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Category: Hospital and Medical

Functional Endoscopic Sinus Surgery

November 18, 2022 Advin Health Care Comment

Functional endoscopic sinus surgery (FESS) is a minimally invasive procedure which uses nasal endoscopes to enlarge the nasal drainage pathways of the paranasal sinuses to improve sinus ventilation and allow access of topical medications. This procedure is generally used to treat inflammatory and infectious sinus diseases, including chronic rhino sinusitis that do not respond to drugs, nasal polyps, some cancers, and decompression of eye sockets/optic nerve in Graves ophthalmopathy. In the surgery, an otolaryngologist removes the uncinate process of the ethmoid bone, while visualizing the nasal passage using a fiber optic endoscope. FESS can be performed under local anesthesia as an outpatient procedure. Generally patients experience only minimal discomfort during and after surgery. The procedure can take from 2 to 4 hours to complete.

Medical applications

Functional endoscopic sinus surgery is most commonly used to treat chronic rhinosinusitis (CRS), only after all non-surgical treatment options such as antibiotics, topical nasal corticosteroids, and nasal lavage with saline solutions[3] have been exhausted. (CRS) is an inflammatory condition in which the nose and at least one sinus become swollen and interfere with mucus drainage It can be caused by anatomical factors such as a deviated septum or nasal polyps (growths), as well as infection. Symptoms include difficulty breathing through the nose, swelling and pain around the nose and eyes, postnasal drainage down the throat, and difficulty sleeping. CRS is a common condition in children and young adults.

The purpose of FESS in treatment of CRS is to remove any anatomical obstructions that prevent proper mucosal drainage. A standard FESS includes removal of the uncinate process, and opening of the ethmoid air cells and Haller cells as well as the maxillary ostium, if necessary. If any nasal polyps obstructing ventilation or drainage are present, they are also removed. In the case of paranasal sinus/nasal cavity tumors (benign or cancerous), an otolaryngologist can perform FESS to remove the growths, sometimes with the help of a neurosurgeon, depending on the extent of the tumor. In some cases, a graft of bone or skin is placed by FESS to repair damages by the tumor.

In the thyroid disorder known as Graves’ ophthalmopathy, inflammation and fat accumulation in the orbitonasal region cause severe proptosis. In cases that have not responded to corticosteroid treatment, FESS can be used to decompress the orbital region by removing the ethmoid air cells and lamina papyracea. Bones of the orbital cavity or portions of the orbital floor may also be removed. endoscopic approach to FESS is a less invasive method than open sinus surgery, which allows patients to be more comfortable during and after the procedure. Entering the surgical field via the nose, rather than through an incision in the mouth as in the previous Caldwell-Luc method, decreases risk of damaging nerves which innervate the teeth. Because of its less-invasive nature, FESS is a common option for children with CRS or other sinonasal complications.

It has been suggested that one of the main objectives in FESS surgery is to allow for the introduction of local therapeutic agents (such as steroids) to the sinuses. Research has shown that a special modification of the nozzle of the nasal spray in patients who had FESS allows for better delivery of local therapeutic agents into the ethmoid sinuses.

What is the difference between ESS and FESS?

ESS or Endoscopic Sinus Surgery is a broader term which covers any endoscopic surgery of the nose and sinuses, including FESS. ESS may not be functional (e.g preservation of mucosa) and some indications for ESS include resection of sinonasal tumour, resection of skull base or brain tumour through the nose and sinuses, surgery of the eye through the nose and sinuses and surgery on the nasal septum.

Why do people call it functional endoscopic sinus surgery?

Functional endoscopic sinus surgery is also called endoscopic sinus surgery. Some healthcare providers use the term “functional” because the surgery is done to restore how your sinuses work, or function.

When would I need functional endoscopic sinus surgery?

Your healthcare provider may recommend FESS if you have chronic sinus inflammation or a chronic sinus infection that doesn’t improve with medical treatments, such as antibiotics and medications to manage allergies.

You develop sinusitis when the tissue that lines your sinuses begins to swell, trapping mucus that typically flows through your sinuses and out through your nose. The trapped fluid can grow bacteria that can cause infections. Healthcare providers may also recommend surgery if you have nasal polyps.

What happens before this procedure?

Your healthcare provider will let you know what to do before your surgery. Every person’s situation is different, but most healthcare providers recommend the following:

If you smoke, stop smoking at least three weeks before your surgery. Smoking can make your sinus symptoms worse. Ask your healthcare provider for advice or resources to help with this.
Don’t take aspirin for at least 10 days before your surgery. Even small amounts of aspirin can increase how much you bleed during and after your surgery.
If your surgery involves general anesthesia, don’t eat or drink anything after midnight the day of your surgery.
Your healthcare provider will administer general anesthesia just before your surgery begins.

How is functional endoscopic surgery performed?

FESS is the standard procedure to treat serious sinus conditions. Healthcare providers continue to refine their approach. Here’s an overview of the process:

Your healthcare provider puts decongestant medication in your nose.
They do a follow-up nasal endoscopy.
They inject a numbing solution into your nose.
Using the endoscope, they gently enter your nose. They insert surgical tools alongside the endoscope to use the endoscope to remove bone, diseased tissue or polyps that may be blocking your sinuses.
They may also use a small rotating burr to scrape out tissue.
Finally, your healthcare provider may pack your nose with material to absorb any blood or discharge.

What is the recovery after FESS?

After sinus surgery, the surgeon will usually place dressings in the sinus cavities to prevent post-operative adhesions and to minimise bleeding. These dressings may be absorbable (which do not require removal) or non-absorbable (which will usually be removed between 5 – 10 days after surgery). In some conditions, “nasal packs” may be inserted in the nasal cavities to minimise bleeding after surgery. These “nasal packs” are non absorbable and are usually removed in 1 – 2 days. Depending on the extent of the sinus operation, the patient may be allowed to go home on the same day (as a Day Surgery Procedure) or may be admitted to the ward and observed overnight. It is common for patients to feel blocked in the nose from the packing material and blood clots. A nasal gauze (“bolster”) will be placed under the nose to collect any blood that drips out (Fig 2). This is usually removed before the patient goes home. There may be mild pain after the surgery but this is usually well-controlled with pain relievers.

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Hospital and Medical

What Is Cancer?

November 17, 2022 Advin Health Care Comment

Cancer is a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body.Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and multiply (through a process called cell division) to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

Sometimes this orderly process breaks down, and abnormal or damaged cells grow and multiply when they shouldn’t. These cells may form tumors, which are lumps of tissue. Tumors can be cancerous or not cancerous (benign).

Cancerous tumors spread into, or invade, nearby tissues and can travel to distant places in the body to form new tumors (a process called metastasis). Cancerous tumors may also be called malignant tumors. Many cancers form solid tumors, but cancers of the blood, such as leukemias, generally do not.

Benign tumors do not spread into, or invade, nearby tissues. When removed, benign tumors usually don’t grow back, whereas cancerous tumors sometimes do. Benign tumors can sometimes be quite large, however. Some can cause serious symptoms or be life threatening, such as benign tumors in the brain.

Differences between Cancer Cells and Normal Cells

Cancer cells differ from normal cells in many ways. For instance, cancer cells:

grow in the absence of signals telling them to grow. Normal cells only grow when they receive such signals.
ignore signals that normally tell cells to stop dividing or to die (a process known as programmed cell death, or apoptosis).
invade into nearby areas and spread to other areas of the body. Normal cells stop growing when they encounter other cells, and most normal cells do not move around the body.
tell blood vessels to grow toward tumors. These blood vessels supply tumors with oxygen and nutrients and remove waste products from tumors.
hide from the immune system. The immune system normally eliminates damaged or abnormal cells.
trick the immune system into helping cancer cells stay alive and grow. For instance, some cancer cells convince immune cells to protect the tumor instead of attacking it.
accumulate multiple changes in their chromosomes, such as duplications and deletions of chromosome parts. Some cancer cells have double the normal number of chromosomes.
rely on different kinds of nutrients than normal cells. In addition, some cancer cells make energy from nutrients in a different way than most normal cells. This lets cancer cells grow more quickly.

Many times, cancer cells rely so heavily on these abnormal behaviors that they can’t survive without them. Researchers have taken advantage of this fact, developing therapies that target the abnormal features of cancer cells. For example, some cancer therapies prevent blood vessels from growing toward tumors, essentially starving the tumor of needed nutrients.

How Does Cancer Develop?

Cancer is a genetic disease—that is, it is caused by changes to genes that control the way our cells function, especially how they grow and divide.

