Cancer drugs, stents at 60% discount soon

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Over 200 cancer drugs, 186 medicines to treat cardiovascular diseases and 148 stents and cardiac implants will now be available at central government hospitals at prices 50-60% lower than the open market.

The health ministry has launched a programme called AMRIT (Affordable Medicines and Reliable Implants for Treatment), under which the government will run pharmacy retail stores to sell medicines in hospitals like AIIMS, Safdarjung and Ram Manohar Lohia.

TOI was the first to report on September 19 that the health ministry was working on a project to make cancer medicines and stents available at substantial discounts by procuring them in bulk. The health ministry’s AMRIT (Affordable Medicines and Reliable Implants for Treatment) programme seeks to make treatment of critical diseases more affordable by bringing down the cost of medicine, which constitute a major part of the total health expenditure, mainly in case of tertiary care.

“This is certainly an innovative initiative. Patients can buy medicines and implants at rates 50-60% cheaper than open market from AMRIT outlet in AIIMS,” health minister J P Nadda said while inaugurating the first store. “The government is pinning a lot of hope on it. We are exploring the possibility of scaling up the facility and also making it accessible to larger number of people in various parts of the country,” he added.

Since the incidence of cancer and heart diseases is high and rapidly increasing in India, the government has chosen these two therapeutic categories for initial focus of the pragramme, an official said. In India, deaths from cancer have increased by 60% since 1990, according to the latest report `Global Burden of Cancer-2013′, released worldwide on Friday. In 2013, there were 14.9 million new cancer cases registered worldwide, whereas 8.2 million people died due to the disease. Cardiovascular diseases are found to be the leading cause of death globally .

Source: TimesofIndia

Antibiotics: Handle with care

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Every five minutes a child dies due to drug-resistant bacteria in the WHO South-East Asia Region. 

Drugs that were effective in treating deadly diseases such as tuberculosis, HIV, malaria etc. are increasingly losing their impact. Misuse and overuse of antibiotics is leading to antibiotic resistance which is emerging as the greatest public health threat.

Antibiotics are often not optimally prescribed – when not needed, or with incorrect choice of medicine or incorrect dosage. Self-medication is common with antibiotics freely available without a prescription. Failure to finish a course of antibiotics or taking them for too long, lack of regulations or standards for health care workers, and misuse and overuse in animal husbandry and agriculture, are factors adding to the increasing antibiotic resistance.

WHO is strongly advocating for urgent action to reverse the growing antibiotic resistance which is threatening to outpace the ability of antibiotics to cure dangerous infections. The consequences could be catastrophic. We are heading to an era when minor cuts might become life-threatening. Common infections that were treatable for decades may once again kill.

Countries in WHO South-East Asia Region signed a declaration in Jaipur in 2011 to prioritize action against antibiotic resistance.

The World Antibiotics Awareness week aims at raising awareness and promoting best practices among the general public, health professionals and policy makers to ensure judicious use of antibiotics to avoid further emergence and spread of antibiotic resistance.

Antibiotics continue to be a precious resource. They have saved millions of lives by treating serious bacterial infections. Let us together work to stop antibiotic resistance.

Source: TimesofIndia

Joint Pain: Some Useful Information

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Most, if not all, who suffer from joint pain are faced with much discomfort throughout their day. Joint pain can be mild, causing some soreness each time you move your joint. Or joint pain can be severe, making it impossible to use your joint altogether. This medical condition is rarely an emergency and most mild cases can be successfully managed at home. 

What Causes Joint Pain? 

There are many causes someone may develop joint pain. The two most frequent cause of joint pain are osteoarthritis and rheumatoid arthritis. According to the Arthritis Foundation, about 27 million individuals in the United States have this chronic condition. Most often the knees, hips and hands are affected. Joint pain due to osteoarthritis results from a breakdown of the cartilage that serves as a cushion and shock absorber for the joints. On the other hand, rheumatoid arthritis affects about 1.3 million Americans and can deform and debilitate the joints over time. This type of arthritis can cause pain, inflammations and fluid buildup in the joints as the membrane that lines them is attacked by the body’s immune system. Other conditions that may cause joint pain include:

• Bursitis (inflammation of the cushioning pads around the joints)

• Lupus

• Gout

• Infection of the bone

• Overuse

• Cancer

 

Who is at Risk for Joint Pain? 

