Brain metastases from systemic cancer are the most common type of intracranial neoplasm in adults, being almost 10 times more common than primary malignant brain tumors, which cause a significant burden on the management of patients with advanced cancer (1). The lungs represent one of the most frequent sources of metastases to the brain, with a probability of (36 64%) (3). Symptoms suffered by the patients include headaches, epilepsy, focal weakness, numbness or changes in mental status. The prognosis of patients with brain metastases is not optimistic and the median survival time is  1 2 months if left untreated. The 1-year survival rate has been recorded as 10.4% (4,5). The treatment of metastatic brain tumors is complex; not only due to being able to provide local control and improve neurological function, but also due to factors such as age, performance and systemic disease status and the size, volume, location and number of metastases at presentation

CyberKnife is a robotic radiosurgery system with a linear particle accelerator (linac), which is coupled with real-time imaging to track and compensate for the patient s or target s motion. As a relatively non-invasive treatment modality, CyberKnife demonstrates certain benefits, including a more accurate target localization and improved dose delivery for the management of metastatic brain tumors that allows higher biologically effective dose delivery without increased incidence of toxicity.

In the present case, the results for the treatment of multiple brain metastases after CyberKnife surgery with a 7 8 Gy marginal dose was promising. CyberKnife for metastatic brain tumors is an effective and safe method for reducing the marginal dose prescribed for multiple brain metastases and for minimizing the radiation-related neurotoxicities. In conclusion, CyberKnife, a focused, highly-targeted radiosurgery and fractionated radiotherapy is particularly useful for multiple brain metastases. CyberKnife provides the advantage of the management of local recurrence and a tolerable complication rate. Although the treatment of brain metastases has been performed with CyberKnife, the clinical significance and optimal dose fractionation scheme require further investigation.

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CyberKnife Therapy Of 24 Multiple Brain Metastases From Lung Cancer!

One of the best and easiest ways to manage the symptoms of the chronic obstructive pulmonary disease or COPD is through a healthy and nutrient dense diet. This would not only help you to not only keep the severity of the symptoms in check but also to maintain a healthy weight.

Tips to keep in mind when choosing a diet

Managing Weight: It is essential for patients with COPD to manage their weight. The symptom of breathlessness could be more severe if you are overweight. You might feel fatigued and tired if you are underweight. Therefore it is crucial to monitor your calorie intake and therefore also your weight as recommended by the American Lung Association.
Balanced Diet: It is essential for patients with COPD to eat a healthy, nutritious and balanced diet. One that is varied and rich in fruits, vegetables, whole grains and lean meats or proteins according to a study published in the August 2014 issue of the International Journal of Chronic Obstructive Pulmonary Disease. A well-balanced diet will ensure that you get all the necessary vitamins such as C, E, and D that are necessary to help you cope with this condition.
Protein: Lean proteins such as eggs, meat, poultry, nuts, beans, and fish especially oily fish such as mackerel and sardines, should be incorporated into your meal plan. These proteins are necessary for patients with COPD especially if they are managing their condition through exercise.
Carbohydrates and food high in fibre such as lentils, oats, and beans will improve the functioning of the digestive system.
Potassium: Fruits and vegetables such as beets, potatoes, bananas are especially beneficial in preventing water retention in patients
Foods To Limit Or Avoid
People react differently to foods, there are some foods that patients with COPD should limit or avoid but if they do not seem to have an impact on your symptoms you can make them a part of your meal plan.

Limiting salt intake irrespective of whether you are a COPD patient or not is always a good step to take. But if you are a COPD patient excessive salt in your diet could cause fluid retention which could worsen your shortness of breath.
Dairy products such as milk and cheese can irritate the respiratory pathways making phlegm thicker.
Certain fruits and vegetables such as apples, cabbage, stone fruits such as peaches and soybeans can cause gas and bloating.
Caffeine in coffee and chocolate could interfere with certain medications that you have been prescribed. Confirm with your doctor if you can still include them in your diet. Patients with COPD need to drink plenty of fluids and it might be beneficial to opt for non-caffeinated beverages.
Fried, greasy and spicy food can cause gas and indigestion which can affect breathing.
Discuss your diet with your doctor or ask for a recommendation of a nutritionist who would help you to work out a meal or diet plan best suited for your condition. 

Best Diet For People Suffering From COPD!

Tuberculosis or TB is an airborne disease that mainly affects the lungs and has the potential to be fatal. People with an impaired immune system such as newborn babies, pregnant women or women who have just delivered a baby, diabetics, cancer patients and HIV positive people are at the highest risk of suffering from this disease. However, this disease can be prevented and treated.

Here are a few ways to protect yourself from this bacterial infection.

