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?

The heart is a muscular organ that functions like a pump by moving blood through a fine, interconnected network of blood vessels. One set of blood vessels collect oxygen-rich blood from various parts of the body and gets it to the heart. It is then sent to all parts of the body through another separate channel of vessels.

The blood also transports various nutrients to the different body parts. Fat molecules or cholesterol is one of them. In fact, with changing diet patterns, there are more of fat molecules. They are heavier than the other particles, and so tend to settle down along the walls. This is known as plaque formation. This attracts more fat molecules to settle down and gradually forms a larger mass of fat cells. It also reduces the diameter of the vessel, thereby lowering the amount of blood that reaches the target organs.

Another effect it has is that it encourages the heart to exert extra pressure to push the blood through the vessels. There are simple ways to reduce blood pressure (BP), and some of these are listed below.

Eat healthy: Avoid processed and/or packaged foods. Increase the intake of fresh foods with lots of grains, vegetables, fruits, and dairy products. Include antioxidants like flaxseed, olive oil and omega-3 fatty acids to improve heart health. Avoid foods rich in calcium, sodium and magnesium. Increase consumption of potassium, which is good for heart.
Exercise regularly: Exercising has multiple benefits, and one of them is to improve heart health. It improves circulation, keeps the heart muscles active and strong and helps them pump blood better throughout the body.
Quit smoking: Smoking has severe effects on the overall health of an individual and heart health in particular. So quitting smoking can be hugely beneficial for the heart. It reduces the rate of plaque build-up and also helps in reversal.
Practise weight management: An increasing waistline is definitely not good for your heart, so watch your weight and keep your body mass index (BMI) in check. Watch what you eat, work out, and get your weight under control.
Follow stress management: The effect that stress has on our health cannot be underrated. Be it yoga, music, meditation, exercise or spending time with family/friends, choose what works best for you and learn to relax and manage stress.
Reduce alcohol consumption: More than two drinks per day can increase blood pressure significantly. So if you can t control, just quit.
Increased blood pressure is more rampant than what it was a few decades back. The age of onset is also reduced, with people in 30s now having hypertension. Making the above lifestyle changes can help lower your BP. Lifestyle diseases are now starting early in child hood. It is important to allow them to eat healthy food and physical activity. Smoking etc starts in school and need to be prohibited.

6 Simple Things That Can Help Lower Your Blood Pressure

For a long time cholesterol in totality was seen as a bad thing for your body although the truth was a little more complicated than that. Cholesterol primarily is divided into two types, one of which can be categorized as bad cholesterol and the other as good cholesterol. Let's have an in-depth look at both the categories.

Ldl or low density lipoprotein aka bad cholesterol: cholesterol is a wax like chemical which is found all over the body and it has important functions to perform. Cholesterol is carried all over the body by lipoproteins. The low density lipoproteins are denoted as bad cholesterol as they can accumulate on the walls of the blood vessels and cause blockages resulting in many ailments. Ldl levels of 190 and above are considered dangerous. 

Some of the risks associated with it are:
1. Heart disease
2. Stroke
3. Atherosclerosis
4. Peripheral artery disease among many others

Hdl or high density lipoprotein aka good cholesterol - this is a form of cholesterol which is usually desired in higher quantities as it removes ldl from the system by dislodging it from the arteries and then carrying it through the bloodstream into the liver. The liver then breaks it down and removes it from the body. Thus, higher number of hdl cholesterol is always desirable. Some of the ideal numbers for hdl cholesterol within the body are:

For women - ideal: 60 mg/dl, dangerous: 50 mg/dl or lower
For men - ideal: 60 mg/dl, dangerous: 50 mg/dl lower

The role of triglycerides
Good and bad cholesterol levels also depend on the levels of triglycerides within the body and not just ldl or hdl cholesterol. Triglycerides are another type of fat which are used to store energy within the body, but can also affect your health. It is most associated with atherosclerosis when the levels of triglycerides are high within the body. 

