What are nasal polyps?

What are nasal polyps?

Nasal polyps are painless and benign (not cancerous) growths. They’re found in nasal passages and sinuses, hollow spaces in the bones around your nose. They form from mucous membranes — thin, soft tissue that lines these body parts.

Nasal polyps can get irritated and swollen, partially blocking the nasal passages and sinuses.

Who gets nasal polyps?

Nasal polyps don’t tend to develop until well into adulthood, when people are in their 30s or 40s. They’re usually linked with some cause of inflammation in the nose, such as:

  • Asthma
  • Allergic Rhinitis or other allergies, such as to aspirin or fungus/fungi
  • Chronic rhinosinusitis (CRS).
  • Cystic fibrosis
  • Repeat sinus infections or other infections.

Do nasal polyps happen on one side or both sides of the nose?

Nasal polyps usually appear on both sides. A growth on only one side may actually be something else, such as a cancerous tumor.

What causes nasal polyps?

Polyps develop because the mucous membranes lining the nose or sinuses change. The membranes become inflamed for a long time or become inflamed over and over again. The inflammation features swelling, redness and fluid buildup.

Researchers believe that allergies and infections cause the inflammation. They think that because they’ve studied tissue taken from nasal polyps. Those samples contained extra eosinophils, white blood cells linked to infections and allergic reactions. The evidence points to inflammation causing small growths filled with fluid. Those growths then turn into polyps.

What are the symptoms of nasal polyps?

Small polyps may not cause any symptoms. But as they grow, they may lead to:

  • Headaches.
  • Loss of smell or taste.
  • Nasal congestion (stuffy nose).
  • Nasal drainage (runny nose).
  • Nosebleeds.
  • Postnasal drip (constantly feeling like you have to clear your throat).
  • Pressure or pain in the sinuses, face or top teeth.
  • Snoring

When polyps get big enough, they can block the nasal passages and sinuses, leading to:

  • Frequent asthma attacks in people with asthma.
  • Repeated sinus infections.
  • Sleep apnea  or other trouble sleeping.
  • Trouble breathing, even in people who don’t have asthma.

How are nasal polyps diagnosed?

If you have symptoms of nasal polyps, talk to a healthcare provider.

  • Ask about your health history, especially allergies, infections and asthma.
  • Ask you about your symptoms and how long you’ve had them.
  • Look inside your nose with a nasal endoscope (thin, flexible tube with a tiny camera and light).
  • Order a CT scan to take detailed pictures inside your sinuses.

How are nasal obstructions treated?

Not all patients can be cured of nasal polyps, but several treatments can help:

  • Steroid sprays to shrink polyps and improve symptoms.
  • Oral steroids (pills you swallow).
  • Injections (shots) under the skin to deliver a medicine called dupilumab.
  • Outpatient (no overnight stay) surgery to place a tiny stent. It props open the nasal passages and delivers steroids or other medications.
  • Outpatient surgery using endoscopy to remove polyps when other treatments don’t work.

What is Cholelithiasis?

Cholelithiasis is a medical condition where hard, pebble-like deposits develop within the gallbladder of an individual. They are also known as gallstones. These stones can be as small as a grain of sand or as large as a golf ball. The gallbladder is a small organ present in the abdominal cavity of human beings whose function is to store the bile. When stones develop within this organ, it may give rise to excruciating pain along with jaundice. Treatment is essential immediately after detection as gallstones may lead to severe complications.

There are two types of gallstones

Cholesterol Stones

The most prevalent kind, approximately 80 per cent of all gallstones fall into this category. They are made of cholesterol and are yellow-green.

Pigment Stones

Also called bilirubin stones, these stones are made of bilirubin, and they mostly develop at the time of haemolysis ( the destruction of red blood cells in the body ). They are dark brown or black in color

How does Cholelithiasis occur?

The exact cause for the occurrence of cholelithiasis has not been determined. Recent studies hint that the presence of excess cholesterol in the blood may be responsible for the formation of cholesterol stones. When bile in the liver cannot dissolve excess cholesterol, it develops into gallstone.

