RMV Diagnostic Centre

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels.

We are all aware that the incidence of heart disease is increasing in India. Generally, the average age of heart patients in India is a decade younger, that means there are younger patients suffering from heart disease in India.

Benign Paroxysmal Positional Vertigo (BPPV)
Benign Paroxysmal Positional Vertigo (BPPV) is the disorder that causes vertigo, which is the false sensation of head’s spinning. The patient with BPPV may feel minor to severe faintness. BPPV may be caused by the incorrect position of the patient’s head. It is most felt when the patient moves head in either direction, lays down, or gets up from the bed especially in the morning.

BPPV is the disorder of the inner ears in which the crystals of calcium carbonate (known as ear rocks or otoconia) are accumulated and turned into the gel. This gel is then migrated into the semi-circular canals, which are normally filled with fluid. This fluid is generally unaffected by the gravity because of its lightweight.

With the migration, the accumulated gel tends to move down with the effect of gravity and bounces up again with any physical movement of the head and other factors. This results in its interference with the normal fluid movement within the canals that are used for the sensation of head motion.

Because of this interference and fluid movement, the nerves at the canal of the patient’s inner ear are excited and send false signals to the brain related to head rotation. In normal cases, this fluid is rested stationary within the canals. These false signals generate information in the brain that does not match with those sent by the second ear and eyes.

This mismatch of the generated information from multiple sources confuses the brain, which may make you feel spinning. This spinning is medically termed as vertigo, which may last up to a minute from its occurrence. Note that some patients would have a normal feel between every two vertigo invocations.

However, some of them may have a constant feeling of light head spinning sensation between two major spins of vertigo. Note that the dizziness caused by BPPV would not impact the hearing ability of the patient. It would also not make the patient difficult to speak. In case you have any of such additional symptoms, you must discuss with your physician immediately.

The occurrence of BPPV is seen mainly in the adults and is very rare in the children. However, it may impact individuals of any age group. The most cases of this disease are reported in the elderly people. Most of the patients with BPPV may feel the surroundings spinning while getting up from the bed in the morning.

However, the same symptom may also be associated with other disorders such as a migraine, trauma, ear infection, diabetes, intubation caused by lying in bed for a long period, osteoporosis, reduced blood flow, and more. It may also be associated with the incorrect posture of sleep. So, you must consult your doctor immediately when such symptoms arise in your body.

Symptoms of BPPV
The various symptoms of BPPV may include:

-  Dizziness

-  Vertigo in which the patient may feel the surrounding moving or spinning, especially while getting up in the morning

-  Disbalancing while getting up from sitting

-  Continual nausea and vomiting for over several weeks

-  Nystagmus in which the eye movements of the patient appear abnormal

Note that these symptoms may appear or disappear in between. It may happen that the patient is relieved from the symptoms for several months. But those may recur with lesser to severe intensity. Along with the symptoms listed above, some patients may observe the following symptoms in the extreme conditions:

-  Severe and intolerable headache

-  Fever

-  Double vision

-  Vision loss

-  Loss of hearing

-  Difficulty in speaking

-  Weakness in the legs or arms

-  Unconsciousness

-  Difficulty in walking

-  Tingling sensations in the brain, ear or other parts of the body

-  Numbness

Causes of BPPV
Age is a crucial factor that increases your chances of getting BPPV. It is often seen that the individuals of age over 50 years are most likely to get BPPV since the muscles of their inner ear may become weaker at that age. There may also be other causes of BPPV. Some of those are mentioned below:

-  Keeping head in a fixed posture for a long duration either on a dentist chair, salon and more

-  Performing the exercises that require high-speed movements of the head

-  Bike riding on a rough track

-  Various types of disorders of inner ear like Meniere’s disease

-  Resting on the bed for long duration for any reason, like hospitalization, prolonged rest over the weekend, working on a laptop for long while lying on the bed

-  Due to migraine

Prevention from BPPV-
Since BPPV may be caused by multiple reasons including the old age, it is very hard to prevent it completely. However, there are the multiple ways through which you may prevent it from happening to a good extent. Some of those are mentioned below:

-  Avoid doing exercises that may involve frequent and severe head movements.

-  Prevent yourself from any possibility of head injury. Wear a helmet while riding a bicycle, bike, and other sports.

-  Avoid lying on the bed for long hours.

-  Avoid prolonged steady head placement when awake.

-  Meditate on a regular basis.

-  Maintain hygiene in your surroundings to avoid the chances of infection in your ears.

-  Have a balanced sleep.

-  Exercise every day.

-  Don’t tip your head back for long hours to watch TV or to talk to your correspondents.

-  Take care of your immune system and adopt the habits that would keep it strong.

-  Avoid frequent head movements in case you are already a patient of BPPV. This may worsen your symptoms.

How BPPV is diagnosed?
If you observe even the mild symptoms of BPPV (mentioned above) for over a week, visit your doctor immediately. The physician would ask the patient several questions related to the symptoms. For instance:

-  When is the dizziness felt most during a day?

-  From how long the symptoms are observed?

-  Do you have a continual temptation of vomiting?

-  How are you normally relieved from the symptoms?

-  For how long at a stretch are the symptoms observed?

-  Do you have any other disease or disorders related to the ears or the brain?

-  Are you a patient of a migraine?

The doctor would also assess the complete medical history of the patient of the past several years. The eye movement of the patient would also be checked for the occurrence of nystagmus. The patient would also be asked to lay down on a table with the head tilted back. This test would help the physician in understanding if the patient has irregular control in eye movement.

It may also be observed if the symptoms occur most with the movement of eyes or head in a particular direction. Post collection of all this information, the physician may also prescribe the patient to undergo an infrared goggle test.

In case the doctor finds it difficult to identify the actual reason for those symptoms, the patient may be prescribed to get one of the following investigations done:

-  Video Nystagmography (VNG) or Electro Nystagmography (ENG) in which the abnormal movement of eyes is detected if any. In the ENG test, electrodes are used and in VNG, small cameras are used to assess if the dizziness is because of some inner ear disease. This is calculated by the measurement of irregular eye movement by placing the patient’s head in multiple positions.

-  Magnetic Resonance Imaging (MRI), in which magnetic fields and radio waves capture multiple images of the patient’s head or other parts of the body from different directions. Such images could be assessed to diagnose the condition of the dizziness and the possible reasons associated with it.

Treatment of BPPV
There are some chances that the symptoms of BPPV may disappear on their own in few weeks to months. However, to get rid of the symptoms sooner, the doctor would provide the treatment for the repositioning of the head movements. This therapy is called as canalith repositioning.

In canalith repositioning, the mispositioned canaliths due to the gel developed from the crystals of calcium carbonate that move from the fluid-filled semi-circular canals of the inner ear, are repositioned. This prevents the nerves of the canal of the patient’s inner ear by sending false signals to the brain related to head rotation. Along with this process, the doctor may also recommend the patient to avoid some particular head position for several weeks to months, which may trigger the symptoms again.

For the first few sessions of canalith repositioning, you are required to visit the therapy centre. Post then, the doctor may teach you the canalith repositioning procedure, which you could practice on your own at home if required. Post such a session, you may be required to take rest for at least 10-15 minutes so that the crystals of calcium carbonate are resettled in the canals of the inner ear.

In some rare situations where the symptoms are extreme and could not be relieved by the canalith repositioning procedure, the patient may be recommended a surgery with which the inner ear’s bone is plugged to prevent the movement of calcium carbonate crystals within the fluid-filled semi-circular canals. This effectively stops the symptoms of dizziness. Such type of surgery is effective with the success rate of around 90%. But in some rare cases, there is the risk of loss of hearing for the patient.

Other than these treatments, there are certain precautions that the patients of BPPV should take. Those are mentioned below:

-  Keep memorising your symptoms and be extra careful about balancing while getting up from your bed. The patients with BPPV are more prone to lose their balance, which may result in them to face injuries.

-  Try to be seated whenever you have a feeling of dizziness. In case you are standing and could not see some nearby seat, just take the support of some wall or any stable object.

-  Keep some lights turned on in your bedroom in the night, so that you would not face many difficulties in getting up in between if required.

