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Ailmemts & Remedies

Buerger’s Disease

Alternative Nane:Thromboangiitis obliterans

Definition:
Buerger’s disease is a rare disease of the arteries and veins in the arms and legs.In this disease, your blood vessels become inflamed, swell and can become blocked with blood clots (thrombi). This eventually damages or destroys skin tissues and may lead to infection and gangrene. Buerger’s disease usually first shows in the hands and feet and may eventually affect larger areas of your arms and legs.

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Buerger’s disease is rare in the United States, but is more common in the Middle East and Far East. Buerger’s disease usually affects men younger than 40 years of age, though it’s becoming more common in women.

Virtually everyone diagnosed with Buerger’s disease smokes cigarettes or uses other forms of tobacco, such as chewing tobacco. Quitting all forms of tobacco is the only way to stop Buerger’s disease. For those who don’t quit, amputation of all or part of a limb may be necess

Symptoms:
The following are the symptoms of Buerger’s:
•Intermittent leg pains
•Leg numbness
•Leg tingling
•Leg burning
•Leg paresthesias
•Foot pains
•Leg pain worse with exertion
•Foot pain worse with exertion
•Foot paresthesias
•Foot numbness
•Foot tingling
•Foot burning
•Cold feet
•Foot discoloration
•Poor leg circulation
•Poor hand circulation – in some less common cases
•Severe pain in extremities at rest
•Insomnia
•Sensation of cold at extremities
•Cold hypersensibility
•Sudden sweating
•Dyshidrosis
•Ulceration of extremities
•Gangrene of extremities
•Blood vessel inflammation
•Blood vessel thrombosis
•Rest pain
•Unremitting ischemic ulcerations
•Gangrene of the digits of hands and feet

The lack of sufficient blood flow to the hands and feet leads to the development of tissue ischemia and sores or lesions. This can eventually lead to the death (necrosis) of affected tissues and gangrene, which may require removal of the dead tissues or amputation in the most severe cases.

Buerger’s disease can mimic or occur in conjunction with a condition called Raynaud’s phenomenon. Symptoms of Raynaud’s phenomenon include a change in color of the affected fingers and toes. The fingers and toes may appear pale, grey or bluish (cyanosis). The hands and feet may feel very cold and there may also be pain, throbbing, burning or numbness….more about Buerger’s disease »

Causes:
The precise cause of Buerger’s disease is unknown.
It’s believed that in genetically susceptible individuals, smoking triggers an autoimmune response that causes the inflammation. The symptoms occur as a result of inadequate blood supply to the tissues.

Diagnosis:
Patient history and physical examination strongly suggest Buerger’s disease.
The condition is characterized by swelling in the arteries and veins of the arms and legs. The cells that cause the inflammation and swelling — and eventually blood clots — form in the vessels leading to your hands and feet and block the blood flow to those parts of your body.

Reduced blood flow means that the skin tissue in your hands and feet doesn’t get adequate oxygen and nutrients. This leads to the signs and symptoms of Buerger’s disease, beginning with pain and weakness in your fingers and toes and spreading to other parts of your arms and legs.

While no tests can confirm whether you have Buerger’s disease, your doctor will likely order tests to rule out other more common conditions or confirm suspicion of Buerger’s disease brought on by your signs and symptoms.

Tests may include:

Blood tests
Blood tests to look for certain substances can rule out other conditions that may cause similar signs and symptoms. For instance, blood tests can help rule out scleroderma, lupus, blood-clotting disorders and diabetes, along with other diseases and conditions.

The Allen’s test
Your doctor may perform a simple test called the Allen’s test to check blood flow through the arteries carrying blood to your hands. In the Allen’s test, you make a tight fist, which forces the blood out of your hand. Your doctor presses on the arteries at each side of your wrist to slow the flow of blood back into your hand, making your hand lose its normal color. Next, you open your hand and your doctor releases the pressure on one artery, then the other. How quickly the color returns to your hand may give a general indication about the health of your arteries. Slow blood flow into your hand may indicate a problem, such as Buerger’s disease.

