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?

To understand about hypothyroidism, it is essential to first understand the thyroid gland. Thyroid is an endocrine gland situated in the neck and produces the thyroid hormone. This hormone is then carried through the blood to different cells of the body. It helps the organs to function properly maintain the temperature of the body. The two thyroid hormones are Triiodothyronine (T3) and Thyroxine (T4). They regulate protein, fat, carbohydrates and vitamins in the body along with the metabolism. They are also responsible for the proper differentiation and development of cells.

Hypothyroidism or underactive thyroid or low thyroid
This is a condition where the thyroid gland is underactive and produces a low amount of the thyroid hormone. To help the thyroid gland produce the required amount of T3 and T4 hormones, the pituitary gland will make additional thyroid stimulating hormone called TSH. Due to this additional secretion of TSH, one also develops chance of thyroid gland enlargement and in some cases, it can form a goiter. 

The major cause of the low level of thyroid hormones is considered to be iodine deficiency. Hence the addition of iodine to the common salt has always been considered to be a safe method to prevent goiter. There can be several other causes of hypothyroidism such as weak immune system, radiation, surgery, Hashimoto s disease, hormonal changes etc. It can be caused due to pregnancy and is called postpartum thyroiditis.

Symptoms of Hypothyroidism
Whatever be the cause of hypothyroidism, it can show the following mild symptoms:

Increased sense of fatigue or tiredness
Sudden increase in weight with puffiness on the face
Hoarse voice
Muscle weakness with aches, tenderness and stiffness
Joint pain or stiffness
Increased sensitivity towards cold thus causing dry skin
Constipation due to slow metabolism
Decreased heart rate
Elevated blood cholesterol level
Irregular menstrual periods
Decreased concentration and depression too
However, it is important to understand that you may show no symptoms or show some mild symptoms that can be easily confused with some other condition. Hence, a proper diagnosis is a must to confirm hypothyroidism.

Diagnosis of hypothyroidism
The most common tests to determine if you have hypothyroidism are TSH Testing and T4 Testing. In case the low level of TSH is due to a defect in the pituitary gland, your doctor may request for another test called TRH. Also, Anti-thyroid Microsomal Antibodies Testing or thyroid peroxidase test (TPO) helps in identifying if the thyroid gland is damaged.

Treatment of hypothyroidism
Hormone replacement therapy is the best form of treatment available today. It involves the use of synthetic Levothyroxine (T4) or liothyronine (synthetic T3). Before these synthetic hormones were used for several years, however, prescribing thyroxine tablets is the most common mode of treatment and they are generally given for a really long period of time, although the dosage may vary. It is only in rare cases of severe decompensated hypothyroidism that one requires hospitalization.

Apart from the above treatment options, it is best advised to avoid soy products, sugary processed foods and alcohol to keep a check on hypothyroidism. In case you have a concern or query you can always consult an expert & get answers to your questions!

Hypothyroidism - Signs Your Kid Is Suffering From It!

A Simple Guide to Arthritis

One of the most common ailments the elderly suffer from is arthritis. However, arthritis can affect people of all ages. It is a rheumatic disease as in, it affects joints and bones. It can be of many types and the term covers a number of inflammatory and non-inflammatory joint diseases. Some of the most well-known types of arthritis are rheumatoid arthritis, bone spurs, gout, and osteoarthritis.

The causes of arthritis have not been defined but there are a number of factors that increase a person's chances of getting it. Foremost amongst these is increasing age and excess weight. Arthritic conditions such as rheumatoid arthritis, ankylosing spondylitis, and lupus are said to be hereditary and linked to certain genes. Sometimes, injuries can also cause arthritic conditions. Misuse of steroids can also result in arthritis.

Here is a look at the most common symptoms of the disease :-

Pain around the joints is the most well-known symptom of arthritis. Along with pain, you may also notice swollen or stiff joints.
Increased body temperature around the affected joints and redness in the area is also a symptom of arthritis. These symptoms range from mild to severe, and can be constant or may come and go.
Everybody suffers from occasional joint pains but if any of the above symptoms persist for a long duration, it is best to consult a doctor. The sooner you seek treatment, the easier it becomes to deal with arthritis. If left untreated for too long, arthritis can result in permanent joint damage.

While there is no single cure for arthritis, it can be effectively controlled if treated in time. Since the type and severity of arthritis differ from person to person, treatment for the same must also be tailored to the needs of the individual.

Drugs for arthritis can be categorized as those that treat symptoms such as pain and stiffness, and those that suppress inflammatory conditions.

In some cases, surgery may be advisable. 

Physical therapy and regular exercise are very important when dealing with arthritis.