Similarly, the pigment stones develop as a result of abundant bilirubin in the body. Specific conditions like liver damage or blood disorders lead to the formation of excess bilirubin which the gallbladder is unable to break down. It may result in the development of hard, dark coloured pigment stones within the gallbladder.

Who is Prone to Cholelithiasis?

The risk of developing cholelithiasis.

  • Age above 40 years.
  • Family history of cholelithiasis.
  • Organ transplant or bone marrow transplant.
  • Diabetes
  • Cirrhosis of the liver.
  • Medical conditions like haemolytic anaemia and sickle cell anaemia.

What are the Symptoms of Cholelithiasis? How is Cholelithiasis Diagnosed?

The symptoms of cholelithiasis include:

  • Pain on the right side of the upper abdomen.
  • Nausea and vomiting.
  • Fever.
  • Jaundice.
  • Dark coloured stools.
  • Dark coloured urine discharge.
  • Diarrhoea.

In some cases, when cholelithiasis does not produce any symptoms, its known as “silent gallstones” or “asymptomatic cholelithiasis.” The pain occurs when these gallstones block the pathway of the cystic duct or common bile duct. This condition is also known as biliary colic. In 80 per cent of the cases, gallstones remain asymptomatic. The patient remains unaware of this condition until it gets detected through X-Ray at the time of routine health analysis.

Diagnosis

In most of the cases, cholelithiasis gets diagnosed at the time of routine health check-up through X-Rays and lower abdomen ultrasound examination. However, if the patient experiences sharp pain in the middle to the upper abdomen, the doctor performs a physical exam to detect abnormalities in the physical characteristic of the body. If he notices a yellow tint on the skin and in the eyes, he diagnostic tests like ultrasound examination, abdominal CT scan, gallbladder radionuclide scan and Endoscopic retrograde cholangiopancreatography (ERCP). All these tests help in the confirmation or ruling out of cholelithiasis in patients. The gallbladder radionuclide scan helps to find out whether there is an infection or blockage associated with the cholelithiasis.

What are the Complications of Cholelithiasis?

If left untreated for a prolonged period, gallstones may lead to severe complications like:

Acute Cholecystitis

Here the gallstones block the cystic duct which supplies the bile juice from the gallbladder. It results in inflammation, infection, along with excruciating pain in the abdominal region. Approximately 1-3 per cent of patients having gallstones may develop cholecystitis in the future.

Other complications of cholelithiasis include sepsis (infection in the blood), gallbladder cancer, cholangitis (a disorder in the gallbladder), fever, chills, jaundice, pain in the abdomen, and appetite loss.

What is the Treatment for Cholelithiasis?

If Cholelithiasis becomes symptomatic, surgery is the best treatment. This process is known as a cholecystectomy. Earlier, surgeons usually performed open cholecystectomy or removal of the entire gallbladder to eliminate the stones. Nowadays, laparoscopic cholecystectomy is a more common course of treatment. Some doctors also use chemicals like chenodeoxycholic acids (CDCA) or ursodeoxycholic acid (UDCA, ursodiol) to dissolve the gallstones and flush it out through urine. However, a higher probability of recurrence of cholelithiasis exists, and this treatment takes a longer time to show effective results.

Sydney COVID-19 cases may hit peak next week as Australia steps up vaccine rollout

SYDNEY, Sept 6 (Reuters) – Authorities in Australia’s New South Wales, the epicentre of the country’s biggest coronavirus outbreak, said on Monday daily infections were expected to peak next week, as they look to speed up immunisations ahead of easing restrictions.

Australia is trying to contain a third wave of infections that has locked down its two largest cities, Sydney and Melbourne, and its capital Canberra, putting more than half its 25 million population under strict stay-at-home restrictions.

New South Wales Premier Gladys Berejiklian said the government’s modelling revealed the state would require its highest number of intensive care beds in early October, with “additional pressure on the system” in the next few weeks.

Daily cases in Sydney’s worst-affected suburbs are expected to rise to as high as 2,000 until the middle of this month, the modelling showed.