There are a number of factors that can increase your risk of joint pain. Those who struggle with excess weight may be putting stress on their joints. If a person is overweight, ordinary activities such as walking or going up and down stairs puts a strain on their joints. Those who have certain structural abnormalities, such as having one leg shorter than the other, misaligned knees and even flat feet, may be caused with joint pain. A lack of strength and flexibility are among the leading causes of knee injuries and joint pain. Tight or weak muscles offer less support for your knee because they do not absorb enough of the stress exerted on the joint.  Those who play certain sports, such as skiing, basketball and running, may be putting strains and stress on their joints, specifically their knees. Lastly, if someone has had a previous injury, they have a higher risk of injuring his or her joint again.

 

How to Manage Joint Pain. 

Both of these forms of joint pain are considered as a chronic condition and nothing can completely eliminate the joint pain. However, there are ways to manage the pain. It may be helpful to:

•Use topical pain relievers

•Take NSAIDs (non-steroidal anti-inflammatory drugs) to reduce the pain, swelling and inflammation

•Stay physically active and follow a fitness program focusing on moderate exercise

•Stretch prior to exercising to maintain a good range of motion in your joints

•Keep your body weight within a healthy range, which will lessen stress on the joints

 

If your pain is not caused by arthritis, you may try general pain relief measures, which include taking a warm bath, stretch frequently, get a massage, get adequate rest or take nonprescription anti-inflammatory medicine. In some cases, your joint pain will require you to see a doctor. You should make an appointment if:

•You do not know the cause of your joint pain and are experiencing other unexplained symptoms

•The area around the joint is swollen, red, tender or warm to the touch

•The pain persists for three days or more

•You have a fever but no signs of the flu

 

Protect Your Joints. 

If you have discomfort in your joints and want to take control over the pain yourself, there are ways to do so.

•First, you should choose the strongest joint available for the job. For example, carry objects with your palm open, distributing the weight equally over your forearm.

•Slide objects along a counter or workbench rather than lifting them. Use your thigh muscles to rise from a chair instead of pushing off with your hands.

•Another way to protect your joints is to use good body mechanics. If you position yourself correctly and use the muscles best suited to a physically demanding task, you can minimize the stress on your joints. For example, carry heavy objects close to your chest, supporting the weight on your forearms.

•If you arrange your work area wisely you can help release tension or stress on your joints.

•Make sure while you are sitting you have hood back and foot support.

•If you are typing on a keyboard for long periods and your chair does not have arms consider using a wrist or forearm support.

•If you stand while working make sure the work surface enables you to work comfortable without stooping.  

There are many ways to protect you from joint pain. You must take precautions and be aware of how you are using your body. You should learn ways to help alleviate stress on your joints and follow through with those instructions daily, before your pain worsens.

 

Reference: iuhealth.org

Amazing Facts on Honey and Cinnamon

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Great information!! Cinnamon and Honey…! Drug companies won’t like this one getting around.

It is found that a mix of honey and cinnamon cures most diseases. Honey is produced in most of the countries of the world. Scientists of today also note honey as very effective medicine for all kinds of diseases. Honey can be used without side effects which is also a plus. Today’s science says that even though honey is sweet, when it is taken in the right dosage as a medicine, it does not harm even diabetic patients. Researched by western scientists:

HEART DISEASES: Make a paste of honey and cinnamon powder, put it on toast instead of jelly and jam and eat it regularly for breakfast. It reduces the cholesterol and could potentially save one from heart attack. Also, even if you have already had an attack studies show you could be kept miles away from the next attack. Regular use of cinnamon honey strengthens the heart beat. In America and Canada, various nursing homes have treated patients successfully and have found that as one ages the arteries and veins lose their flexibility and get clogged; honey and cinnamon revitalize the arteries and the veins.

ARTHRITIS: Arthritis patients can benefit by taking one cup of hot water with two tablespoons of honey and one small teaspoon of cinnamon powder. When taken daily even chronic arthritis can be cured. In a recent research conducted at the Copenhagen University, it was found that when the doctors treated their patients with a mixture of one tablespoon Honey and half teaspoon Cinnamon powder before breakfast, they found that within a week (out of the 200 people so treated) practically 73 patients were totally relieved of pain — and within a month, most all the patients who could not walk or move around because of arthritis now started walking without pain.

BLADDER INFECTIONS: Take two tablespoons of cinnamon powder and one teaspoon of honey in a glass of lukewarm water and drink it. It destroys the germs in the bladder….who knew?