Genetic changes that cause cancer can happen because:

of errors that occur as cells divide.
of damage to DNA caused by harmful substances in the environment, such as the chemicals in tobacco smoke and ultraviolet rays from the sun.
they were inherited from our parents.

The body normally eliminates cells with damaged DNA before they turn cancerous. But the body’s ability to do so goes down as we age. This is part of the reason why there is a higher risk of cancer later in life.

Each person’s cancer has a unique combination of genetic changes. As the cancer continues to grow, additional changes will occur. Even within the same tumor, different cells may have different genetic changes.

Types of Genes that Cause Cancer

The genetic changes that contribute to cancer tend to affect three main types of genes—proto-oncogenes, tumor suppressor genes, and DNA repair genes. These changes are sometimes called “drivers” of cancer.

Proto-oncogenes are involved in normal cell growth and division. However, when these genes are altered in certain ways or are more active than normal, they may become cancer-causing genes (or oncogenes), allowing cells to grow and survive when they should not.

Tumor suppressor genes are also involved in controlling cell growth and division. Cells with certain alterations in tumor suppressor genes may divide in an uncontrolled manner.

DNA repair genes are involved in fixing damaged DNA. Cells with mutations in these genes tend to develop additional mutations in other genes and changes in their chromosomes, such as duplications and deletions of chromosome parts. Together, these mutations may cause the cells to become cancerous.

As scientists have learned more about the molecular changes that lead to cancer, they have found that certain mutations commonly occur in many types of cancer. Now there are many cancer treatments available that target gene mutations found in cancer. A few of these treatments can be used by anyone with a cancer that has the targeted mutation, no matter where the cancer started growing.

When Cancer Spreads

A cancer that has spread from the place where it first formed to another place in the body is called metastatic cancer. The process by which cancer cells spread to other parts of the body is called metastasis.

Metastatic cancer has the same name and the same type of cancer cells as the original, or primary, cancer. For example, breast cancer that forms a metastatic tumor in the lung is metastatic breast cancer, not lung cancer.

Under a microscope, metastatic cancer cells generally look the same as cells of the original cancer. Moreover, metastatic cancer cells and cells of the original cancer usually have some molecular features in common, such as the presence of specific chromosome changes.

In some cases, treatment may help prolong the lives of people with metastatic cancer. In other cases, the primary goal of treatment for metastatic cancer is to control the growth of the cancer or to relieve symptoms it is causing. Metastatic tumors can cause severe damage to how the body functions, and most people who die of cancer die of metastatic disease.

Tissue Changes that Are Not Cancer

Not every change in the body’s tissues is cancer. Some tissue changes may develop into cancer if they are not treated, however. Here are some examples of tissue changes that are not cancer but, in some cases, are monitored because they could become cancer:

Hyperplasia occurs when cells within a tissue multiply faster than normal and extra cells build up. However, the cells and the way the tissue is organized still look normal under a microscope. Hyperplasia can be caused by several factors or conditions, including chronic irritation.
Dysplasia is a more advanced condition than hyperplasia. In dysplasia, there is also a buildup of extra cells. But the cells look abnormal and there are changes in how the tissue is organized. In general, the more abnormal the cells and tissue look, the greater the chance that cancer will form. Some types of dysplasia may need to be monitored or treated, but others do not. An example of dysplasia is an abnormal mole (called a dysplastic nevus) that forms on the skin. A dysplastic nevus can turn into melanoma, although most do not.
Carcinoma in situ is an even more advanced condition. Although it is sometimes called stage 0 cancer, it is not cancer because the abnormal cells do not invade nearby tissue the way that cancer cells do. But because some carcinomas in situ may become cancer, they are usually treated.

Types of Cancer

There are more than 100 types of cancer. Types of cancer are usually named for the organs or tissues where the cancers form. For example, lung cancer starts in the lung, and brain cancer starts in the brain. Cancers also may be described by the type of cell that formed them, such as an epithelial cell or a squamous cell.

You can search NCI’s website for information on specific types of cancer based on the cancer’s location in the body

Here are some categories of cancers that begin in specific types of cells:

Carcinoma

Carcinomas are the most common type of cancer. They are formed by epithelial cells, which are the cells that cover the inside and outside surfaces of the body. There are many types of epithelial cells, which often have a column-like shape when viewed under a microscope.

Carcinomas that begin in different epithelial cell types have specific names:

Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus. Tissues with this type of epithelial cell are sometimes called glandular tissues. Most cancers of the breast, colon, and prostate are adenocarcinomas.

Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin.

Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys. Squamous cells look flat, like fish scales, when viewed under a microscope. Squamous cell carcinomas are sometimes called epidermoid carcinomas.

Transitional cell carcinoma is a cancer that forms in a type of epithelial tissue called transitional epithelium, or urothelium. This tissue, which is made up of many layers of epithelial cells that can get bigger and smaller, is found in the linings of the bladder, ureters, and part of the kidneys (renal pelvis), and a few other organs. Some cancers of the bladder, ureters, and kidneys are transitional cell carcinomas.

Sarcoma

Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood vessels, lymph vessels, and fibrous tissue (such as tendons and ligaments).

Osteosarcoma is the most common cancer of bone. The most common types of soft tissue sarcoma are leiomyosarcoma, Kaposi sarcoma, malignant fibrous histiocytoma, liposarcoma, and dermatofibrosarcoma protuberans.

Leukemia

Cancers that begin in the blood-forming tissue of the bone marrow are called leukemias. These cancers do not form solid tumors. Instead, large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells. The low level of normal blood cells can make it harder for the body to get oxygen to its tissues, control bleeding, or fight infections.

There are four common types of leukemia, which are grouped based on how quickly the disease gets worse (acute or chronic) and on the type of blood cell the cancer starts in (lymphoblastic or myeloid). Acute forms of leukemia grow quickly and chronic forms grow more slowly.

Lymphoma

Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.

There are two main types of lymphoma:

Hodgkin lymphoma – People with this disease have abnormal lymphocytes that are called Reed-Sternberg cells. These cells usually form from B cells.

Non-Hodgkin lymphoma – This is a large group of cancers that start in lymphocytes. The cancers can grow quickly or slowly and can form from B cells or T cells.

Multiple Myeloma

Multiple myeloma is cancer that begins in plasma cells, another type of immune cell. The abnormal plasma cells, called myeloma cells, build up in the bone marrow and form tumors in bones all through the body. Multiple myeloma is also called plasma cell myeloma and Kahler disease.

Melanoma

Melanoma is cancer that begins in cells that become melanocytes, which are specialized cells that make melanin (the pigment that gives skin its color). Most melanomas form on the skin, but melanomas can also form in other pigmented tissues, such as the eye.

Brain and Spinal Cord Tumors

There are different types of brain and spinal cord tumors. These tumors are named based on the type of cell in which they formed and where the tumor first formed in the central nervous system. For example, an astrocytic tumor begins in star-shaped brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign (not cancer) or malignant (cancer).

Other Types of Tumors

Germ Cell Tumors

Germ cell tumors are a type of tumor that begins in the cells that give rise to sperm or eggs. These tumors can occur almost anywhere in the body and can be either benign or malignant.

Neuroendocrine Tumors

Neuroendocrine tumors form from cells that release hormones into the blood in response to a signal from the nervous system. These tumors, which may make higher-than-normal amounts of hormones, can cause many different symptoms. Neuroendocrine tumors may be benign or malignant.

Carcinoid Tumors

Carcinoid tumors are a type of neuroendocrine tumor. They are slow-growing tumors that are usually found in the gastrointestinal system (most often in the rectum and small intestine). Carcinoid tumors may spread to the liver or other sites in the body, and they may secrete substances such as serotonin or prostaglandins, causing carcinoid syndrome.

Hospital and Medical

Bronchoscopy

November 16, 2022 Advin Health Care Comment

Bronchoscopy is a procedure that lets doctors look at your lungs and air passages. It’s usually performed by a doctor who specializes in lung disorders (a pulmonologist). During bronchoscopy, a thin tube (bronchoscope) is passed through your nose or mouth, down your throat and into your lungs.

Bronchoscopy is most commonly performed using a flexible bronchoscope. However, in certain situations, such as if there’s a lot of bleeding in your lungs or a large object is stuck in your airway, a rigid bronchoscope may be needed.

Common reasons for needing bronchoscopy are a persistent cough, infection or something unusual seen on a chest X-ray or other test.

Bronchoscopy can also be used to obtain samples of mucus or tissue, to remove foreign bodies or other blockages from the airways or lungs, or to provide treatment for lung problems.

