Rheumatoid arthritis, symptoms, diagnosis and treatment
Article by Imran Khan
Rheumatoid arthritis – a systemic disease of connective tissue, mainly affecting small joints of the type of erosive and destructive poly-arthritis of unknown etiology with a complex autoimmune pathogenesis.
Causes of the disease on this day are unknown. Indirect data, such as increasing the number of white blood cell count and erythrocyte sedimentation rate (ESR) indicate the infectious nature of the process. It is believed that the disease develops as a result of infection, which causes a compromised immune system in genetically susceptible individuals, with formation of so-called. immune complexes (of the antibodies, viruses, etc..), which are deposited in tissues and lead to joint damage. But the ineffectiveness of antibiotic treatment of RA is likely to indicate the incorrectness of this assumption.
The disease is characterized by high disability (70%), which comes pretty early. The main causes of death from the disease are infectious complications and renal failure.
Treatment focuses primarily on relieving pain, slowing disease progression and restore damaged by surgery. Early detection of disease with the help of modern tools can significantly reduce the harm that can be inflicted joints and other tissues.
For the first time may occur after heavy physical exertion, emotional shock, fatigue, hormonal changes during the period, the impact of adverse factors or infection.
Epidemiology
Rheumatoid arthritis is distributed worldwide and it affects all ethnic groups. Prevalence of 0,5-1% (up 5% in the elderly) ratio M: F = 1:3 peak of illness onset – 30-35 years
Etiology
As with most autoimmune diseases, there are 3 main factors:
1. Hereditary susceptibility to autoimmunity.
2. Infection factor Hypothetical triggers of rheumatic diseases
* Paramyxovirus – viruses, mumps, measles, respiratory syncytial infection * Hepatitis B virus * Herpes virus – herpes simplex viruses, herpes zoster, cytomegalovirus , Epstein-Barr virus (much higher in the synovial fluid of RA patients * Retroviruses – T-lymphotropic virus
3. Start-up factor (hypothermia, insolation, intoxication, mutagenic drugs, endocrinopathy, stress, etc.). For women, duration of breast-feeding reduces the risk of RA. Breastfeeding for 24 months or more reduces the risk of developing RA by half.
The course of disease
Rheumatoid arthritis progresses in three stages. In the first stage, the swelling of the synovial bags causing pain, heat and swelling around the joints. The second stage is the rapid cell division that leads to compaction of the synovial membrane. In the third stage, the inflamed cells release an enzyme that attacks the bones and cartilage, which often leads to deformation of the affected joints, increasing pain and loss of motor functions.
Typically, the disease progresses slowly at first, with the gradual deployment of clinical symptoms for several months or years, much less – sub acute or acute. In about 2 / 3 of cases fever occurs, and the rest – a mono-or oligoarticular form, and articular syndrome often has no clinical specificity, which greatly complicates the differential diagnosis. Articular syndrome is characterized by morning stiffness for more than 30 minutes and similar expressions in the second half of the night – symptoms of “stiff gloves”, “corset”; ongoing spontaneous pain in the joints, increasing during active movements. The disappearance of the stiffness depends on the activity of the process: the more activity, the greater the duration of restraint. For the joint syndrome in rheumatoid arthritis is characterized by monotony, the duration, preservation of residual effects after treatment.
There may be prodromal clinical symptoms (mild transient pain, pain relationship with meteorological conditions, autonomic dysfunction). Distinguish “joint damage” and “joints exception.” Rheumatoid arthritis is often combined with other joint diseases – osteoarthritis, rheumatism, systemic connective tissue diseases.
Allocate the following options for the clinical course of rheumatoid arthritis:
* The classic version of the (symmetric defeat both small and large joints * Mono-or oligoarthritis, mainly affecting the large joints, most often the knee. Severe disease onset and reversibility of all manifestations during 1-1,5 months (arthralgias are migratory in nature, radiographic changes are absent, anti-inflammatory drugs offer relatively positive effect in the latter there are all the symptoms of rheumatoid arthritis).
