Be it burgers, bagels, muffins, sandwiches or simple toasts, bread has made headway into the diets of a huge portion of the populace. Although a staple diet for many since time immemorial, the consumption of bread has increased extensively in the recent past. But, which type of bread should we intake to incur the best health impacts is a question that bothers many. The general assumption is that the wholegrain variety is the best alternative. However, the barrage of marketing tactics makes it impossible to distinguish the best variety from the others. 

There are a whole lot of myths surrounding the best variety of bread and you must choose wisely before settling for one particular type. It is expedient to look beyond the overt appearance or the name of the bread, one needs to be wary of the ingredient before taking a call.

Mostly, white bread is made out of refined flour which is often striped off essential nutrients and fibers. To worsen the situation, white bread is often bleached with certain chemicals to enhance its appearance.
Certain assumptions deem brown bread as the healthier option. Unfortunately, it isn't true always. More often than not, brown bread is simply white bread with artificial coloring added to it or is caramelized. They essentially add no surplus nutritional value.

Similarly, multigrain bread can often mislead the consumers about its health impacts. Unlike whole wheat bread, multigrain breads are usually chemically treated with softened grains. This does not effectively recover the lost nutrients of the bread.

Whole wheat bread has more pronounced health benefits. It contains more wheat germ and fibers in comparison to the more processed varieties of bread. Having evaded the toxic additives, it has relatively healthier effects on our blood sugar levels.

As you realize that the bread that you eat does not necessarily affect your health favorably, wisdom lies in seeking out the least harmful variety. In that context, rye bread or spelt bread contains greater amount of minerals. Besides, bread made from barley, oats and millets have greater mineral content than the commercially hybridized varieties and promote better health.

Brown Bread Vs White Bread Vs Whole Grain?

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?

What is Stroke?

A medical condition in which the blood supply to the brain is interrupted, hence prevents the brain tissues from getting enough oxygen and nutrients. In a matter of minutes, the brain cells tend to die.

What Are The Symptoms?

Paying attention to the warning signals is extremely important. It s important to watch the signs, if you feel that any of your friends or near and dear ones might be having a stroke. The longer you take to detect, the treatment options would also get affected accordingly. Let s take a closer look at the symptoms:

Person having problem with speaking as well as interpreting things : If you come across a person or for that matter, if you feel as if you are getting confused or eating up words while speaking, then it s a clear indication as well as a warning that a stroke is on the cards.

Facing trouble to see in one or both the eyes: Are you having a blurred vision or feel as if there are blackouts at short intervals or you are seeing double of everything around you, all these are signs that you might have a stroke in the near future.

Feeling numb or paralysed on certain parts of the body: Sudden numbness or paralysis is a very common symptom for anyone who are about to get affected by stroke. This actually affects one side of the body, where you are unable to move your hands, legs or feel anything on the mouth. At that time, it s important to try and raise both the arms over one s head. In such a situation, if one arm starts to fall, then might be on the verge of having a stroke.

Trouble while walking: People who are on the verge of having stroke, might stumble or feel a tinge of dizziness, resulting in loss of balance or lack of coordination. All these point towards a definite chance that the concerned person might get affected by stroke.

When Should You Go To Visit A Doctor?

There is need to seek for immediate medical attention as and when you notice any of the symptoms of a stroke, even if you feel there is fluctuation in them or seems to have disappeared. Taking prompt action is the need of the hour. You can do the following:

You can ask the person to raise their arms and notice if one of them drift downward or they are having problem in raising one of the arms.

To see if they are able to talk properly, you can say a phrase and ask him or repeat after you, hence notice if their speech is twisted or strange.

Tell the person to smile and notice whether one side of the face droop.

So we have looked at the aspects of the symptoms related to stroke and how could you get an idea if a person is about to get affected by the disease.

All You Need To Know About Brain Stroke!

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?

Cholesterol is a type of fatty acid that is produced by the liver. The body uses cholesterol to perform various activities such as synthesizing of hormones, bile acid and vitamin D. Ayurveda views it as an important component of the body in terms of lubrication. The Ayurvedic approach of balancing cholesterol is not only to curb the cholesterol amount, but also to strictly control diet so that the secretion of cholesterol can be curtailed. Here are a few Ayurvedic hat-tips that can help to lower cholesterol and restore normal body function of the body:

Medicago satina: They are better known as Alfalfa and is famous for their ability to deal with artery-related diseases. They are capable of clearing arteries that are congested with cholesterol. They can be consumed daily as a whole or by mixing them in juice.
Arjuna: Arjuna is yet another powerful Ayurvedic herb that is mighty powerful in dealing with cardiac conditions such as heart blockages, heart attacks etc. The bark of the Arjuna tree can be taken and consumed in the form of powder. They have the capability to dissolve cholesterol and prevent heart blockages. This should be consumed earlier in the morning, before breakfast with lukewarm water.
Coriander: Coriander is considered to be one of the best herbal diuretic agents. It can revitalize the kidneys and help them perform better in terms of excretion of waste. The kidney, therefore, can flush the excess cholesterol from the body. Coriander can be consumed along with food on a daily basis.
Garlic: Garlic again has been known to mankind for centuries and is extremely beneficial for people suffering from high cholesterol. Two cloves of garlic on a daily basis can completely neutralize the effect of high cholesterol in the blood. Apart from freeing up arteries, garlic has multiple other health benefits.
Guggulu: This herb is one of the popular herbs among ayurvedic practitioners for treating high blood pressure and high cholesterol in the blood. They contain guggulsterones, which is known to be an active blocker of bad cholesterol in the blood. Consumption of 25 mg of this substance can make a person totally free from high cholesterol. They can be taken after any meals.
Holy basil or tulsi: Holy basil is another popular and traditional Indian hub that is extensively used by ayurvedic practitioners to treat high cholesterol in the bloodstream. They can eliminate excess cholesterol through the kidneys. It is used for preparing multiple medicines. It is a proven medicinal herb that is very efficient in dealing with excess cholesterol in the blood. They have the ability to disintegrate cholesterol from the body. 2-3 leaves of tulsi can be consumed on a daily basis.

High Cholesterol - 6 Top Ayurvedic Remedies to Lower It!

Hemothorax is a serious and possibly a life-threatening condition in which blood collects between the lungs and the chest wall due to a traumatic injury or some other factor. It can be caused due to an extrapleural or an intrapleural injury. An extrapleural injury damages the chest wall on the outside while an intrapleural injury damages the chest wall on the inside.
Sometimes, Hemothorax is accompanied by excess air in the pleural cavity, known as pneumothorax. If they both occur at the same time, the condition is said to be hemopneumothorax. When blood accumulation is as large as nearly one liter, it has the potential to lead to shock and is referred to as Massive Hemothorax, which can be fatal.

Causes-
Hemothorax can be caused by a number of factors discussed as follows:
  Traumatic injury in an accident or sports causes the pleural lining of the lungs or chest to rupture. It causes blood to spill over into the pleural cavity, and it finds no way to drain itself out. Chest and lungs are so sensitive that even the smallest of injuries (or seemingly small) have the potential to cause Hemothorax.
  Tuberculosis and other lung infections can cause Hemothorax.
  Pulmonary embolism refers to a blood clot in the lungs that can cause Hemothorax.
  Lung or pleural cancer also have the potential to cause grave disease.
  Defective blood clotting as in hemophilia in which blood lacks clotting factors can cause Hemothorax.
  Tissue necrosis in the lungs or pulmonary infarction is a lung tissue dysfunction which can cause Hemothorax.
  Tearing of pulmonary blood vessels due to an invasive surgical procedure also has the potential of causing Hemothorax.
  Patients who have undergone major surgeries like lung transplant and open- heart surgery are very likely to get Hemothorax.


Symptoms-
There are many symptoms associated with Hemothorax like low blood pressure, rapid rate of heart, cold and pale skin color, chest pain while breathing, tense and shallow
breathing, difficulty in breathing, anxiety, and restlessness.


Diagnosis-
  Physical examination includes listening to the sounds of abnormal breathing and to the sounds of liquid in the chest.
  An X-Ray image reveals the presence of liquid in the pleural cavity.
  A full Computed Tomography Scan can reveal the occurrence as well as the cause of Hemothorax.
  An ultrasound provides good insight into the situation of the lungs and the pleural cavity.
  Sometimes, a sample of the pleural fluid is extracted for test and diagnosis.


Treatment-
The procedure is performed under anesthesia. A catheter or a needle is inserted into the chest through ribs for removing air and blood from the pleural cavity. If the lung collapses, it is expanded using the chest tube, which is left attached to a closed system. This ensures the escape of air and fluid from the pleural cavity and prevents additional air from entering the pleural space. This section is hence left in a water seal or hooked up to suction.
If the injury is small, chest drainage might be sufficient depending upon the case. However, if there is a major injury, it might require stopping bleeding at its source through a surgery.


Take Away-
Hemothorax can cause a collapsed lung that might progress to lead to respiratory failure. If left untreated, Hemothorax can cause infection in pleura, lung or pleural fluid in the chest cavity. Hemothorax can cause scarring of the lung tissue and pleural membranes. Retained Hemothorax occurs when blood stays in the pleural cavity for too long. It might clot and get difficult to remove through the catheter. It might also cause the buildup of pus in the surrounding region leading to an infection. Retained Hemothorax is treated by draining the fluid differently or through a video-assisted surgical procedure. Before opting for any treatment or surgery, one should always consult a doctor.

Chest Injuries And Hemothorax - Know How Serious It Can Be!

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