What is bronchoscopy?

Bronchoscopy is a procedure to look directly at the airways in the lungs using a thin, lighted tube (bronchoscope). The bronchoscope is put in the nose or mouth. It is moved down the throat and windpipe (trachea), and into the airways. A healthcare provider can then see the voice box (larynx), trachea, large airways to the lungs (bronchi), and smaller branches of the bronchi (bronchioles).

There are 2 types of bronchoscopes: flexible and rigid. Both types come in different widths.

A rigid bronchoscope is a straight tube. It’s only used to view the larger airways. It may be used within the bronchi to:

Remove a large number of secretions or blood
Control bleeding
Remove foreign objects
Remove diseased tissue (lesions)
Do procedures, such as stents and other treatments

A flexible bronchoscope is used more often. Unlike the rigid scope, it can be moved down into the smaller airways (bronchioles). The flexible bronchoscope may be used to:

Place a breathing tube in the airway to help give oxygen
Suction out secretions
Take tissue samples (biopsy)
Put medicine into the lungs

Why might I need bronchoscopy?

A bronchoscopy may be done to diagnose and treat lung problems such as:

Tumors or bronchial cancer
Airway blockage (obstruction)
Narrowed areas in airways (strictures)
Inflammation and infections such as tuberculosis (TB), pneumonia, and fungal or parasitic lung infections
Interstitial pulmonary disease
Causes of persistent cough
Causes of coughing up blood
Spots seen on chest X-rays
Vocal cord paralysis

Diagnostic procedures or treatments that are done with bronchoscopy include:

Biopsy of tissue
Collection of sputum
Fluid put into the lungs and then removed (bronchoalveolar lavage or BAL) to diagnose lung disorders
Removal of secretions, blood, mucus plugs, or growths (polyps) to clear airways
Control of bleeding in the bronchi
Removing foreign objects or other blockages
Laser therapy or radiation treatment for bronchial tumors
Placement of a small tube (stent) to keep an airway open (stent placement)
Draining an area of pus (abscess)

Your healthcare provider may also have other reasons to advise a bronchoscopy.

How do I prepare for bronchoscopy?

Your healthcare providers will give you specific instructions about how to prepare.

You’ll need to fast (not eat or drink) for a certain period of time before the procedure. You may also have to stop taking certain medications that can thin your blood, like warfarin.

You will have a sedative or anesthesia before the procedure. You should plan on having someone available to drive you home afterward.

What happens during a bronchoscopy?

The entire bronchoscopy procedure typically takes from 30 minutes to a couple of hours. It’s usually performed in a hospital as an outpatient procedure. During a bronchoscopy:

You lie on a bed or table with your head propped up.
Your provider inserts an IV into your arm to deliver a sedative to help you relax. Some people may prefer to be asleep for the procedure. Rigid bronchoscopy and certain types of flexible bronchoscopy usually requires general anesthesia (being asleep). You and your provider can decide if general anesthesia is right for you.
Your provider applies a numbing spray to your mouth (or nose) and throat.
Once the area is numb and you are sedated, the provider inserts the bronchoscope through your nose or mouth and down into your windpipe to your lungs.
After the procedure, the provider gently removes the bronchoscope. Your healthcare team monitors your condition until you are fully awake.

What happens after a bronchoscopy?

Bronchoscopy is an outpatient procedure, so you will not need to spend the night in the hospital. Patients can typically go home within a few hours of the procedure.

Your healthcare team will monitor you after the procedure to ensure you are breathing and swallowing properly. It will take a couple of hours for the numbness in your throat to wear off. You may have a sore throat, cough or hoarseness after the procedure for the next 24 hours.

Your healthcare team will let you know when you should expect test results and when you should schedule a follow-up appointment.

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Hospital and Medical

Tuberculosis

November 10, 2022 Advin Health Care Comment

TB is caused by bacteria (Mycobacterium tuberculosis) and it most often affects the lungs. TB is spread through the air when people with lung TB cough, sneeze or spit. A person needs to inhale only a few germs to become infected.

Every year, 10 million people fall ill with tuberculosis (TB). Despite being a preventable and curable disease, 1.5 million people die from TB each year – making it the world’s top infectious killer.

TB is the leading cause of death of people with HIV and also a major contributor to antimicrobial resistance.

Most of the people who fall ill with TB live in low- and middle-income countries, but TB is present all over the world. About half of all people with TB can be found in 8 countries: Bangladesh, China, India, Indonesia, Nigeria, Pakistan, Philippines and South Africa.

About one-quarter of the world’s population is estimated to be infected by TB bacteria. Only 5-15% of these people will fall ill with active TB disease. The rest have TB infection but are not ill and cannot transmit the disease. Both TB infection and disease are curable using antibiotics.

What IS TB?

Tuberculosis (TB) is a bacterial disease that usually attacks the lungs. But it can also attack other parts of the body, including the kidneys, spine, and brain.

Not everyone infected with TB bacteria (germs) becomes sick. So, there are two types of TB conditions:

Latent TB infection, where the TB germs live in your body but don’t make you sick.
TB disease (active TB) where you get sick from the TB germs. TB disease can almost always be cured with antibiotics. But if it’s not treated properly, it can be fatal.

What causes tuberculosis (TB)?

TB is caused by bacteria (germs) called Mycobacterium tuberculosis. The germs spread from person to person through the air. People who have TB disease in their throat or lungs spread the germs in the air when they cough, sneeze, talk, or sing. If you breathe in the air that has the germs, you can get TB. TB is not spread by touching, kissing, or sharing food or dishes.

You’re more likely to catch TB from people you live or work with than from people you see for shorter amounts of time.

Although tuberculosis is contagious, it’s not easy to catch. You’re much more likely to get tuberculosis from someone you live or work with than from a stranger. Most people with active TB who’ve had appropriate drug treatment for at least two weeks are no longer contagious.

HIV and TB

Since the 1980s, tuberculosis cases have increased dramatically because of the spread of HIV, the virus that causes AIDS. HIV suppresses the immune system, making it difficult for the body to control TB bacteria. As a result, people with HIV are much more likely to get TB and to progress from latent to active disease than are people who aren’t HIV positive.

Drug-resistant TB

Tuberculosis also remains a major killer because of the increase in drug-resistant strains. Over time, some TB germs have developed the ability to survive despite medications. This is partly because people don’t take their drugs as directed or don’t complete the course of treatment.

Drug-resistant strains of tuberculosis emerge when an antibiotic fails to kill all of the bacteria it targets. The surviving bacteria become resistant to that drug and often other antibiotics as well. Some TB bacteria have developed resistance to the most commonly used treatments, such as isoniazid and rifampin (Rifadin, Rimactane).

Some TB strains have also developed resistance to drugs less commonly used in TB treatment, such as the antibiotics known as fluoroquinolones, and injectable medications including amikacin and capreomycin (Capastat). These medications are often used to treat infections that are resistant to the more commonly used drugs.

What are the symptoms of tuberculosis (TB)?

Most people who have TB germs in their bodies don’t get sick with TB disease. Instead, they have latent TB infection. With a latent TB infection, you:

Don’t have symptoms
Can’t spread TB to others
Could get sick with active TB disease in the future if your immune system becomes weak for another reason
Need to take medicine to prevent getting sick with active TB disease in the future

If you have TB disease, the TB germs are active, meaning that they are growing (multiplying) inside your body and making you sick. If the TB is growing in your lungs or throat, you can spread the TB germs to other people. You can get sick with TB disease weeks to years after you’re infected with TB germs.

With TB disease, your symptoms will depend on where the TB is growing in your body

General symptoms may include:

Chills and fever
Night sweats (heavy sweating during sleep)
Losing weight without trying
Loss of appetite
Weakness or fatigue

Symptoms from TB disease in your lungs may include:

A coughthat lasts longer than 3 weeks
Coughing up blood or sputum (a thick mucus from the lungs)
Chest pain

What is the treatment for tuberculosis (TB)?

The treatment for both latent TB infection and TB disease is antibiotics. To make sure you get rid of all the TB germs in your body, it’s very important to follow the directions for taking your medicine.

If you don’t follow the directions, the TB germs in your body could change and become antibiotic resistant. That means the medicine may stop working and your TB may become hard to cure.

For latent TB infections, you usually take medicines for 3 to 9 months. Treatment helps make sure you don’t get TB disease in the future.
For active TB disease, you usually need to take medicines for 6 to 12 months. Treatment will almost always cure you if you take your pills the right way.
For TB disease in your lungs or throat, you’ll need to stay home for a few weeks, so you don’t spread disease to other people.