-  Keep visiting your doctor periodically unless your symptoms are subsided.

-  Do not lay with the head tilted back, if you are already suffering from the symptoms of BPPV.

-  Avoid laying or sleeping towards the affected side of the head where symptoms are felt the most. Use two pillows while sleeping to ensure this.

-  Even when the symptoms are disappeared, those may recur. Prepare your mindset for that.

-  While waking up in the morning, lift the head very slowly and sit on the bed for a few minutes before standing up.

-  Avoid bending down for picking up something.

Complications
Although BPPV is not a fatal disease by its own, its symptoms may cause you to face complicated problems if not taken care of or treated on time. It often happens that the patients with BPPV collapse on the floor due to dizziness, which may cause them severe fatal injuries. It is very important for them to bring the practice to their habit of sitting down or holding some stationary object whenever they observe dizziness. Else than that, BPPV may cause the patient to have an uncomfortable feeling. If it lasts for long, the patient may suffer from depression.

Another related complication is associated with the surgery in which the inner ear’s bone is plugged to prevent the movement of calcium carbonate crystals within the fluid-filled semi-circular canals. This surgery is carried out with an attempt to eliminate the symptoms of dizziness caused by BPPV. However, in some rare cases, this surgery may cause loss of hearing.

Myths
Myth #1: Children may not suffer from BPPV

It has been seen that elderly individuals are more likely to be affected by BPPV. However, individuals of any age (including children) may suffer from this disorder. Some children may not be able to express the problems that they would be facing. So, in case your kids collapse by their own on a frequent basis, it is must for you to take them to a paediatrician.

Myth #2: BPPV is caused only by a migraine

A migraine is one of the causes because of which BPPV may occur. However, there are multiple other factors associated with this disorder.

Myth #3: BPPV is always healed by its own

It is not necessary that BPPV is healed by its own every time. If the symptoms are severe, you must get a proper treatment before facing any injury due to the associated dizziness.

Spending excessive time on computer or mobile phone often leads to neck pain which has grown to be a common problem among masses over the past few years.

What are Piles? 
Piles, originally known as hemorrhoids, are a medical condition characterized by the swelling of veins in the lower rectum and the anus.  The veins are twisted and swollen, restricting the conventional blood flow in the anus and rectum. Even though it is very difficult to actually ascertain the cause of piles, the occurrence of this condition can be due to multiple reasons.

The most common causes of piles range from straining the veins at the time of being pregnant to additional pressure being applied to the veins during a bowel movement.   This condition can occur internally or on the surface of the skin, depending on the cause and effect of the reason behind the occurrence of this condition. 

Piles is a very common condition and are said to affect 3 out of 4 adults multiple times during their life.  Symptoms of the disease are often spotted amongst patients before they even reach the age of 50.  The symptoms of piles may be minimal or very evident, depending on the severity of the situation.  In a basic situation, a patient usually feels a little discomfort. While in a more serious situation such as thrombosed hemorrhoid, there may be the formation of blood clots which can cause excruciating pain. There are various treatments for this disease. Piles is not a very dangerous medical condition can usually be treated by making changes in the lifestyle or by easy home remedies which cause relief to the patient.

What are  The Types of Piles?
The piles disease can be divided into 4 different classifications based on the location, symptoms, and side- effects caused by their occurrence.

Internal hemorrhoids
External hemorrhoids
Thrombosed External Haemorrhoids
Prolapsed Haemorrhoids

1) Internal hemorrhoids-
This condition is the least restrictive type of piles. The symptoms of this piles condition arise inside the rectum and are found on the border that divides the upper part of the anal canal from the lower of the rectum. Internal piles don’t cause too much discomfort to the patient as they are enclosed in an external lining called mucosa, which protects it from causing pain to the patient. This is because the mucosa is insensitive to temperature, touch, stretching or pain.

On the basis of the level of the protrusion, internal hemorrhoids or internal piles can be classified in 4 levels-

Grade I: It is possible to bleed during this stage as the hemorrhoids are noticeable but they don't poke into the anal canal.
Grade II: At this piles stage, the hemorrhoids protrude momentarily outside the anal canal during a bowel movement, but shift back inside after the movement.
Grade III: In this piles stage, any pressure or exertion causes the hemorrhoids to protrude outside the anal canal. Fingers need to be used to push the hemorrhoids back in the anal canal.
Grade IV: Hemorrhoids have fallen out of the anal canal remain outside the rectum in this stage. They cannot be pushed back in and thus are quite uncomfortable.

2) External hemorrhoids-
This type of hemorrhoids is also known as a perianal hematoma. The side effects of this piles condition are usually bluish in color and feel painful and lumpy and are noticeable under the skin around the outer part of the anus. This type of hemorrhoids is similar in nature to the above described prolapsed internal hemorrhoids. External hemorrhoids may lead to additional skin tags on the verge of the anus, which may feel very uncomfortable to the patient. This happens due to the fact that these hemorrhoids are covered by normal skin which causes discomfort.

The occurrence of these skin tags is caused by the clot of blood formed due to stretching of the overlying skin.

3) Thrombosed External Haemorrhoids-
Thrombosed external hemorrhoids occur due to the formation of a clot in various small veins which causes pain and discomfort to the patient. This type of hemorrhoids is characterized by the presence of a painful and hard lump in the anus. The main cause of this type of piles is the excessive stretching of the skin which covers hemorrhoid. This causes the splitting of the vein, making it inflamed and cutting off the blood supply in it.

4) Prolapsed Haemorrhoids-
This is a type of hemorrhoids which have fallen out of the anal canal. The most common symptoms of prolapsed hemorrhoids are bleeding in the stool, toilet or on the toilet paper.   Most patients of this condition experience a feeling of not being able to completely pass stools. Prolapsed hemorrhoids can be quite painful because of the presence of nerves in them which can easily sense pain. Pain can arise in prolapsed hemorrhoids because of the pain-sensing nerves within them. Other possible causes of pain are -

• Swelling with hemorrhoid or abnormal accumulation of fluid in the hemorrhoid
• Blood clot formation or thrombosis
• Obstructed supply of blood in the hemorrhoid
• Overstretching of hemorrhoid caused by external pressure

What are the symptoms of piles?
The warning signs and common symptoms of hemorrhoids are listed below:

• Irritation or itching near the anal region
• Pain and bleeding during bowel movements
• Swelling in the anal region
• Lump near the anus which is painful and uncomfortable
• Painless bleeding

The various types of hemorrhoids or piles have specific symptoms depending on the location of their occurrence:

Internal hemorrhoids or Internal  piles
These hemorrhoids usually do not carry any specific symptoms which can be noticed by the patient. Excess straining of this type of hemorrhoids can lead to damage on the surface or minor bleeding. In case internal hemorrhoid passes through the anal canal, it becomes a prolapsed hemorrhoid which may be painful.

External hemorrhoids or External Piles
In case of application of pressure or external strain, these hemorrhoids can bleed or cause itching and discomfort.

Thrombosed hemorrhoids or Thrombosed Piles
This type of hemorrhoids is characterized by the formation of a blood clot in the anal region. This blood clot causes swelling, severe pain, inflammation or a hard lump near the anus.

 How are piles diagnosed?
Since there are multiple types of piles or hemorrhoids, they are all diagnosed differently.

Internal hemorrhoids can be diagnosed in the following ways-

• Digital rectal exam- This exam is done by the method of inserting a gloved and lubricated finger in the patient’s anus in order to identify any abnormalities. In case of any additional growth or abnormal diagnosis, the additional examination is prescribed.
• Sigmoidoscopy- This physical exam is done by inserting a really tiny fiber-optic camera in the rectum.  This allows the physician to check the surface for hemorrhoids.
• Proctoscopy- The physician inserts a hollow tube with a light at the end of the rectum in order to clearly review the anal canal and a large part of the large intestine.
• Anoscopy- This procedure entails the insertion of an anoscope in the anus in order to examine the anal region for hemorrhoids. An anoscope is generally made of stainless steel or plastic.
• Colonoscopy- This is a procedure in which a colonoscope is inserted in the anus and slowly moved around the colon area. This apparatus has a light source and camera attached to it which enables the physician to check for hemorrhoids.

