News on Health & Science

Say No to Pneumonia

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This year once again Pneumonia Day (November 12) came and went without much fanfare. Although great progress has been made in preventing and treating the disease, it still affects three in 1,000 people annually and has a 10-15 per cent rate of mortality.
Pneumonia can occur as a result of infection with a wide spectrum of organisms, with viruses, bacteria, fungi and parasites implicated. Infection can be acquired from others in the community. It can develop as a complication of prolonged hospitalisation for other illnesses or surgery.

In infants less than three weeks, the organism is often acquired from the birth canal. School-going children may get it from their peers. Adults are more likely to develop pneumonia if they smoke, drink, are obese or have diabetes. People who are immune-compromised (the system doesn’t work as well as it should) as a result of steroids, treatment for cancer or if they have AIDS are also at a higher risk.

Our stomach contains partially digested food that is held back by sphincters (muscles that constrict or relax passages as required). Sometimes the sphincters become lax and the food may regurgitate into the lungs. This is “aspiration pneumonia” and can occur with loss of consciousness or a stroke, after surgery, or when a person is fed through a tube. The infection is “mixed” with a bouquet of organisms and is difficult to treat.

The mouth contains many organisms, which proliferate with dental caries or gum disease. These organisms may pass inadvertently into the lungs during sleep causing pneumonia.

Influenza can cause viral pneumonia. This is seasonal and is often associated with conjunctivitis or diarrhoea. It can be severe like in SARS, avian flu or swine flu. Initially, it is difficult to distinguish between a viral pneumonia (which doesn’t require or respond to antibiotics) and a bacterial infection. Many viral pneumonias progress to bacterial infections.

The cilia (fine hair) lining the lungs initially try to push out infecting organisms. The lung cells then secrete antibody-containing mucous in which the organisms get trapped. Cough reflexes set in trying to expel the organism. When this fails, the organism gains a foothold, starts to proliferate and causes pneumonia.

Tobacco contains nicotine which paralyses the protective cilia. They became inactive, inefficient and ineffective. This is why smokers develop pneumonia frequently. Others (particularly women and children) who live with smokers are also affected similarly by the smoke filled environment.

The common signs of pneumonia are fever, rapid breathing, a cough, breathlessness, sweating, chills, headache, muscle pain and tiredness. The chest overlying the affected portion of the lung may hurt while breathing.

These typical symptoms may not occur in older people. The temperature may fall below normal instead of rising. The breathing may become shallow and ineffective. Coughing may become difficult.

Pneumonia was a dangerous and fatal disease before the antibiotic era. Timely, adequate and appropriate treatment has considerably reduced its mortality. It can still be life threatening.

If you have been diagnosed with pneumonia, take the medication as prescribed without resorting to alternative systems of medicine. Seven to 14 days of antibiotics may be required to eliminate the infection. Pneumonia can recur if inadequately treated. Also, drink plenty of fluids. This helps keep the secretions fluid, making it easy to cough out. Do not be in a hurry to return to school or work. If you do so before you are fully cured, you will spread the infection.

Pneumonia is often a complication of seasonal influenza. A vaccine is available against seasonal flu and certain types like swine flu. Timely immunisation prevents infection.

Two of the common bacteria casing pneumonia are H. infuenzae and Strep pneumonia. Immunisation is available against both and should be given to children. Pneumococcal vaccine is available for adults too. It should be taken after the age of 55, preferably by all adults and definitely by those with diabetes, asthma, kidney or liver disease.

Contaminated hands efficiently carry bacteria. Washing your hands frequently helps remove disease-causing bacteria and reduces the incidence of pneumonia.

Visit a dentist regularly and take care of your teeth. Maintain your health and immunity. You can do this not by consuming tonics, rejuvenators and health supplements, but by maintaining your ideal body weight, exercising regularly, and adding fresh fruits and raw vegetables to your diet.