You can protect the people you live with by:

Covering your nose and mouth.
Opening windows when possible.
Not getting too close to them.

Hospital and Medical

Blood Cancer

November 9, 2022 Advin Health Care Comment

Your blood, which accounts for about 8 percent of your normal body weight, plays an important role in how your body functions. As your blood circulates throughout your vascular system, it supplies all of your organs with oxygen, nutrients, hormones and antibodies. Blood is made of an almost equal mix of plasma (the liquid that transports cells, waste and nutrients, among other things) and blood cells (red blood cells, white blood cells and platelets).

When cancer occurs in the blood, it’s usually the result of an abnormal and excessive reproduction of white blood cells. Blood cancers account for about 10 percent of all diagnosed cancers in the U.S. each year. Blood cancers (including leukemia, lymphoma and myeloma) are more common in men than women. Childhood leukemia accounts for about 25 percent of all cancers in children.

Treatments for blood cancers also vary, ranging from active surveillance without cancer-directed therapy to standard cancer treatments including immunotherapies, chemotherapies and targeted agents. “With over 100 different types of blood cancers now recognized, it is important to have an accurate diagnosis prior to deciding on treatment

What is Blood ?

Your blood is made up of liquid and solids. The liquid part, called plasma, is made of water, salts, and protein. Over half of your blood is plasma. The solid part of your blood contains red blood cells, white blood cells, and platelets.

Red blood cells (RBC) deliver oxygen from your lungs to your tissues and organs. White blood cells (WBC) fight infection and are part of your immune system. Platelets help blood to clot when you have a cut or wound. Bone marrow, the spongy material inside your bones, makes new blood cells. Blood cells constantly die and your body makes new ones. Red blood cells live about 120 days, and platelets live about 6 days. Some white blood cells live less than a day, but others live much longer.

There are four blood types: A, B, AB, or O. Also, blood is either Rh-positive or Rh-negative. So if you have type A blood, it’s either A positive or A negative. Which type you are is important if you need a blood transfusion. And your Rh factor could be important if you become pregnant – an incompatibility between your type and the baby’s could create problems.

Types of blood cancer

The three main types of blood and bone marrow cancer are leukemia, lymphoma and myeloma:

Leukemia is a blood cancer that originates in the blood and bone marrow. It occurs when the body creates too many abnormal white blood cells and interferes with the bone marrow’s ability to make red blood cells and platelets.
Non-Hodgkin lymphoma is a blood cancer that develops in the lymphatic system from cells called lymphocytes, a type of white blood cell that helps the body fight infections.
Hodgkin lymphoma is a blood cancer that develops in the lymphatic system from cells called lymphocytes. Hodgkin lymphoma is characterized by the presence of an abnormal lymphocyte called the Reed-Sternberg cell.
Multiple myeloma is a blood cancer that begins in the blood’s plasma cells, a type of white blood cell made in the bone marrow. Also, learn about the stages of multiple myeloma.

There are also less common forms of blood and bone marrow cancers, or associated disorders, including:

Myelodysplastic syndromes (MDS): These are rare conditions that may result from damage to blood-forming cells in the bone marrow.
Myeloproliferative neoplasms (MPNs): These rare blood cancers occur when the body overproduces white blood cells, red blood cells or platelets. The three main subcategories are essential thrombocythemia (ET), myelofibrosis (MF) and polycythemia vera (PV).
Amyloidosis: This rare disorder, characterized by the buildup of an abnormal protein called amyloid, is not a form of cancer. But it is closely associated with multiple myeloma.
Waldenstrom macroglobulinemia: This is a rare type of non-Hodgkin lymphoma that starts in B cells.
Aplastic anemia: This rare condition occurs when key stem cells are damaged and can only be treated with a bone marrow transplant.

Blood cancer symptoms

Some common bone marrow and blood cancer symptoms include:

Fever, chills
Persistent fatigue, weakness
Loss of appetite, nausea
Unexplained weight loss
Night sweats
Bone/joint pain
Abdominal discomfort
Headaches
Shortness of breath
Frequent infections
Itchy skin or skin rash
Swollen lymph nodes in the neck, underarms or groin

Who is at risk for blood cancer?

The risk factors for blood cancer are not fully understood, though it is believed that blood cancers develop from a combination of genetic and environmental factors. Smoking, radiation exposure, and exposure to certain chemicals have all been linked to increased risk of some types of blood cancers. Epstein-Barr virus, HIV and human T-cell lymphoma/leukemia virus infections are also risk factors for developing lymphomas and leukemias.

How is blood cancer diagnosed?

Leukemia: Your doctor will obtain a complete blood count (CBC) test, which can identify abnormal levels of white blood cells relative to red blood cells and platelets.
Lymphoma: Your doctor will need to perform a biopsy, which removes a small portion of tissue to be examined under a microscope. In some cases, your doctor may also order an X-ray, CT or PET scan to detect swollen lymph nodes.
Myeloma: Your doctor will order a CBC, or other blood or urine tests to detect chemicals or proteins produced as a function of myeloma development. In some cases, bone marrow biopsy, X-ray, MRI, PET, and CT scans can be used to confirm the presence and extent of the spread of myeloma.

What are the treatments for blood cancer?

Treatment will depend on several factors. These include the type of blood cancer you have, your age, how fast the cancer is progressing, and whether the cancer has spread to other parts of your body.

Because treatments for blood cancer have vastly improved over the last several decades, many types of blood cancers are now highly treatable. Common treatments include the following:

Chemotherapy: Anticancer drugs are introduced to the body (via injection into the vein or sometimes by taking a pill) to kill and halt the production of cancer cells.
Radiation therapy: This form of cancer treatment uses high-energy rays to kill cancer cells.
Targeted therapies: This form of cancer treatment uses drugs that specifically kill malignant blood cells, without harming normal cells. Targeted therapies are most commonly used to treat leukemia.
Stem cell transplantation: Healthy stem cells can be infused into your body to help resume healthy blood production following therapy to destroy malignant blood cells.
Cancer Surgery: This treatment involves removing the affected lymph nodes to treat some lymphomas.
Immunotherapy: This treatment activates the immune system to specifically kill cancer cells.

Blood cancer treatment and therapy options

Treatment for blood and bone marrow cancers depends on the type of cancer, your age, how fast the cancer is progressing, where the cancer has spread and other factors. Some common blood cancer treatments for leukemia, lymphoma, and multiple myeloma include:

Stem cell transplantation: A stem cell transplant infuses healthy blood-forming stem cells into the body. Stem cells may be collected from the bone marrow, circulating blood and umbilical cord blood.

Chemotherapy: Chemotherapy uses anticancer drugs to interfere with and stop the growth of cancer cells in the body. Chemotherapy for blood cancer sometimes involves giving several drugs together in a set regimen. This treatment may also be given before a stem cell transplant.

Radiation therapy: Radiation therapy may be used to destroy cancer cells or to relieve pain or discomfort. It may also be given before a stem cell transplant.

Hospital and Medical

Diabetes

November 8, 2022 Advin Health Care Comment

What is Diabetes?

Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy.

Your body breaks down most of the food you eat into sugar (glucose) and releases it into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy.

With diabetes, your body doesn’t make enough insulin or can’t use it as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.

What are the different types of diabetes?

Type 1 diabetes

If you have type 1 diabetes, your body does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.

Type 2 Diabetes

With type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90-95% of people with diabetes have type 2. It develops over many years and is usually diagnosed in adults (but more and more in children, teens, and young adults). You may not notice any symptoms, so it’s important to get your blood sugar tested if you’re at risk. Type 2 diabetes can be prevented or delayed with healthy lifestyle changes,

Gestational Diabetes

Gestational diabetes develops in pregnant women who have never had diabetes. If you have gestational diabetes, your baby could be at higher risk for health problems. Gestational diabetes usually goes away after your baby is born. However, it increases your risk for type 2 diabetes later in life. Your baby is more likely to have obesity as a child or teen and develop type 2 diabetes later in life.

How common is diabetes?

As of 2015, 30.3 million people in the United States, or 9.4 percent of the population, had diabetes. More than 1 in 4 of them didn’t know they had the disease. Diabetes affects 1 in 4 people over the age of 65. About 90-95 percent of cases in adults are type 2 diabetes.1

Who is more likely to develop type 2 diabetes?

You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes.

