Is your child getting exhausted after a bout of cough? Does he or she suffer from constant wheezing and tightness of the chest? Does your child feel drained out after climbing a flight of stairs? Do you know a child who always seems to run out of breath and cannot participate in school sports tournaments or play outside for a long time? The child could be suffering from asthma, which is a serious breathing problem. Most children are affected by asthma. Staying in a polluted city just makes the condition worse.

Asthma - Know the disease

Asthma is a condition that causes inflammation of the airways, known as trachea and bronchioles.
The muscles around the airways constrict and prevent the smooth flow of air.
The lining of the bronchioles swell and block the airways.
Asthma is mostly triggered by an allergic reaction.
There is a difficulty in breathing out. Exhalation of air is often accompanied by a wheezing, that is, a whistling sound.
There is a constant shortness of breath, feeling out of breath and gasping for air.
There is an uncomfortable tightness in the chest, the feeling of not breathing in enough air.
Coughing bouts in the middle of the night, that leave the child feeling exhausted and completely out of breath.
Causes of Asthma 

Asthma is mostly triggered by asthma allergens. These allergens are mostly pollens and animal fur.

Exposure to pollution, such as dust and smoke
Heredity
Obesity
History of heartburn, GERD and acid reflux
Inflammation of sinus and airways
History of bronchial disorders and pneumonia
Viral infections
Chronic rhinitis
Low immunity causing constant cold and blockage of nose
Treatments of asthma

A nebulizer that turns asthma medicine into a mist can then be inhaled easily
An inhaler can be used to take in inhaled steroids into the lungs or a bronchodilutor
Try and avoid asthma triggers and allergens as much as possible
Avoid physical stress and heat
Get sufficient rest of about 7-8 hours every day

Troubled Breathing - Can It Be a Sign of Asthma?

During breathing activity, chest wall moves out & in, lungs expand & relax. For the smooth movement of the lungs inside the chest cavity, they are lined by pleura.

Pleura includes two thin linings, the layer lining lungs is called visceral pleura and the one lining chest wall is called parietal pleura. The cavity formed between these two layers is called Pleural cavity. It contains a small amount of lubricant called Pleural fluid which helps smooth sliding of two pleural surfaces. Any condition which results in inflammation of the pleural surfaces or accumulation of excessive fluid in the pleural cavity gives rise to symptoms attributable to pleural involvement or disease.

Pleural effusion is nothing but the collection of excess fluid in the pleural cavity. Excess fluid in the pleural space is not normal and can occur due to a variety of reasons. Depending on the chemical composition it is broadly divided into two categories, transudate and exudate. 


What Causes Pleural Effusion?

1. Transudate pleural effusions 

Transudate pleural effusion is formed when fluid leaks from blood vessels into the pleural space. Chemically, transudates contain less protein and LDH than exudates. It is generally seen in the following conditions.

Congestive heart failure

Liver failure or cirrhosis

Kidney failure or nephrotic syndrome

Peritoneal dialysis

2. Exudate pleural effusions 

Exudate pleural effusion is caused by inflammation of the pleura itself and are often due to diseases involving the lung. Following are some common illnesses giving rise to exudate pleural effusion.

Tuberculosis
Pneumonia
Lung or breast cancer
Lymphoma
Pulmonary embolism
Post chest wall trauma or surgery
Asbestosis and mesothelioma
Secondary to intra-abdominal pathology 
Pancreatic pseudocyst, etc
Symptoms of Pleural Effusion -

Chest Pain: Chest pain is mainly due to irritation of the pleural lining. The pain is sharp, localized and worsens with a deep breath, yawning, coughing which is usually described as pleuritic. If the effusion causes inflammation of the diaphragm the pain may be referred to the shoulder or the upper abdomen. As the pleural effusion increases in size, the pain may increase or disappear altogether due to the separation of inflamed pleural surfaces.

Shortness of breath: As the effusion grows larger with more fluid, the harder it is for the lung to expand and the more difficult it is for the patient to breathe resulting in shortness of breath.