This procedure may be additionally prescribed if the physician suspects any of the following situations in people who might have-
Any other disease related to digestive system

Signs and symptoms of colorectal cancer-
Are over the age of 50, and have never undergone a rectal examination
External hemorrhoids or external piles can be identified by a physician by simply undertaking a physical exam and visual notice.

What are Causes of Piles?
Veins have a tendency to swell up or bulge on the application of increased pressure. 

The various causes for swelling up of the veins, causing hemorrhoids or piles are-

• The excessive strain caused by pressure applied during a bowel movement
• Sitting on the toilet bowl for too long
• Constipation, Diarrhea or some other digestive system related problem
• Pregnancy
• Anal intercourse
• Low- Fiber Diet
• Obesity
• People over the age of 50 are more susceptible to hemorrhoids becomes over time, the veins in the anus and rectum that support their functioning tend to get overstretched or weak.  

Prevention from Piles/Hemorrhoid:
The most appropriate way to avoid getting hemorrhoids is to ensure that the stool to be passed by the anus is soft so that it passes easily.

Other than this, to prevent and reduce the occurrence of the symptoms of piles or hemorrhoids, the following steps can be followed.

• Eating high fiber food- Consuming more fruits, vegetables, and whole grains increases the fiber content in the body. This fiber ensures that the stool is soft and is easy to pass through the anus. This helps in avoiding a situation of application of additional pressure during a bowel movement.
• Drinking plenty of fluids- It is essential for everyone to consume at least 6- 8 glasses of water and juices in order to maintain the proper procedure of the body functions. This also ensures that the stool remains soft.
• Taking fiber supplements- The average recommended intake of fiber for males is 38 grams and for females is 25 grams. Most population is unable to fulfill the daily requirement of recommended fiber intake. This substantially affects the functioning of the digestive system as well as the consistency of the stool passed by a person. In order to maintain the proper functioning of the digestive system and produce soft stools.
• Not applying pressure- Most people have the tendency to hold their breath and apply strain while passing stool. This often causes a buildup of pressure in the veins of the lower rectum. Go as soon as you feel the urge. If you wait to pass a bowel movement and the urge goes away, your stool could become dry and be harder to pass.
• Following the urge- It is very important to go to the washroom to pass the stool as soon as the urge arises. In case the urge goes away, the stool becomes harder to pass.
• Exercising- Being active is a quintessential requirement for a healthy body. Being active and exercising helps in avoiding constipation and to reduce pressure on veins.
• Avoiding sitting in one place for a long time- sitting in one place for a long times puts added pressure on the anus, thus contributing to the occurrence of piles or hemorrhoids.

What are Home Remedies for Piles?
The mild swelling, inflammation, and pain caused hemorrhoids can be relieved or reduced by use of simple home remedies and change in food habits. 

A few of these home remedies for piles or Haemorrhoids are mentioned below-

• Eating a high fiber diet
• Using tropical treatment
• Soaking regularly in warm water
• Keeping the anal area clean
• Avoiding the using of dry toilet paper
• Applying cold water
• Taking oral pain relievers

The symptoms of hemorrhoids generally subside within a week of following the above- stated remedies.

How does Doctor would do treatment for Piles?
In case of minor discomfort and pain, a physician generally prescribes an over- the- counter cream, ointment, pad or suppository. Ingredients present in these medicines namely witch hazel, lidocaine and hydrocortisone help in relieving pain and discomfort. It is not advised to use this over-the-counter, steroid containing, cream for more than 7 days in case symptoms of piles or hemorrhoid do not subside.
External hemorrhoid thrombectomy is a procedure undertaken by a physician in order to treat a painful blood clot formed in external hemorrhoid. This is a very simple procedure and includes only making an incision in the clot and draining it to provide instant relief to the patient.
In case of constant bleeding and major discomfort caused due to hemorrhoids, a physician may suggest one of many minimally invasive procedures available for treatment.
Rubber band ligation
Injection (sclerotherapy)
Coagulation (infrared, laser or bipolar)
 

What are Surgical Procedures for Piles:
In case all other procedures are unable to treat the disease, the doctor may recommend a surgical treatment. A few of the most commonly performed surgical treatments are mentioned below-

• Hemorrhoid removal
• Hemorrhoidectomy
• Hemorrhoid stapling
   

What are Risk Factors Related to Piles?
Although hemorrhoids can affect anyone, there are a few things that make a person more vulnerable to contract this disease. 

A few of these situations are-

• Alcoholism
• Severe heart disease or liver disease
• Obesity
• Chronic constipation or diarrhea
• Lack of physical activity
• Anal intercourse
• Diet low in fiber (high fiber foods include whole grain foods, fresh fruits, and vegetables)
• Diet high in fat
• Jobs that require sitting or standing for long periods
• Loss of tone of the pelvic floor muscle due to childbirth, age, pregnancy or surgery
   

What are the complications due to piles?
Complications relating to hemorrhoids are very rare but may arise. The less commonly occurring but probable complications for patients with hemorrhoids are-

1. Strangulated hemorrhoid- This situation causes extreme pain to the patient suffering from piles or hemorrhoids. This arises when the blood supply to the hemorrhoid is cut off.
2. Anemia- As it has been inferred that various types of hemorrhoids have a tendency to cause extensive blood loss, it may lead to anemia if left unattended. Anemia is a condition in which the production of healthy red blood cells is not adequate.
 

What are Common Myths Related To Piles?
Myth #1: Elderly people are the only ones who can get hemorrhoids.
Reality- Haemorrhoids can affect people of any age. Although it is a stated fact that people between the age group of 45 to 60 are more susceptible to this disease, it can affect a person of any age.  

Myth #2: Eating spicy foods can cause hemorrhoids.
Reality- Hemorrhoids is caused due to excessive pressure on the veins near the anus and rectum, causing them to swell and even bleed at few instances. Eating spicy food does not have anything to do with the occurrence of this disease.

Myth #3: The composition of the food being consumed does not affect hemorrhoids.
Reality- Constipation is one of the main causes behind developing hemorrhoids. It is quintessential to include fiber and water/ other fluids in the diet in order to have a soft bowel moment. This enables a person to avoid being susceptible to constipation and thus steer clear of being affected by hemorrhoids. 

Myth #4: Surgery is the most common treatment for piles or hemorrhoids.
Reality- Symptoms of this disease usually subside by making a few changes in the lifestyle as well as by using home remedies. Depending on the severity of the situation, a physician often prescribes a few an over-the-counter medicines and ointments to relieve pain and help the symptoms subside.  It should be noted that surgery is the least common treatment for hemorrhoids.

Myth #5: Haemorrhoids causes cancer.
Reality- There is no evidence to associate colon cancer with hemorrhoids. Even though they have similar symptoms such as rectal bleeding, they can easily be differentiated by a physician on examination.  

Myth #6: Once a person gets hemorrhoids, it will be a recurring problem for them.  
Reality- People may develop hemorrhoids for a temporary duration due to a situation such as pregnancy, childbirth, constipation etc. Most available treatments of this condition are quite effective and are able to cure the problem fully. In case a person takes care of their diet and drinks a lot of fluid, they do not face this problem again.

Myth #7: Having hemorrhoids or piles is a reason for embarrassment.
Reality- By the time most people turn 50, they would have faced the problem of piles at least once. In both men and women, the occurrence is common irrespective of their age and it is nothing to be embarrassed about. 

Myth #8: Eating a lot of fiber eliminates the occurrence of piles completely.
Reality- Although inculcating fibrous food in the diet may help in preventing the development of hemorrhoids; it is not the only contributing factor to its occurrence. Long sitting, especially on the toilet, is also an influential factor in the occurrence of this condition. It is also advised to have at least eight glasses of water to ensure an easy bowel movement.

Myth #9: Haemorrhoids are difficult to treat.
Reality- There are multiple remedies available to treat both internal as well as external hemorrhoids or external piles.  

All modes of treatment ranging from surgery to lifestyle change are effective and painless. Hemorrhoids that cause mild swelling, inflammation, and pain can easily be relieved or reduced by use of simple home remedies such as eating a high fiber diet, drinking plenty of water, taking over the counter ointments and oral medication etc.