Symptoms

Diabetes symptoms depend on how high your blood sugar is. Some people, especially if they have prediabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Some of the symptoms of type 1 diabetes and type 2 diabetes are:

Feeling more thirsty than usual.
Urinating often.
Losing weight without trying.
Presence of ketones in the urine. Ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin.
Feeling tired and weak.
Feeling irritable or having other mood changes.
Having blurry vision.
Having slow-healing sores.
Getting a lot of infections, such as gum, skin and vaginal infections.

Hospital and Medical

Internet of Things (IoT) Used In Heath Care

November 7, 2022 Advin Health Care Comment

What is the Internet of Things (IoT)?

The internet of things (IoT) is a catch-all term for the growing number of electronics that aren’t traditional computing devices, but are connected to the internet to send data, receive instructions or both.

There’s an incredibly broad range of ‘things’ that fall under the IoT umbrella: Internet-connected ‘smart’ versions of traditional appliances such as refrigerators and light bulbs; gadgets that could only exist in an internet-enabled world such as Alexa-style digital assistants; and internet-enabled sensors that are transforming factories, healthcare, transportation, distribution centers and farms.

The term IoT, or Internet of Things, refers to the collective network of connected devices and the technology that facilitates communication between devices and the cloud, as well as between the devices themselves. Thanks to the advent of inexpensive computer chips and high bandwidth telecommunication, we now have billions of devices connected to the internet. This means everyday devices like toothbrushes, vacuums, cars, and machines can use sensors to collect data and respond intelligently to users.

The Internet of Things integrates everyday “things” with the internet. Computer Engineers have been adding sensors and processors to everyday objects since the 90s. However, progress was initially slow because the chips were big and bulky. Low power computer chips called RFID tags were first used to track expensive equipment. As computing devices shrank in size, these chips also became smaller, faster, and smarter over time.

How does the IoT work?

The first element of an IoT system is the device that gathers data. Broadly speaking, these are internet-connected devices, so they each have an IP address. They range in complexity from autonomous mobile robots and forklifts that move products around factory floors and warehouses, to simple sensors that monitor the temperature or scan for gas leaks in buildings.

They also include personal devices such as fitness trackers that monitor the number of steps individuals take each day.

In the next step in the IoT process, collected data is transmitted from the devices to a gathering point. Moving the data can be done wirelessly using a range of technologies or over wired networks. Data can be sent over the internet to a data center or the cloud. Or the transfer can be performed in phases, with intermediary devices aggregating the data, formatting it, filtering it, discarding irrelevant or duplicative data, then sending the important data along for further analysis.

The final step, data processing and analytics, can take place in data centres or the cloud, but sometimes that’s not an option. In the case of critical devices such as shutoffs in industrial settings, the delay of sending data from the device to a remote data centre is too great. The round-trip time for sending data, processing it, analysing it and returning instructions (close that valve before the pipes burst) can take too long.

In such cases edge computing can come into play, where a smart edge device can aggregate data, analyse it and fashion responses, if necessary, all within relatively close physical distance, thereby reducing delay. Edge devices also have upstream connectivity for sending data to be further processed and stored.

A growing number of edge computing use cases, such as autonomous vehicles that need to make split-second decisions, is accelerating the development of edge technologies that can process and analyse data immediately without going to the cloud.

Why Healthcare Needs IoT?

To Enhance Patient Satisfaction & Engagement: IoT can increase patient satisfaction by optimizing surgical workflow. E.g., informing about patient’s discharge from surgery to their families. It can increase patient engagement by allowing patients to spend more time interacting with their physicians as it reduces the need for direct patient-physician interaction as devices connected to the internet are delivering valuable data.

To Advance Population Health Management: IoT enables providers to integrate devices to observe the growth of wearables as data captured by the device will fill in the data that is otherwise missed out in EHR. Care teams can receive insight driven prioritization and use IoT for home monitoring of chronic diseases. This is another way that caregivers can make their presence felt in daily lives of the patients.

To Promote Preventive Care: Prevention has become a primary area of focus as health care expenses are projected to grow unmanageable in the future. The widespread access to real-time, high fidelity data on each individual’s health will reform health care by helping people live healthier lives and prevent disease.

To Advance Care Management: It can enable care teams to collect and connect millions of data points on personal fitness from wearables like heart-rate, sleep, perspiration, temperature, and activity. Consequently, sensor-fed information can send out alerts to patients and caregivers in real-time so they get event-triggered messaging like alerts and triggers for elevated heart-rate etc. This will not just massively improve workflow optimization but also, ensure that all care is managed from the comfort of home.

To Improve Patient Health: What if the wearable device connected to a patient tells you when his heart-rate is going haywire or if he has lagged behind in taking good care of himself and shared that information on other devices that you used while working? By updating personal health data of patients on the cloud and eliminating the need to feed it into the EMRs, IoT ensures that every tiny detail is taken into consideration to make the most advantageous decisions for patients. Moreover, it can be used as a medical adherence and home monitoring tool.

To Turn Data Into Actions: Quantified health is going to be future of healthcare because health that is measurable can be better improved. Therefore, it is wise to take advantage of quantified health technology. We also know that data affects performance so, an object measurement and tracking of health for better outcomes is why we need IoT.

IoT for Hospitals

Apart from monitoring patients’ health, there are many other areas where IoT devices are very useful in hospitals. IoT devices tagged with sensors are used for tracking real time location of medical equipment like wheelchairs, defibrillators, nebulizers, oxygen pumps and other monitoring equipment. Deployment of medical staff at different locations can also be analyzed real time.

The spread of infections is a major concern for patients in hospitals. IoT-enabled hygiene monitoring devices help in preventing patients from getting infected. IoT devices also help in asset management like pharmacy inventory control, and environmental monitoring, for instance, checking refrigerator temperature, and humidity and temperature control.

IoT for Health Insurance Companies

There are numerous opportunities for health insurers with IoT-connected intelligent devices. Insurance companies can leverage data captured through health monitoring devices for their underwriting and claims operations. This data will enable them to detect fraud claims and identify prospects for underwriting. IoT devices bring transparency between insurers and customers in the underwriting, pricing, claims handling, and risk assessment processes. In the light of IoT-captured data-driven decisions in all operation processes, customers will have adequate visibility into underlying thought behind every decision made and process outcomes.

Insurers may offer incentives to their customers for using and sharing health data generated by IoT devices. They can reward customers for using IoT devices to keep track of their routine activities and adherence to treatment plans and precautionary health measures. This will help insurers to reduce claims significantly. IoT devices can also enable insurance companies to validate claims through the data captured by these devices.

Benefits in health care

Simultaneous reporting and monitoring

Remote health monitoring monitoring via connected devices can save lives in event of a medical emergency like heart failure, diabetes, asthma attacks, etc.

With real-time monitoring of the health condition in place by means of a smart medical device connected to a smartphone app, connected medical devices can collect medical and other required health data and use the data connection of the smartphone to transfer collected information to a physician or to a cloud platform.

Center of Connected Health Policy conducted a study that indicates that there was a 50% reduction in 30-day readmission rate because of remote patient monitoring on heart failure patients.

The IoT device collects and transfers health data: blood pressure, oxygen and blood sugar levels, weight, and ECGs.

These data are stored in the cloud and can be shared with an authorized person, who could be a physician, your insurance company, a participating health firm or an external consultant, to allow them to look at the collected data regardless of their place, time, or device.

End-to-end connectivity and affordability

IoT can automate patient care workflow with the help healthcare mobility solution and other new IoT technologies, and next-gen healthcare facilities.

IoT in healthcare enables interoperability, artificial intelligence machine-to-machine communication, information exchange, and data movement that makes healthcare service delivery effective.

Connectivity protocols: Bluetooth LE, Wi-Fi, Z-wave, ZigBee, and other modern protocols, healthcare personnel can change the way they spot illness and ailments in patients and can also innovate revolutionary ways of treating across different healthcare fields.

Consequently, technology-driven setup brings down the healthcare cost, by cutting down unnecessary visits, utilizing better quality resources, and improving the allocation and planning.

Data assortment and analysis

Vast amount of data that a healthcare device sends in a very short time owing to their real-time application is hard to store and manage if the access to cloud is unavailable.

Even for healthcare professionals to acquire data originating from multiple devices and sources and analyze it manually is a tough bet.

IoT devices can collect, report and analyses the real time information and cut the need to store the raw data.

This all can happen overcloud with the providers only getting access to final reports with graphs.

Moreover, healthcare operations allow organizations to get vital healthcare analytics and data-driven insights which speed up decision-making and is less prone to errors.

Tracking and alerts

On-time alert is critical in chronic condition. Medical IoT devices gather vital signs of any disease and transfer that data to doctors for real-time tracking, while dropping notifications to people about critical parts via mobile apps and smart sensors.