Other Symptoms: Other symptoms are generally attributable to the underlying disease process.

Diagnosis of Pleural Effusion -

Patient s Detailed History and Clinical Examination are the mainstays of diagnosing pleural effusion and it s the underlying cause. Following investigative modalities are generally opted for working out the final diagnosis before instituting appropriate therapy.

Chest X-ray: X-ray will help indicate the presence of fluid. 
Chest Ultrasound(USG): will help in confirming the presence of the fluid and it s localization which in turn can guide the physician about its quantity and its capability.
CT Scan: CT scan of the chest may at times be required to ascertain the underlying cause or to know about any other co-morbid conditions.
Thoracentesis: Thoracentesis is a procedure used to sample the fluid from the pleural effusion. Using a long thin needle, fluid can be removed and sent for testing to confirm the diagnosis.
This can be just for diagnostic purposes or can even be used as a therapeutic procedure.
Chemical analysis of the fluid will help determine the type of pleural effusion.
Treatment of Pleural Effusion -

Treatment of underlying Disease: The treatment of a pleural effusion usually requires that the underlying illness or disease is treated and controlled to prevent the accumulation of the pleural fluid. Like anti-TB therapy for Tubercular etiology or treatment of Cancer in malignant pleural effusion, etc.

Thoracentesis: As discussed earlier Thoracentesis can be used as a therapeutic procedure to remove excess fluid and help lung expand and function properly.

Tube thoracostomy: Thoracostomy or chest tube insertion may be done to drain and treat fluids which cannot be removed by needle aspirations, e.g. empyemas (pus collections).

Pleurodesis: Some pleural effusions reoccur multiple times; sclerosing agents that induce scarring such as talc or tetracycline was used to prevent a recurrence.

Decortication: If sclerosing agents fail, surgery may be required, called Decortication.

Pleural Effusion - What Is It?

Dialysis is a very important and life-saving procedure. It is performed to replace kidney function in case of renal failure. Wastes and extra fluids in the blood are filtered out during this process. To be able to perform Dialysis, the connection between the patient s bloodstream and the equipment for performing Dialysis (dialyzer) outside the body is established. This connection is created through Dialysis Access Surgery. It is a type of Vascular Surgery which forms the vascular opening for access during Dialysis. Thus, Dialysis Access Surgery is the lifeline for the survival of the patient.

Types of Vascular Access for Dialysis- 
There are three types of Vascular Access for Dialysis: Arteriovenous (AV) Fistula, Arteriovenous (AV) Graft, and Venous Catheter.

  Arteriovenous (AV) fistula is a surgical connection of an artery to a vein. An AV fistula is usually placed in the upper arm or in the forearm. It causes extra blood to flow into vein making it grow large. A larger vein hence provides easy access to blood vessels. An AV fistula is preferred over other methods as it lasts longer than other methods of access and provides a good flow of blood. Moreover, it is less prone to infection and blood clots than other methods. Before an AV Surgery, a Vessel Mapping Test is sometimes performed for assessing the blood vessels most suitable for Dialysis. An AV fistula is performed under local anaesthesia and requires two to three months for maturation before hemodialysis. If it fails to mature, the procedure is repeated.

  Arteriovenous (AV) graft is performed when AV fistula fails to mature. It is hence the second most preferred choice for long-lasting access to vascular tissues for Dialysis. An AV graft is a looped plastic tube which establishes a connection between an artery and a vein. Like AV fistula, AV graft is also performed under local anaesthesia. It is slightly more difficult to maintain than an AV fistula.

  A venous catheter is used for short- term hemodialysis. It is a tube which is inserted into chest, neck, leg, or near groin for vascular access. After exiting the body, the tube splits into two halves. In the case where a renal disease has made quick progression leaving little or no time for the AV fistula or AV graft to mature, a venous catheter is used to establish the required vascular connection. This procedure is also performed under local anaesthesia. It is a tool for emergencies but is not suited for long- term use. It can cause narrow vein due to an infection,
scarring, or blood clot. If long- term venous catheter is used, it is tunnelled under the skin which has fewer problems associated with it and is more comfortable. 

