Know about Hazards of Tobacco

 

HAZARDS OF 

TOBACCO AND SMOKING

            World No Tobacco Day is observed annually on May 31st and serves as a global initiative to raise awareness about the health risks associated with tobacco use and advocate for effective policies to reduce tobacco consumption worldwide. 

The day is organized by the World Health Organization (WHO) and is part of their efforts to promote tobacco control measures.

Each year, World No Tobacco Day focuses on a specific theme related to tobacco control. The theme for the day can vary, addressing topics such as the impact of tobacco on heart health, the harmful effects of second-hand smoke, the targeting of youth by the tobacco industry, and more. The chosen theme aims to highlight a particular aspect of tobacco control and encourage action and public engagement.

                HEALTH HAZARDS OF TOBACCO

        Tobacco use is associated with a wide range of health hazards and is a leading cause of preventable diseases and premature death worldwide. Here are some of the major health risks associated with tobacco:

1. Cancer: Tobacco use is a significant risk factor for various 

types of cancer, including lung, throat, mouth, oesophagus, pancreas, bladder, kidney, and cervix. Approximately 30% of all cancer deaths are estimated to be directly related to tobacco use.                 

2. Respiratory Diseases: Smoking can cause chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. It also increases the risk of respiratory infections, such as pneumonia and bronchitis.

3. Cardiovascular Diseases: Tobacco use is a major cause of heart diseases, including coronary artery disease, heart attacks, stroke, and peripheral vascular disease. It damages blood vessels, reduces blood flow, increases blood pressure, and promotes the formation of blood clots.

4. Respiratory Effects: Smoking damages the respiratory system, leading to chronic coughing, wheezing, and shortness of breath. It can exacerbate asthma symptoms and increase the risk of developing respiratory conditions like asthma in children.

5. Reproductive Issues: Tobacco use can have adverse effects on reproductive health. In men, it can lead to erectile dysfunction and reduced fertility. In women, it increases the risk of infertility, complications during pregnancy, premature birth, low birth weight, and stillbirth.

6. Oral Health Problems: Smoking is a significant risk factor for various oral health issues, including gum disease, tooth decay, tooth loss, and oral cancer.

7. Eye Diseases: Smoking is associated with an increased risk of vision loss and eye conditions such as cataracts and age-related macular degeneration.

8. Increased Infection Risk: Tobacco weakens the immune system, making individuals more susceptible to infections, such as respiratory infections, pneumonia, and periodontal diseases.

9. Skin Damage: Smoking accelerates the ageing process of the skin, leading to premature wrinkling, dryness, and a dull complexion. It also increases the risk of developing skin cancer.

10. Second-hand Smoke: Non-smokers who are exposed to second-hand smoke are also at risk of developing various health problems, including lung cancer, heart disease, and respiratory issues.

    These are just a few of the many health hazards associated with tobacco use. Quitting smoking and avoiding tobacco products are crucial steps towards improving overall health and reducing the risk of these serious health conditions.

LUNG CANCER

The most important health risk of Smoking, the widely used tobacco form, is Lung Cancer. Lung cancer is a type of cancer that starts in the lungs. It is one of the most common cancers worldwide and a leading cause of cancer-related deaths. Lung cancer can be broadly categorized into two main types: 

• Non-small cell lung cancer (NSCLC) 

• Small cell lung cancer (SCLC). Here's some important information about lung cancers:

1. Non-Small Cell Lung Cancer (NSCLC): 

This is the most common type of lung cancer, accounting for about 85% of cases. NSCLC includes subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. It tends to grow and spread more slowly than small-cell lung cancer.

2. Small Cell Lung Cancer (SCLC): 

SCLC accounts for about 15% of lung cancer cases. It tends to grow and spread more rapidly than NSCLC. SCLC is strongly associated with smoking, and it is often diagnosed at more advanced stages.

Causes and Risk Factors: The primary cause of lung cancer is tobacco smoke, including both active smoking and exposure to second-hand smoke. Other risk factors include exposure to radon gas, asbestos, certain chemicals (such as arsenic, chromium, and nickel), a family history of lung cancer, and previous radiation therapy to the chest.

Symptoms: Lung cancer may not cause noticeable symptoms in the early stages, but as the disease progresses, common symptoms can include persistent coughing, chest pain, shortness of breath, wheezing, hoarseness, weight loss, fatigue, coughing up blood, and recurrent lung infections.