Reports and alerts give a firm opinion about a patient’s condition, irrespective of place and time.

It also helps healthcare providers to make well-versed decisions and provide on-time treatment.

Thus, IoT enables real-time alerting, tracking, and monitoring, which permits hands-on treatments, better accuracy, apt intervention by doctors and improve complete patient care delivery results.

Remote medical assistance

In event of an emergency, patients can contact a doctor who is many kilometers away with a smart mobile apps.

With mobility solutions in healthcare, the medics can instantly check the patients and identify the ailments on-the-go.

Also, numerous IoT-based healthcare delivery chains that are forecasting to build machines that can distribute drugs on the basis of patient’s prescription and ailment-related data available via linked devices.

IoT will Improve the patient’s care In hospital. This in turn, will cut on people’s expense on healthcare

Hospital and Medical

Organ Donation

November 5, 2022 Advin Health Care Comment

What is Organ Donation?

Organ donation is the process of surgically removing an organ or tissue from one person (the organ donor) and placing it into another person (the recipient). Transplantation is necessary because the recipient’s organ has failed or has been damaged by disease or injury.

Organ transplantation is one of the great advances in modern medicine. Unfortunately, the need for organ donors is much greater than the number of people who actually donate.

Why is donation important?

At any one time, there are around many peoples on the organ transplant waiting list. Unfortunately, there are fewer donor organs available than there are people waiting. Some people die waiting for a transplant. Some spend weeks or months in hospital, while others make several trips to hospital every week for treatment.

People who need an organ transplant are usually very sick or dying, because one or more of their organs is failing.

Many on the organ transplant waiting list have a congenital or genetic condition, illness or sudden organ failure that will make them very sick and in need of a transplant.

We never know when illness could affect a family member, friend or colleague who may need a transplant.

What Tissue Donation?

Tissue Donation is the process of retrieving or procuring tissues from a living or decreased persons, called a Donor, and transplanted into the Recipient who need it.

Medical Science has made tremendous progress in recent times in the field of organ donation and transplantation, with organ donation from one person capable of saving up to 9 lives and improving the lives if many others.

However, due to the prevalence of myths about organ donation, and the lack of awareness about the topic in india, majority of people do not take up this noble cause for the benefits of others.

Which Organs Can Be Donated ?

Let’s take a closer look at the different organs that can be donated by a person after death and while the person is still alive. There are 8 organs that can be donated and transplanted:

Kidneys: Both Kidneys can be donated by a deceased donor. On average the lifespan of a transplanted Kidney is around nine years. But it varies for individual to individual. Of all organs in the human body, the demand for kidneys is the highest, and kidneys are the most frequently donated organs. A kidney disease most likely affects both kidneys at the same time. A living donor can easily donate one kidney to someone and function well for their lives.

Liver: The Liver is an important organ with primary function of bile production & excretion; excetion of bilirubin, cholesterol, Hormens, and drugs; metabolism of fats, proteins and carbohydrates: enzyme activation: storage of glycogen, vitamins and minerals; synthesis of plasma proties; blood detoxification and purification. The Liver is the only organ in the human body that can grow cells and regenerate. A donated liver from someone who has died ( a deceased donor) can further be split into 2 pieces and transplanted into 2 different people to save their lives. A Living donor can have a portion of her/his liver removed ti donate to someone and the remaining protion will regenerate to almost its full previous sie.

Heart: A heart is a muscular organ which pumps blood through the human body. In a person’s life. The heart will beat around 2.5 billion times on average and keep the blood running in the body. After being retrieved from the donor, a heart can survive for 4-6 hr only.

Lungs: Single or double-lung transplants can be performed from deceased donors. Additionally, living donors can donate a single lobe from the lungs, through it will not regenerate.

Pancreas: A deceased donor pancreas can be transplanted into an ailing Patient. A living donor can also donate a portion of the pancreas and still retain pancreas functionality.

Intestine: After death, a donor can donate tissues such as corneas, skin, bones ligaments, heart valves etc.

Which Tissues Can be Donated?

Layers of cells that function together to serve a specific purpose are called Tissues. Should be donated within 6 hr of the donor’s death.

Cornea: Cornea donation or eye donation is the most common tissue donation. The cornea is a transparent covering over the eye. It is also they eye’s primary focusing element. Recipients who suffer from corneal blindness can gain their sight again after a corneal transplant. These patients are those who may have been blinded by an accident, infection or disease. Either the entire cornea can be transplanted or it can be transplanted in parts. A Corneal Transplant is does not need any anti-rejection drugs in the recipient. Corneas from all ages of recipients are effective as long as the doctors as they are healthy.

Bones: Bones from deceased donor are used to replace bones of recipients whose bones are cancerous. A Bone transplant can be done instead of amputating the cancerous arm.

Skin: Skin can be used as grafting for burn victims, acid attack victims or for post-mastectomy breast reconstruction, among other things.

Veins: Donated veins are commonly used in surgeries for cardiac bypass.

Types of Organ Donation

Living Organ Donation: This is when you retrieve an organ from a health living person and transplant it into the body of someone who is suffering from end-stage organ failure. This is commonly done in the case of a liver or a kidney failure.

Living donors are classified as either a near relative or a distant relative/ friend etc.

A near-relative is spouse, son/daughter, brother/sister, parents, grandparents and grandchildren.

Those other than near-relative can be distant relatives and friends who will need the permission of the state authorization committee to donate organs. If the hospital refuses to entertain such cases. The patient may send a legal notice to the hospital for not following the transplant act.

Deceased Organ Donation: When we talk about pledging your organs for donation or about organ donation after death, we are talking about deceased organ donation. This is an organ donation from a person who has been declared brain stem dead when there is an irreversible loss of consciousness, absence of brain stem reflexes and irreversible loss of the capacity to breath.

A lot of people think that whenever and however they die. Their organs can be donated. That is not true. In India, organ donation after death is only possible in the case of brain stem death.

Donation after cardiac death is common in the west, but in india it is rare for donations to take place after cardiac death.

Although it is possible for organs such as the liver and the kidney to be easily donated from a living donor to a recipient, we should work towards an environment where everyone donates their organs after their deaths, so no living person should have to donate an organ to another.

Hospital and Medical

Breast Cancer

November 2, 2022 Advin Health Care Comment

What Is Breast Cancer?

Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.

Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk. The ducts are tubes that carry milk to the nipple. The connective tissue (which consists of fibrous and fatty tissue) surrounds and holds everything together. Most breast cancers begin in the ducts or lobules.

Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.

Where breast cancer starts?

Breast cancers can start from different parts of the breast. The breast is an organ that sits on top of the upper ribs and chest muscles. There is a left and right breast and each one has mainly glands, ducts, and fatty tissue. In women, the breast makes and delivers milk to feed newborns and infants. The amount of fatty tissue in the breast determines the size of each breast.

The breast has different parts:

Lobules are the glands that make breast milk. Cancers that start here are called lobular cancers.
Ducts are small canals that come out from the lobules and carry the milk to the nipple. This is the most common place for breast cancer to start. Cancers that start here are called ductal cancers.
The nipple is the opening in the skin of the breast where the ducts come together and turn into larger ducts so the milk can leave the breast. The nipple is surrounded by slightly darker thicker skin called the areola. A less common type of breast cancer called Paget disease of the breast can start in the nipple.
The fat and connective tissue (stroma) surround the ducts and lobules and help keep them in place. A less common type of breast cancer called phyllodes tumor can start in the stroma.
Blood vessels and lymph vessels are also found in each breast. Angiosarcoma is a less common type of breast cancer that can start in the lining of these vessels. The lymph system is described below.

A small number of cancers start in other tissues in the breast. These cancers are called sarcomas and lymphomas and are not really thought of as breast cancers.

How breast cancer spreads?

Breast cancer can spread when the cancer cells get into the blood or lymph system and then are carried to other parts of the body.

The lymph (or lymphatic) system is a part of your body’s immune system. It is a network of lymph nodes (small, bean-sized glands), ducts or vessels, and organs that work together to collect and carry clear lymph fluid through the body tissues to the blood. The clear lymph fluid inside the lymph vessels contains tissue by-products and waste material, as well as immune system cells.