“I do want to qualify that to say that modelling depends on a number of things, a number of variables … if too many of us do the wrong thing, there are too many super-spreading events, we could see those numbers higher,” Berejiklian said during a media briefing in Sydney, the state capital.

A total of 1,071 COVID-19 cases are currently in hospitals, with 177 people in intensive care (ICU), 67 of whom require ventilation. Officials have said they had quadrupled ICU beds to about 2,000 in the state early last year to handle the pandemic.

The state detected 1,281 new cases on Monday, most of them in Sydney, down from 1,485 a day earlier. Five new deaths were recorded.

Victoria state, which includes Melbourne, reported 246 new cases on Monday, its biggest daily rise of the year.

Despite the recent outbreaks, Australia’s coronavirus numbers have remained relatively low at around 63,000 cases and 1,044 deaths.

VACCINE RUSH

Officials are trying to accelerate the vaccine rollout to help minimise deaths and hospitalisations with the government pledging more freedom of movement once 70-80% of the population aged over 16 is vaccinated.

Just over 38% of Australia’s adult population has been fully vaccinated, with the country expected to reach 70% by early November based on current rates.

Last week, Australia entered into vaccine swap deals with Britain and Singapore for a total of around 4.5 million doses of the Pfizer-BioNTech vaccine, double this month’s supply. read more

Nearly half a million doses, the first batch of shipments, arrived overnight.

“There will be another set of flights in a couple of days, but we’ll pretty much be getting a million of the four million every week over the next four weeks,” Lieutenant General John Frewen, head of the vaccination taskforce, told broadcaster ABC.

Under the vaccine swap deals, Australia will return equivalent numbers of Pfizer-BioNTech vaccines to Britain and Singapore later this year. Reuters

What is Myasthenia Gravis.

Myasthenia gravis is a chronic neuromuscular disease that leads to fluctuating muscle weakness and fatigue. The disease is characterized by variable degrees of weakness of the skeletal muscles. The name myasthenia gravis is derived from a Latin word, meaning “grave muscle weakness.”

The muscle weakness happens mainly due to the circulation of antibodies which block nicotinic acetylcholine receptors at the postsynaptic neuromuscular junction. By blocking the ability of the neurotransmitter acetylcholine to bind to these receptors in the muscle, these antibodies deter motor neurons from signalling the muscle to contract.

Alternatively, in a much rarer form, muscle weakness is the result of a genetic defect in some portion of the neuromuscular junction that is inherited at birth as compared to the development through passive transmission from the mother’s immune system at birth or through autoimmunity later in life.

Symptoms of myasthenia gravis include:

  • Hoarse voice.
  • Double vision.
  • Drooping of eyelids.
  • Difficulty in talking.
  • Difficulty in swallowing or chewing.
  • Problems in lifting objects and walking upstairs.
  • Difficulty in breathing due to muscular weakness.

Although myasthenia gravis could affect any of the muscles that you control voluntarily, certain muscle groups are more commonly affected than others, some of them are:

  1. Eye Muscles
  • Double vision.
  • Drooping of one or both eyelids.
  1. Face and Throat Muscles
  • Altered speaking.
  • Difficulty swallowing.
  • Problems in chewing.
  • Limited facial expressions.

Myasthenia Gravis Causes

Myasthenia gravis is resulted by a defect in the transmission of nerve impulses to muscles. It occurs when normal communication between the nerve and muscle is interrupted at the neuromuscular junction—the place where nerve cells connect with the muscles they control.

This neuromuscular disease is caused by transmission defects in nerve impulses to muscles. The neuromuscular junction is apparently affected: acetylcholine, which produces muscle contraction under normal conditions no longer produces the contractions necessary to muscle movement.

Myasthenia Gravis Causes

Myasthenia gravis is resulted by a defect in the transmission of nerve impulses to muscles. It occurs when normal communication between the nerve and muscle is interrupted at the neuromuscular junction—the place where nerve cells connect with the muscles they control.

This neuromuscular disease is caused by transmission defects in nerve impulses to muscles. The neuromuscular junction is apparently affected: acetylcholine, which produces muscle contraction under normal conditions no longer produces the contractions necessary to muscle movement.