CHOLESTEROL: Two tablespoons of honey and three teaspoons of Cinnamon Powder mixed in 16 ounces of tea water given to a cholesterol patient was found to reduce the level of cholesterol in the blood by 10 percent within two hours. As mentioned for arthritic patients, when taken three times a day, any chronic cholesterol-could be cured. According to information received in the said Journal, pure honey taken with food daily relieves complaints of cholesterol.

COLDS: Those suffering from common or severe colds should take one tablespoon lukewarm honey with 1/4 spoon cinnamon powder daily for three days. This process will cure most chronic cough, cold, and, clear the sinuses, and it’s delicious too!

UPSET STOMACH: Honey taken with cinnamon powder cures stomach ache and also is said to clear stomach ulcers from its root.

GAS: According to the studies done in India and Japan, it is revealed that when Honey is taken with cinnamon powder the stomach is relieved of gas.

IMMUNE SYSTEM: Daily use of honey and cinnamon powder strengthens the immune system and protects the body from bacterial and viral attacks. Scientists have found that honey has various vitamins and iron in large amounts. Constant use of Honey strengthens the white blood corpuscles (where DNA is contained) to fight bacterial and viral diseases.

INDIGESTION: Cinnamon powder sprinkled on two tablespoons of honey taken before food is eaten relieves acidity and digests the heaviest of meals

INFLUENZA: A scientist in Spain has proved that honey contains a natural ‘Ingredient’ which kills the influenza germs and saves the patient from flu.

LONGEVITY: Tea made with honey and cinnamon powder, when taken regularly, arrests the ravages of old age. Use four teaspoons of honey, one teaspoon of cinnamon powder, and three cups of boiling water to make a tea. Drink 1/4 cup, three to four times a day. It keeps the skin fresh and soft and arrests old age. Life spans increase and even a 100 year old will start performing the chores of a 20-year-old.

RASPY OR SORE THROAT: When throat has a tickle or is raspy, take one tablespoon of honey and sip until gone. Repeat every three hours until throat is without symptoms.

PIMPLES: Three tablespoons of honey and one teaspoon of cinnamon powder paste. Apply this paste on the pimples before sleeping and wash it off the next morning with warm water. When done daily for two weeks, it removes all pimples from the root.

SKIN INFECTIONS:Applying honey and cinnamon powder in equal parts on the affected parts cures eczema, ringworm and all types of skin Infections.

WEIGHT LOSS: Daily in the morning one half hour before breakfast and on an empty stomach, and at night before sleeping, drink honey and cinnamon powder boiled in one cup of water. When taken regularly, it reduces the weight of even the most obese person. Also, drinking this mixture regularly does not allow the fat to accumulate in the body even though the person may eat a high calorie diet.

FATIGUE: Recent studies have shown that the sugar content of honey is more helpful rather than being detrimental to the strength of the body. Senior citizens who take honey and cinnamon powder in equal parts are more alert and flexible. Dr. Milton, who has done research, says that a half tablespoon of honey taken in a glass of water and sprinkled with cinnamon powder, even when the vitality of the body starts to decrease, when taken daily after brushing and in the afternoon at about 3:00 P.M., the vitality of the body increases within a week.

BAD BREATH: People of South America, gargle with one teaspoon of honey and cinnamon powder mixed in hot water first thing in the morning so their breath stays fresh throughout the day.

HEARING LOSS: Daily morning and night honey and cinnamon powder, taken in equal parts restores hearing.

 

Cold-cap treatment in preventing chemotherapy related hair loss in cancer patients

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Cold-cap treatment seems to be successful in preventing chemotherapy related hair loss in cancer patients, according to recent report from The New York Times.

The most common side effect of chemotherapy that a cancer patient has to endure is hair loss. But, now for all those people who fear hair loss while undergoing chemotherapy can be relieved by this recent advancement.

Cold cap therapy involves wearing ice-filled caps frozen between 15 and 40 degrees Fahrenheit before, during, and after a chemotherapy session. It is yet to be approved by the U.S Food and Drug Administration but the treatment is showing promise with the initial clinical trials indicating high percentage of participants not losing their hair.

A renowned oncologist in the Manhattan, US says that he has come across dozens of patients using cold-cap with about 70 percent retaining their hair.