Myth #10: Haemorrhoids or piles can be caused by sitting on too hot or too cold surfaces.
Reality- The temperature of the surface you sit on does not affect cause piles. A habit of sitting in one place, especially on the toilet, makes a person more susceptible to having piles.

Cough
A cough is a reflex action to clear the throat from mucus and the external irritants such as the dust particles, smoke, microbes, and fluids etc. In short, the cough is a quick eviction of air from the lungs, which passes through the mouth. It is a common reflex that helps remove the obstruction of breathing and does not need immediate medical attention at the initial stage. However, if a cough lasts longer, it may possibly a sign of the serious disease as well.

A cough can be divided into two parts viz. an Acute Cough and Chronic Cough. Coughs that last not more than 2 to 3 weeks are called Acute Cough while Chronic Coughs last longer than 3 weeks and can be dangerous for health. These kinds of coughs are known as Persistent Coughs as well.

Causes of Acute Coughs (Short-Term Coughs)
A quite common infection that causes the Acute Coughs is called the Upper Respiratory Tract Infection, which is also known as the URI or URTI. This infection affects the throat, trachea and sinuses, which triggers flu, common cold, and Laryngitis.

Another reason that causes Acute Coughs is called the Lower Respiratory Tract Infection (LRTI), which affects the lungs and lower airways. This infection causes Pneumonia and Bronchitis. Besides, Acute Coughs can cause Hay Fever as well.

Causes of Chronic or Persistent Coughs (Long-Term Coughs)
There can be a number of reasons that cause Chronic Coughs such as smoking, Asthma, Bronchitis, post-nasal drip, Gastro-Oesophageal Reflux Disease (GORD) or Gastro-Esophageal Reflux Disease (GERD) etc.

1. Smoking:
A cough caused by the smoking is often called the ‘Smoker’s Cough’. It usually lasts longer and may lead to loads of complications in the respiratory system of the body including the Chronic Obstructive Pulmonary Disease (COPD), which obstructs the lung and creates several breathing problems and poor airflow for a long-term.

2. Asthma: 
Asthmatic Coughs include symptoms such as wheezing, chest tightness, shortness of breath, and tiredness etc. This type of coughs increases during the nights and cause difficulty sleeping.

3. Bronchitis:
 Bronchitis is a type of inflammation that damages the bronchial tubes, which carries the air to the lungs. It produces thick mucus that can further result in bronchial tubes to be swelled and/ or blocked.

4. Post-Nasal Drip: 
The body produces mucus, a thick, wet and stingy fluid substance, on a regular basis to help gets rid of the external dust particles and virus. Usually, it is not noticeable and drips down the throat from the back of the nose. However, when the body produces an excessive amount of mucus, it comes out of the nostrils and mouth and causes running nose.

5. Gastro-Oesophageal Reflux Disease (GORD) or Gastro-Esophageal Reflux Disease (GERD): 
The Acute Coughs often cause stomach acid to leak up into the tube that joints mouth and stomach, which is called oesophagus/ esophageal or gullet. The tube is also known as the food pipe. GORD usually leads to the heartburn and affects the taste buds as well.

Types of Coughs
Coughs can further be divided into four distinct categories namely Croup Coughs, Dry Coughs, Wet Coughs and Whooping Coughs. Let us know about these four types of coughs first.

1. Croup Coughs: 
Croup is an infection that is caused by the viruses and bacteria, and affects the Larynx, also called the voice box, trachea, known as the windpipe and the bronchial tubes that supply air to the lungs. Croup Coughs are usually contagious, especially at the initial stages. It irritates the Upper Respiratory Tract and makes it swelled that causes complications while breathing.

2. Dry Coughs: 
Dry Coughs are often caused by several factors such as the infection in the nose and throat, allergies air pollution, change in the temperature, dry atmosphere and acid reflux etc. It produces very less or no mucus during the infection and is also known as the Tickly Coughs and Non-Productive Coughs.

3. Wet Coughs: 
Wet Coughs are also known as the Chesty Coughs and Productive Coughs. This type of coughs produces a large amount of mucus and phlegm, which is stored in the Lower Respiratory Tract due to the infection and/ or asthma. Wet Cough occurs to remove the additional mucus through the nostrils and mouth.

4. Whooping Coughs: 
Whooping Coughs are also known as the Pertussis. This type of coughs is caused by the bacterial infection into the Upper Respiratory Tract and is highly contagious. Some of the symptoms the Whooping Coughs cause include the running nose, fever, nasal blockage, watery eyes, and extreme fatigue in some cases.

Cough Symptoms and Signs-
-  Sore throat

-  Heartburn

-  Excessive production of the mucus and phlegm

-  Blocked nasal

-  Running nose

-  Post-nasal drips

-  Unpleasant and sore taste

-  Hoarseness

These are the common symptoms, in case of multiple symptoms, ask your doctor to consult the patient.

Complications of Cough
While Acute Cough is a protective function that removes the blockage in the airways and fights the external bacteria and germs, Chronic Cough can sometimes be quite dangerous and can lead to many other serious diseases. Some of the common and major complications that cough causes include:

1. Fainting and Dizziness
The severe coughs sometimes cause fainting and dizziness and are often known as the Cough Syncope. It affects the sensory organs and reduces the blood flow to the brain while coughing, which can lead to major damages. Usually, Asthma, Gastro-Oesophageal Reflux Disease (GORD), Chronic Obstructive Pulmonary Disease (COPD), Whooping Coughs, and some kinds of heart diseases cause fainting during the coughs.

2. Insomnia-
Insomnia is a sleep disorder, which is among the common complications caused by the coughs. Regular production of mucus makes the body release it through the coughs and makes it difficult to sleep at nights. The post-nasal drips and symptoms of GERD are the two main causes that increase the chances of having insomnia.

3. Abdominal Hernia-
Chronic Coughs often cause throat infection, which can spread throughout the body and can affect other parts as well; and can lead to tearing the abdominal wall. This condition is however quite rare. Usually, the abdominal hernia caused by other infections or diseases is hard to identify, however, the hernia caused by the coughs are easily identified.

4. Fractured Ribs-
As per the article published by the World Journal of Emergency Surgery in 2006, fractured ribs caused by the Chronic Coughs are among the quite common complications occurred by the coughs. It mainly occurs in the old adults and has an effect on women for the most part. Chronic Coughs majorly affect the middle ribs and increased the chances of attacking the people having low bone density.

5. Hypoxia-
The severe Persistent Coughs affect the gas exchange in the lungs and blocks the necessary amount of oxygen required by the body tissues. This condition is called the Hypoxia. Hypoxia caused by the Persistent Coughs commonly attacks infants and babies as compared to the adults. Furthermore, Whooping Coughs develop the bacteria in the body that cause the Pneumonia, which may increase the risks of getting Brain Hypoxia.

Other Complications of Cough
-  Headache

-  Physical exhaustion

-  Cough-induced urine leakage

-  Hoarse voice

-  Muscle uneasiness 

-  Small blood vessel injury

-  Inflammation in the throat tissues

-  Coughing up blood

How to Prevent Coughing?
-  Avoid the extreme change in the temperature, such as the sudden exposure to the Sun or moving to the air-conditioned rooms from the heat outside.

-  Avoid taking warm bath late at nights or early in the morning.

-  Avoid consuming pickles and fried foods as sour food items increase the chances of getting a cough

-  Avoid extremely cold food items, especially the cold drinks and ice creams

-  Keep the hands and body clean to get rid of the germs

-  Keep the house clean and make sure bathroom and kitchen are hygienic and germ-free

-  Avoid getting in touch with dust

-  Keep the rooms ventilated with filtered air-conditioning system

-  Keep the body hydrated and consume enough water or any other beverages

-  Avoid being in contact with infected people. Many types of coughs are contagious and transmit the bacteria very quickly.

-  Have proper sleep

-  Avoid consuming alcohol and smoking

Cough Diagnosis-
The doctor starts the diagnosis procedure with examining the throat and test out if the infection persists. Further analysis includes listening to the sound of coughs and enquiring about the symptoms the patient is having. If the patient has a bacterial infection that causes coughs, the doctor will recommend some oral antibiotics.