Myasthenia Gravis Treatment

Myasthenia gravis is believed to be caused by variations in certain genes. The disorder occurs when the immune system malfunctions and attacks the body’s tissues. There is no cure for myasthenia gravis. The goal of treatment is to manage symptoms and control the activity of your immune system through the below-mentioned ways:

  • Medication.
  • Plasma Exchange.
  • Lifestyle Changes.
  • Thymus Gland Removal.
  • Intravenous Immune Globulin.
  • Avoid stress and heat exposure.
  • Rest to help minimize muscle weakness.

Pandemic surge causes major shortage of a drug that treats rheumatoid arthritis and severe Covid-19

(CNN)Renée Melendez is frustrated with the unvaccinated for more reasons than just the renewed spread of Covid-19, she said.The Virginia woman says she and her whole family got the vaccine as soon as it was available. She’s immunocompromised and susceptible to getting really sick if she caught Covid-19. She has lupus and rheumatoid arthritis and it is these diseases that add an extra layer to her frustration and anger.

To keep her rheumatoid arthritis symptoms under control, to be able to function every day, once a month she gets an infusion of a biologic called Actemra, also known as tocilizumab. But now, because of the pandemic and the recent surge in cases, there is no Actemra available

Pandemic surge causes major shortage of a drug that treats rheumatoid arthritis and severe Covid-19

Updated 1655 GMT (0055 HKT) August 27, 2021

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‘Stop it’: FDA urges people to stop taking livestock drug to treat Covid-19 02:03

(CNN)Renée Melendez is frustrated with the unvaccinated for more reasons than just the renewed spread of Covid-19, she said.The Virginia woman says she and her whole family got the vaccine as soon as it was available. She’s immunocompromised and susceptible to getting really sick if she caught Covid-19. She has lupus and rheumatoid arthritis and it is these diseases that add an extra layer to her frustration and anger.

Make the unvaccinated pay out for their deadly decisions

Make the unvaccinated pay out for their deadly decisionsTo keep her rheumatoid arthritis symptoms under control, to be able to function every day, once a month she gets an infusion of a biologic called Actemra, also known as tocilizumab. But now, because of the pandemic and the recent surge in cases, there is no Actemra availablenull”We did our part to preserve ourselves, our community, in trying to help battle this by getting vaccinated,” Melendez said. “It’s just unfortunate that the ignorance and laziness, for lack of better words, of other people who avoided taking the vaccine and ended up in the hospital with Covid, now has to impact me.”

Repurposing drugs to treat Covid-19

In June, the US Food and Drug Administration gave Actemra an emergency use authorization to treat hospitalized Covid-19 patients. This monoclonal antibody can reduce inflammation that can make patients sicker.The antibody treatment blocks an inflammatory protein called IL-6 that causes damage in rheumatoid arthritis. That same protein plays a role in some of the serious symptoms in people with severe Covid-19 infections.

The latest surge in cases caused a global shortage. Genentech, the company that makes Actemra, doesn’t have enough for everyone who needs it. Last week, the companysaid demand for the drug went up more than 400% beyond pre-Covid levels in just two weeks.In the United States, supplies of several dose levels of this medicine have been out of stock since last Monday.

A life saver and life changer

For patients with Covid-19, the drug can be lifesaving. For patients with rheumatoid arthritis, like Melendez, it can be life-altering.

Trial suggests malaria sickness could be cut by 70%

new approach to protecting young African children from malaria could reduce deaths and illness from the disease by 70%, a study suggests.

Giving them vaccines before the worst season in addition to preventative drugs produced “very striking” results, London researchers say.

The trial followed 6,000 children aged under 17 months in Burkina Faso and Mali.

Most of the 400,000 deaths from malaria each year are in the under-fives.

And the mosquito-borne disease is still a major health issue in many parts of sub-Saharan Africa.

Booster dose

This trial, published in the New England Journal of Medicine, focused on giving very young children a vaccine already in use and anti-malarial drugs at the time of year they are most vulnerable – often the rainy season (from June in Burkina Faso), when mosquitoes multiply.