Diagnosis
Diagnosis of rheumatoid arthritis (RA) – For a long time there was no specific test that would unambiguously confirm the presence of the disease . Currently, diagnosis of disease based on biochemical analysis of blood, changes in the joints are visible on x-rays, and the use of basic clinical markers, but also in conjunction with the general clinical manifestations – fever, malaise, and weight loss
In the analysis of blood examined ESR, rheumatoid factor, platelet count, etc. The most advanced analysis is the titer of antibodies to cyclic citrulline-containing peptides – ACCP, anti-CCP, anti-CCP. The specificity of this indicator is 90%, while it is present in 79% of sera from patients with RA.
Diagnostically important clinical features are the lack of discoloration of the skin over the inflamed joints, the development of tenosynovitis flexors or extensors of the fingers and the formation of amyotrophy, typical strains of brushes, so-called “rheumatoid wrist.
The criteria for poor prognosis are:
* Early damage of large joints and the appearance of rheumatoid nodules * swollen lymph nodes * involvement of new joints in the subsequent exacerbation; * systemic disease; * persistent disease activity with no remission for over a year; * persistent increase in the ESR; * early appearance (within the first year) and high titers of rheumatoid factor * early (up to four months), radiographic changes in the affected joints – a rapid progression of destructive changes; * Detection of antinuclear antibodies and LE-cells * Carrier antigens HLA-DR4
Symptoms
Rheumatoid arthritis can begin at any joint, but most often starts from small joints in the fingers, hands and wrists. Typically, joint damage is symmetric, for example if the sore joint on his right hand, then ill be the same joint on the left. The more joints afflicted the more advanced stages of disease.
* Other common symptoms include: * Fatigue * Morning stiffness. Generally, the longer the constraint, the disease activity. * Weakness * Flu-like symptoms, including low heat. * Pain during prolonged sitting * Outbreaks of disease activity are accompanied by remission. * Muscle pain * Loss of appetite, depression, weight loss, anemia, cold and / or sweaty palms and feet * Violation of glands near the eyes and mouth, causing insufficient production of tears and saliva.
Treatment
In the presence of infection need the appropriate antibacterial therapy. In the absence of bright extraarticular manifestations (eg, high fevers, Felty’s syndrome or polynervopathy) treatment of joint syndrome begin with the selection of non-steroidal anti-inflammatory drugs (NSAIDs). At the same time in the most inflamed joints injected corticosteroids. An important point in the treatment of rheumatoid arthritis is the prevention of osteoporosis – restoration of the calcium balance in the direction of increasing its absorption in the intestine and reducedthe excretion. Sources of calcium are dairy products (especially cheese, which contains from 600 to 1000 mg of calcium per 100 g of the product, as well as cheese, to a lesser degree of cottage cheese, milk, sour cream), almonds, hazelnuts and walnuts, etc., and calcium supplements in combination with vitamin D or its active metabolite.
Importance in the treatment is therapeutic exercise, aimed at maintaining maximum joint mobility and maintaining muscle mass.
Physiotherapy (electrophoresis of nonsteroidal anti-inflammatory drugs, hydrocortisone phonophoresis) and spa treatment. With persistent mono-and oligoarthritis includes introduction of isotopes of gold, yttrium, etc., With persistent strains of joints is carried out re constructive surgery.
Modern Therapy
Systemic drug therapy involves the use of four classes of drugs:
1. non steroidal anti-inflammatory drugs (NSAIDs),
2. basic drugs
3. gluco-corticosteroids (GCS)
4. biological agents.
Non-steroidal anti-inflammatory drugs
NSAIDs remain the first line of therapeutic agents that are directed primarily to the relief of acute manifestations of the disease, as well as ensuring stable clinical and laboratory remission.
In the acute phase of illness use of NSAIDs, corticosteroids, pulse therapy with corticosteroids or in combination with cytotoxic immunosuppressive agents.