Cough Treatment-
Generally, there is no need to have intense treatment for mild and Acute Coughs as it usually does not harm the body severely at the initial stages. Such mild coughs can be treated at some by consuming fluids and keeping the body hydrated. Taking painkillers such as Paracetamol or Ibuprofen will also work. However, if the coughs persist for weeks and becoming rigorous day by day, a medical care is required immediately.

Home Remedies for Cough-

1.Treatment of Cough by Honey-
Honey is being used to cure the coughs since the centuries now and is considered as one of the most effective remedies for coughs. Having honey with warm tea, warm lemon water or even with the grape juice helps soothe a sore throat. Drinking honey alone is also quite effective as it coats the throat and lessens the irritation caused by the infection.

(Note: Do not give honey to infants and babies under the age of one year as it contains the bacterium called Clostridium Botulinum, which may increase the risks of infant botulism).

2. Treatment of Cough by Herbal Tea-
Drinking a couple of cups tea helps tame coughs as fluids soothe the throat and reduces the infection. One of the best parts of having tea is one can experiment the drink with several herbs and spices such as ginger, cardamom, cinnamon, honey, and clove etc. Further, adding turmeric, marshmallow root, or liquorice root is a scientifically proven treatment to cure coughs.

3. Treatment of Cough by Steam Inhalation-
One of the great ways to treat Chronic Coughs includes inhaling the steam. It helps reduce the amount of mucus and phlegm stored in the lungs and helps hydrate the airways, thus, providing relief in a cough and cold. Using eucalyptus oil while inhaling steam proves to be quite helpful in reducing the mucus.

4. Treatment of Cough by Warm Water-
Water, as always, is the best remedy to cure both Acute and Chronic Coughs. While gargling with salted water helps cure the swollen throat tissues, adding lemon, honey and eucalyptus leaves in the warm water helps reduce the soreness in the throat.

5. Treatment of Cough by Peppermint Leaves-
Peppermint has the menthol possessions that reduce the congestion produced by the mucus and helps soothe the throat from infection. Peppermint’s antibacterial properties help relax the muscles that cause fever and sore throat. Drinking peppermint tea with honey is also a proven remedy that is often used to cure Wet Cough.

(Note: Avoid giving peppermint to infants as it can cause burning mouth and tongue.)

6. Treatment of Cough by Lemon-
Lemon is also an effective remedy to calm the soaring throat caused by the infection. Lemon has the Antioxidants and Vitamin C that helps stimulate saliva and reduce the throat irritation. Cut a lemon in half and sprinkle black pepper and salt on it. Squeeze it in the mouth and slurp it to get an instant relief. Drinking lemon juice with added honey in it is also quite helpful to cure coughs.

7. Treatment of Cough by Garlic
Garlic possesses antibacterial and antimicrobial properties that help restore the Upper Respiratory Tract from throat infections. Boil a cup of water and add garlic, two to three cloves and one teaspoon honey and mix in properly. Wait for 5 to 10 minutes and let it cool to a room temperature. Once its temperature gets down, drink it.

8. Treatment of Cough by Almonds
Almond is believed to have the nutritional properties that help relieve bronchial problems. Soak few almonds in the water at night and make a smooth paste of it in the morning. Add teaspoon butter or sip it with the orange juice. Repeat this activity for a couple of days to remove the symptoms of coughs.

Varicocele
Testicles are held in a loose bag of skin and the enlargement of veins in the area is called varicocele. It appears similar to the varicose vein present in the leg. If you are suffering from varicocele, there will be an impact on the production of sperm. The reduction in sperm production and quality will have an impact on the reproduction. It can interfere with the normal development of the testicles and in some cases, it leads to the shrinkage of testicles.

In some cases, Varicocele may lead to complications. You should be aware of the symptoms so that you will get medical attention at the earliest. When you get the medical attention, you can prevent serious issues. You should be aware of the causes of Varicocele as well. If you are aware of the causes, you can take preventive steps so that further progression of the condition will be arrested.

Varicocele  Symptoms
The development of varicocele will take over a period of time. Hence, you may not witness the symptoms immediately. Pain, swelling and difference in size of testicles are the predominant testicular symptoms. The medical professional can check these symptoms very easily.

-  Some patients suffer from pain. The pain will be either sharp or moderate.

-  The pain will increase with physical exertion (over a long period of time)

-  Will become worse during the day

-  There will be relief from pain when you lie down on the back

-  It will impact your fertility

-  The enlargement of varicoceles will take place over time. If the enlargement is abnormal, it will appear like a bag of worms.

-  The testicle will swell and the swelling will be prominent on the left side.

-  The testicle is made up of the sperm-producing tubules. If the testicle is damaged, it will become soft and small.
 

Varicocele Causes
In the male reproductive system, the passage of blood will take place to and from the testicles and it takes place through the spermatic cord.

-  As per the opinion of experts, the formation of varicocele will take place due to the obstruction of blood flow by the valves in the cord. The veins will widen in this process. It might lead to the damage of the testicle and it will affect the reproduction system.

-  The formation of varicocele will take place in puberty. The varicocele will occur on the left (in most of the cases) due to the presence of the left testicular vein.

-  It will lead to grade I varicocele when the spermatic vein fills with the blood.

-  There will be damage to the spermatic vein and other veins when you suffer from a shunt type of Varicocele. It is considered as Grade II or III Varicocele.

-  If a patient suffers from Varicocele on one side, it will affect the sperm production on both sides.

Varicocele Diagnosis-
In most of the cases, the varicocele can be diagnosed very easily.

-  Physical examination is sufficient to diagnose the condition and it will be done by your doctor.

-  You will not find or feel varicocele when you are in lying condition. The examination of the condition will take place while you are standing up or lying down.

-  For some patients, a scrotal ultrasound test will be recommended by the doctor. The procedure will help to figure out the spermatic veins and the doctor will get a detailed picture of the condition.

-  There are three clinical grades in the varicocele. They are grade 1, grade 2 and grade 3. You should understand that the grade 1 is the smallest and the grade 3 is the largest.

-  The treatment is not based on the size but on the degree of comfort and the inconvenience caused due to infertility.

-  Sound waves of certain high frequency will be used to figure out the root issue associated with varicocele. The object identification and measurement of distances will be done very efficiently with ultrasound imaging technology.

Varicocele Prevention
The following preventive measures can be taken to overcome the Varicocele.

-  Avoid hot temperatures – The symptoms of Varicocele will worsen by being exposed to hot temperatures as it will lead to dilation of veins. Hence, you should avoid hot bath and exposure to hot temperatures. It will help you contain the pain in a very efficient manner.

-  Lifestyle – Healthy eating and fitness practices will enhance the fertility chances. If the patient is suffering from reduced sperm production, varicocelectomy or embolization will be performed.

-  Avoid lifting heavyweights – You should avoid lifting of heavyweights as there will be great pressure on the abdomen. Bodybuilding and weightlifting exercises should be avoided.

Varicocele Treatment-
There are no significant risk factors for the development of varicocele. If you are going through the assisted reproductive methods, you should undergo the treatment.

-  Varicocele does not require treatment in many cases.

-  If there are symptoms in the patient, the condition can be corrected surgically.

The following conditions warrant the treatment of varicocele:
-  Causes pain

-  Leads to infertility

-  Leads to testicular atrophy

-  Varicocele will alter the functioning of testicles. Hence, you will want to go for the most appropriate treatment. The sperm production will improve if you take the treatment at the earliest.

-  To overcome the pain, you might want to wear tight underwear or a jock strap. With the firm support offered by the underwear, there will be a great comfort.

-  The other forms of treatment include varicocelectomy and varicocele embolization. These procedures are chosen when the suffering of the patient is severe.

-  Varicocelectomy procedure can be performed on out-patient mode. The abnormal veins will be tied by entering through the abdomen or pelvis. In this process, the blood flow will take place to the normal veins. You should want to talk to your doctor about the procedure so that the precautions, as well as aftercare measures, can be followed.