“It worked better than we thought would be the case,” said Prof Brian Greenwood, a member of the research team, from the London School of Hygiene & Tropical Medicine (LSHTM), which led the trial.

“Hospital admissions were less, deaths were less in both countries – and we really didn’t expect to see that.”

Over three years, the trial found three doses of the vaccine and drugs before the worst malaria season, followed by a booster dose before subsequent rainy seasons, controlled infections much better than vaccines or drugs alone – and, the researchers said, could save millions of young lives in the African Sahel.

Among the children who received vaccine doses and drugs, there were:

  • 624 cases of malaria
  • 11 children treated in hospital with severe malaria
  • three deaths from malaria

Among the same number of children who received preventative drugs alone, there were:

  • 1,661 malaria cases
  • 37 admissions to hospital
  • 11 deaths from malaria

Scientists say the combined effects of the vaccine and drugs in the trial appear to be surprisingly powerful.

The vaccine – called RTS,S and created by GlaxoSmithKline more than 20 years ago – kills parasites that multiply very quickly in the liver, while anti-malarial drugs target parasites in the body’s red blood cells.

Flu vaccines have been used seasonally, to protect people ahead of winter, for many years – but it has rarely been tried for malaria.

The World Health Organization’s global malaria programme director, Dr Pedro Alonso, said: “We welcome this innovative use of a malaria vaccine to prevent disease and death in highly seasonal areas in Africa.”

The vaccine has already reached more than 740,000 children in Ghana, Kenya and Malawi, as part of routine childhood-vaccine programme.

And researchers in Mali say they look forward to “a quick policy decision” by the WHO for this new approach. BBC

U.S. FDA authorizes COVID-19 vaccine boosters for the immunocompromised

Aug 13 (Reuters) – The U.S. Food and Drug Administration has authorized a third dose of COVID-19 vaccines by Pfizer Inc (PFE.N)-BioNTech and Moderna Inc (MRNA.O) for people with compromised immune systems.

The amended emergency use authorization on Thursday paves the way for people who have had an organ transplant, or those with a similar level of weakened immune system, to get an extra dose. The patients may consult with their doctor to see if they are eligible, FDA spokesperson Abby Capobianco said.

“After a thorough review of the available data, the FDA determined that this small, vulnerable group may benefit from a third dose of the Pfizer-BioNTech or Moderna vaccines,” Janet Woodcock, U.S. FDA’s acting commissioner, said in a tweet on Thursday.

“Others who are fully vaccinated are adequately protected & do not need an additional dose of COVID-19 vaccine at this time.”

The vulnerable group makes up less than 3% of U.S. adults, Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), had said before the authorization.

Supporting the move to approve an additional shot, Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, said it would be important for the CDC to provide clear recommendations about who should receive it.

“Most clinicians are not going to know what an equivalent level of compromise is for solid organ transplant patients… hopefully the CDC will be more specific about that… (and) whether or not therapies can be manipulated so you can give your patient an optimal chance of having an immune response.”

A panel of advisers to the CDC will meet on Friday to discuss booster doses, and a vote later by the committee will help decide on the rollout of the extra shots.

BOOSTERS FOR YOUNG, HEALTHY

Scientists are still divided over the broad use of COVID-19 vaccine boosters among those without underlying problems as benefits of the boosters remain undetermined.

Pfizer has said the efficacy of the vaccine it developed with partner BioNTech drops over time, citing a study that showed 84% effectiveness from a peak of 96% four months after a second dose. read more

Moderna has also said it sees the eventual need for booster doses, especially since the Delta variant has caused “breakthrough” infections in fully vaccinated people.

Reports of infections among vaccinated people and concerns about diminishing protection have galvanized wealthy nations to distribute booster shots, even as many countries struggle to access first vaccine doses.

The World Health Organization last week called for a moratorium on COVID-19 vaccine booster shots until at least the end of September. read more

“We think other countries might also follow suite, despite WHO’s concerns for vaccine equity, due to the rising health risks posed by the Delta variant and diminishing protection of the vaccine over time,” CFRA Research analyst Sel Hardy said.