Some habits that contribute to high levels of it are
A. Lack of physical activity
B. Obesity or being overweight
C. Excesses in alcohol consumption
D. Smoking
E. Bad diet and others

Thus the good cholesterol vs bad cholesterol war also includes other factors, most of which can be easily changed by making subtle changes in lifestyle and incorporating healthier habits. This will increase the good cholesterol and the other relevant elements and reduce the bad.

Good Cholesterol Vs Bad Cholesterol

Hypertension is a condition where the blood has to exert extra pressure to flow through the blood vessels. While there is a genetic component to it, the more strong contributing factors are modified lifestyle and dietary changes. There are also a lot of environmental changes that have contributed to this new epidemic. While earlier people in their 50s and 60s would be diagnosed with hypertension, now there are people in 30s and 40s taking hypertension pills. Excess fat accumulation is the major cause of hypertension in younger patients.

There begins the complexity of the issue. Hypertension which requires medications to control it, they lead to side effects and bring in a host of other diseases like diabetes, and obesity which in turn bring in a whole lot of complications. A more easy way to manage would be to prevent and of course, after onset, look at how naturally it can be managed.

Ayurveda has numerous substances that have been proven to have beneficial effects in controlling blood pressure over the past 1000s of years.

1. Celery or ajwain helps blood vessels to dilate and reduces concentration of stress hormones in the blood.

2. Ashwagandha has a wide range of actions and improves the body's ability to handle physical and mental stress. This in turn improves blood pressure, obesity, and depression.

3. Citrus fruits contain vitamin c which prevents fragility of the capillaries (thinner blood vessels).

4. Cow's urine prevents hardening of blood vessels and is of curative value in those who have blood pressure due to hardening of blood vessels. 

5. Triphala which is a combination of amla, haritaki, and bibhitaki helps reduce inflammation that leads to blood pressure, thereby helping to control it.

6. Jatamansi - by helping the free radical damage on the arteries, it protects the arteries and prevents cholesterol accumulation. It also is a very well-proven stress reliever and has additional benefits on hypertension.

7. Arjuna - by helping the metabolism of the bad cholesterol in the liver, this protects the inner lining of the heart and thereby helps control hypertension.

8. Calcium and potassium containing substances help remove sodium and thereby improve blood pressure.

9. Natural herbs like brahmi, sarpagandha, shankhpushpi, and chandana are effective ayurvedic cure and treatment for hypertension.

10. Rasayana treatment from ayurveda is having excellent results, however everyone requires unique rasayan as per their body types.

11. Watermelon helps in dilation of the blood vessels.

12. Aloe gel, barberry, calamus, valerian, skullcap, gotu kola cayenne, myrrh, motherwort, hawthorn and jatamansi have all been shown to help manage hypertension over thousands of years.

13. A glass of warm milk mixed with saraswat powder is also helpful for patients with high blood pressure.

These are natural remedies which were a part of diet since times immemorial. Including them in the diet, reducing processed foods, regular exercise, avoiding alcohol and smoking can be some natural ways to prevent and if required control hypertension. Stress is here to stay, but can definitely be managed with a little conscious effort.

Control Blood Pressure With Ayurveda

When you experience shortness of breath for no reason, you might wonder if there is something to worry. Breathing difficulty (dyspnea) affects around 1 in every 10 adults. The causes are varied, and just like other health problems like dizziness, fatigue, and abdominal pain, shortness of breath too has several causes. While a few are harmless, a few may be the signs of a possible complication. Though a common complaint in adults, it is a tough diagnostic challenge. Being aware of the symptoms will take you a step further in deciding whether or not the breathing difficulty is a cause of concern.