Angiogram
An angiogram, also called an arteriogram, helps doctors see the condition of your arteries. A special dye is injected into an artery, after which you undergo

X-rays or other imaging tests. The dye helps to delineate any artery blockages that show up on the images. Your doctor may order angiograms of both your arms and your legs — even if you don’t have signs and symptoms of Buerger’s disease in all of your limbs. Buerger’s disease almost always affects more than one limb, so even though you may not have signs and symptoms in your other limbs, this test may detect early signs of vessel damage.

* Doppler ultrasonography to show diminished circulation in the peripheral vessels

* plethysmography to help detect decreased circulation in the peripheral vessels

Risk Factors:

Tobacco use
Cigarette smoking greatly increases your risk of Buerger’s disease. Heavy cigarette smokers (people who smoke one and a half packs a day or more) are most likely to develop Buerger’s disease, though it can occur in people who use any form of tobacco, including cigars and chewing tobacco. People who smoke hand-rolled cigarettes using raw tobacco may have the greatest risk of Buerger’s disease.

It isn’t clear how tobacco use increases your risk of Buerger’s disease, but virtually everyone diagnosed with Buerger’s disease uses tobacco. It’s thought that chemicals in tobacco may irritate the lining of your blood vessels, causing them to swell. Rates of Buerger’s disease are highest in areas of the Middle

East and Far East where heavy smoking is most common.

Although secondhand smoke isn’t thought to be a major risk factor for Buerger’s disease, if you’re diagnosed, you should stay away from people who are

Smoking. Secondhand smoke could worsen your condition.

Chronic gum disease :Long-term infection of the gums is also associated with the development of Buerger’s disease.

Treatment:
The only effective treatment for Buerger’s disease is to quit smoking (smoking cessation) and to abstain from the use of all tobacco products, such as chewing tobacco. At this time, there are no medications that are effective in treating Buerger’s disease.

If an affected individual continues to smoke, they’re likely to have toes and/or fingers amputated. Infections should be treated promptly.

Smoking cessation is a challenging process and requires a multifaceted approach to be successful. For optimal results with smoking cessation, it is recommended that a smoker consults with a health care provider prior to quitting. Smoking cessation can include a combination of nicotine replacement therapy to minimize the nicotine cravings associated with nicotine withdrawal, and participation in a smoking cessation support group, such as Freedom From Smoking (http://www.ffsonline.org/ ) or Nicotine Anonymous (http://www.nicotine-anonymous.org).

Lifestyle & Home Remedies:
Take care of your fingers and toes if you have Buerger’s disease. Check the skin on your arms and legs daily for cuts and scrapes, keeping in mind that if you’ve lost feeling to a finger or toe you may not feel, for example, a cut when it happens. Keep your fingers and toes protected and avoid exposing them to cold.

Low blood flow to your extremities means your body can’t resist infection as easily. Small cuts and scrapes can easily turn into serious infections. Clean any cut with water, apply antibiotic ointment and cover it with a clean bandage. Keep an eye on any cuts or scrapes to make sure they’re healing. If they get worse or heal slowly, see your doctor promptly.

Visit your dentist regularly to keep your gums and teeth in good health and avoid gum disease, which in its chronic form is associated with Buerger’s disease.
Prognosis: The disease is progressive in patients who do not stop smoking. Areas with gangrene must be removed surgically.

Prevention:
Quit using tobacco in any form
Virtually everyone who has Buerger’s disease has used tobacco in some form, most prominently cigarettes. To prevent Buerger’s disease, it’s important to not use tobacco.

Quitting smoking can be hard. If you’re like most people who smoke, you’ve probably tried to quit in the past, but haven’t been successful. It’s never too late to try again. Talk to your doctor about strategies to help you quit.