Source : The Telegraph ( Kolkata, India)

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Diagnonistic Test

Sputum Evaluation (and Sputum Induction)

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If your doctor thinks you have pneumonia, he or she might examine a sample of your sputum, the phlegm that you cough out of your lungs, to try to determine what type of bacteria or other infectious agent might be the cause.

Sputum induction is also  a new support tool for the diagnosis and evaluation of occupational asthma.
In order to evaluate a new test for helping in the diagnosis and evaluation of occupational asthma, 24 workers with occupational asthma were recruited. Besides assessing their respiratory function, their bronchial inflammation was evaluated by sputum induction, a simple method that evaluates bronchial cellularity non-invasively. The results show that the functional and inflammatory parameters of subjects with occupational asthma improve mainly in the 6 months following removal from exposure. Furthermore, it appears that the workers with eosinophilic bronchial inflammation at the time of diagnosis evolve more favourably after removal from exposure than those without this inflammation.


How do you prepare for the test?
Drink plenty of fluids the night before the test; this may help to produce a sample.

What happens when the test is performed?
You need to cough up a sample of sputum. To be useful for testing, the stuff you cough up has to be from deep within the lungs. If your cough is too shallow or dry, the doctor might ask you to breathe in a saltwater mist through a tube or mask. This mist makes you cough deeply, usually producing an excellent phlegm sample.

You may click to see:->

Method and apparatus for inducing sputum samples for diagnostic evaluation

Lung Tests in Asthma

Risk Factor: No risk is involved.

Must you do anything special after the test is over? : Nothing

How long is it before the result of the test is known?
The technician stains the sputum sample and views it under a microscope. Some of the sample is incubated to grow the bacteria or other germs in it for further testing. This step is called a sputum culture.While some stain results might be available on the day of your test, the culture usually requires several days.


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Diagnonistic Test

Chest X-Ray

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Definition:The chest x-ray is the most commonly performed diagnostic x-ray examination. A chest x-ray makes images of the heart, lungs, airways, blood vessels and the bones of the spine and chest.

An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves exposing a part of the body to a small dose of ionizing radiation to produce pictures of the inside of the body. X-rays are the oldest and most frequently used form of medical imaging.

Doctors have used x-rays for over a century to see inside the body in order to diagnose a variety of problems, including cancer, fractures, and pneumonia. During this test, you usually stand in front of a photographic plate while a machine sends x-rays, a type of radiation, through your body. Originally, a photograph of internal structures was produced on film; nowadays, the image created by the x-rays goes directly into a computer. Dense structures, such as bone, appear white on the x-ray films because they absorb many of the x-ray beams and block them from reaching the plate (see Figure 16). Hollow body parts, such as lungs, appear dark because x-rays pass through them. (In some other countries, like the United Kingdom, the colors are reversed, and dense structures are black.)

Back x-rays and chest x-rays are among the most common conventional x-ray tests. You should not have an x-ray if you’re pregnant, because radiation can be harmful to a developing fetus.

A chest x-ray provides black-and-white images of your lungs, ribs, heart, and diaphragm.


Some common uses:
The chest x-ray is performed to evaluate the lungs, heart and chest wall.

A chest x-ray is typically the first imaging test used to help diagnose symptoms such as:

*shortness of breath
*a bad or persistent cough
*chest pain or injury
Physicians use the examination to help diagnose or monitor treatment for conditions such as:

*heart failure and other heart problems
*lung cancer
*other medical conditions.

How should you prepare for the test?

A chest x-ray requires no special preparation.

You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. Many imaging tests are not performed during pregnancy so as not to expose the fetus to radiation. If an x-ray is necessary, precautions will be taken to minimize radiation exposure to the baby. See the Safety page for more information about pregnancy and x-rays.

You are usually asked to remove all clothing, undergarments, and jewelry above your waist, and to wear a hospital gown.