The cold-cap being so cold causes narrowing of the blood vessels beneath the skin of the scalp. This reduces the amount of chemotherapy medicine that reaches the hair follicles. When less chemotherapy medicine reaches the follicles, it is less likely that the hair will fall out.

During each chemotherapy session, you can wear these caps for:

  • 20 to 50 minutes before
  • during
  • after each chemotherapy session

The important part is that the amount of time you have to wear the cap after the chemotherapy session depends highly on the type of chemotherapy you are being given.

Following are the precautionary measures that women who use cold caps during chemotherapy are advised to follow:

  • no blow drying, hot rollers, or straightening irons
  • shampoo only every third day with cool water and a gentle shampoo
  • no colouring until 3 months after chemotherapy is done
  • gentle combing and brushing

There have been concerns in the medical community where some doctors have raised issues like the caps may prevent the chemotherapy medicine from reaching cancer cells that may be in the scalp. But there are studies which say otherwise.

In Europe, the cold-caps have been in use since 1970s and the studies have shown no increase in risk for skin metastasis.

In the U.S. there are several clinical trials going on at present to check the safety and efficacy of these caps. Currently, the DigniCap System is being studied in clinical trials in California, North Carolina, and New York and is only available to study participants. Similarly, the Paxman Scalp Cooling System is only available to clinical study participants in Houston, TX.

Reference: Healthaim.com

 

Common anticholinergic drugs like Benadryl linked to increased dementia risk

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A report published online this week in JAMA Internal Medicine offers compelling evidence of a link between long-term use of anticholinergic medications like Benadryl and dementia.

Anticholinergic drugs block the action of acetylcholine. This substance transmits messages in the nervous system. In the brain, acetylcholine is involved in learning and memory. In the rest of the body, it stimulates muscle contractions. Anticholinergic drugs include some antihistamines, tricyclic antidepressants, medications to control overactive bladder, and drugs to relieve the symptoms of Parkinson’s disease.

What the study found 

A team led by Shelley Gray, a pharmacist at the University of Washington’s School of Pharmacy, tracked nearly 3,500 men and women ages 65 and older who took part in Adult Changes in Thought (ACT), a long-term study conducted by the University of Washington and Group Health, a Seattle healthcare system. They used Group Health’s pharmacy records to determine all the drugs, both prescription and over-the-counter, that each participant took the 10 years before starting the study. Participants’ health was tracked for an average of seven years. During that time, 800 of the volunteers developed dementia. When the researchers examined the use of anticholinergic drugs, they found that people who used these drugs were more likely to have developed dementia as those who didn’t use them. Moreover, dementia risk increased along with the cumulative dose. Taking an anticholinergic for the equivalent of three years or more was associated with a 54% higher dementia risk than taking the same dose for three months or less.

The ACT results add to mounting evidence that anticholinergics aren’t drugs to take long-term if you want to keep a clear head, and keep your head clear into old age. The body’s production of acetylcholine diminishes with age, so blocking its effects can deliver a double whammy to older people. It’s not surprising that problems with short-term memory, reasoning, and confusion lead the list of anticholinergic side effects, which also include drowsiness, dry mouth, urine retention, and constipation.

The University of Washington study is the first to include nonprescription drugs. It is also the first to eliminate the possibility that people were taking a tricyclic antidepressant to alleviate early symptoms of undiagnosed dementia; the risk associated with bladder medications was just as high.

“This study is another reminder to periodically evaluate all of the drugs you’re taking. Look at each one to determine if it’s really helping,” says Dr. Sarah Berry, a geriatrician and assistant professor of medicine at Harvard Medical School. “For instance, I’ve seen people who have been on anticholinergic medications for bladder control for years and they are completely incontinent. These drugs obviously aren’t helping.”

Many drugs have a stronger effect on older people than younger people. With age, the kidneys and liver clear drugs more slowly, so drug levels in the blood remain higher for a longer time. People also gain fat and lose muscle mass with age, both of which change the way that drugs are distributed to and broken down in body tissues. In addition, older people tend to take more prescription and over-the-counter medications, each of which has the potential to suppress or enhance the effectiveness of the others.

What should you do? 