Current NSAIDs have a marked anti-inflammatory effect which is caused by inhibition of the activity of cyclooxygenase (COX) – a key enzyme of arachidonic acid metabolism. Of particular interest is the discovery of two isoforms of COX, which are identified as COX-1 and COX-2 and play different roles in regulating the synthesis of prostaglandins (PG). Proved that NSAIDs inhibit the activity of COX isoforms, but their anti-inflammatory activity is due to inhibition of COX-2.
Most of the known NSAIDs inhibit primarily COX-1 activity, which explains the appearance of complications such as gastropathy, renal failure, encephalopathy, hepatotoxicity.
Thus, depending on the nature of blocking COX, NSAIDs are divided into selective and nonselective COX-2 inhibitors.
Representatives of the selective COX-2 inhibitors are meloxicam, nimesulide, celecoxib. These drugs have minimal side effects and retain high anti-inflammatory and analgesic activity. COX-2 inhibitors can be used in all programs of the treatment of rheumatoid arthritis, which require the use of NSAIDs. Meloxicam (Movalis) in the early treatment of inflammatory activity assigned to 15 mg / day and subsequently transferred to 7.5 mg / day as maintenance therapy. Nimesulide is assigned a dose of 100 mg twice a day.
Celecoxib (Celebrex) – a specific inhibitor of COX-2 – is assigned to 100-200 mg twice a day. Selection for the elderly dosage of the drug is not required. However, patients with body weight below the median (50 kg) it is desirable to begin treatment with the lowest recommended dose.
You should avoid combining two or more NSAIDs, because of their effectiveness remain unchanged, and the risk of side effects increases.
Basic Preparations
Basic drugs continue to play a pivotal role in the treatment of rheumatoid arthritis, but now there has been a new approach to their destination. In contrast to the well-known tactic of gradual treatment of rheumatoid arthritis (“principle of the pyramid”), is now advocated early aggressive treatment of basic drugs immediately after diagnosis, the purpose of which – changed the flow of rheumatoid arthritis and remission maintenance. The reason for this are the lack of early rheumatoid arthritis deformities, osteopenia, and severe complications, formed by autoimmune mechanisms, the high likelihood of remission.
The main drugs of basic therapy of rheumatoid arthritis include: methotrexate, sulfasalazine, gold preparations, D-penicillamine,. By means of the reserve include cyclophosphamide, azathioprine, cyclosporine A . The new group consisted of the following drugs: Remicade.
Ineffective for 1.5-3 months of basic drugs should be replaced or used in combination with corticosteroids in low doses, thus reducing the activity of rheumatoid arthritis before the start of the first. Six months – a critical period, no later than that should be adjusted effective basic therapy.
The best preparation for the start of basic therapy in severe rheumatoid arthritis and RF-positivity, presence of extraarticular manifestations of methotrexate is considered – cytotoxic immunosuppressive agent, which is well tolerated for prolonged use and has fewer side effects than other drugs of this group .
In the treatment of basic drugs carefully monitored the activity of the disease and side effects.Corticosteroids
A new approach is the use of high doses of corticosteroids (pulse therapy) in combination with slow acting tools that can improve the efficiency of the latter; combinations of methotrexate with salts of gold, sulfasalazine, as well as a selective immunosuppressive agent cyclosporin A.
With a high degree of inflammatory activity are used corticosteroids, and in cases of systemic manifestations of rheumatoid arthritis a form of pulse therapy is used. Corticosteroids only or in combination with cytostatic drugs – cyclophosphamide. SCS is also used as supporting anti-inflammatory therapy after failure of other medicines.
In some cases, corticosteroids are used as local therapy. The indications for their use are: mostly mono-or oligoarthritis of large joints,
Biological agents
In rheumatoid arthritis the synovial membrane , for unclear reasons, secrete a large amount of the enzyme glucose-6-phosphate dehydrogenase that also destroys the disulfide bonds in the cell membrane. In this case, there is “leakage” of proteolytic enzymes from the cell lysosomes, which cause damage to surrounding bones and cartilage. The body responds to this by making cytokines , among which also has a tumor necrosis factor -the A TNF . Cascade of these reactions in cells are triggered by cytokines, further aggravating the symptoms of the disease. Chronic rheumatoid inflammation associated with TNF-?, often causing damage to the cartilage and joints, leading to physical disability.
