your energy level, reduce stress, increase your endurance and reduce your anxiety.

Cultural asanas are so named because they play a central role in forming a comprehensive physical culture of exercise and general well-being. Cultural asanas are sub-divided into physical asanas and relaxative asanas. Physical asanas greatly assist in rendering the body healthy, while relaxative asanas work on the Chitta (the understated aspect of consciousness) level, eliminating physical and mental tension.

Certain therapeutic poses can be helpful for different ailments, like imbalance, dizziness, diabetes, arthritis, or back pain. Yoga can be considered “therapeutic” when poses are adjusted to fit the unique needs of the practitioner. Some yoga classes are designed for special groups with unique needs, such as people with balance issues.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Help taken from:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/benign-paroxysmal-positional-vertigo-bppv

https://www.mayoclinic.org/diseases-conditions/vertigo/symptoms-causes/syc-20370055#:~:text=Benign%20paroxysmal%20positional%20vertigo%20(BPPV)%20is%20one%20of%20the%20most,changes%20in%20your%20head’s%20position.
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