Diagnosis: Lung cancer is typically diagnosed through various tests and procedures, including imaging tests (such as chest X-rays, CT scans, or PET scans), sputum cytology, bronchoscopy, biopsy (taking a tissue sample for examination), and molecular testing to determine specific genetic mutations in the tumour.

Staging: Lung cancer is staged to determine the extent of the disease and guide treatment decisions. The staging system takes into account factors such as tumour size, location, lymph node involvement, and presence of metastasis (spread to other parts of the body).

Treatment: The treatment options for lung cancer depend on the type and stage of the cancer. They may include surgery, radiation therapy, chemotherapy, targeted therapy (using drugs that specifically target certain genetic mutations in the cancer cells), immunotherapy, or a combination of these approaches. Palliative care may also be provided to manage symptoms and improve the quality of life.

8. Prognosis: The prognosis for lung cancer varies depending on the stage at diagnosis and other factors. Overall, the prognosis for lung cancer tends to be poorer compared to some other types of cancer, largely due to late-stage diagnoses. However, early detection, advances in treatment options, and personalized approaches are improving outcomes for some patients.

    If you or someone you know is concerned about lung cancer, it is important to consult a healthcare professional for a proper evaluation, diagnosis, and treatment plan.

Quitting Smoking- How?

        Quitting smoking can be challenging, but it is absolutely possible. Here are some strategies and approaches that can help you stop smoking:

1. Set a Quit Date: Choose a specific date to quit smoking and mark it on your calendar. Having a target date can provide you with a goal to work towards and mentally prepare yourself.

2. Make a Plan: Develop a quit plan that includes strategies to cope with cravings and triggers. Identify your reasons for quitting and remind yourself of them regularly.

3. Seek Support: Inform your friends, family, and co-workers about your decision to quit smoking. Seek support from your loved ones, as their encouragement can be valuable during this process. Consider joining a support group or seeking counselling to receive additional guidance and motivation.

4. Nicotine Replacement Therapy (NRT): NRT products,

such as nicotine patches, gum, lozenges, inhalers, or nasal sprays, can help alleviate withdrawal symptoms by providing controlled doses of nicotine. Consult with a healthcare professional to determine the most suitable NRT option for you.

5. Prescription Medications: There are prescription medications available that can aid in smoking cessation by reducing cravings and withdrawal symptoms. Consult a healthcare professional to discuss whether these medications are appropriate for you.

6. Behavioural Therapies: Consider behavioural therapies such as cognitive-behavioural therapy (CBT) or motivational interviewing. These approaches can help you identify triggers, develop coping strategies, and change your behaviour and thought patterns associated with smoking.

7. Identify and Avoid Triggers: Recognize situations, activities, or emotions that trigger your urge to smoke and find healthier alternatives or coping mechanisms. Modify your routines to minimize exposure to triggers, at least in the initial stages of quitting.

8. Practice Stress Management: Find healthy ways to manage stress, such as exercising, practising relaxation techniques (e.g. deep breathing, meditation, and yoga), engaging in hobbies, or spending time with supportive friends and family.

9. Stay Active: Regular physical activity can help reduce cravings and manage nicotine withdrawal symptoms. Find activities you enjoy and incorporate them into your routine.

10. Stay Positive and Persistent: Quitting smoking is a process, and it may take multiple attempts before you succeed. If you experience a setback, don't be too hard on yourself. Learn from the experience and use it as motivation to try again.

    Remember, quitting smoking is a personal journey, and

different strategies work for different individuals. Finding what works best for you and staying committed to your goal is key. If you find quitting smoking on your own challenging, consider consulting with a healthcare professional that can provide personalized guidance and support throughout the process.

BIPOLAR DISORDER : A NOT SO UNCOMMON MENTAL ILLNESS

 BIPOLAR DISORDER 

A NOT SO UNCOMMON MENTAL ILLNESS

- DR. Avinash Bhondwe

  

 The birth anniversary of distinguished painter Vincent van Gogh is celebrated as World Bipolar Day on March 30. The mental disorder is not as talked about as other issues like depression, anxiety, and PTSD. 

          Bipolar disorder can be described as a mental condition when the brain suffers from extreme mood and energy changes, hampering the ability to function normally. These mood episodes can also result in depression and stress, and the condition is also known as manic-depressive disorder.

          Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

          The person suffering from bipolar disorder feels sad or hopeless and loses interest or pleasure in most activities. His mood shifts to mania or hypomania (less extreme than mania), he may feel euphoric, full of energy, or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior, and the ability to think clearly.

          Episodes of mood swings may occur rarely or multiple times a year. While most people will experience some emotional symptoms between episodes, some may not experience any.

          Although bipolar disorder is a lifelong condition, you can manage your mood swings and other symptoms by following a treatment plan. In most cases, bipolar disorder is treated with medications and psychological counseling (psychotherapy).

Symptoms

          There are several types of bipolar and related disorders. They may include mania or hypomania and depression. The symptoms can cause unpredictable changes in mood and behavior, resulting in significant distress and difficulty in life.

          Bipolar I disorder. The patient has one manic episode that may be preceded or followed by Hypomaniac or major depressive episodes. In some cases, mania may trigger a break from reality (psychosis).

          Bipolar II disorder. The patient has a history of at least one major depressive episode and at least one hypomanic episode, but you've never had a manic episode.

          Cyclothymic disorder: The patient has at least two years — or one year in children and teenagers — of many periods of hypomania symptoms and periods of depressive symptoms (though less severe than major depression).

          Other types:  These include, for example, bipolar and related disorders induced by certain drugs or alcohol, or due to a medical condition, such as Cushing's disease, multiple sclerosis, or stroke.

          Bipolar II disorder is not a milder form of bipolar I disorder, but a separate diagnosis. While the manic episodes of bipolar I disorder can be severe and dangerous, individuals with bipolar II disorder can be depressed for long periods, which can cause significant impairment.

          Although bipolar disorder can occur at any age, typically it's diagnosed in the teenage years or early 20s. Symptoms can vary from person to person, and symptoms may vary over time.

Mania and hypomania

          Mania and hypomania are two distinct types of episodes, but they have the same symptoms. Mania is more severe than hypomania and causes more noticeable problems at work, school and social activities, as well as relationship difficulties. Mania may also trigger a break from reality (psychosis) and require hospitalization.

          Both a manic and a hypomanic episode include three or more of these symptoms:

·        Abnormally upbeat, jumpy, or wired

·        Increased activity, energy, or agitation

·        Exaggerated sense of well-being and self-confidence (euphoria)

·        Decreased need for sleep

·        Unusual talkativeness

·        Racing thoughts

·        Distractibility

·        Poor decision-making — for example, going on buying sprees, taking sexual risks or making foolish investments

Major depressive episode

          A major depressive episode includes symptoms that are severe enough to cause noticeable difficulty in day-to-day activities, such as work, school, social activities or relationships. An episode includes five or more of these symptoms:

·        Depressed mood, such as feeling sad, empty, hopeless or tearful (in children and teens, depressed mood can appear as irritability)

·        Marked loss of interest or feeling no pleasure in all — or almost all — activities

·        Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in children, failure to gain weight as expected can be a sign of depression)

·        Either insomnia or sleeping too much

·        Either restlessness or slowed behavior

·        Fatigue or loss of energy

·        Feelings of worthlessness or excessive or inappropriate guilt

·        Decreased ability to think or concentrate, or indecisiveness

·        Thinking about, planning or attempting suicide

·        Other features of bipolar disorder

Signs and symptoms of bipolar I and bipolar II disorders may include other features, such as anxious distress, melancholy, psychosis or others. The timing of symptoms may include diagnostic labels such as mixed or rapid cycling. In addition, bipolar symptoms may occur during pregnancy or change with the seasons.

Symptoms in children and adolescents

          Symptoms of bipolar disorder can be difficult to identify in children and teens. It's often hard to tell whether these are normal ups and downs, the results of stress or trauma, or signs of a mental health problem other than bipolar disorder.

          Children and teens may have distinct major depressive or manic or hypomanic episodes, but the pattern can vary from that of adults with bipolar disorder. And moods can rapidly shift during episodes. Some children may have periods without mood symptoms between episodes.

          The most prominent signs of bipolar disorder in children and teenagers may include severe mood swings that are different from their usual mood swings.

          Despite the mood extremes, people with bipolar disorder often don't recognize how much their emotional instability disrupts their lives and the lives of their loved ones and don't get the treatment they need.

          Some patients may enjoy the feelings of euphoria and cycles of being more productive. However, this euphoria is always followed by an emotional crash that can leave him depressed, worn out — and perhaps in financial, legal or relationship trouble.

When treatment is necessary?