The treatment uses a monoclonal antibody to the cytokine TNF-the A , which is effective with high affinity in binding to TNF, both in its soluble and transmembrane forms resulting in neutralizing activity of TNF .
During the progression of rheumatoid arthritis, Joint damage in patients with rheumatoid arthritis is observed as a narrowing of the joint space between bones and erosion of bone in the articular space. Clinical trials of monoclonal antibody showed its use as a slow erosion and narrowing of the space between the bones.
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Leave a commentHealth And Wellness Living
With obesity and incidences of cancer and illness on the rise and metal health seemingly in decline, there is much one can do to feel better about one’s self and world in which one lives. There are many health and wellness practices that you can incorporate into your life.
For example, the first is a proper diet. Think about it. Most people in our modern society try to get most of their nutritional intake from a fast food burger. Not only is this type of food high in calories, fat, and artificial content (which is bad for your body), they can also affect your mood. Eating refined starches and ultra-processed foods can drop you into daily depression. What is worse is that we try to combat this by getting “high” again with more sugars or caffeine. A proper diet is the foundation for a healthy lifestyle and is a great health and wellness tip.
Vitamins can also lead you down the path of excellent health and wellness. Many of us do not get the nutrition we need from our food. Vitamins are a great way of filling in those gaps. An easy way of getting the nutrients you need is to take an all-in-one daily supplement. Most of these supplements cover all the bases and should leave you feeling better. Though you should be careful not to ingest too much of certain minerals, like iron, for example. Studies have shown an excess of iron to be dangerous, so talk to your doctor about specific supplement issues.
Another health and wellness practice involves the dreaded “e” word: exercise. Many of our lives are so packed there is no way we could fit in a half hour of jogging every morning (at least that is what we say). Though what many people don’t consider is that moderate daily exercise is not a form of torture. Actually, a steady regimen of exercise can leave you feeling better than you ever thought possible. When you exercise daily, your body grows accustomed to it and acts accordingly. You pain threshold is raised and endorphins are released in your brain, which means you will feel better, longer.
Stress is something that a lot of us have to cope with. If you find that you are stressed and having difficulties coping, seek help. You may wish to talk to your loved ones or family doctor about the problems that you are facing. Learning on how to cope with your anxieties and stress can prevent many illnesses from happening. Some believe that it is your mental health that can determine whether you have a poor or strong immune system.
It is important to live well and enjoy life. Taking preventive measures for health and wellness is worth the price and pain of being hospitalized and being bedridden. Adopt some health and wellness practices and see your overall well-being soar!
This week we have Kim Barnouin, author of Skinny Bitch and Heather Lounsbury, Holistic Healthcare Advisor. For more information, show notes, and an upcoming schedule, go to www.thisweekin.com.
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Sleep in Children: Developmental Changes in Sleep Patterns, Second EditionSleep and Breathing in Children: Developmental Changes in Breathing, Second … Sleep (Lung Biology in Health and Disease) Reviews
Sleep and Breathing in Children, 2nd Edition: Developmental Changes in Breathing During Sleep (Lung Biology in Health and Disease)
Infants and children spend one- to two-thirds of their life asleep. Despite this, very little attention has been paid to understanding both normal sleep and sleep-related abnormalities during child development. This volume is devoted to breathing during sleep, its changes with development (from the fetus onwards), and the pathophysiology of sleep-related breathing disorders.
Sleep and Breathing in Children:
- investigates breathing during sleep from the fetus onwards
- examines the effects of sleep on upper airway resistance, ventilatory drive, and respiratory muscle tone
- compares differences between childhood and adult obstructive sleep apnea, and the profound changes in breathing and sleep during growth and maturation
- discusses the current research within the field of pediatric sleep disorders
- reviews the history of childhood obstructive sleep apnea syndrome, and outlines a future framework for the study of childhood sleep-disordered breathing
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Posted in Lungs And Breathing | Biology, Breathing, Changes, Children, Developmental, Disease, EditionSleep, Health, Lung, Patterns, Reviews, Second, Sleep | Leave a commentProper Care of the Digestive System
The energy we need to work and play comes from the food we eat. Food contains nutrients that our body needs. There are nutrients that make the bones hard and strong, and nutrients that build muscles and repair bones that are worn-out. There are also nutrients that keep other parts of our body healthy and strong. Therefore, it is important to keep the digestive system in good condition so that all the cells in the body can get nourishment.