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:
http://www.wrongdiagnosis.com/b/buergers_disease/intro.htm
http://edition.cnn.com/HEALTH/library/buergers-disease/DS00807.html
http://www.mayoclinic.com/health/buergers-disease/DS00807
http://www.bbc.co.uk/health/physical_health/conditions/buergher1.shtml

Buerger’s Disease

http://modernmedicalguide.com/buergers-disease/

http://indiahealthtour.com/treatments/vascular/buerger-disease-thromboangiitis-obliterans-treatment-india.html

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Health Alert

Stub That Butt Out

Pharmaceutical companies play up the use of anti-tobacco aids, which makes quitting smoking without help seem impossible……….. But it’s not, T.V. Jayan points out
…..….
Are the global efforts to kick the butt dimmed by distortion and deception? Perhaps, says tobacco control expert Simon Chapman.

A public health researcher at the University of Sydney, Chapman — who wrote more than a dozen tomes on tobacco control — has unearthed a disturbing trend in smoking cessation attempts. The pharmaceutical industry has been trying to create the false impression that attempting to quit smoking without medicines or nicotine replacement therapy (NRT) is futile, reveal Chapman and his colleague Ross McKenzie. Their article appeared in the journal PLoS Medicine last week.

With the industry proclaiming that “willpower alone is not enough to quit”, smokers may think it’s useless to try to kick the habit without any aid, they say.

“The aim should be to encourage attempts to quit smoking, and not constantly describe it as difficult. The process has become overly medicalised for many,” Chapman told KnowHOW.

Not surprisingly, nearly two-third to three-quarters of those who quit smoking did so without any professional or therapeutic help, he adds. This, even though anti-tobacco drugs — such as bupropion and varenicline — and NRT products like patches, gum and lozenges have been in the market for more than 25 years.

NRT, medicines and professional counselling or support may help many smokers, but are not necessary for quitting, asserts Chapman.

According to experts, the cold-turkey method — where you progressively reduce the number of cigarettes before stopping completely — is still the most preferred approach. And campaigners are pleased that in a growing number of countries, there are now more non-smokers than smokers.

Chapman and McKenzie, who analysed more than 660 papers on smoking cessation published in 2007 and 2008, found that the industry and many tobacco control researchers have conveniently neglected the power of unaided cessation. On the other hand, there has been an attempt to play up the benefits of pharmacological intervention.

The study also brought to light a bias in research on assisted cessation. While industry-supported research showed that quit-smoking medicines and NRT products have a 51 per cent efficiency, independent studies said the impact was just 22 per cent.

“Because of these attitudes, smoking cessation is becoming increasingly pathologised, a development that risks distorting public awareness of how most smokers quit, to the obvious benefit of the pharmaceutical companies,” say the researchers.

The study comes at a good time, when India is embarking on a major tobacco control campaign. In the last week of January, the Union cabinet approved a Rs 182-crore tobacco control programme. The project — which would cover 42 districts in 21 states — is expected to step up public awareness of the ill effects of tobacco use by setting up testing labs and conducting adult tobacco surveys over the next two years.

Sadly, India has one of the poorest rates of quitting: only about 2 per cent of the smoking population is able to kick the habit annually.

Chapman’s views are echoed by Prakash Chopra, a tobacco control expert and director of the Healis-Sekhsaria Institute of Public Health, Mumbai. Chopra strongly believes that there is a need to publicise the fact that most smokers quit without any aid.

“It isn’t enough for public health policymakers to simply stress this fact; they must also assist unassisted cessation,” he says. This can be done by allocating funds for initiating and enforcing policies in this direction, he suggests.

Chapman points out that most of the government money for tobacco control is spent in support of NRT or similar strategies rather than in aiding unassisted cessation. The criticism seems more than valid, as within a couple of days of publishing his paper many experts from all over the world came up with similar views.

Prabhat Jha, director of the Centre for Global Health Research in Canada, however, believes that pharmaceutical aids do help, though only for a brief while. “These aids double the effectiveness of smoking cessation attempts from a quit rate of about 3 per cent to up to 8 per cent in the following six months. It is true that a vast number of quitters quit cold turkey. But pharmaceutical drugs do help, and if they help more smokers to quit, it’s a good thing,” says Jha.