-  Varicocele embolization is a procedure which is performed on the same day. The less-invasive procedure will be done by inserting a small catheter through the groin or nerve vein. A coil will be placed in the catheter and into the varicocele. Thus, the blood that oozes out to the abnormal veins will be blocked.

-  After the surgery, you can attend the work in one or two days. However, you should not do exercise for at least 2 weeks.

-  If you undergo the embolization, the recovery will be quick.

-  If there is a change in size, shape and appearance of testes, you should consult the physician.

Management of varicoceles through non-surgical methods-
The non-surgical treatment of Varicocele is an effective means to manage the condition. There will be a great relief from discomfort and pain with the non-surgical treatment.

-  Anti-inflammatory non-steroidal treatment – There will be symptomatic relief from pain by using non-steroidal anti-inflammatory medication. However, you will treat the symptoms and it is not considered a specific treatment. If there is severe pain, the surgical repair of a varicocele will be the only option.

-  If the patients wait for the surgery, painkilling medication can be used. If you are using painkillers such as aspirin, you should want to inform the doctor about the same. The painkillers will bear a risk of prevention of blood clotting ability.

-  There will be relief from pain by lying down on the bed. However, there will be temporary relief from pain. If there is severe pain, the surgery is the highly recommended option.

Varicocele Complications
You should visit the doctor in the following circumstances:

-  Pain or swelling in the scrotum

-  Presence of mass on the scrotum

-  The testicles are of different sizes

-  The development of varicocele during the youth

-  Having issues with the fertility

-  The shrinkage of the affected testicle is called atrophy. The testicle is made up of sperm-producing tubules. The testicle will shrink and damage due to the formation of a varicocele.

-  The exact reason for the shrinkage of the testicle is not yet ascertained by doctors. However, due to the malfunction of the valve, the blood will pool in the veins. It will lead to enhanced pressure in the veins and with enhanced exposure to toxins from the blood, the testicles will be damaged.

-  The local temperature around the testicles will be high when you are affected by varicocele. It will have a direct influence on the sperm formation, motility and function.

-  It may lead to primary infertility in 35% to 44% of men if the couple fails to produce the child after one year of trying.

-  It may lead to secondary infertility in 45% to 81% of men if the couple manages to produce the child at least once but not later.

-  If you fail to treat the varicocele, there will be a decrease in the sperm quality and quantity. It will lead to infertility and the prolongation of the issue on a long-term basis will lead to testicular injury which cannot be reversed.

-  The low level of testosterone will lead to many issues such as the inability to get a firm erection, low sex drive, fatigue, depression, lack of focus, hot flashes, decreased muscle mass, difficulty sleeping.

-  Varicocele may lead to hormone imbalance. The cells will react if there is an increase in pressure and it can lead to a change in hormones. Luteinizing hormone (LH) is present in both men and women. However, it may increase is men due to Varicocele. The testosterone levels will be normal to sub-normal.

-  Bleeding into tissues which is also called as hematoma is one of the common complications associated with Varicocele.

-  Some men will suffer from the accumulation of fluid around the testicle which is affected by Varicocele.

-  The possible other kinds of complications are infection and injury to scrotal tissues or structures. If there is an injury to the testicle, it will lead to loss of testicle as well.

Varicocele Myths
Myth #1: It is difficult to live with varicocele

Varicocele is a common complication in males. You can consult your doctor to get an appointment with the specialist. The reproductive specialist will help you and your partner in getting the children.

Myth #2:  Surgery cannot be performed to obtain children

Surgery is the option to get children. If you are suffering from severe pain, the doctor will suggest the most appropriate surgery so that you will overcome the pain and there will be a great scope to produce children as well.

Myth #3:  Varicocele is similar to varicose veins

Even though varicocele is similar to varicose veins, it occurs around the legs. Even though there are no serious issues with the varicocele, it will affect the reproductive system.

Myth #4:  Varicocele affects both sides

Varicocele generally affects the left side

Myth #5:  Tests are not mandatory for Varicocele treatment

Urologists will conduct various tests to figure out the Varicocele’s impact on fertility. By conducting ultrasound tests, blood tests and semen analysis, it is possible to diagnose the case.

Myth #6:  Most of the men who are infertile suffer from Varicocele

It is only reported in around 15% of men. It was also observed that 35% of the men who were tested for infertility suffer from Varicocele. Hence, 80% of men have issues which are not related to the Varicocele.

Myth #7 Varicocele surgery will improve male fertility

It is not proven whether varicocele surgery can improve the male fertility due to lack of clinical data.

Conclusion
Varicocele is similar to varicose veins. However, it will affect the testicular area in men and it may have a negative impact on the reproduction system. About 15% of men between the age of 15 and 25 years suffer from Varicocele. Even though the exact cause for Varicocele is not known, it will be similar to varicose veins. You will not want to suffer from varicose veins as it is not a serious issue. However, you should undergo the treatment to overcome the fertility issues. If there are severe complications, you should undergo the surgery.

Nasal polyps
Nasal polyps are soft and painless benign growths on the lining of the sinuses and nasal passages. Nasal polyps hang down as grapes or teardrops. Polyps can occur in one or both nostrils at a time. They can occur due to allergies, chronic infection, drug sensitivity, some immune disorders, or chronic inflammation because of asthma. You may not experience symptoms if you have small nasal polyps. People with many nasal polyps or larger growths may experience blockage in the nasal passages, breathing problems, frequent infections and loss of sense of smell. Nasal polyps are more prone to adults and males but they can affect any person. Your doctor may prescribe you certain medicines in order to eliminate or shrink nasal polyps. In some cases, surgery is required in order to remove nasal polyps. There is a possibility that nasal polyps can return even after proper treatment.

Symptoms
It is not necessary that you will experience symptoms if you have nasal polyps. Due to polyps, there can be a blockage in the nasal passages leading to chronic congestion. Check out various signs or symptoms of nasal polyps:

-  People with nasal polyps may have a sensation that their nose is blocked.

-  Due to nasal polyps, people may not sense the smell properly.

-  People with nasal polyps may feel a pressure in the face or forehead.

-  Nasal polyps can make you breathe through the mouth.

-  Running nose, nasal stuffiness, and nasal congestion are all the possible signs of nasal polyps.

-  You may suffer from sleep apnea due to nasal polyps. Postnasal drip is a situation in which excess mucus collects in the back of the nose or throat.

-  Snoring can be a symptom of nasal polyps.

-  If you also have a sinus infection with the nasal polyps then you may also suffer from headaches or pain.

Causes-
The causes of polyps are still not known. There is no clarification on the part that why people get chronic inflammation or why inflammation leads to the formation of nasal polyps in some people and not in other people. The chronic inflammation happens in the mucous membrane of the sinuses and nose. As per some evidence, it is clear that people who get nasal polyps have different chemical makers in the fluid-producing lining and a different response of immune system than people who do not get nasal polyps. Nasal polyps can occur to any person at any age. But it has been noticed that they are more prone to middle-aged and young adults. There is a possibility that people can get nasal polyps with no nasal problems in the past. As per scientists, there can be some possible triggers including:

-  Churg-Strauss syndrome

-  Asthma

-  Cystic fibrosis

-  Allergic rhinitis or hay fever

-  Recurring or chronic sinus infections

-  Non-steroidal anti-inflammatory drug sensitivity including aspirin or ibuprofen

How is it diagnosed?
As soon as you discover that you have nasal polyps, you should see a doctor as polyps can lead to various complications. Your doctor conducts a general physical examination and also an exam of your nose. Your doctor will check the polyps with the help of a lighted instrument. Your doctor will do a diagnosis depending on your various answers to queries about the symptoms that you are experiencing. Your doctor may ask you to get various diagnostic tests done in order to confirm the diagnosis:

-  Nasal endoscopy: Your doctor conducts a detailed examination of the sinuses and nose with the help of a narrow tube with an illuminated magnifying lens or small camera, known as a nasal endoscope. The doctor inserts the nasal endoscope into your nostril and then guides it into your nasal passage or nasal cavity.

