Hypertension

Lung cancer is the second most common type of cancer in adults in the United States. It is also the leading cause of death from cancer.

Lung cancer treatment is much more effective when the disease is in its earlier stages. However, most people with lung cancer do not experience symptoms until the disease has spread.

Some people experience subtle symptoms of early stage lung cancer, but these symptoms more often stem from other health issues or factors such as smoking.

Below, we describe early symptoms of lung cancer, as well as risk factors and when to see a doctor.

Possible signs and symptoms of early stage lung cancer

According to the American Cancer Society (ACS), most types of lung cancer do not cause symptoms until they have spread to other areas.

However, some people experience subtle symptoms during the earlier stages of the disease.

The early lung cancer symptoms that we describe below usually result from some other cause. However, people who experience these symptoms should consider visiting their doctors as a precautionary measure.

Sudden weight loss

The American Society of Clinical Oncology report that weight loss is often the first noticeable sign of cancer.

They estimate that 40% of people who receive a cancer diagnosis experience unexplained weight loss during that time.

Cancer can cause weight loss for many reasons, including:

  • changes to immune function
  • changes to metabolism
  • changes to hormones
  • a sudden loss of appetite
  • difficulty swallowing

Shortness of breath

Shortness of breath and wheezing can also be early symptoms of lung cancer.

Some people may experience a slight cough in addition to shortness of breath. Others may have difficulty catching their breath but have no cough.

Cough

A slight cough that does not go away can indicate early stage lung cancer. Some people assume that this cough is only a result of smoking.

A person who regularly coughs because of another lung condition may notice changes in their cough, and these can likewise indicate lung cancer.

Also, a cough that produces blood may result from lung cancer or another issue with the lungs. Anyone who experiences this symptom should see a doctor.

General fatigue

Lung cancer can cause the number of red blood cells in the body to drop. The medical term for this issue is anemia.

Because red blood cells carry oxygen, a person with anemia may not take in enough oxygen to support their body’s needs. This can result in tiredness and fatigue. Severe fatigue can make it difficult to function on a day-to-day level.

Shoulder, chest, or back pain

Most people with lung cancer do not feel pain or other symptoms during the early stages. This is because there are very few nerve endings in the lungs.

However, pain can occur when lung cancer invades the chest wall, ribs, vertebrae, or certain nerves. For example, Pancoast tumors, which form at the very top of the lungs, often invade nearby tissues, causing shoulder pain.

As a tumor develops, a person may begin to feel pain in their:

  • arms
  • chest
  • back

Hoarse voice

A person with lung cancer or another respiratory disease may develop a hoarse, raspy voice.

This can happen if a tumor presses on the laryngeal nerve, which is located within the chest. When the nerve is compressed, it can paralyze a vocal cord, causing the voice to change.

Risks

According to the Centers for Disease Control and Prevention (CDC)cigarette smoking is still the biggest risk factor for lung cancer, accounting for 80–90% of lung cancer-related deaths.

Other risk factors for lung cancer include:

  • using other tobacco products, such as cigars or pipe tobacco
  • inhaling secondhand smoke
  • being exposed to radon gas, possibly from materials within the home
  • working with dangerous chemicals, such as asbestos, arsenic, or diesel
  • living in a highly polluted area
  • having other lung conditions, such as chronic obstructive pulmonary disease
  • having a family history of lung cancer

When describing risk, organizations and experts sometimes use the term “pack-year.” A pack-year refers to the number of cigarettes smoked per day each year. So a person with a 30 pack-year smoking history may have:

  • smoked one pack per day for 30 years
  • smoked two packs per day for 15 years

The ACS recommend yearly lung cancer screenings for people aged 55–74 who:

  • currently smoke or have quit smoking in the past 15 years
  • have at least a 30 pack-year smoking history
  • currently smoke and are receiving counseling to help them quit
  • are aware of the potential benefits and harms of screening
  • have access to a facility that has experience with lung cancer screening and treatment

Screening cannot detect every instance of lung cancer, but it does lower a person’s chance of dying from the disease.

Smokers vs. nonsmokers

According to the CDC, people who smoke are 15–30 times more likely to die from lung cancer than people who do not.

Meanwhile, according to statistics from 2013–2014, about 1 in 4 people who do not smoke, including children, are exposed to secondhand smoke. This increases their risk of developing the disease.

Quitting smoking at any age can lower the risk of lung cancer.

When to see a doctor

The symptoms above usually result from issues other than lung cancer. However, anyone who experiences any of the following issues should visit a doctor:

  • a cough that lasts longer than 2–3 weeks
  • a persistent cough that worsens
  • a cough that produces blood
  • aches or pains when breathing or coughing
  • persistent shortness of breath
  • persistent tiredness or fatigue
  • recurrent chest infections
  • unexplained weight loss

Summary

Lung cancer is the second most common form of cancer. It can affect anyone but is particularly prevalent among people who smoke.