According to Jha, there is another way out of the haze — tobacco products should be taxed higher. In developing countries, a 10 per cent higher price, it has been found, results in about 3 to 4 per cent of smokers quitting, and another 3 to 4 per cent of individuals not taking up the habit, he says.

Higher prices and then drugs and therapy — why not use your willpower and save your health as well as money?

Source: The Telegraph (Kolkata) India

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Liquid Smoking

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A sip of smoke to help drop the fag . A puff of cigarette may not be in vogue anymore with a sip promising the same smoking experience sans nicotine.
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Called ‘Liquid Smoking‘ the drink has South African herbal extracts, say its Dutch manufacturers United Drinks and Beauty Corporation.

The drink has already been on sale for one year now in Netherlands and United Drinks hopes the product would be available in the UK before Christmas, The Telegraph reported recently.

“The manufacturers say it does not contain the drug nicotine but rather a mix of roots from South African plants which is said to give ‘a slight energising effect, followed by a euphoric sense of calming and relaxation,” the newspaper said.

‘Liquid Smoking’ would cost about 1.50 pounds in the shops and would have less than 21 calories in every 275 ml can.

Meanwhile, The Guardian in a recent report about the drink said, “Coming in a can reminiscent of a cigarette packet, it has a box proclaiming ‘no warning needed’ where a health warning would be on a packet of cigarettes“.

Quoting United Drinks Chief Executive Martin Hartman, The Telegraph said, “The product we (United Drinks) have developed has got similar properties to nicotine, so we are trying to help people out who are affected by the ban on nicotine.

People might use this instead of a cigarette or tobacco to help the cravings.”

Martin Hartman was further quoted as saying “it will take the edge off of a need for nicotine for between one to four hours… I think it will help people who feel the need for nicotine in bars, restaurants, long-haul flights and on the train,” Martin Hartman added.

Sources: The Times Of India

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Smokers at Greater Risk of Mishaps

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We have all heard the perils of drunken driving and talking on the cell phone while driving. But here’s a new one. Studies suggest that smoking while driving is a leading contributor to injuries, and motor vehicle crashes….click & see

You may click to see:->Plea to ban drivers from smoking

Studies done in US have pointed out that smoking causes risk factors for injury including fires, depressed reflexes, non-coordination, impaired fitness and, possibly, depressed moods.

The study done by B N Leistikow, D C Martic and S J Samuels interviewed adults (ages 18 plus) and followed up for vital status after a gap of five years using the National Death Index (NDI). Participants were classified as never smokers (fewer than 100 lifetime cigarettes), ex-smokers, and current smokers (smokers by baseline self report).

For smokers, cigarettes per day were recorded into 1-14, 15-24 and 25-plus cigarettes-per-day categories.
The study found that smokers have significant dose-response excesses of injury and death, independent of age, education and marital status. This supports earlier studies suggesting that smoking may be a leading contributor to injuries.

In fact, researchers have suggested that the correlation of smoking and driving should be studied in Asia, Latin America and Africa. Also, smoking-involved crashes may be studied in the same manner as alcohol-involved crashes.

Dr Ashok Seth, chairman and chief cardiologist of Max Heart Institute, says: “This is an interesting study. Smoking and driving may lead to accidents, and smoking is a distraction – far more distractive than any activity in the car. The accidents may occur as cigarette is an inflammable object, and lead to fires.

It may make the smoker distracted and spoils his concentration with one hand constantly engaged and moving to drop the ash. Smoking is also believed to release certain hormones which pump up confidence levels, leading to errors.”

The study is of critical importance to India, where smoking is responsible for about one in 20 deaths of women and one in five deaths of men in the age group of 30-69 years. By 2010, it is estimated that smoking will lead to one million deaths in the country.

Says Dr Anoop Misra director and head, department of diabetes, Fortis Hospitals: “Tobacco smoke contains high quantity of carboxy haemoglobin, which replaces normal haemoglobin and transiently decreases oxygenation of brain.

Smoking impairs certain motor reflexes and has adverse effects on message transfer in brain due to shifts in neurochemicals.

