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Dyspnoea or breathlessness can be defined as the unpleasant subjective awareness of sensation of breathing. It is the common symptom of the cardiac disease and the respiratory disease. In physiological terms, the patients usually perceive discomfort either from the increased ventilatory rate or drive, that can be provoked by the variety of factors or from a disease that causes enough reduction of ventilatory capacity. Other factors, including stimulations of J receptor leading to the amplification of ventilatory response in asthma or restrictive disorders, can also contribute.

It is obvious that diseases having dyspnoea may have a multifacteral etiology e.g., acute respiratory infections can stimulate respiratory rate as a result of fever, hypoxaemia and in serious cases, by acidoemia or hypercapnia. They can also reduce ventilatory capacity by increasing the bronchial resistance and also by restricting the ventilation because of pleural pain.

Different diagnosis in Patients with chronic Exertional Dyspnoea: -

Chronic obstructive pulmonary disease (COPD): -Very often there is a history of exertional dyspnoea over many years or months, with steady chronic decline exercise capacity. Chronic persistence cough and the daily production of sputum is the common rule and they can be a history of recurrent acute exacerbations of bronchitis. Wheezing on exercise can be prominent. In the late disease, especially if corpulmonale develops, orthopnoea, nocturnal breathlessness and ankle swelling many also supervene.

On Investigation, cyanosis may be at rest or on the trivial exertion, together with the expiratory wheeze, pursing of lips and intercostals indrawing, Antero-posterior diameter of chest may be increased and they may also be a reduced crico-sternal distance with ‘tracheal tug’ on inspiration. Chest radiograph shows signs of hyperinflation and bullae, arterial blood gases may expose hypoxaemia, hypercapnia and the raised plasma bicarbonate. There will often be the severe obstructive defeat on the spirometry which may or may not improve after the inhaled bronchodilators.

Heart Disease: - Sometime it is difficult to differentiate dyspnoea due to the heart disease. History of cough, wheezing and the nocturnal breathlessness may also occur in the cardiac failure as well as chronic obstructive pulmonary disease. History of angina or hypertension can be useful in implicating the cardiac cause. On investigation an increase in the heart size as judged by a displaced apex beat, the raised JVP and the cardiac murmurs may implicate cardiac disease. Chest radiograph and the ECG may provide the evidence of left ventricular or the arterial enlargement. Read more…

The global growth of the pharmaceutical market and industry has shown a tremendous increase in the last few decades. During last five years, these industries have offered total revenues of USD $ 534.8 billion. It is reported (world Pharmaceutical market 2007) that North America is the biggest Pharmaceutical market that constitute 49% of the global market followed by Europe and Asia Pacific. In accordance with the IMS report, there was an 8.3% increase in sales of prescribed drugs in 2006 in USA alone. It is also reported that India’s USD$3.1 billion Pharmaceutical industry is growing at the rate of 14% every year.

The Pharmaceutical and Personal Care Products are an assemblage of numerous chemical compounds used vividly in most human endeavors. These products imply to any product used by people for personal health or cosmic reasons or used by agri-business to increase the growth. PPCP (Pharmaceutical and Personal Care Products) include a multiple collection of thousands of chemical substances, including prescription and over-the-counter therapeutic drugs, veterinary drugs, fragrances and cosmetics. These are considered to be the pollutants agents present everywhere in our environment. The products used globally by individuals and domestic animals generally end up in the surrounding environment causing serious havoc at microgram levels.

The compounds used for pharmaceutical production are biologically active drugs such as hormones, antibiotics, lipid regulations and analgesics. These chemical compounds pose potential danger when they are discharged into the environment because they are basically containing low biodegradability. Some investigations have predicted that it is almost impossible to get rid of most chemical compounds of entering the drinking water system during ground water recharge.

Exogenous agents that interfere with the synthesis, secretion, transport, binding action or elimination of the natural hormones of the body are endocrine disrupters. They are responsible for the maintenance of homeostasis, reproduction, development and behavior. The mechanism of action of these compounds lead to carcinogenic, reproductive or developmental effects by interfering with the various hormonal pathways. Phenols are byproducts of widely used industrial detergents and surfactants. Various kinds including alkyl phenol ethoxycarboxylate have been found in persisting through tertiary treatment. This alkylphenolic compounds have been found in rivers and tap water. They one found to cause endocrine disruption and alteration in reproductive physiology in fish.

A variety of sources are there that lead to the disposal of these pharmaceutical & Personal Care Products into the environment. The sources can be specified as point and non- point sources. Read more…

Many people suffer from a mysterious disease – the unusual and sudden loss of consciousness. It is known as syncope – simply temporary loss of consciousness. According to studies, even some doctors are not aware of this syndrome, and they take it as a result of weak heartbeat and implant pacemakers. Sometimes, even thorough medical tests like - electrocardiography – Tilt test can’t detect the exact causes for syncope. However, only 10% of syncope cases have cardiac causes.

In this scenario, the invention of Insetable Loop Recorder (ILR) is a great relief for both medics and patients suffering from the mysterious disease.

The thumb-sized device is inserted through a non-invasive procedure and only local anesthesia is used. It records and stores data of the heart beat thus helping in the documentation of the heart’s behavior during sudden loss of consciousness. No longer, doctors need to rely any presumptive process as the syncope has no regular pattern of repetition, making it difficult to document

People who suffer from the chronic fatigue, muscle pain, and stiffness of fibromyalgia finally have a drug to call their own. Last year the FDA ( Federal Drug Agency) approved the antiseisure drug Lyrcia (pregabalin), made by Pfizer, as a treatment for fibromyalgia. The news was a long time coming for the 3 to 6 million Americans, most of them women, who suffer from the frustratingly elusive and complex condition; the pain of fibromyalgia is unique and, therefore, unresponsive to conventional painkillers. In studies, Lyrcia not only soothed the aches of fibromyalgia but also significantly improved patients’ quality of life. Lyrcia already had the FDA’s okay as a treatment for epilepsy, discomfort from shingles, and neuropathy or nerve pain, often caused by diabetes. Patients benefiting from Lyrcia report an 80 per cent improvement in their pain, but there are some side effects initially so you have to weigh all those factors when you speak with your doctor.