Wall Street analysts expect the authorization of a booster dose for a broad population to bolster profits of COVID-19 vaccine makers. BBC

‘Serious incidents’ at Nottingham maternity units to be investigated

Five “serious incidents” that occurred at a hospital trust’s maternity units are to be investigated.

Independent investigators will look into the incidents, including an infant “born in poor condition”, at Nottingham University Hospitals (NUH) NHS Trust.

It follows plans for a wider review of the trust’s maternity units after a report found dozens of babies had died or been injured.

The trust said offering the best care was a “top priority”.

It comes after the Care Quality Commission (CQC) rated the maternity services “inadequate” in May.

An investigation by Channel 4 News and the Independent also revealed in July the trust had paid out more than £91m in damages and costs.

Through a freedom of information probe, BBC News learned there have been 34 maternity investigations following adverse incidents at NUH since 2018.

The Local Democracy Reporting Service said trust board papers showed that in June, five serious incidents – one of which occurred in 2019 – were declared.

Among them was the birth of an infant “born in poor condition” following a forceps delivery, and a mother who experienced a post-partum haemorrhage.

Two of the incidents will be investigated by the Healthcare Safety Investigation Branch (HSIB).

Another two will be looked at by the Local Maternity and Neonatal System (LMNS), and one will be probed by NUH themselves.

In total, NUH said 16 maternity-related serious incidents were declared over two months, six of which were historic cases.

Serious incidents are now being declared retrospectively to ensure they have been categorised in the right way.

The Department of Health and Social Care previously confirmed NHS England and the Nottingham clinical commissioning group were “finalising the terms of reference for an independent review”, which would go back to 2016. BBC

Covid-19: Vaccine portal for 12 to 15-year-olds in Ireland opens

Children in the Republic of Ireland aged between 12 and 15 can now register to get the Covid-19 vaccine.

They will need consent from a parent or guardian, either when registering online, or at the vaccination centre.

Those eligible can get the jab at vaccination centres and some pharmacies or GPs.

The Irish Health Service Executive (HSE) said that it will try to facilitate parents who are working with later appointment times.

About 280,000 children will be eligible for immunisation with a Pfizer or Moderna vaccine.

The National Immunisation Advisory Committee (NIAC) made the recommendation to extend the country’s vaccination programme in July.

The Irish health service has asked parents to study the expert advice on vaccination for this group and make a decision from there as to what is best for their child. BBC

Australia’s east coast battles rising COVID-19 cases

MELBOURNE, Aug 1 (Reuters) – Australia’s east coast states of New South Wales and Queensland faced an escalating battle against the COVID-19 Delta variant on Sunday, with millions under strict lockdown and authorities urging more testing and vaccinations to rein in the outbreaks.

Sydney and its surroundings, under a stay-at-home order for five weeks already, reported 239 new locally acquired cases of the highly infectious Delta strain, matching the record daily number in the current outbreak that was reported on Thursday.

The city’s 5 million residents and those in neighbouring regional centres spanning 200 km (120 miles) of coastline are to stay home until Aug. 28 at least. The total number of cases in the outbreak, which began in mid-June, has reached 3,427.

“I think what is important to know is that there is no roadmap for the Delta variant,” NSW Premier Gladys Berejiklian said.

“The challenge for us is getting as many people vaccinated in August as possible so by the time 28 of August comes around, we have options as to how we can ease restrictions.”

Australia’s vaccination drive has been sluggish, with only 18% of adults fully vaccinated so far. Brad Hazzard, NSW health minister, said that 70% of the state’s population could be fully vaccinated in about four months.

In neighbouring Queensland, there were nine new locally acquired cases of COVID-19, the biggest daily spike in almost a year. More than 3 million residents were put into a three-day snap lockdown on Saturday.

“It is vital (to get tested), anyone with any symptoms at all, it doesn’t matter where you are, because I don’t know where this virus is at the moment,” Queensland’s chief health officer Jeannette Young said.