The lymph vessels carry lymph fluid away from the breast. In the case of breast cancer, cancer cells can enter those lymph vessels and start to grow in lymph nodes. Most of the lymph vessels of the breast drain into:

Lymph nodes under the arm (axillary lymph nodes)
Lymph nodes inside the chest near the breastbone (internal mammary lymph nodes)
Lymph nodes around the collar bone (supraclavicular [above the collar bone] and infraclavicular [below the collar bone] lymph nodes)

If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have traveled through the lymph system and spread (metastasized) to other parts of your body. Still, not all women with cancer cells in their lymph nodes develop metastases, and some women with no cancer cells in their lymph nodes might develop metastases later.

Types of breast cancer

There are several different types of breast cancer, including:

Infiltrating (invasive) ductal carcinoma. Starting in your milk ducts of your breast, this cancer breaks through the wall of your duct and spreads to surrounding breast tissue. Making up about 80% of all cases, this is the most common type of breast cancer.
Ductal carcinoma in situ. Also called Stage 0 breast cancer, ductal carcinoma in situ is considered by some to be precancerous because the cells haven’t spread beyond your milk ducts. This condition is very treatable. However, prompt care is necessary to prevent the cancer from becoming invasive and spreading to other tissues.
Infiltrating (invasive) lobular carcinoma. This cancer forms in the lobules of your breast (where breast milk production takes place) and has spread to surrounding breast tissue. It accounts for 10% to 15% of breast cancers.
Lobular carcinoma in situ is a precancerous condition in which there are abnormal cells in the lobules of your breast. It isn’t a true cancer, but this marker can indicate the potential for breast cancer later on. So, it’s important for women with lobular carcinoma in situ to have regular clinical breast exams and mammograms.
Triple negative breast cancer (TNBC). Making up about 15% of all cases, triple negative breast cancer is one of the most challenging breast cancers to treat. It’s called triple negative because it doesn’t have three of the markers associated with other types of breast cancer. This makes prognosis and treatment difficult.
Inflammatory breast cancer. Rare and aggressive, this type of cancer resembles an infection. People with inflammatory breast cancer usually notice redness, swelling, pitting and dimpling of their breast skin. It’s caused by obstructive cancer cells in their skin’s lymph vessels.
Paget’s disease of the breast. This cancer affects the skin of your nipple and areola (the skin around your nipple).

What are the early signs of breast cancer?

Breast cancer symptoms can vary for each person. Possible signs of breast cancer include:

A change in the size, shape or contour of your breast.
A mass or lump, which may feel as small as a pea.
A lump or thickening in or near your breast or in your underarm that persists through your menstrual cycle.
A change in the look or feel of your skin on your breast or nipple (dimpled, puckered, scaly or inflamed).
Redness of your skin on your breast or nipple.
An area that’s distinctly different from any other area on either breast.
A marble-like hardened area under your skin.
A blood-stained or clear fluid discharge from your nipple.

Some people don’t notice any signs of breast cancer at all. That’s why routine mammograms and are so important.

What causes breast cancer?

Breast cancer develops when abnormal cells in your breast divide and multiply. But experts don’t know exactly what causes this process to begin in the first place.

However, research indicates that are several risk factors that may increase your chances of developing breast cancer. These include:

Age. Being 55 or older increases your risk for breast cancer.
Sex. Women are much more likely to develop breast cancer than men.
Family history and genetics. If you have parents, siblings, children or other close relatives who’ve been diagnosed with breast cancer, you’re more likely to develop the disease at some point in your life. About 5% to 10% of breast cancers are due to single abnormal genes that are passed down from parents to children, and that can be discovered by genetic testing.
Smoking. Tobacco use has been linked to many different types of cancer, including breast cancer.
Alcohol use. Research indicates that drinking alcohol can increase your risk for certain types of breast cancer.
Obesity. Having obesity can increase your risk of breast cancer and breast cancer recurrence.
Radiation exposure. If you’ve had prior radiation therapy — especially to your head, neck or chest — you’re more likely to develop breast cancer.
Hormone replacement therapy. People who use hormone replacement therapy (HRT) have a higher risk of being diagnosed with breast cancer.

There are many other factors that can increase your chances of developing breast cancer. Talk to your healthcare provider to find out if you’re at risk.

How is breast cancer diagnosed?

Your healthcare provider will perform a breast examination and ask about your family history, medical history and any existing symptoms. Your healthcare provider will also recommend tests to check for breast abnormalities. These tests may include:

Mammogram. These special X-ray images can detect changes or abnormal growths in your breast. A mammogram is commonly used in breast cancer prevention.
Ultrasonography. This test uses sound waves to take pictures of the tissues inside of your breast. It’s used to help diagnose breast lumps or abnormalities.
Positron emission tomography (PET) scanning: A PET scan uses special dyes to highlight suspicious areas. During this test, your healthcare provider injects a special dye into your veins and takes images with the scanner.
Magnetic resonance imaging (MRI): This test uses magnets and radio waves to produce clear, detailed images of the structures inside of your breast.

If your healthcare provider sees anything suspicious on the imaging tests, they may take a biopsy of your breast tissue. They’ll send the sample to a pathology lab for analysis.

What are the breast cancer stages?

Staging helps describe how much cancer is in your body. It’s determined by several factors, including the size and location of the tumor and whether the cancer has spread to other areas of your body. The basic breast cancer stages are:

Stage 0. The disease is non-invasive. This means it hasn’t broken out of your breast ducts.
Stage I. The cancer cells have spread to the nearby breast tissue.
Stage II. The tumor is either smaller than 2 centimeters across and has spread to underarm lymph nodes or larger than 5 centimeters across but hasn’t spread to underarm lymph nodes. Tumors at this stage can measure anywhere between 2 to 5 centimeters across, and may or may not affect the nearby lymph nodes.
Stage III. At this stage, the cancer has spread beyond the point of origin. It may have invaded nearby tissue and lymph nodes, but it hasn’t spread to distant organs. Stage III is usually referred to as locally advanced breast cancer.
Stage IV. The cancer has spread to areas away from your breast, such as your bones, liver, lungs or brain. Stage IV breast cancer is also called metastatic breast cancer.

How is breast cancer treated?

There are several breast cancer treatment options, including surgery, chemotherapy, radiation therapy, hormone therapy, immunotherapy and targeted drug therapy. What’s right for you depends on many factors, including the location and size of the tumor, the results of your lab tests and whether the cancer has spread to other parts of your body. Your healthcare provider will tailor your treatment plan according to your unique needs. It’s not uncommon to receive a combination of different treatments, too.

Breast cancer surgery

Breast cancer surgery involves removing the cancerous portion of your breast and an area of normal tissue surrounding the tumor. There are different types of surgery depending on your situation, including:

Lumpectomy. Also called a partial mastectomy, a lumpectomy removes the tumor and a small margin of healthy tissue around it. Typically, some of the lymph nodes — in your breast or under your arm — are also removed for evaluation. People who have a lumpectomy often have radiation therapy in the weeks following the procedure.
Mastectomy. Removal of your entire breast is another option. In some cases, doctors can perform a nipple-sparing mastectomy to preserve your nipple and areola (the dark skin around your nipple). Many women choose to undergo either immediate or delayed breast reconstruction following their mastectomy.
Sentinel node biopsy. Because early detection of breast cancer has resulted in the lymph nodes being negative (for cancer) in most cases, the sentinel node biopsy was developed to prevent the unnecessary removal of large numbers of lymph nodes that aren’t involved by the cancer. To identify the sentinel lymph node, doctors inject a dye that tracks to the first lymph node that cancer would spread to. If that lymph node is cancer-free, then other lymph nodes don’t need to be removed. If that lymph node has cancer in it, it may be necessary to remove additional lymph nodes. Often, there’s more than one sentinel node identified, but the fewer lymph nodes removed the lower the chance of developing swelling in your arm (lymphedema). A sentinel lymph node biopsy can be done with either a lumpectomy or a mastectomy.
Axillary lymph node dissection. If multiple lymph nodes are involved by the cancer, an axillary lymph node dissection may be done to remove them. This means removing many of the lymph nodes under your arm (your axilla).
Modified radical mastectomy. During this procedure, your entire breast is removed in addition to your nipple. Nearby lymph nodes in your underarm area are also removed, but your chest muscles are left intact. Breast reconstruction can often be an option if desired.
Radical mastectomy. This procedure is rarely performed today unless the breast cancer has spread to your chest wall muscles. During a radical mastectomy, your surgeon removes your entire breast, your nipple, underarm lymph nodes and chest wall muscles. People who undergo this procedure may choose to have breast reconstruction as well.