-  Imaging studies: Your doctor obtains the images with the help of computerized tomography which helps your doctor to point to the location and size of polyps in deeper regions of the sinuses. It also helps the doctor to find out the range of the inflammation. Other obstructions in the nasal cavity including abnormalities in the structure or different type of noncancerous or cancerous growth can be found out by the doctors with the help of these studies.

-  Allergy tests: Your doctor may ask you to get the epidermis test done in order to find out if allergies are developing due to chronic inflammation. A skin prick test can be conducted in which a few drops of allergens, substances that might be causing an allergy are pricked into the epidermis of your upper back or forearm. The drops of allergens are left on your epidermis for some minutes. Then your doctor observes your epidermis to check the signs or symptoms of allergic reactions. If it not possible to conduct a skin test then your doctor may ask you to get a blood test done that find out specific antibodies to allergens.

-  Test for cystic fibrosis: If it is diagnosed that your child has nasal polyps then your doctor may order you to get the tests done for cystic fibrosis. Cystic fibrosis is an inherited disorder in which the lungs and digestive system damage and it can threaten the life of the affected person. The diagnostic test for cystic fibrosis is a sweat test which is noninvasive that determines if the perspiration of your child is saltier as compared to the sweat of most people.

Prevention
Check out various ways that will help you to get prevention from nasal polyps:

-  If you feel the dry air in your home then you should use a humidifier.

-  You should wash your hands frequently especially after coming from outside or before starting a meal. This helps to reduce the chances of catching a viral or bacterial infection which can lead to a case of inflammation of the nasal passages and sinuses.

-  You should avoid those substances that can create an irritation including chemicals, airborne pollutants, and some allergens. This may help you to reduce the chances of developing nasal polyps.

-  You should manage your allergies and asthma properly. It is important to follow whatever is recommended by your doctor related to allergy and asthma treatment as it will reduce the risk of developing polyps.

-  You should rinse the nasal passages with a saline spray or nasal lavage as it will help you to remove allergens and irritants and make better the flow of mucus.

Treatment
It is a challenge to clear polyps completely. Your doctor will suggest you the best treatment option as per your condition in order to manage your symptoms and treat the factors that can lead to chronic inflammation. The treatment is given so that the size of polyps can be reduced or polyps can be eliminated. Initially, medicines are given to treat the affected person. In certain situations, the doctor may prescribe to go for a surgery. There is a possibility that polyps can recur that is why surgery is not a permanent treatment option.

Medications:
In the treatment of nasal polyps, the doctor generally prescribes medicines in the starting. The medicines help to shrink and remove the polyps even the larger ones. Check out various medicines for the treatment of polyps:

-  Nasal corticosteroids: Your doctor may prescribe nasal corticosteroid spray that will help you to minimize inflammation. By this treatment, polyps can eliminate or shrink. Budesonide (Rhinocort), fluticasone (Veramyst, Flonase), mometasone (Nasonex), flunisolide, ciclesonide (Omnaris), beclomethasone (Beconase AQ), and triamcinolone (Nasacort Allergy 24HR) are some of the nasal corticosteroids.

-  Oral and injectable corticosteroids: Your doctor may recommend you an oral corticosteroid including prednisone if a nasal corticosteroid does not work for you. You can take it alone or in combination with a spray related to the nose. There are some side effects of oral corticosteroids that is why they are taken for a short period. If you have severe nasal polyps then your doctor may recommend injectable corticosteroids.

-  Other medications: To treat the conditions which may contribute to inflammation (chronic) in the sinuses and nasal passages, a doctor may prescribe medication to curb the same. In order to treat allergies, antihistamines are used and to treat a recurring chronic infection, antibiotics are used. Patients with aspirin sensitivity and nasal polyps may get benefit from the treatment of aspirin desensitization.

Surgery:
If medications are not effective in eliminating or shrinking polyps then the doctor may ask you to go for endoscopic surgery. This will help in solving the problems related to sinuses and removing nasal polyps. In the surgery, the surgeon inserts a tiny tube with a camera or magnifying lens into the nostrils and guides the tube into the sinus cavities. Some instruments are used to eliminate nasal polyps and other obstacles that block the fluids from the sinuses. The affected person can be discharged on the same day of the surgery. Your doctor may recommend the patient to use the nasal spray after the surgery in order to prevent polyps from recurring. Saltwater (saline) rinse may also be prescribed by the doctor to catalyze the process of healing after the surgery.

Complications:
Complications occur due to nasal polyps because it restricts the normal airflow, fluid drainage and also because of the degenerative inflammation that underlies their development. The major complications of nasal polyps generally include the following:

-  Obstructive sleep apnea: In this chronic condition you usually stop and begin to breathe frequently during the time you sleep.

-  Asthma flare-ups: The serious and chronic rhinosinusitis can cause and even worsen the condition of asthma.

-  Sinus infections: It has been observed that you are more likely to get sinus infections if you suffer from the disease nasal polyps. These sinus infections occur very frequently and sometimes, they can also become serious or chronic.

-  Disfigured structure of the face: Nasal polyps can alter the shape or structure of the face which consequently causes the condition of double vision. Often if the patient has cystic fibrosis, he or she can have eyes which are set wider apart than they are normally.

-  Complications due to surgery: When nasal polyps are treated, especially by surgery, they can cause severe nosebleeds. Along with that, surgery in case of nasal polyps can also cause infections. If the treatment with nasal steroids sprays or oral corticosteroids is continued, it can reduce your ability to fight off and counteract sinus infections.

Conclusion:
Noncancerous, soft, painless growths which may form on one’s sinuses or nasal passages are known as nasal polyps. They may look like teardrops or hanging grapes. Due to allergies, asthma, drug sensitivity, recurring infection or some immune disorders may result from chronic inflammation.

People generally do not experience symptoms when they have small nasal polyps. Nasal polyps may lead to breathing problems, frequent infections blockage in the nasal passages, and loss of sense of smell. Men are more prone to nasal polyps than women. Polyps can happen to a person of any age.

Sesame Seeds - Be Hearty Healthy!

Asthma
The word "asthma" originates from the Greek word, ásthma that means, "panting.” Asthma is a medical condition in which the airways swells and produces extra mucus that can make breathing difficult. Because of the inflammation and the extra mucus, it can trigger shortness of breath and wheeze or coughing.

Documented as early as Ancient Egypt, Asthma can be either a minor nuisance or life-threatening. In asthma, the inside walls of the airways get inflamed so that lesser air can pass through them from and to the lungs making breathing a difficult exercise. This swelling can also make the airways really sensitive and increase a person’s susceptibility to allergic reactions.

Asthma has been on the rise significantly since the 1960s and now according to WHO estimate, around 300 million people suffer from asthma worldwide. In fact Asthma is one of the most common chronic childhood illness.

Symptoms of Asthma-
The symptoms of asthma vary. But what most people with asthma have in common is the extreme airway sensitivity because of triggered airway inflammation. Some people have frequent asthma attacks, some people experience asthma only during certain times, some people have it all the time and some people only experience it infrequently.

Common asthma signs and symptoms include:
-  Wheezing or coughing

-  Shallow breathing

-  Breathlessness

-  Chest pain

-  Throat infection

-  Faster heart rate

-  Trouble in sleeping

-  Difficulty in speaking

Types of Asthma-
Normally people suffering from an asthma attack tend to have a whistling or wheezing sound when exhaling. There are different types of asthma. Some of the most common types of asthma are: 

1. Exercise-induced asthma 
Also called exercise-induced bronchoconstriction, this type of asthma is induced by strenuous exercises and can cause symptoms like coughing, wheezing, shortness or breath and other symptoms. These symptoms may worsen when the air is dry and cold and usually get triggered during or after an exercise.

2. Occupational asthma 
As the name suggests, occupational asthma is triggered by breathing in certain chemical fumes, dust, gases, or other kinds of exposure to allergens at the workplace.

3. Allergy-induced asthma 
Allergy-induced asthma is the most common type of asthma, which is triggered by common airborne allergens like pollen, mold spores, dust mites, or particles of skin.