Usually, lung cancer does not cause symptoms until it has spread. As a result, it is not always possible to detect lung cancer in its earliest stages.

Nonetheless, some people experience subtle symptoms during the initial stages. It is important to recognize these because treatment is typically more effective when a person receives it early.

Anyone who experiences early symptoms of lung cancer should see a doctor. In many cases, something other than cancer is the cause. Still, it is best to seek medical advice as a precaution.

Lower abdominal pain is pain that occurs below a person’s belly button. Bloating refers to a feeling of pressure or fullness in the abdomen, or a visibly distended abdomen. Sometimes, these symptoms occur together.

Though occasional lower abdominal pain and bloating are common, a person should speak to their doctor if it becomes a regular occurrence. In some cases, this combination of symptoms may indicate an underlying issue that requires medical treatment.

Keep reading for more information on some of the more common causes of abdominal pain and bloating. We also outline various treatment options for this combination of symptoms.

Causes of both abdominal pain and bloating

There are several causes of combined lower abdominal pain (LAP) and bloating. Some relatively harmless, or benign, causes include:

  • consumption of high fat foods
  • swallowing too much air
  • stress

In some cases, LAP and bloating can occur as a result of an underlying medical condition, such as:

  • constipation
  • food intolerances, such as lactose or gluten intolerance
  • gastroesophageal reflux disease (GERD), although this more commonly causes upper abdominal pain-gastroenteritis, which is inflammation of the gastrointestinal (GI) tract that causes vomiting and diarrhoea
  • diverticulitis, which is inflammation or infection of part of the large intestine
  • ileus, which is a condition that slows the function of the small and large intestine
  • delayed stomach emptying, or gastroparesis, which is a complication of diabetes mellitus
  • intestinal obstruction
  • inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

Other conditions that can cause LAP and bloating are specific to females. These include:

  • menstrual pain
  • endometriosis
  • ovarian cysts
  • pelvic inflammatory disease (PID)
  • pregnancy
  • ectopic pregnancy

LAP and bloating can also be due to conditions that do not necessarily affect the stomach, intestines, or reproductive organs. These conditions include;

  • drug allergies
  • side effects of certain medications
  • hernia
  • cystitis, or infection of the urinary tract infection
  • appendicitis, or inflammation of the appendix
  • kidney stones

When to see a doctor

If the cause of LAP and bloating is relatively benign, symptoms should go away within a few hours to days.

A person should see a doctor if:

  • their symptoms last longer than a few days
  • their symptoms begin to interfere with their daily life
  • they are pregnant and are unsure of the cause of LAP and bloating

People should seek immediate medical attention if vomiting or the inability to pass gas occur alongside LAP and bloating.

People who experience LAP and bloating along with one or more of the following symptoms should seek emergency medical attention:

  • sudden worsening of pain
  • fever
  • unusual vaginal discharge
  • bloody stool
  • unexplained weight loss
  • severe nausea and vomiting

Diagnosis

To make a diagnosis, a doctor will begin by carrying out a physical examination. An initial examination will involve applying pressure to the abdomen. This will help the doctor to check the location of pain and to feel for any abnormalities.

A doctor will also make a note of the person’s medical history, and any other symptoms they experience. They may also ask whether there is anything that triggers the pain or makes it worse.

Diagnostic tests, such as urine, blood, or stool tests, may also be necessary. These can help to identify signs of infection or other underlying conditions.

In some cases, a doctor may order one of the following imaging tests to check for abnormalities in the abdomen:

  • ultrasound
  • X-ray
  • CT or MRI

If the imaging tests come back normal, a doctor may perform a colonoscopy for a closer look inside the intestines.

Treatment

The following are some general home treatment options that may help to alleviate symptoms of LAP and bloating:

  • increasing fluid intake
  • exercising to help alleviate gas and bloating
  • taking over-the-counter (OTC) pain medications
  • taking OTC antacids

If home treatments do not work, a person should speak to their doctor about other treatment options. These will vary, depending on the cause of LAP and bloating. However, some examples include:

  • prescription medications to treat pain and bloating
  • antibiotics to help treat a bacterial infection
  • emergency surgery to remove a ruptured appendix

Prevention

There are some steps a person can take to help alleviate LAP and bloating. Two key steps include quitting smoking and avoiding trigger foods.

The following are examples of foods that may cause or contribute to LAP and bloating:

  • high fat foods
  • certain plant-based foods, such as cabbage, lentils, and beans
  • dairy products if a person is lactose intolerant
  • carbonated drinks
  • beer
  • chewing gum
  • hard candy

Also, people may benefit from increasing their intake of high fiber foods such as fruits, vegetables, and whole grains. This will help to prevent constipation and associated bloating.

If an underlying condition is the cause of LAP and bloating, then treating the condition should help to alleviate these symptoms.

Outlook

There are many potential causes of lower abdominal pain and bloating. Some causes are relatively benign and easy to treat, while others may be more serious.