          If a person has any symptoms of depression or mania, he must see his family doctor or mental health professional. Bipolar disorder doesn't get better on its own. Getting treatment from a mental health professional with experience in bipolar disorder can help you get your symptoms under control.

Emergency help

          Suicidal thoughts and behavior are common among people with bipolar disorder. If the person has thoughts of hurting himself, a family doctor must call the local emergency number immediately, send him to an emergency room, or confide in a trusted relative or friend. Or call a suicide hotline number.

    If anybody is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. The reference to a hospital with an emergency treatment setup is a must.  

Causes

The exact cause of the bipolar disorder is unknown, but several factors may be involved, such as:

Biological differences: People with bipolar disorder appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.

Genetics:  Bipolar disorder is more common in people who have a first-degree relative, such as a sibling or parent, with the condition. Researchers are trying to find genes that may be involved in causing bipolar disorder.

Risk factors

Factors that may increase the risk of developing bipolar disorder or act as a trigger for the first episode include:

·        Having a first-degree relative, such as a parent or sibling, with bipolar disorder

·        Periods of high stress, such as the death of a loved one or other traumatic event

·        Drug or alcohol abuse

Complications

Left untreated, bipolar disorder can result in serious problems that affect every area of a person's life, such as:

·        Problems related to drug and alcohol use

·        Suicide or suicide attempts

·        Legal or financial problems

·        Damaged relationships

·        Poor work or school performance

Co-occurring conditions

          If a person has bipolar disorder, he may also have another health condition that needs to be treated along with the bipolar disorder. Some conditions can worsen bipolar disorder symptoms or make treatment less successful. Examples include:

·        Anxiety disorders

·        Eating disorders

·        Attention-deficit/hyperactivity disorder (ADHD)

·        Alcohol or drug problems

·        Physical health problems, such as heart disease, thyroid problems, headaches or obesity

Prevention

          There's no sure way to prevent bipolar disorder. However, getting treatment at the earliest sign of a mental health disorder can help prevent bipolar disorder or other mental health conditions from worsening.

          If someone has been diagnosed with bipolar disorder, some strategies can help prevent minor symptoms from becoming full-blown episodes of mania or depression:

·        Pay attention to warning signs. Addressing symptoms early on can prevent episodes from getting worse. The person may have identified a pattern to your bipolar episodes and what triggers them. Advise him to call his family doctor if he feels he is falling into an episode of depression or mania.

·         Involve family members or friends in watching for warning signs.

·        Avoid drugs and alcohol. Using alcohol or recreational drugs can worsen your symptoms and make them more likely to come back.

·        Advise taking medications exactly as directed. A patient may be tempted to stop treatment — but advise he should not.  Stopping the medication or reducing the dosages on his own, should be strictly avoided. It may cause withdrawal effects or the symptoms may worsen or return.

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Confession of a smoker

Confession of a smoker

I am a practicing Physician.

I am a doctor, who has always been preaching health & its principles to the society, schools, colleges & patients in general, for about a decade.

I am suffering from hypertension also.

And yet I would like to confess that I am a smoker.

As smoker, I have always shown a strong resistance and confrontation to the experiments for quitting.

It all started on a wonderful day of my results of second MBBS. The examination we took was a very tuff one. It was said that only 5 percent of the students cleared all the subjects. In those days, in mid eighties, the results used to be seen at any Newspaper office, on the day prior to the official results. I went to such an office of a Daily paper.

Throughout my medical education my roll number in the class used to be 13, however; my roll number for this examination was 14. There was A.T.K.T. system for the second MBBS and hence the classes for the third MBBS had begun. I was again accustomed to my usual lucky 13.

I went in side the newspaper office and asked for the result. I was provided with a photocopy of a typewritten result sheet. I searched for the number 13. It was not there in the list of passed student’s numbers. Crestfallen, dejected and gloomy; I climbed down the staircase and went to my bicycle. Suddenly I remembered that my exam number was 14………..! I climbed up in a Olympian athlete’s speed to the office again, requested the list, went again through the successful numbers and I did not believed my eyes……..number 14, my exam number was there amongst the booming numbers!

I again went hurriedly to the bicycle and ran to a friend’s house. He was alone. He said he did not pass. I was in ecstasy he was totally deflated. We went on the terrace of his home; he took out two cigarettes offered one to me and said, ‘let us celebrate your success!’ I accepted the evil, clad in the white paper. I agreed the offer, just to sympathize him. I vividly remember my act made with only intention, that he should not feel hurt.