There are two common ways of upsetting our digestive system. One is by drinking water contaminated with bacteria, or polluted water. Another is by eating food that has been contaminated with bacteria brought by flies and other insects that feed on garbage. These are both causes of pollution, pollution of water and land. Some ailments and disorders such as flatulence, constipation, gastric ulcer, hepatitis and diarrhea can affect the digestive system.
Here are two important things you should know in the proper care of our digestive system.
Good food habits. Some ailments of the digestive system are caused by the food we eat. We should develop a good food habits to avoid ailments that can affect our digestive system.
Eat food with fibers such as leafy vegetables and fruits. Fiber enables undigested food to pass smoothly through the large intestine. It is effective in preventing constipation.
Eat less spicy and fatty foods. Eating salty and spicy snacks is not a good food habit because it deprives the body of the essential nutrients that healthy snacks give. Furthermore, too much salt can bring ailments which can affect other body systems.
Eat fewer sweets during snacks. Sweets can destroy our appetite for the next meal.
When buying ready-to-eat foods, be sure they come from covered containers. Uncovered foods can easily be contaminated by bacteria.
Avoid food fads. A food fad is an extreme like or dislike for a particular food.
Eating fresh food instead of preserved or packaged food is good dietary habit.
Good eating habits. Good eating habits help us take care of our digestive system too.
Chew your food well so that it will be easy to digest.
Avoid swallowing large chunks of food. They might block your pharynx.
Relax as you eat your meal. Talk about nice things that can stimulate your appetite and make you enjoy your meal.
Avoid eating too much at a time to avoid indigestion.
Practice good food and eating habits to take proper care of your digestive system.
Diagnosis And Treatment Of Arthritis Neck Pain
Article by Meredith Walker
Everybody at one time or another experiences some sort of neck pain. It’s fairly common, and most times nothing to worry about. Usually, it’s only a result of some stiffness or tension, and at the most can last a few days. And even if it does become persistent, it’s often treatable with medicines, some rest, and maybe a better sleeping position.
But when neck pains become not only persistent, but serious and chronic, then you may be having arthritis neck pains. Arthritis neck pain is caused by a specific form of osteoarthritis called cervical spondylosis. This is a result of wear and tear of the invertebral disks and facet joints in your neck, and can be a source of some worry.
This form of osteoarthritis may cause the nerve roots to become compacted or pinched, resulting in pain or numbness. It may even cause dizziness or blackouts if a vertebral artery is pinched by the damaged vertebrae. The worst cases of this can even result in weakness and numbness in the extremities because of a pinched spinal cord. If you find you are experiencing any of these symptoms, you may have cervical spondylosis.
Obviously this is not only discomforting, this can be outright scary and dangerous. Osteoarthritis is an incurable disease, and the degeneration that occurs is continuous – this means that the pain you are going through may only get worse. Because of this it is important to get an early diagnosis, and to get treatment as soon as you can.
Diagnosis is fairly easy, requiring only that your doctor perform a simple examination. It’s not uncommon for the doctor to order X-rays, however, or even an MRI (magnetic resonance imaging) or blood tests, to better determine the causes of your neck pain.
Treatment will often require drugs and medication, and even physical therapy to strengthen neck muscles and ease pressure on your damaged vertebrae. Acupuncture has even proved effective in dealing with the pain; you can even combine these treatments in order to get an effective pain relief program to help you with your daily life.
In very rare instances, surgery may be required if a nerve has been pinched because of the damage, particularly if you experience severe pain or weakness.