In 2008, Indiana University School of Medicine geriatrician Malaz Boustani developed the anticholinergic cognitive burden scale, which ranks these drugs according to the severity of their effects on the mind. It’s a good idea to steer clear of the drugs with high ACB scores, meaning those with scores of 3. “There are so many alternatives to these drugs,” says Dr. Berry. For example, selective serotonin re-uptake inhibitors (SSRIs) like citalopram (Celexa) or fluoxetine (Prozac) are good alternatives to tricyclic antidepressants. Newer antihistamines such as loratadine (Claritin) can replace diphenhydramine or chlorpheniramine (Chlor-Trimeton). Botox injections and cognitive behavioral training can alleviate urge incontinence.

One of the best ways to make sure you’re taking the most effective drugs is to dump all your medications — prescription and nonprescription — into a bag and bring them to your next appointment with your primary care doctor.

Reference: Harvard Health 

Natural Approaches for Easing Anxiety

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  • Kava. Numerous studies find that this herb, a member of the black pepper family, works better than a placebo to reduce symptoms in people with generalized anxiety disorder (GAD). Kava can interfere with how your body metabolizes certain medications, however, so, as with any supplement, check with your health care professional first.
  • Inositol (vitamin B8). Studies find that supplementing with 12 to 18 grams a day works about as well as selective serotonin reuptake inhibitors (SSRIs) like fluvoxamine (Luvox), and better than a placebo, to reduce the intensity and frequency of panic attacks. Other studies find inositol works better than a placebo to reduce symptoms of obsessive compulsive disorder (OCD).
  • Herbal teas. Valerian and passionflower have long been used to calm nervousness and treat anxiety, although there are no studies showing they’re effective in treating anxiety disorders. However, I believe that any time you brew a pot of hot tea and sit in a quiet place to sip it, you will feel better.
  • Acupuncture. There is some limited evidence that acupuncture may help reduce the symptoms of GAD. As with many alternative remedies, I think the effectiveness is often individual. If you are comfortable with acupuncture, talk to a licensed acupuncturist about the possibility of using it as an adjunct treatment for your anxiety.
  • Journaling. I know that when I can’t sleep at night, writing down what I’m worried about or making a list of everything I have to do clears my mind and allows me to fall asleep. You might try this when you feel your mind going around and around the same groove.
  • Applied relaxation. Relaxation techniques such as meditation, progressive muscle relaxation and systematic breathing, can all reduce stress hormone levels. Studies suggest they can also improve symptoms of GAD nearly as well as CBT and may provide some benefit in panic disorder. I suggest taking a class at your community hospital or recreation center to learn the proper techniques.
  • Exercise. You knew this would be here, didn’t you? We know that exercise is a terrific treatment or treatment addition for depression, boosting levels of feel-good hormones. So it’s no surprise that studies suggest the same benefits for anxiety disorders. One interesting study found levels of the neurotransmitter gamma aminobutyric acid, or GABA, increased in yoga practitioners after a 60-minute session compared to people who just read for 60 minutes. This is important because studies find low levels of GABA in people with some anxiety disorders, particularly panic disorder. In another interesting study, researchers used a drug to stimulate a panic attack in 15 healthy people after they either exercised or rested quietly. Just six participants had a panic attack after exercising, but 12 had one after resting. I don’t think you have to train for a marathon, but a daily walk sure wouldn’t hurt!

Reference: Healthywomen

Switch off smartphone for healthy sleep

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The more your teenage son or daughter chats on Facebook during the sleep hours, more he or she is at an increased risk of sleep problems and depressive symptoms, finds a study.

Researchers from University of Basel in Switzerland analysed more than 300 students and found that that teenagers who own smartphones spend more time online – also during the night which may affect their sleep.

“Due to wireless internet connections and cheap flat rates, teenagers with smartphones spend more time online and communicate with their peers for less money – for example via WhatsApp – which has changed their digital media use pattern profoundly,” they noticed.

The results showed that during weekdays, teenagers with smartphones spent more time on the internet than their peers with conventional mobile phones; on average two hours compared to one hour.

In addition, they wrote more text messages daily – on average 85 messages compared to seven messages.

A particularly noticeable difference was found for the time when the teenagers were in their beds at night.

Only 17 per cent of smartphone owners switched their devices off or put them on silent during the night compared to 47 per cent of the teenagers with conventional mobile phones.

Moreover, teenagers with smartphones indicated to watch videos, to be online, and to text with friends more often during the night than their counterparts with conventional mobile phones.

“Most importantly, teenagers who used digital media at night had an increased risk for poor sleep and depressive symptoms,” the team said.

The researchers recommend that teenagers who suffer from sleep disorders or severe daytime tiredness to switch their digital media devices off at least one hour before bedtime.