All these would impair any complex motor task as driving. Those who are heavy smokers or relatively new smokers are worst affected. Over long periods, smoking causes permanent damage to neurons and this results in decline of intellectual functions.”

You may click to see:->PREVENT TOBACCO-CAUSED BRAIN DAMAGE

Sources: The Times Of India

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Smoke Signals

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Facebook has many uses, but scientific research is not usually considered to be one of them. However, this social networking site, immensely popular among young people, helped Canadian researchers track children who were part of a study five years ago. The study was on nicotine dependence among school children. As they followed the habit once again among the teenagers, the scientists gained two valuable insights on smoking and adolescents — first, that smoking does not make girls thin and, second, that it makes boys shorter. Both findings contradicted common perceptions about smoking in North America, and probably in the rest of the world as well.

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Researchers have been looking at smoking in children and adolescents for some time now, because tobacco addiction generally starts somewhere in high school or early university life. By global standards, the problem is not very serious in North America, which has seen a decline in smoking over the years. In fact, the World Health Organization lists India as one of the nations with a high prevalence of smoking among the young, along with Central and Eastern Europe and some Pacific Islands. However, smoking does start early sometimes in North America, as in India and other parts of the world. And misconceptions about smoking are often a strong motivation to start tobacco use.

As a young girl, Jennifer ’ Loughlin had heard about smoking and weight control early in life. “Smoking will make you thin,” she was told by many while she was growing up. Now as an epidemiologist and biostatistician at the University of Montreal, she has been studying the natural history of nicotine dependence. A few years ago, she had found compelling evidence for a genetic role in the development of nicotine dependence among teenagers. Now her study, done with colleagues in other Canadian institutions, debunks a popular myth: that smoking is good for weight control among girls.

As she had known always, girls in North America often cite this as a reason to start smoking. This finding should thus be a strong deterrent, but what the scientists found among boys was even more interesting. Boys who smoked regularly grew up to be an inch shorter. Since growing tall is one of the ambitions of adolescent boys, this finding should be an even stronger deterrent to smoking among boys. Says ’ Loughlin: “Boys now may see smoking as a bad choice if they want to grow tall.”

Smoking among children and adolescents has received considerable attention among scientists of various disciplines. Most of these studies did not provide any conclusive evidence of why adolescents smoked or how smoking affects them. For example, a part of the Global Youth Tobacco Survey in Punjab in 2003 got conflicting results regarding motivations. The participants said that boys or girls who smoke have more friends. But they also said that those who smoke are less attractive.

Three years ago, scientists at the Yale University studied all the research literature on smoking and weight concerns among teenagers. They found that a significant number of teenage girls believed smoking was a way of weight control, but they did not find any relationship in practice. On the other hand, heavier boys reduced their body mass index when they smoked. Girls who smoked more cigarettes were more concerned about gaining weight after they quit, which provided a strong motivation to continue smoking.

’ Loughlin had started studying smoking in children in 1999. She had funding from the Canadian Cancer Society. She followed a cohort of students in high school for five years. “Children in North America generally start smoking at the age of 12,” she says. “Some start even at eight.” She had then found a possible genetic link, a predisposition that makes some pick up the habit when exposed to it.

A few years later, she wanted to follow these students again. There were 1,300 of them, and many of them had gone away from where they originally lived. But the scientists managed to trace every one of them. “We used Facebook heavily to trace the students,” says ’ Loughlin. She had a grant of $650 million, again from the Canadian Cancer Society. The results of the study provided compelling evidence of smoking and height and weight among children aged between 12 and 17. Girls do not shed weight when they smoked. Boys shed height when they did.

While common sense says that smoking should not cause any difference in weight, the decrease in height is more intriguing. The study found that boys who smoked 10 cigarettes a day from the age 12 to 17 would be an inch shorter than a boy who did not smoke. This was not true of girls, probably because boys attain full height a few years later than girls do. Why does this happen? There is no clear answer, but we can hazard a guess. Maybe nicotine deprives the body of oxygen. Maybe it somehow affects the growth hormones. Whatever the reason is, the message is loud and clear.

Sources: The Telegraph (Kolkata,India)

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