It’s well known that arthritis has no known cure, and Arthritis Neck Pain is no exception to this rule. But like other forms of arthritis, there are many treatments available in order to relieve the pain and discomfort; find them here, at ArthritisNaturalRemedies.com.
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Health Insurance in India
In case of government funded health care system, the quality and access of services has always remained major concern. A very rapidly growing private health market has developed in India. This private sector bridges most of the gaps between what government offers and what people need. However, with proliferation of various health care technologies and general price rise, the cost of care has also become very expensive and unaffordable to large segment of population. The government and people have started exploring various health financing options to manage problems arising out of growing set of complexities of private sector growth, increasing cost of care and changing epidemiological pattern of diseases.The new economic policy and liberalization process followed by the Government of India since 1991 paved the way for privatization of insurance sector in the country. Health insurance, which remained highly underdeveloped and a less significant segment of the product portfolios of the nationalized insurance companies in India, is now poised for a fundamental change in its approach and management. The Insurance Regulatory and Development Authority (IRDA) Bill, recently passed in the Indian Parliament, is important beginning of changes having significant implications for the health sector.
The privatization of insurance and constitution IRDA envisage to improve the performance of the state insurance sector in the country by increasing benefits from competition in terms of lowered costs and increased level of consumer satisfaction. However, the implications of the entry of private insurance companies in health sector are not very clear. The recent policy changes will have been far reaching and would have major implications for the growth and development of the health sector. There are several contentious issues pertaining to development in this sector and these need critical examination. These also highlight the critical need for policy formulation and assessment. Unless privatization and development of health insurance is managed well it may have negative impact of health care especially to a large segment of population in the country. If it is well managed then it can improve access to care and health status in the country very rapidly.
Health insurance as it is different from other segments of insurance business is more complex because of serious conflicts arising out of adverse selection, moral hazard, and information gap problems. For example, experiences from other countries suggest that the entry of private firms into the health insurance sector, if not properly regulated, does have adverse consequences for the costs of care, equity, consumer satisfaction, fraud and ethical standards. The IRDA would have a significant role in the regulation of this sector and responsibility to minimise the unintended consequences of this change.Health sector policy formulation, assessment and implementation is an extremely complex task especially in a changing epidemiological, institutional, technological, and political scenario. Further, given the institutional complexity of our health sector programmes and the pluralistic character of health care providers, health sector reform strategies in the context of healthinsurance that have evolved elsewhere may have very little suitability to our country situation. Proper understanding of the Indian health situation and application of the principles of insurance keeping in view the social realities and national objective are important.
Indian economic system has been developed on paradigm of mixed economy in which public and private enterprises co-exist. The past strategies of development based on socialistic thinking were focusing on the premise of restrictions, regulations and control and less on incentives and market driven forces. This affected the development process in the country in serious way. After the economic liberalization the paradigm changed from central planning, command and control to market driven development. Deregulation, decontrol, privatization, delicensing, globalization became the key strategies to implement the new framework and encourage competition. The social sectors did not remain unaffected by this change. The control of government expenditure, which became a key tool to manage fiscal deficits in early 1990s, affected the social sector spending in major way. The unintended consequences of controlling the fiscal deficits have been reduction in capital expenditure and non-salary component of many social sector programmes. This has led to severe resource constraints in the health sector in respect of non-salary expenditure and this has affected the capacity and credibility of the government health care system to deliver good quality care over the years. Given the increasing salaries, lack of effective monitoring and lack of incentives to provide good quality services the provides in the government sector became indifferent to the clients. Clients also did not demand good quality and better access, as government services were free of cost.
During the last 50 years India has developed a large government health infrastructure with more than 150 medical colleges, 450 district hospitals, 3000 Community Health Centers, 20,000 Primary Health Care centers and 130,000 Sub-Health Centers. On top of this there are large number of private and NGO health facilities and practitioners scatters though out the country. Over the past 50 ears India has made considerable progress in improving its health status. Deathrate has reduced from 40 to 9 per thousand, infant mortality rate reduced from 161 to 71 per thousand live births and life expectancy increased from 31 to 63 years. However, many challenges remain and these are: life expectancy 4 years below world average, high incidence of communicable diseases, increasing incidence of non- communicable diseases, neglect of women’s health, considerable regional variation and threat from environment degradation. It is estimated that at any given point of time 40 to 50 million people are on medication for major sickness in India. About 200 million workdays are lost annually due to sickness. Survey data indicate that about 60% people use private health providers for outpatient treatment while 60 % use government providers for in-door treatment. The average expenditure for care is 2-5 times more in private sector than in public sector.