Causes

In older people: If you are an older person, then your breathing problems will most likely be associated with a heart or lung disease such as COPD, pneumonia, and heart failure. Other causes include a stroke and cancer. It is advised to consult a doctor if you are experiencing serious breathing problems since the past few days and more so if you see other symptoms. Symptoms to worry about are pain or trouble staying upright.
In the young: The common causes of shortness of breath in younger people are usually minor and partially treatable. Shortness of breath may occur due to myofascial pain syndrome. This is a condition in which trigger points or muscle knots occur in the respiratory muscles. Other causes are pneumonia and bad respiratory habits and/or weak breathing muscles.
Stress can be the cause: Another common cause of shortness of breath in teenagers and working professionals is anxiety. This is a very significant cause and should be taken seriously because this may not necessarily be a minor problem. Its diagnosis is still reassuring when compared to other medical problems since this can be worked upon with a few techniques.
Should you worry or not?

When the breathing difficulty is caused due to an acute condition like pneumonia or a chronic condition like asthma, treating the cause is imperative. Because, when the cause is treated, the episodes of shortness of breath is reduced.
Any patient suffering from any one or more of the problems mentioned above can still take a sigh of relief as remedies are available. Various pressure point massages can be performed with proper technique to ease out the trigger points when you are suffering from muscle knots.
When it comes to bad breathing habits, old habits die hard. Although changing your bad breathing habits may seem frustrating at first, it is relatively easier to achieve this if taken up with the mentality of achieving a goal. If regular breathing exercises are performed, respiratory strength can be increased. Moreover, breathing correctly has many long-term benefits as well.
Anxiety is more of a mind over body kind of thing. Although it may seem tough to overcome, determined and head strong people can find relief if they try.
Ensuring safety first
If you are wondering about whether your condition is serious or not, it is advised to tell your doctor about any persisting symptom. If you have developed any new symptoms such as a chronic wheeze or a cough, fatigue and pale appearance, dry, painful cough and shortness of breath during physical activity, then these are slow and sneaky indicators of an onset of some serious medical problem. 

Thus, breathing difficulty occurring often is a reason to worry, and you must seek medical advice at the earliest.


Shortness of Breath Reasons - Should I Be Worried?

Your diet plays a major role in the health of your heart, so eating healthy should be somewhere on the top of the list for keeping your heart healthy as well. There are numerous heart disorders that occur due to unhealthy food patterns and consumption. Lifestyle factors are the major causes of heart disease, and diet occupies an almost compelling spot when lifestyle factors are taken into consideration. Here is a list of foods that keeps your heart healthy:

Salmon: Omega-3 fatty acids are very important for your heart to function optimally. Fishes such as salmon and sardines are rich in omega-3 fatty acids which lower the risk of heart diseases such as arrhythmia (irregular heartbeat) and atherosclerosis (accumulation of plaque in the arterial walls).

Oats: Like oats and milk for breakfast!? Congratulations! You are in luck; oatmeal has soluble fibers which help in lowering bad cholesterol levels. Just make sure that there is no added sugar in your oatmeal, as it will defeat the entire purpose.

Blueberries: Blueberries are rich in antioxidants that reduce the risks of heart attack and also decrease your blood pressure. So go ahead! Toss some blueberries in your oatmeal to get your daily dose of antioxidants which are such pre-requisites for supreme health.

Dark Chocolate: This will probably bring a smile to your lips. Dark chocolates contain polyphenols, a type of flavonoid, which is very good for your heart. Dark chocolate is known to reduce the risks of strokes and heart attacks. Watch the portion size as no matter what its benefits are, dark chocolates are still rich in calories.

Citrus Fruits: Citrus fruits such as lemons and Indian gooseberry are rich in compounds that lower cholesterol levels in the body. Tip   Start your day with a lemon juice and warm water. This betters your metabolism and also keeps your heart in fine shape.

Soy: Lo Behold Vegetarians! (and non-vegetarians as well). Soy is a protein rich food that is so good for your heart. It also contains heart-healthy fats and fibers that help bring down and normalize cholesterol levels.

Tomatoes: Tomatoes are rich in an antioxidant called  lycopene , which is very effective in getting rid of bad cholesterol. It thus helps in keeping your arteries healthy and reduces the risks of heart attacks.

Nuts: Nuts such as almonds and walnuts are rich in Vitamin E which helps in lowering bad cholesterol in the body. Avoid nuts that come with added salt.

Foods That Help You Maintain A Healthy Heart

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