How to Care for a Vascular Access?
  Get checked for infections and other problems before each hemodialysis session;
  Use the operated site for access only for the intended use;
  Always keep the access clean;
  Prevent cutting or bumping the access;
  Check for thrill/ vibration in the access and inform the doctor if any;
  Do not put pressure on the access site;
  Do not put blood pressure cuff around the access arm;
  Do not wear jewellery or tight-fitting garments over the site;
  Do not lift a weight.

Take Away-
Vascular Surgery for Dialysis is performed to provide vascular access for the procedure. AV fistula is the most preferred type followed by an AV graft. A venous catheter is recommended to be used only in case of an emergency when there is not much time left for the other two options to mature.

Vascular Surgery - Can It Help For Dialysis?

What Happens When the Electrical Activity of Your Heart Changes?

The heart's electrical conduction system plays a very important role in cardiovascular functioning. Also known as the atrioventricular (AV) conduction system, it regulates and controls the timing of the heartbeat.

How does the heart's electrical conduction system work?

There is a collection of electrical cells in the upper right atrium of the heart known as the sinoatrial (SA) node which acts as a natural pacemaker and generates electrical signals. These signals travel through specialized electrical pathways and stimulate the muscular walls of the heart to contract in a rhythmic manner. This gives rise to the heartbeat that pulses at a specific frequency every minute.

What is the effect of fluctuations in electrical activity on the heart?

The standard heart rate in human being ranges from 60 to 100 beats per minute. It slows down when a person sleeps and speeds up when one experiences physical or emotional heightening. These fluctuations are triggered by the brain or other systems of the body and signal the SA node to generate charges more rapidly or slowly. This leads to spikes and drops in the heart rate, depending on the nature of the situation.

What happens when there is dysfunction in the heart's electrical activity?

When the heart's electrical conduction system does not function properly, it leads to the occurrence of a condition known as arrhythmia or abnormal heart rhythm. This happens when electrical impulses are generated in an irregular manner and causes tachycardia (rapid heartbeats) or bradycardia (slow heartbeats) which takes place in jarring infrequent tempos.

What causes fluctuations in the heart's electrical activity?

There are various kinds of triggers that cause the heart rate to fluctuate. The exact nature of fluctuation also depends on the type of trigger. A few everyday examples of these causes are as follows:
- Exercise and strenuous physical activity increases electrical activity as the heart is required to beat faster so as to increase the supply of blood and oxygen to the muscles.
- Sleep and rest reduce heart rate as the body is not needed to exert itself.
- Release of adrenaline into the bloodstream causes the heart rate to spike up.



What Happens When the Electrical Activity of Your Heart Changes?

There is no fixed definition for the best diet. It solely depends on the health condition, requirement, and restrictions of a patient that a diet can be planned that can help deal with or prevent a particular health threat while ensuring overall good health.

Cholesterol is becoming a widely known threat responsible for inflammation and forming blood clots which may lead to strokes and heart attacks. Since it is a growing concern, it is recommended the patient follows a proper diet that can help in keeping the cholesterol level in the blood under control. To make such a best diet, below are few necessary and practical tips.

Opt For Healthier Fats
One must remember that the saturated fat found in the dairy products and red meat raise the level of the bad cholesterol or LDL, instead of reducing it. Receiving around 7 percent of the regular calorie need of the body is necessary from saturated fats. Therefore, one needs to opt for healthier saturated fats, such as canola or olive oils, monounsaturated fat products, low-fat dairy products, etc.

Increase the Intake of Fiber
The more the sources of fiber will be there in one s diet, especially the soluble ones, the more health benefits one can have from that diet regarding the cholesterol reduction. Fresh fruits, oat bran, oats, beans, vegetables, and lentil are excellent sources of fiber and must be there in one's diet to make it the best.