What does the equipment look like?
The equipment typically used for chest x-rays consists of a wall-mounted, box-like apparatus containing the x-ray film or a special plate that records the image digitally and an x-ray producing tube, that is usually positioned about six feet away.
The equipment may also be arranged with the x-ray tube suspended over a table on which the patient lies. A drawer under the table holds the x-ray film or digital recording plate.

A portable x-ray machine is a compact apparatus that can be taken to the patient in a hospital bed or the emergency room. The x-ray tube is connected to a flexible arm that is extended over the patient while an x-ray film holder or image recording plate is placed beneath the patient.

What happens when the test is performed?
Chest x-rays usually are taken while you are standing. A technician positions you against the photographic plate (which looks like a large board) to obtain the clearest pictures. He or she takes pictures from the front and from one side while asking you to take in a deep breath just before each picture. The technician leaves the room or stands behind a screen while the x-rays are taken.

How does the procedure work?
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. Once it is carefully aimed at the part of the body being examined, an x-ray machine produces a small burst of radiation that passes through the body, recording an image on photographic film or a special digital image recording plate.

Different parts of the body absorb the x-rays in varying degrees. Dense bone absorbs much of the radiation while soft tissue, such as muscle, fat and organs, allow more of the x-rays to pass through them. As a result, bones appear white on the x-ray, soft tissue shows up in shades of gray and air appears black.

On a chest x-ray, the ribs and spine will absorb much of the radiation and appear white or light gray on the image. Lung tissue absorbs little radiation and will appear dark on the image.

Until recently, x-ray images were maintained as hard film copy (much like a photographic negative). Today, most images are digital files that are stored electronically. These stored images are easily accessible and are sometimes compared to current x-ray images for diagnosis and disease management.

How is the procedure performed?

Typically, two views of the chest are taken, one from the back and the other from the side of the body as the patient stands against the image recording plate. The technologist, an individual specially trained to perform radiology examinations, will position the patient with hands on hips and chest pressed the image plate. For the second view, the patient’s side is against the image plate with arms elevated.


Patients who cannot stand may be positioned lying down on a table for chest x-rays.

You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained.

The chest x-ray examination is usually completed within 15 minutes.

Additional views may be required within hours, days or months to evaluate any changes in the chest.

What will you experience during and after the procedure?
A chest x-ray examination itself is a painless procedure.

You may experience discomfort from the cool temperature in the examination room and the coldness of the recording plate. Individuals with arthritis or injuries to the chest wall, shoulders or arms may have discomfort trying to stay still during the examination. The technologist will assist you in finding the most comfortable position possible that still ensures diagnostic image quality.
Who interprets the results and how do you get them?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will discuss the results with you.

In an emergency, the results of a chest x-ray can be available almost immediately for review by your physician.
What are the benefits vs. risks?

*No radiation remains in a patient’s body after an x-ray examination.
*X-rays usually have no side effects in the diagnostic range.
*X-ray equipment is relatively inexpensive and widely available in emergency rooms, physician offices, ambulatory care *centers, nursing homes and other locations, making it convenient for both patients and physicians.
*Because x-ray imaging is fast and easy, it is particularly useful in emergency diagnosis and treatment.


*There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.

*The chest x-ray is one of the lowest radiation exposure medical examinations performed today. The effective radiation dose from this procedure is about 0.1 mSv, which is about the same as the average person receives from background radiation in 10 days. See the Safety page for more information about radiation dose.

*Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.

How long is it before the result of the test is known?
Although digital images may be available immediately, it will take additional time for a doctor to examine and interpret them. You’ll probably get the results later in the day.

A Word About Minimizing Radiation Exposure:
Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection councils continually review and update the technique standards used by radiology professionals.

State-of-the-art x-ray systems have tightly controlled x-ray beams with significant filtration and dose control methods to minimize stray or scatter radiation. This ensures that those parts of a patient’s body not being imaged receive minimal radiation exposure.

What are the limitations of Chest Radiography?
The chest x-ray is a very useful examination, but it has limitations. Because some conditions of the chest cannot be detected on an x-ray image, this examination cannot necessarily rule out all problems in the chest. For example, very small cancers may not show up on a chest x-ray. A blood clot in the lungs, a condition called a pulmonary embolism, cannot be seen on chest x-rays.