The findings were published in the Journal of Youth and Adolescence.

Reference: http://indianexpress.com

 

What is Chronic fatigue syndrome (CFS) ?

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Chronic fatigue syndrome (CFS) is an illness characterized by prolonged, debilitating fatigue that does not improve with rest and worsens with physical or mental activity. It is also characterized by multiple nonspecific symptoms such as headaches, recurrent sore throats, muscle and joint pains, and memory and concentration difficulties.

CFS can be hard to diagnose, and its cause or causes are unknown. Even its name can be confusing: CFS is also known as myalgic encephalomyelitis (ME or ME/CFS or CFS/ME), as well as chronic fatigue and immune dysfunction syndrome (CFIDS).

Profound fatigue, the hallmark of the disorder, can come on suddenly or gradually and persists or recurs throughout the period of illness. Unlike the short-term disability of an illness such as the flu, by definition CFS symptoms must have lasted for at least six months. They often linger for years.

CFS affects women at about four times the rate that it affects men, and the illness is diagnosed more often in people in their 40s and 50s. It can affect any sex, race or socioeconomic class. Research shows that it is at least as common in Hispanics and African Americans as it is in Caucasians. And although CFS is less common in children than in adults, children can develop the illness, particularly during the teen years. It can be as disabling as multiple sclerosis and chronic obstructive pulmonary disease.

The prevalence of CFS is difficult to measure because the illness can be difficult to diagnose, but, in general, it is estimated that at least 1 million people in the United States have CFS, according to the CDC. CFS is sometimes seen in members of the same family, suggesting there may be a genetic link; more research is needed to prove this link.

CFS does not appear to be a new illness, although it only recently was assigned a name. Relatively small outbreaks of similar disorders have been described in medical literature since the 1930s. Furthermore, case reports of comparable illnesses date back several centuries.

The international group organized by the CDC named the illness chronic fatigue syndrome because the name reflects the most common symptom: long-term, persistent fatigue. It is important to note, however, that the word “fatigue” may be extremely misleading. Fatigue is but one symptom among many that make up this illness, and it doesn’t reflect the significance of other disabling symptoms. The word also adds to generalized misunderstanding and trivialization of the illness..

There are no indications that CFS is contagious or that it can be transmitted through intimate or casual contact. Research continues to determine the safety of blood donation by people with CFS. The AABB, an organization representing blood banking centers in the United States and around the world, has recommended the indefinite deferral of potential blood donors with a past or current history of CFS. This recommendation has been adopted by the American Red Cross and America’s Blood Centers, the two largest blood collectors in the United States.

CFS may begin suddenly or come on gradually. The sudden onset frequently follows a respiratory, gastrointestinal or other acute infection, including mononucleosis. Other cases develop after emotional or physical traumas such as serious accidents, bereavement or surgery.

Although CFS can persist for many years, long-term studies indicate that CFS generally is not a progressive illness. Symptoms are usually most severe in the first year or two. Thereafter, the symptoms typically stabilize, then persist chronically, wax and wane, or improve. For some people with CFS, however, symptoms can get worse over time.

It appears that while the majority of people with CFS partially recover, only a few fully recover, while others experience a cycle of recovery and relapse. There’s no way to predict which category you might fall into. There is some evidence that the sooner a person is diagnosed with CFS and symptoms are managed and treated, the better the chances of improvement, which illustrates the importance of early diagnosis and treatment

Source: Healthywomen

What are the symptoms of swine flu?

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Symptoms of swine flu are similar to most influenza infections: fever (100 F or greater), cough, nasal secretions, fatigue, and headache, with fatigue being reported in most infected individuals. Some patients may also get a sore throat, rash, body aches, headaches, chills, nausea, vomiting, and diarrhea.The incubation period from exposure to first symptoms is about one to four days, with an average of two days. The symptoms last about one to two weeks and can last longer if the person has a severe infection.

Some patients develop severe respiratory symptoms and need respiratory support (such as a ventilator to breathe for the patient). Patients can get pneumonia (bacterial secondary infection) if the viral infection persists, and some can develop seizures. Death often occurs from secondary bacterial infection of the lungs; appropriate antibiotics need to be used in these patients. The usual mortality (death) rate for typical influenza A is about 0.1%, while the 1918 “Spanish flu” epidemic had an estimated mortality rate ranging from 2%-20%.