Avoid having Trans Fats
Trans fats are known to increase the bad cholesterol(LDL) and reduce the good cholesterol (HDL). Therefore, eliminating sources of trans fats from one's diet will automatically contribute to keeping the cholesterol levels under control. Usually, it is the fried foods, various commercial products such as snack cakes, crackers or cakes, junk foods that are filled with trans fats and must be avoided.

Include Whey Protein
Whey protein has found to be a good source of reducing LDL or low-density lipoprotein and maintaining a balance in the overall cholesterol production inside the body. Therefore, including foods like ricotta cheese, yogurt, cereals, oatmeal, etc., each of them being rich in whey, can be a smart way of making one's diet more heart-friendly.

Add Omega 3 Fatty Acid Rich Foods
To make your diet a cholesterol reducer, try eating foods that are rich in omega 3 fatty acid. Though this particular fat is not associated with affecting the LDL cholesterol, it helps in the good cholesterol or HDL level in the blood, reducing both the triglycerides in the blood and blood pressure. Walnuts, ground flaxseeds, almonds, fishes like salmon, herring and mackerel are a few good sources of omega 3 fatty acid.

Apart from making the diet healthier and heart friendly, one should consider making some lifestyle changes such as to exercise regularly, to quit smoking, etc., to make the diet more effective and its results long-lasting.

Diet That Can Keep Cholesterol Under Control!

Performing physical activities on a daily basis always have its benefits, but doing exercise in a well-planned manner is essential for those people who suffer from either type-1 or type-2 diabetes. Becoming more active helps lower blood sugar levels and keep diabetes under control.

Relation between exercise and sugar levels
The food we consume contains sugars which are stored in our blood in the form of glucose. This glucose is absorbed by the muscles in our body, but body fat is the enemy of this absorption process. An obese person is prone to type-2 diabetes since excessive amounts of fat are present in the body which does not allow the muscles to absorb the glucose from the blood. This results in more glucose or sugar level in the blood which leads to diabetes.

By regularly exercising, a person not only burns his/her excessive body fat, but also makes use of the muscles in his body thus allowing the muscles to absorb the glucose present in the blood readily. This helps reduce the sugar level in the blood. Moreover, doing exercise on a regular basis helps increase insulin sensitivity. It helps cells to use available insulin in taking up glucose during and after physical activity.

Understanding blood glucose reaction
The duration for which you perform physical activities will determine your blood glucose level. Physical activity has its effect on your blood glucose level and can keep it in check for up to 24 hours by increasing your body s insulin sensitivity. Every individual needs to monitor how his body responds to physical exercise by regularly monitoring the blood sugar level before and after exercise or as advised by the doctor.
Once you are familiar with the results you achieve with respect to duration and types of exercises you perform you shall be able to control your blood sugar levels more effectively and prevent your sugar levels from going either too high or too low.

Hypoglycemia and physical activity
People who have diabetes should be prepared to treat hypoglycemia or low blood sugar level. Hypoglycemia is more common in people with type-1 diabetes, and people with type-2 diabetes are at lesser risk unless they are on insulin. Individuals who experience Hypoglycemia during or after exercise should consult a doctor immediately.

If you choose to resume your exercise routine, make sure you take a break and treat your low blood sugar level. Once your sugar level gets normal, you can begin your physical activity. What you need to know is that a drop, in sugar level, can occur just after exercise or even long after exercise.

Chances of a drop, in sugar level, occur in those diabetic people who either take insulin, skip meals, or exercise for too long or too hard. If you are finding it hard to keep your sugar level in check, consult a doctor immediately and follow his advice diligently.

In order to avoid hypoglycaemia, you can eat a fruit or nuts before exercise. It is also very important to hydrate yourself during the exercise. Ideally, take a fruit half hour before exercising. Keep yourself hydrated during the workout. Avoid energy drinks.

Why Exercising Is Important In Reducing Sugar Level In Blood?

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