What Are Causes of Asthma?
Although the causes are not particularly clear and anyone can get asthma at any age, it is more common childhood ailment. The studies are still underway to prove a clear asthma cause but according to the researches this disease is believed to be caused by a blend of genetic and environmental factors. Genomics, which is the study of how a person’s genes interrelate with environmental factors, may be the key to understanding why certain people are more prone to asthma than others.

Asthma Triggers-
Asthma triggers can differ from person to person and the key is to know what irritants trigger your asthma to ensure minimized exposure to it. Some generic asthma signs and symptoms can include:

-  Cold air

-  Exercise and other physical activities

-  Common cold and other respiratory infections

-  Stress

-  Airborne substances like pollen, mold spores, pet dander, cockroach waste, dust mites, etc.

-  Airborne substances, such as pollen, dust mites, mold spores, pet dander

-  Certain chemicals and air pollutants (smoke)

-  Certain preservatives (added to food and beverages)

-  Gastroesophageal reflux disease (GERD)

-  Certain medicines like aspirin, ibuprofen, etc.

Risk factors-
There are several risk factors that can increase your chances of developing asthma including:

-  Genetics. Having a family especially a blood relative suffering from asthma

-  Having other allergic condition (hay fever)

-  Smoking

-  Exposure to secondary smoking

-  Obesity (people who are overweight are at a greater risk of developing asthma)

-  Exposure to increasing amount of smoke or other pollutants

-  Occupational triggers

-  Stress and anxiety

Diagnosis of Asthma-
Even though it is a common childhood disease, it doesn’t mean, as an adult one cannot develop it. If a person is feeling any of the symptoms whether a child or an adult, it is always a good idea to get checked to know for sure if you have asthma. Asthma symptoms can come and go since it is a ‘variable’ disease.

It is also important to not do self-diagnosis, as some symptoms, which may look like asthma triggers, may not be actually asthma-like persistent cough caused by other diseases like certain heart diseases and chronic obstructive pulmonary disease (COPD).

Effective diagnosis of Asthma depends upon its classification. There are four different classifications of Asthma:

Classification of Asthma
-  Mild intermittent – It is a mild case of asthma if the symptoms last only for up to two days a week, symptoms flaring up mainly at night and asthma lasting not more than two nights in a month.

-  Mild persistent – Mild persistent asthma is when the symptoms can occur twice in a week but not more than one episode per day.

-  Moderate persistent – This happens when a person experiences symptoms once a day and in excess of one night a week.

-  Severe persistent - Symptoms can last throughout the day and frequently at night on most days.

Diagnosis of Asthma
1. Physical test
The doctor would want to rule out other possible condition through a physical exam to get to know the signs and symptoms.

Some lung function tests can help in determining how the lung in functioning in a person.

2. Spirometry
One of the most common pulmonary function tests, spirometry measures lung function by checking the amount of air a person can inhale and exhale after deep breaths.

3. Peak flow
The peak expiratory flow is a pulmonary device that can measure the maximum speed one can breathe out. If the readings are low, it may be a sign that the person’s lungs are not working properly and could be a potential sign of asthma.

These tests can be done with a medicine called as bronchodilator (albuterol) to check if the lung functions better with the medication. If the test gets better after the use of bronchodilator, then it is highly likely for a person to suffer from asthma

Additional tests and Diagnosis For Asthma
Other tests that may be required to diagnose asthma include:

1. Methacholine challenge-
Methacholine is considered an asthma trigger and so when it is inhaled it can cause mild constriction of the airways. Most people who have asthma are likely to react to methacholine. Doctor could use this test to determine whether you have asthma.

2. Imaging tests-
Certain imaging tests like x-rays and CT scan can help in identifying certain abnormalities that might be causing breathing issues.

3. Allergy testing-
Most allergy tests can help in identifying allergy to triggers like pollen, dust, etc.

4. Sputum eosinophils-
This test can help in identifying the while blood cells in the mucus to see if asthma is present or not.

5. Nitric oxide test-
For people whose airways are inflamed, they may have higher nitric oxide level than normal which may be able to help in identifying whether the person is suffering from asthma or not.

7. Provocative testing for exercise and cold-induced asthma-
As the name suggests, in this a person is made to perform vigorous physical activities in a controlled environment to check for the triggers.

Treatment of Asthma-
Although there is no known cure available for asthma and it is generally a life-long condition, treatment can control asthma symptoms so a person can lead a normal life. Also when it comes to asthma, there is no one-size fit all treatment methodology. The idea is to understand the triggers that worsen your symptoms, taking steps to avoid them and taking the medication on time to keep asthma in check.

1. Inhalers 
Inhalers are medical devices, which are used for supplying medication into the body through the lungs. There are three types of inhalers. These are:

-  Reliever Inhalers: These inhalers are used for the purpose of relieving symptoms at the time of asthma attack. Normally reliever inhalers don’t have many side effects, in some people they may increase heart beat and induce shaking. 

-  Preventive Inhalers: True to their name, this types of inhalers are used to stop the symptoms from developing.

-  Combination Inhalers: If either of these kinds of inhalers doesn’t work for a person, they would need an inhaler that would both relieve the attack and prevent it from happening again.

2. Tablets -
If inhalers don’t work to control the symptoms, one may also use tablets.

Leukotriene receptor antagonists (LTRAs) 
LTRAs are the oral tablets prescribed for asthma and are also available in syrup and powder forms. It can be taken every day without many side effects. However, some people may experience some side effects including headaches and stomach pain.

• Theophylline

If LTRAs tablets cannot be prescribed for some reasons or is not working, doctors may also prescribe Theophylline. It should be taken every day.

• Steroid tablets-

Steroid tablets are given to give relief from an asthma attack. Long-term usage of steroid tablets for is not recommended unless a person is suffering from severe asthma and if inhalers aren’t handy controlling the symptoms. Some possible side effects of using steroid tablets for long-term are mood swings, fragile bones, high blood pressure, etc.

Other treatments for Asthma
Other treatments like surgery or injections may be required in case other treatments don’t work for a person.

Injections 
For certain people with severe asthma, some injections like omalizumab, mepolizumab, or reslizumab may be able control the symptoms. For some severe asthma patients, injections are prescribed every few weeks in order to control the symptoms. However, these injections should be taken only under the prescription from an asthma specialist, as these injections may are not advisable for every asthma patient.

Surgery 
For some people for whom treatments like inhalers, tablets, and injections don’t work or in certain cases cannot be administered, a surgical procedure called bronchial thermoplasty can be used. In this treatment, a flexible thin tube is passed down the throat into the lungs and heat is used to warm up muscles surrounding the air controlling nerves to stop causing asthma-like symptoms.

However, this process is fairly new and so much research has not been done on its long-term relief.

Complementary therapies 
There are many complementary therapies that can help ease the symptoms, prevent asthma from happening, and help strengthen the lungs and the airway muscles. However, before incorporating any of these therapies in your lifestyle, it is always best to check with your asthma specialist first. These therapies include

Certain breathing exercises including yoga
-  Alternative medicines like homeopathy, chiropractic, and Ayurveda

-  Dietary supplements

-  Acupuncture

-  Certain traditional Chinese medicine

-  Ionizers

Common Myths About Asthma
Myth #1: Asthma is a psychological disease

One of the biggest beliefs that many people have is that asthma is psychological and thus they don’t believe in getting medical help. Since asthma affects the airways it is to be noted that is not psychological as it causes the immune system and the lungs to behave erratically when it comes to certain triggers.

Myth #2: Asthma medications lose their effectiveness over time

Asthma meds don’t lose their effectiveness over time and can be used for long-term if the right doses are taken as directed.

Myth #3: People with asthma should avoid physical activity

Although strenuous exercises can sometimes induce asthma, simple exercises can keep a person fit and healthy and help them lead a normal life.

Myth #4: You can outgrow asthma

Some asthma symptoms may improve over time. People also learn how to deal with asthma better as they age since they know what triggers it and what doesn’t. However, there is no outgrowing asthma because it is a lifelong condition.

Myth #5: Asthma Is Easy to Control

Asthma can be easy or difficult to control depends on the kind of asthma a person is suffering from and the triggers. Although even in mild form of asthma, the treatment is required to give the necessary relief to a person to reduce flares and maintain proper lung functions.