It is equally important to eat a healthy, nutritious and well-balanced diet. If you are overweight, try and lose the excess kilos.

You must also look after your joints to ensure that there is no further degradation of bone or muscle tissue. Avoid staying in one position for a long time, and try and maintain a good posture. These simple techniques can be very effective when dealing with all types of arthritis.

A Simple Guide to Arthritis

A swelling of breast tissues in men due to estrogen and testosterone hormonal imbalance. This swelling in the chest could often resemble a breast. In babies and newborns, gynecomastia is caused by the estrogen from the mother. Breast buds and tissues are common in baby boys. They go away after a few months naturally. However, in some babies, they tend to stay. The result can be the enlarged breasts.

In teenage years, the estrogen-producing hormones naturally tend to get into an overdrive mode and in many instances, if they are hyperactive the swelling in the chest region can occur during puberty. It usually goes away within 6 months to 2 years. In some extreme cases, the swelling can also be as a result of lung or liver cancer. Also, it depends on a little on lifestyle. Drug abuse and excess alcohol can cause gynecomastia. This may also be common in older adults where the skin loses its natural elasticity and tend to sag. Apart from it, their lifestyle also plays a detrimental part in its forming.

Very few people put on weight uniformly all over their body. Some people put on weight around the abdomen and develop bellies while others put on weight on their thighs. For some, fat could also be deposited on the chest, while it may not be much of an issue for a woman but it can make male breasts protrude abnormally. Clinically, this is known as gynecomastia. Gynecomastia is not a serious condition and does not hamper a man s health but it can damage his self-esteem. In the long run, this can also be harmful for his psychological and emotional health. Thankfully dealing with it is easy.



What are the symptoms and diagnoses?
Gynecomastia is associated with enlarged breasts and in addition to that, it could feel rubbery or firm. Sometimes only one of the regions either the left or right side may experience this problem while the other side stays firm. It is diagnosed purely by a physical examination. Also, the lump may be checked for biopsy.

Treatment
90% of the cases in babies go away on its own. There is no treatment required. However in young adults, if the conditions do not go away then surgery is the most treatable option under the circumstances. Getting medications and drugs that can decrease the tissue structure is not advisable as indirectly you might be playing with the hormones and they can tend to get risky after some time. Also, surgeries of the day are not just like taking out the enlargement. They also do concentrate on the features and shape too. You can technically sculpt the region while opting for such breast reduction surgeries.

However, contrary to popular belief, surgery is not the only recourse. In fact, though surgically removing the fat deposits can have faster effects; these fat deposits may develop again over time. Thus, surgery is not a long-term solution. So, let s look at an alternative form of treatment which is Ayurveda as this can be very effective against gynecomastia. This is a holistic form of treatment that not only addresses the symptoms showcased, but attacks the root cause of the problem. In this case, fat deposits are caused usually by weight gain and slow metabolism, which makes it essential for the person to lose weight in order to treat this condition.

Before you start on weight loss regime, starving yourself is no solution for this. Instead, one must eat food according to one s body type and needs. According to Ayurveda, there are three different types of doshas present in the body. An imbalance of these doshas could contribute towards weight gain and in turn gynecomastia. Depending on your body type, an Ayurvedic doctor will be able to advise you on the type of foods to eat and avoid so as to maintain a balance of the doshas.

In addition to this, you must also exercise regularly. The best time to exercise is in the early morning. This raises your metabolism rates and helps your body utilize energy being created through the day instead of simply storing it as fat. Aim for at least half an hour s exercise each day. There are a number of yoga asanas that target the chest muscles and can help treat gynecomastia. These include the Dhanurasana, Gomukhasana and Natrajasana. These asanas burn fat in the chest and tighten chest muscles. When it comes to yoga, it isn t enough to simply perform the asanas, they must be practiced in the right way. Thus, it is always advisable to practice under a teacher s guidance.

One of the biggest advantages of treating gynecomastia with Ayurveda is the absence of side effects. Unlike surgery, there is no hospitalization needed and you may continue your normal lifestyle as you get treatment. Once treated, there is a very low chance of the condition recurring and hence, this is a permanent solution.

Self-care:
While people do opt for weight reducing measures to keep gynecomastia under check it doesn t always work like that. The reason is these are not exactly what causes the enlargement. They are as a direct result of hormones. Hence weight reduction plans and medications may not work out efficiently. Also, experts would suggest going in for a surgery before going for an exercise regime in a gym. Some people do have a misconception that hitting the gym can take care of the swelling. However, it may not be beneficial and it would give out the desired impact.

For complete treatment of your problem, you can Consult the doctor. 

Weight Loss - Can It Help Reduce Male Breast?