Today, after almost thirty years, my friend has stopped smoking long back and I am still consuming packets after packets.

In all these years, my memory gives me the vibrant account of all my best moments and saccharine hours are associated with puffs of cigarette. I never smoked for the depression or gloom. Only other moments I may include were those of overwork and tiredness, which are off course out number happy happenings, now days.

I tried to avert smoking many times ditto to a famous quote by Mark Twain. The very first time, I remember, was when I got married. While going for the sacred visit to Jejuri, on the next day of the wedding, I admitted to her that I smoke. I also added that if she disdains it I would quit. To my bewilderment, she exclaimed that she would not mind and more over she added that she liked the smell of the cigarette smoke. After getting a clean chit, there was no stop no secret smoking like many of my friends, whose wives and progenies are still unaware of their vices, only because they do it surreptitiously. These gentlemen never buy their own packs, always borrow from their pals and do gargles their mouth and chew the mouth fresheners before going home. I never ever hide my weakness about smoking from my family or friends, not even from my parents. However; as a respect I never smoke in the presence of my parents or teachers or the people I revere.

Few years ago, I had a problem. I started getting palpitations after smoking. This used to occur even after inhaling the passive smoke of a passer bye on the road. I used to be symptom free if I did not smoke. After two days I began to get similar missed heart beats even after having tea, coffee, cold drinks even the popular government drink ‘Energy’. I underwent all the cardiac tests including stress test and 2-D echocardiography. Nothing was abnormal even in ECG. My physician cleverly decided to have a smoke and take an ECG. The missed beats appeared there with their ghastly ups and downs on the strip.

I immediately stopped the habit. I had to do a lot to control my concentration which used get haywire after feeling the urge to smoke. I started doing exercise, running, climbing the hill, yoga, meditation. All these workouts were going on for three months. I started feeling fresh, healthy & fit.

During this period there was a party from a hospital, for its first anniversary. I attended it. It was on a lush green lawn of a very trendy hotel. The music was going on, doctors dressed in formals were enjoying. Many of them, including I myself, came directly after their hard day schedule, some were busy in discussions about there new adventures, some were in the joke sessions with fizzling laughter. With such jolly and blissful decorum I was offered a cigarette. Engorged in a hot discussion on a current topic, I accepted it without any hesitation, unconsciously and without any conscience. After taking few puffs I realized that I am smoking and there are no palpitations!!

Again the destiny had cleared all the hindrances and I embarked on ceaseless sessions of my favorite play with fire. There after I tried to get released from this habit but with a big letdown each time. I became a confirmed addict.

I get severe cravings if I do not smoke for few hours. My temperament gets lost with all the sense of balanced behavior. My tongue becomes venomous and the voice with high pitch becomes mind piercing sword. In these frenzied & frantic moments, I have hurt many. My patients, my friends, colleagues and more often my family are amongst the worst sufferers. I have committed many illogical, vicious and destructive acts in my explosions during cravings. I have hurt people physically, demolished the precious things like a glassware set, which was collected with years of efforts by my wife. I have shattered a television set in my home. I repent a lot after such acts, but none the less it keeps on repeating.

I still remember the hell of a time when I travelled to Europe on a 16 hour journey by air with 4-5 hors added for the time for reporting and the clearance before coming out of the airport at the end. There are smoking lounges in some airports but I was ignorant of such facilities. I was under constant stress that something will ignite me during the course and I will burst out with all the paint up vengeance. During the extended hours in my medical practice, a buzz starts humming in my head. The extra-ordinary professional coolness, for which I boast myself, starts cracking. I begin behaving erratically. At such times, I take break, saying I have to go for a home visit. I fly to a tea house, because during last few years the restaurants around do not permit smoking. I relish my cigarette with a badly concocted tea at the lousy tea vendor and come back with the buzz in my head comfortably calmed down.

I understand this is an extreme case of Nicotine dependence. I have tried counseling, medicines, chewing gums, antidepressants, sedatives, even homeopathy and Dr. Bakh’s medicines also. All went in vain. I realize that this habit has to go.

Everyday I think I will quit on next Monday, first of next month, from Dasara, Gudhi Padva, my birthday; but alas I cannot do it every time I plan. I feel strongly and sturdily to quit, before it is too late.
 Please pray for me and help me if you can.