Health insurance can be defined in very narrow sense where individual or group purchases in advance health coverage by paying a fee called “premium”. But it can be also defined broadly by including all financing arrangements where consumers can avoid or reduce their expenditures at time of use of services. The health insurance existing in India covers a very wide spectrum of arrangements and hence the latter- broader interpretation of health Insurance is more appropriate.It is estimated that the Indian health care industry is now worth of Rs. 96,000 crore and expected to surge by 10,000 crore annually. The share of insurance market in above figure is insignificant. Out of one billion population of India 315 million people are estimated to be insurable and have capacity to spend Rs. 1000 as premium per annum. Many global insurance companies have plans to get into insurance business in India. Market research, detailed planning and effective insurance marketing is likely to assume significant importance. Given the health financing and demand scenario, health insurance has a wider scope in present day situations in India. However, it requires careful and significant effort to tap Indian health insurance market with proper understanding and training.
In India has limited experience of health insurance. Given that government has liberalized the insurance industry, health insurance is going to develop rapidly in future. The challenge is to see that it benefits the poor and the weak in terms of better coverage and health services at lower costs without the negative aspects of cost increase and over use of procedures and technology in provision of health care. The experience from other places suggest that ifhealth insurance is left to the private market it will only cover those which have substantial ability to pay leaving out the poor and making them more vulnerable. Hence India should proactively make efforts to develop Social Health Insurance patterned after the German model where there is universal coverage, equal access to all and cost controlling measures such as prospective per capita payment to providers. Given that India does not have large organized sector employment the only option for such social health insurance is to develop it through co-operatives, associations and unions. The existing health insurance programmes such as ESIS and Mediclaim also need substantial reforms to make them more efficient and socially useful. Government should catalyze and guide development of such social health insurance in India. Researchers and donors should support such development.
Smokers Lungs Learn How to Get Clear Lungs and Get Rid of that Smokers Cough
Article by Jo Mark
So, what in the heck are smokers lungs? The answer is really easy. If you smoke, you fillyour lungs with tar, nicotine, and nasty crap every time you inhale. And unfortunately, up to 60 percent of those deadly chemicals stay in your lungs when you exhale. As time goes on, these nasty chemicals continually build up inside your lungs.Early on, before smokers lungs starts to develop, your lungs can clear themselves naturally. Minutehairs located in your lungs called cilia constantlysweep the nasty chemicals and poisons from your lungs. As you continue to smoke, more and more chemical are delivered into your lungs. Over time, the cilia become damaged and cannot completely do their job.If enough of the cilia are damaged, you can start to notice early signs of smokers lungs. A nasty dry hacking cough, also known as a smokers cough is one of the early symptoms. An additional sign of smokers lungs is shortness of breath. If you notice this or other signs, you should see your physician. If you have been a smoker for a while, you should be concerned with your lungs. This is especiallytrue if you have a chronic cough. If you can quit the habit now, your lungs might be able to clear themselves over a period of fifteen or twenty years. But, if you’ve not been able to to stop smoking, you should be aware that there is a simple, easy technique you can use to get clear lungs much faster. Unfortunately, most people do not even know that this simple technique is possible. Employing this simple technique, you can get rid of smokers lungs and get clean healthy lungs in a relatively short time. In fact, this process can clean your lungs 15 or 20 times as fast as your body can do it naturally.And the solution to this problem is extremely easy. It involves a little known combination of food supplements and vitamins that clean the poisons out of your lungs and ejectthem out of your body. If you’ve been a smoker for some time, do something positive for your body and clean up those smokers lungs. Get clear lungs Now!
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