Yoga is the healing system par excellence. It can help all of us stay healthy without medicines and surgeries. It is also the go-to modality for spiritual and mental peace. The selection of yoga asanas for different age groups is extremely critical in yoga. How asanas are done, at what time and for how long are some of the basics that matter a lot too.

Here are a few easy-to-do asanas for three different age groups:
Age: 9-19
Before the age of seven, children should not do yoga. This is because their heart s capacity to pump blood is limited and it may not be able to handle the heightened load during practice.

1. Virabhadrasana: This asana strengthens the muscles of the legs and makes leg and back muscles flexible. It tones the abdominal organs too. It helps children be active and fit.
Method:

Stand straight with your legs wide apart.
Turn your right foot out by 90 degrees.
And turn left foot in by 15 degrees.
Lift both arms sideways to shoulder height with your palms facing upwards.
Now breathe out and bend your right knee.
Turn your head to your right. Push your hips down and hold the posture.
Breathe in while you come up.

2. Naukasana: This asana works on the muscular, digestive, circulatory, nervous and hormonal systems, and gets rid of belly fat.
Method:

Lie down flat on a mat on your back.
Breathe in and hold the breath.
Raise your arms, shoulders, head and trunk off the ground.
Balance body on buttocks and keep the spine straight.
Keep arms in the same line as your toes with palms facing downwards.
Age- 20-34
1. Sukhasana: This asana is excellent to calm and soothe. It eliminates anxiety.
Method:
Sit with your legs stretched in front.
Bend your knees and fold your legs towards your middle.
Cross your legs and keep the arches of the foot on the thighs.
Sit with your hips in a neutral position.

2. Trikonasana: This is a very good pose for the spine and pelvis. It cures a backache and is good for digestion.
Method:

Stand erect, inhale and step to the right with left heel turned inward.
Exhale and reach out over your foot with your right hand, bending to the right.
Feel the stretch.
Raise the left hand vertically upwards.
Turn your head to look up towards the left thumb.
Age- 35 and above
1. Vajrasana: It improves blood supply to upper torso and head and builds stamina. Excellent for digestion and can be done on a full stomach.
Method:

Stand on your knees with the lower legs stretched backwards, with toes crossing.
Now lower your body to sit on your heels with buttocks resting on them.
Keep your hands on knees and head straight.
Breathe in deep and concentrate on the breath.
2. Halasana: Cervical spondylosis, back pain and shoulder stiffness can all be cured through this asana. It is very useful for menopausal women too.
Method:

Lie on your back with knees bent and legs together.
Place your hands underneath the back supporting it.
Exhale and swing your knees and thighs over your torso.
Raise your hips and abdomen to support the position.
Straighten your legs parallel to the ground.

Yoga Asanas For Different Age Groups!

It s frustrating to see that though there is little change in diet, weight gain becomes normal as we get older.  Tyres  around the tummy and heavy hips are often seen as a sign of being middle aged. There are many reasons for this change in the rate of weight gain. Some of them are:


Lower metabolic rate: As children and teenagers, the body is constantly growing and changing and hence has a high metabolic rate. Metabolic rate refers to the speed with which fat is burned to produce energy. After the age of 30, this metabolic rate naturally slows down and fewer calories are burned. This leads to the accumulation of fat. The only way to boost your metabolic rate and burn fat is by exercising. 
Less muscle mass: With age, the muscles in the body also begin to shrink. Thus, instead of forming muscle, fat cells are formed as a result of digestion. When comparing muscles and fat cells, the former burn more calories and hence when they are unavailable, the rate of burning calories is lowered leading to weight gain. 
Weight gain in menopause: When it comes to women, menopause is another trigger for weight gain. This is because, this condition is marked by hormonal imbalances. This leads to a sudden drop in estrogen levels that triggers a response in the body to draw out more estrogen from the fat cells. Ultimately, this leads to the formation of more fat. Men too can suffer from hormonal imbalances as they age. This is seen by a drop in testosterone levels that leads to abdominal weight gain.
Sedentary lifestyle: As we get older, our lifestyle turns more sedentary. A sedentary lifestyle is very unhealthy and leads to not only weight gain, but a number of other problems as well. Without regular exercise, the body s existing metabolic rate further reduces leading to accumulation of fat cells. To combat this, take half an hour out of your schedule every day to go for a walk, cycle or practice any form of exercise. 
Stress: Stress not only affects your psychological health, but your physical well-being as well. Being under pressure or anxious can increase the cortisol levels in the body. This creates hunger pangs that lead to unhealthy snacking. When eating in a stressful condition, little or no attention is paid to the food being eaten or the messages your body is trying to give you. This often results in overeating that causes weight gain.

5 Reasons Why You Gain Weight As You Age

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