Further imaging studies may be necessary to clarify the results of a chest x-ray or to look for abnormalities not visible on the chest x-ray.

Click for More Additional Information and Resources: ->
*RadiologyInfo: Radiation Therapy for Lung Cancer

* Radiation Therapy for Lung Cancer


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Diagnonistic Test


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Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. An instrument (bronchoscope) is inserted into the airways, usually through the nose or mouth, or occasionally through a tracheostomy. This allows the practitioner to examine the patient’s airways for abnormalities such as foreign bodies, bleeding, tumors, or inflammation. Specimens may be taken from inside the lungs: biopsies, fluid (bronchoalveolar lavage), or endobronchial brushing. The construction of bronchoscopes ranges from rigid metal tubes with attached lighting devices to flexible fibreoptic instruments with realtime video equipment.
A bronchoscope is a long snakelike instrument with a tiny video camera and biopsy instruments on one end. It can be maneuvered through your mouth and directly into the airways of your lungs. Bronchoscopy is usually done to obtain a sample of deep lung mucus or lung tissue to help diagnose cancer, pneumonia, or other lung disease.

Why it is done?
Bronchoscopy is usually done to find the cause of a lung problem. Samples of mucus or tissue may be taken from the patient’s lungs during the procedure to test in a lab.

Bronchoscopy may show a tumor, signs of an infection, excess mucus in the airways, the site of bleeding, or something blocking the airway, like a piece of food.

Sometimes bronchoscopy is used to treat lung problems. It may be done to insert a stent in an airway. An airway stent is a small tube that holds the airway open. It is used when a tumor or other condition blocks an airway.

In children, the procedure is most often used to remove something blocking the airway. In some cases, it is used to find out what’s causing a cough that has lasted for at least a few weeks.

How do you prepare for the test?
You will need to sign a consent form giving your doctor permission to perform this test. Some patients have this test done in a clinic procedure area, while others are admitted to the hospital for it. Generally your doctor will decide whether you need to be in the hospital based on your medical condition. If you are not staying in the hospital afterward, you should arrange for a ride home.

Talk with your doctor ahead of time if you are taking insulin, or if you take aspirin, nonsteroidal antiinflammatory drugs, or other medicines that affect blood clotting. It may be necessary to stop or adjust the dose of these medicines before your test. Most people need to have a blood test done some time before the procedure to make sure they are not at high risk for bleeding complications. Also tell your doctor if you have ever had an allergic reaction to the medicine lidocaine or the numbing medicine used at the dentist’s office.

Usually you will be told not to eat anything after midnight on the night before the test. This is so you will have an empty stomach in case you experience nausea from anti-anxiety medicines (sedatives) or have a choking sensation or nausea when the camera is first lowered past your throat.

What happens when the test is performed?
You wear a hospital gown during the procedure. You have an IV (intravenous) line inserted into a vein in case you need medicines or fluid during the procedure.

Bronchoscopy can be performed in a special room designated for such procedures, operating room, intensive care unit, or other location with resources for the management of airway emergencies. The patient will often be given antianxiety and antisecretory medications (to prevent oral secretions from obstructing the view), generally atropine, and sometimes an analgesic such as morphine. During the procedure, sedatives such as midazolam or propofol may be used. A local anesthetic is often given to anesthetise the mucous membranes of the pharynx, larynx, and trachea. The patient is monitored during the procedure with periodic blood pressure checks, continuous ECG monitoring of the heart, and pulse oximetry.

During the procedure, a thin, flexible tube called a bronchoscope is passed through the patient’s nose (or sometimes the mouth), down the throat, and into the airways. If the patient has a breathing tube, the bronchoscope can be passed through it to the airways.

At the bronchoscope’s tip are a light and a mini-camera, so the doctor can see your windpipe and airways. The patient will be given medicine to make them relaxed and sleepy during the procedure.