Keep your distance: TB is a communicable disease and hence can spread from one person to another. If someone around you suffers from this disease, try limiting your contact with them. In cases where this is not possible, wear protective gloves and a mask to keep yourself safe. Avoid crowded, unhygienic places and always wash your hands with a disinfectant after contact with a TB patient.
Boost your immunity: A strong immune system can fight off TB bacteria and keep you from getting infected. To build a strong immune system, eat plenty of fresh fruits and vegetables along with the required amount so carbohydrates, proteins and fats every day. Along with this, consult your doctor and start taking multivitamins or antioxidants on a daily basis.
Maintain proper hygiene: Keeping your surroundings clean are crucial to the prevention of tuberculosis. Ensure that not only your home is kept clean, but the surrounding area is cleaned as well. Do not allow garbage to accumulate around your house. Make it a habit of washing your hands with disinfectant soap every time you come home and before eating anything.
Vaccinate your children: When getting your children vaccinated, ensure that your child also receives the BCG or Bacillus Calmette-Guerin vaccine that can protect him or her against TB.
Ventilate the house: The bacteria that causes tuberculosis, thrives in stagnant air and enclosed spaces. Hence, open your windows and let some fresh air in. Not only does this prevent the multiplication of bacteria and viruses in your house, it also does not allow your home to have a musty odour.
Follow the complete course of treatment: If you have been diagnosed with TB, it is essential to complete the full course of antibiotics and not stop midway even if the symptoms have disappeared. Not adhering to the prescription gives the bacteria the ability to develop resistance to the drugs. When this resistant bacteria is exhaled it can infect more people with drug-resistant tuberculosis that is harder to cure.

6 Precautionary Measures You Must Follow In Tuberculosis!

Asthma, the long term inflammatory disease, affects the airways of lungs. A number of symptoms, including obstruction of air flow into the lungs, which can cause breathlessness, coughing, wheezing, allergic reactions and swelling of the tubes, points to it. The causes include genes as well as pollution in the environment which is resulting in an increasing number of cases. The diagnosis is usually done with a spirometry and the treatment is a long term process. 

Women who suffer from asthma have to be especially vigilant during pregnancy as it can lead to a number of complications including less air passage to the foetus. This can result in a slow rate of development and certain anomalies in extreme cases. So how can a pregnant lady manage asthma? here are a few tips:

 Involve pulmologist: to begin with, the obstetrician and the pulmonologist must both be well aware of the situation. The pulmonologist must be given detailed information with regards to allergies as well as past treatment and medical history so that the treatment is done systematically to prevent an asthmatic attack and any complications to the foetus. 
 Lung function: during pregnancy, the doctor must monitor lung function carefully with monthly check ups to ensure that the right amount of oxygen is reaching the foetus. This is done because the severity of asthma changes in most women during pregnancy. A spriometry or peak flow metre can be used to measure the lung function. Also, the foetal movements must be monitored on a monthly basis, or rather, once every 28 days, to be more specific. 
 Influenza: flu is a common outcome of asthma, especially when it becomes severe during pregnancy. The onset of flu or influenza must be prevented at all costs with the help of a flu vaccine that will be effective at least for a season at a time. It is a pregnancy safe injection. 
 Triggers: there are many things that may trigger an asthmatic attack or an allergic reaction that can lead to the same. Ensure that you do not suffer from these triggers by avoiding dust, pollen, tobacco smoke and varied other substances that can lead to choking and wheezing. 
 Medication: one must ask the doctor about pregnancy safe inhaled corticosteroids that one can take during pregnancy if and when the need arises.

 It is recommended to take medication for asthma during pregnancy only after a consultation with the doctor. Also, do not reduce the dose of the medicine unless your doctor has recommended a change.

How to Deal With Asthma During Pregnancy

Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

Although your body is already in possession of the bacteria leading to tuberculosis, your immune system is able to prevent you from becoming sick. Doctors have made a distinction between latent and active tuberculosis (TB). In case of latent TB, the bacteria in the body in a passive state and it causes no symptoms, and therefore it is not contagious. But, in the case of active TB, you would become sick and may even spread the disease to others. It can take place in the first few weeks or even after several months of being infected with TB bacteria.

What are the symptoms of active TB?

If you are coughing for over three weeks and sometimes even coughing up blood, it can be a sign of TB. 
Chest pain and pain while coughing and breathing along with fatigue, fever, chills and night sweat are the common symptoms of TB along with loss of appetite and unintentional weight loss. TB may even affect other organs of your body, including your brain, spine and kidneys. 
When TB takes place outside the lungs, then the signs of TB can vary as per the organs that are involved. For instance, TB in the spine can cause back pain and that in kidneys may cause blood in the urine.
What are the causes of TB?
TB is caused by a bacteria which spreads from individual to individual via the microscopic droplets that are released into the air. This may happen when an affected person is left untreated and he speaks or sneezes or coughs or laughs. 

Though the disease is contagious, it is not easy to be affected by it. As a result, you are much more likely to get affected with active tuberculosis from a person you live with or come in regular contact with, rather than a stranger. It is important to note here that people who are affected with TB and going through proper medications for over two weeks are no more contagious.

Right from the 1980s, the number of individuals affected with TB has increased dramatically, owing to the spread of HIV, which is the virus known for causing AIDS. A person infected with HIV has a weak immunity system as a result of which it becomes difficult for the body to deal with TB bacteria. So those who have AIDS are more likely to be affected with active TB and sometimes the latent form also progresses to an active one very quickly. Therefore, it is important to seek medical assistance and detect if you have any such health complications concerning TB.

Tuberculosis - Watch Out For These Warning Signs!

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