Chemotherapy for breast cancer

Your healthcare provider may recommend chemotherapy for breast cancer before a lumpectomy in an effort to shrink the tumor. Sometimes, it’s given after surgery to kill any remaining cancer cells and reduce the risk of recurrence (coming back). If the cancer has spread beyond your breast to other parts of your body, then your healthcare provider may recommend chemotherapy as a primary treatment.

Radiation therapy for breast cancer

Radiation therapy for breast cancer is typically given after a lumpectomy or mastectomy to kill remaining cancer cells. It can also be used to treat individual metastatic tumors that are causing pain or other problems.

Hormone therapy for breast cancer

Some types of breast cancer use hormones — such as estrogen and progesterone — to grow. In these cases, hormone therapy can either lower estrogen levels or stop estrogen from attaching to breast cancer cells. Most often, healthcare providers use hormone therapy after surgery to reduce the risk of breast cancer recurrence. However, they may also use it before surgery to shrink the tumor or to treat cancer that has spread to other parts of your body.

Immunotherapy for breast cancer

Immunotherapy uses the power of your own immune system to target and attack breast cancer cells. Treatment is given intravenously (through a vein in your arm or hand). Your healthcare provider might use immunotherapy for breast cancer in combination with chemotherapy.

Targeted drug therapy for breast cancer

Some drugs can target specific cell characteristics that cause cancer. Your healthcare provider might recommend targeted drug therapy in cases where breast cancer has spread to other areas of your body. Some of the most common drugs used in breast cancer treatment include monoclonal antibodies (like trastuzumab, pertuzumab and margetuximab), antibody-drug conjugates (like ado-trastuzumab emtansine and fam-trastuzumab deruxtecan) and kinase inhibitors (such as lapatinib, neratinib and tucatinib).

Hospital and Medical

Artificial Intelligent (AI) In Health Care

November 1, 2022 Advin Health Care Comment

Artificial intelligence (AI) and related technologies are increasingly prevalent in business and society, and are beginning to be applied to healthcare. These technologies have the potential to transform many aspects of patient care, as well as administrative processes within provider, payer and pharmaceutical organisations.

There are already a number of research studies suggesting that AI can perform as well as or better than humans at key healthcare tasks, such as diagnosing disease. Today, algorithms are already outperforming radiologists at spotting malignant tumours, and guiding researchers in how to construct cohorts for costly clinical trials. However, for a variety of reasons, we believe that it will be many years before AI replaces humans for broad medical process domains. In this article, we describe both the potential that AI offers to automate aspects of care and some of the barriers to rapid implementation of AI in healthcare.

How AI works in healthcare?

AI is able to analyze large amounts of data stored by healthcare organizations in the form of images, clinical research trials and medical claims, and can identify patterns and insights often undetectable by manual human skill sets.

AI algorithms are “taught” to identify and label data patterns, while NLP allows these algorithms to isolate relevant data. With DL, the data is analyzed and interpreted with the help of extended knowledge by computers. The impact of these tools is huge, considering a Frost & Sullivan analysis indicated artificial intelligence and cognitive computing systems in healthcare will account for $6.7 billion this year from the market compared to $811 million in 2015.

The use of AI is supporting many stakeholders in healthcare:

Teams of clinicians, researchers or data managers involved in clinical trials can speed up the process of medical coding search and confirmation, crucial in conducting and concluding clinical studies.
Healthcare payers can personalize their health plans by connecting a virtual agent via conversational AI with members interested in customized health solutions.
Clinicians can improve and customize care to patients by combing through medical data to predict or diagnose disease faster.

Top 10 uses of AI in healthcare

AI supports medical imaging analysis

AI is used as a tool for case triage. It supports a clinician reviewing images and scans. This enables radiologists or cardiologists to identify essential insights for prioritizing critical cases, to avoid potential errors in reading electronic health records (EHRs) and to establish more precise diagnoses.

A clinical study can result in huge amounts of data and images that need to be checked. AI algorithms can analyze these datasets at high speed and compare them to other studies in order to identify patterns and out-of-sight interconnections. The process enables medical imaging professionals to track crucial information quickly.

AI provides valuable assistance to emergency medical staff

During a sudden heart attack, before ambulance arrival is crucial for recovery. For an increased chance of survival, emergency dispatchers must be able to recognize the symptoms of a cardiac arrest in order to take appropriate measures. AI can analyze both verbal and nonverbal clues in order to establish a diagnostic from a distance.

Corti is an AI tool that assists emergency medicine staff. By analyzing the voice of the caller, background noise and relevant data from medical history of the patient, Corti alerts emergency staff if it detects a heart attack. Like other ML technologies, Corti does not search for particular signals, but it trains itself by listening to many calls in order to detect crucial factors.

Based on this learning, Corti improves its model as an ongoing process. The technology Corti is equipped with can detect the difference between background noise, such as sirens, and clues from the caller, or the patient sounds in the background.

AI analyzes unstructured data

Clinicians often struggle to stay updated with the latest medical advances while providing quality patient-centered care due to huge amounts of health data and medical records. EHRs and biomedical data curated by medical units and medical professionals can be quickly scanned by ML technologies to provide prompt, reliable answers to clinicians.

In many cases, health data and medical records of patients are stored as complicated unstructured data, which makes it difficult to interpret and access. AI can seek, collect, store and standardize medical data regardless of the format, assisting repetitive tasks and supporting clinicians with fast, accurate, tailored treatment plans and medicine for their patients instead of being buried under the weight of searching, identifying, collecting and transcribing the solutions they need from piles of paper formatted EHRs.

AI supports health equity

The AI and ML industry has the responsibility to design healthcare systems and tools that ensure fairness and equality are met, both in data science and in clinical studies, in order to deliver the best possible health outcomes. With more use of ML algorithms in various areas of medicine, the risk of health inequities can occur.

Those responsible for applying AI in healthcare must ensure AI algorithms are not only accurate, but objective and fair. Since many clinical trial guidelines and diagnostic tests take into account a patient’s race and ethnicity that a debate has arisen:

Is the selection of these factors evidence-based? Is race and ethnicity data more likely to solve or to increase universal health inequities? It is established that ML comprises a set of methods that enables computers to learn from the data they process. That means that, at least in principle, ML can provide unbiased predictions based only on the impartial analysis of the underlying data.

AI and ML algorithms can be educated to decrease or remove bias by promoting data transparency and diversity for reducing health inequities. Healthcare research in AI and ML has the potential to eliminate health-outcome differences based on race, ethnicity or gender.

AI can forecast kidney disease

Acute kidney injury (AKI) can be difficult to detect by clinicians, but can cause patients to deteriorate very fast and become life-threatening. With an estimated 11% of deaths in hospitals following a failure to identify and treat patients, the early prediction and treatment of these cases can have a huge impact to reduce life-long treatment and the cost of kidney dialysis.

AI uses data collected for predictive analytics

Turning EHRs into an AI-driven predictive tool allows clinicians to be more effective with their workflows, medical decisions and treatment plan. NLP and ML can read the entire medical history of a patient in real time, connect it with symptoms, chronic affections or an illness that affects other members of the family. They can turn the result into a predictive analytics tool that can catch and treat a disease before it becomes life-threatening.

AI builds complex and consolidated platforms for drug discovery

AI algorithms are able to identify new drug applications, tracing their toxic potential as well as their mechanisms of action. This technology led to the foundation of a drug discovery platform that enables the company to repurpose existing drugs and bioactive compounds.

By combining the best elements of biology, data science and chemistry with automation and the latest AI advances, the founding company of this platform is able to generate around 80 terabytes of biological data that is processed by AI tools across 1.5 million experiments weekly.

The ML tools are created to draw insights from biological datasets that are too complex for human interpretation, decreasing the risk for human bias. Identifying new uses for known drugs is an appealing strategy for Big Pharma companies, since it is less expensive to repurpose and reposition existing drugs than to create them from scratch.

AI accelerates the discovery and development of genetic medicine

AI is also used to help rapidly discover and develop medicine, with a high rate of success. Genetic diseases are favored by altered molecular phenotypes, such as protein binding. Predicting these alterations means predicting the likelihood of genetic diseases emerging. This is possible by collecting data on all identified compounds and on biomarkers relevant to certain clinical trials.

AI can decrease the cost to develop medicines

Supercomputers have been used to predict from databases of molecular structures which potential medicines would and would not be effective for various diseases. By using convolutional neural networks, a technology similar to the one that makes cars drive by themselves, AtomNet was able to predict the binding of small molecules to proteins by analyzing hints from millions of experimental measurements and thousands of protein structures.

This process enabled convolutional neural networks to identify a safe and effective drug candidate from the database searched, reducing the cost of developing medicine.