In some cases, your doctor decides that this procedure would be safer or easier if you were intubated before the test and for a short time afterward. This means having a plastic tube placed through your mouth into your main airway. If you are intubated, you are able to breathe, but you cannot speak while the tube is in place, as it passes between your vocal cords in your voice box. Intubation is always done with the assistance of an anesthesiologist, who gives you medicines to relax your throat muscles and make you unconscious for a minute or two while the tube is placed. Most patients do not require intubation.

If you are not intubated, your doctor or nurse sprays a numbing medicine onto the back of your throat just before the procedure. This medicine makes it easier for you to have the bronchoscope placed. Most patients are also given some medicine through the IV to relax them.

You lie on a hospital bed for the procedure. Your doctor (usually a pulmonary specialist) moves one end of the bronchoscope through your mouth and throat and into your trachea (windpipe). Some patients cough or gag briefly when this is done. The bronchoscope is much narrower than your trachea, so you are able to breathe easily during the procedure.

The doctor can see into your lungs by watching a TV screen that shows the view from the camera on the end of the bronchoscope. Your doctor can control a miniature vacuum at the end of the scope that allows him or her to take a sample of mucus from inside the lung. It is also possible for the doctor to take a biopsy sample of the lung tissue using a needle that can be moved through the scope. At the end of the test, the bronchoscope is pulled out, and you might cough forcefully a few times, possibly coughing out some phlegm.

Bronchoscopy usually takes 30 minutes to an hour, including setup time. The camera is usually in place for less than 20 minutes.

What risks are there from the test?
Besides the risks associated with the drug used, there are also specific risks of the procedure. Although the rigid bronchoscope can scratch or tear airway or damage the vocal cords, the risk of bronchoscopy is limited. Complications from fiberoptic bronchoscopy remain extremely low. Common complications include excessive bleeding following biopsy. A lung biopsy also may cause leakage of air called pneumothorax. Pneumothorax occurs in less than 1% of cases requiring lung biopsy. Laryngospasm is a rare complication but may sometimes require intubation. Patients with tumors or significant bleeding may experience increased difficulty breathing after a bronchoscopic procedure, sometimes due to swelling of the mucous membranes of the airways.

The risks of bronchoscopy are primarily associated with the needle biopsy procedure that is sometimes done through the bronchoscope. If a biopsy is done, the risks include bleeding in the lung or the formation of an air leak. If a patient vomits during the procedure and stomach contents leak down around the bronchoscope, this can irritate the lung and cause a type of pneumonia called aspiration pneumonia. Some patients have a hoarse voice or a sore throat for a day or two after bronchoscopy. Most people have no side effects from the procedure.

The other risks include:

*A drop in a patient’s oxygen level during the procedure. Oxygen will be administered if this happens.
*A slight risk of minor bleeding and developing a fever or pneumonia.

A rare but more serious side effect is a pneumothorax. A pneumothorax is a condition in which air or gas collects in the space around the lungs. This can cause the lung(s) to collapse.

This condition is easily treated and may go away on its own. If it interferes with breathing, a tube may need to be placed in the space around the lungs to remove the air.

A chest X-ray may be done after bronchoscopy to check for problems

Must you do anything special after the test is over?
You will probably feel sleepy after the procedure for a few hours, due to the anti-anxiety medicines. Generally, patients either spend a few hours in a recovery room or stay overnight in the hospital after bronchoscopy. If you do go home the same day, you should not drive or drink alcohol.

What does bronchoscopy show?
Bronchoscopy may show a tumor, signs of an infection, excess mucus in the airways, the site of bleeding, or something blocking the airway.

The doctor will use the procedure results to decide how to treat any lung problems that were found. Other tests may be needed.
Recovery and recuperation :
Patients will be advised by their doctors about when they can return to their normal activities, such as driving, working, and physical activity. For the first few days, a sore throat, cough, and hoarseness are common. The doctor should be called right away if the patient:

*Develops a fever
*Has chest pain
*Has trouble breathing
*Coughs up more than a few tablespoons of blood

How long is it before the result of the test is known?
Your doctor can tell you what the airways in your lungs look like as soon as the test is over. If a sample of mucus or lung tissue was obtained, analysis will require anywhere from a few hours to a few days.


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Ailmemts & Remedies


Pasteurellosis is an infection with a species of the bacteria genus Pasteurella , which is found in humans and animals. Pasteurella multocida (P. septica) is carried in mouth and respiratory tract of several animals, including cats, dogs and rabbits, and some birds and fish. It is a small gram negative bacillus with bipolar staining by Wayson coloration. In animals it can originate fulminant septicaemia (chicken cholera), but is also a common commensal. It is usually harmless, but sometimes it can lead to a disease caused pasteurellosis, which is especially prominent in rabbits (where it known as rabbit flu). Pasteurellosis in humans is associated with a close animal contact, namely a catbite or dogbite.

P. multocida is present in the saliva and faecal material of animals.The most common form of infection in humans is through a bite or scratch, usually from a cat or dog, from an animal carrying the bacteria.Once the bacteria have been passed to a person, there is a possibility that they may go on to develop pasteurellosis. John Freeman was thought to have contracted the infection from the rabbit through a blister on his thumb.


Several hundred people are infected with pasteurellosis each year.But deaths are very rare, according to the Office of National Statistics the last recorded death from pasteurellosis was in 2001.

There are several forms of the infection:

Cutaneous / subcutaneous disease : this is a septic phlegmon that develops classically in the hand and forearm after cat bite. Inflammatory signs are very rapid to develop, in 1 or 2 hours edema , severe pain and serosanguineous exudate appears. Fever , moderate or very high can be seen alongside with vomiting, headache and diarrhea. Lymphangitis is usual. Complications are possible, in the form of septic arthritis, osteitis or evolution to chronicity.

Septicaemia : is very rare, but can be as fulminant as septicaemic plague , with high fever, rigors and vomiting followed by shock and coagulopathy.

Pneumonic disease : is also rare and appears in patients with some chronic pulmonary pathology. it usually presents as billateral consolidating pneumonia , sometimes very severe.

Other locations are possible, like septic arthritis, meningitis and acute endocarditis but are very rare

Pasteurellosis in animals
P. multocida causes numerous pathological conditions in domestic animals. It often acts together with other infectious agents, like Chlamidiae, Mycoplasmae, viruses. The environmental conditions play also a role like transportation, bad weather, housing deficiency.

The following diseases are considered caused by P. multocida, alone or associated to other pathogens :

* Shipping fever in cattle and sheep.
* Enzootic pneumonia of sheep (and goats, with frequent intervention of Mannheimia haemolytica)
* Fowl cholera (chicken and other domestic poultry and cage birds)
* Enzootic pneumonia of pigs
* Pasteurellosis of chinchilla
* Pasteurellosis of rabbits

The first signs of pasteurellosis can occur a few hours after infection, and include pain, redness and swelling around the area of the infection.If the infection spreads and gets into the bloodstream, it can cause flu-like symptoms such as fever, headaches, chills and swollen glands, and if left untreated can result in pneumonia or septicaemia, and on rare occasions, death.

Diagnosis is made with isolation of Pasteurella multocida in a normally sterile site ( blood, pus or CSF).

Pasteurellosis is usually treated with high dose penicillin. Tetracycline and chloramphenicol provides an alternative in beta-lactam intolerant patients.

What should I do if I have been scratched or bitten by an animal?
You are advised to carefully wash the wound, using a disinfectant soap, and to seek medical advice.Immuno-suppressed people are at greater risk of serious complications, as with any infection, so should seek medical advice immediately.
Should I be worried if I keep animals?
Vets urge pet owners not to worry, the bacteria is extremely common and usually harmless, but they say bites or scratches should be treated with caution.

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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