Occasional lower abdominal pain and bloating are usually not a cause for concern. However, people should see a doctor if their symptoms worsen, last more than a few days, or disrupt their daily activities.

People who experience additional symptoms, such as vomiting, fever, or blood in the stool, should seek emergency medical attention.

In some cases, people can prevent lower abdominal pain and bloating by avoiding foods that may trigger these symptoms.

Asthma makes people’s airways hyperreactive, causing them to get smaller and often resulting in difficulty breathing. While it is not always possible to prevent asthma, people can try to avoid risk factors such as smoking, being overweight, and having prolonged exposure to air pollution.

According to the Centers for Disease Control and Prevention (CDC)asthma is responsible for around 10 deaths per day in the United States.

Although asthma affects both children and adults, adults are four times as likely to die from asthma-related complications than young people.

So, preventing asthma symptoms whenever possible is vital. The following are some avoidable asthma risk factors.

1. Smoking

Exposure to firsthand cigarette smoke can irritate the airways and make it more likely that a person with asthma will have more frequent and severe symptoms.

This is also true for secondhand smoke. Even when people smoke outside the home or in a car, the lingering smoke and chemicals can expose others to secondhand smoke.

Children whose mothers smoke cigarettes during pregnancy are also at greater risk of asthma than children whose mothers do not, according to the American Lung Association.

2. Obesity

Doctors are not yet sure of the underlying cause, but obesity seems to be linked with asthma. Scientists have a theory that obesity can cause inflammation in the body, including in the airways, leading to asthma.

Obesity increases the amount of specific inflammatory factors that can increase the number of white blood cells in the body. This may cause inflammation and airway irritation.

3. Air pollution

People who live in urban areas, where there is more smoke and smog, are more likely to have asthma. Smog is darker air pollution that tends to be present in bigger cities with more vehicles and factories.

Ozone, which is a major component of smog, can trigger asthma symptoms such as wheezing and shortness of breath.

As well as ozone, smog contains sulfur dioxide, which can irritate the airways and trigger asthma attacks.

4. Occupational exposures

Scientists have linked exposure to irritants such as pesticides to a higher risk of asthma. This risk extends beyond those who work with pesticides, such as farmers.

In fact, other at-risk groups include:

  • children of pesticide workers who store equipment near the home or wear clothes that carry pesticide residue
  • people who live near pesticide-treated areas or factories
  • people who live in agricultural areas where it is likely that pesticide spraying occurs indoors or outdoors

Exposure to harsh chemicals such as cleaning products may also be a risk factor for asthma. This is especially true for spray cleaning products distributed into the air.

5. Allergies

Allergens such as pet dander and pollen can trigger asthma attacks. People who have allergy-related conditions such as eczema and allergic rhinitis are more likely to have asthma.

As a result, avoiding allergic triggers can help prevent asthma reactions.

Examples of allergens that may trigger asthma include:

  • pet dander
  • dust mites
  • mold
  • pollens

If certain allergens trigger asthma symptoms, avoiding these triggers whenever possible is vital.

6. Respiratory infections

Children with asthma who have upper respiratory infections are more likely to experience wheezing. During an upper respiratory infection, such as a cold, the airways may be more prone to the wheezing that can lead to asthma symptoms.

While it is not always possible to prevent upper respiratory infections, it is vital to take steps to prevent illness in children. A caregiver can achieve this by encouraging frequent handwashing and avoiding exposure to people with colds or other respiratory infections.

Family history

Scientists have found more than 100 genes potentially responsible for asthma, according to a study paper in the Italian Journal of Pediatrics. However, no single gene by itself causes asthma.

Some research suggests that 35–95 percent of people with a family history of asthma will get the condition, according to a study paper in the journal Pediatrics & Neonatology.

Although it is not possible to change family history, people can be aware that others in their family have asthma and seek treatment if they start to have asthma-like symptoms.

Such people can also avoid common asthma triggers if they know they have a genetic predisposition to the condition.

Treatment and prevention

Some strategies to help prevent asthma symptoms include:

  • stopping smoking and refraining from smoking around others, especially children
  • avoiding public places where cigarette smoking occurs
  • limiting outdoor exposure on days with heavy smog or smoke
  • encouraging a diet high in fruit, vegetables, whole grains, and lean protein
  • encouraging childhood vaccinations that can prevent common respiratory infections that could lead to worsening asthma symptoms
  • avoiding allergens that trigger asthma attacks, such as pet dander, dust mites, mold, and pollen

A person should consider talking with their doctor if they think that allergens are triggering their asthma.

Recognizing asthma symptoms, such as wheezing, coughing that is worse at night, and shortness of breath, is vital because it can help people seek suitable treatments for the condition.

An estimated 75 percent of severe asthma attacks are preventable, according to the American Academy of Allergy, Asthma, & Immunology.

Doctors can prescribe many different treatment types and combinations to help a person treat their asthma. This includes inhalers to open up the airways, steroid medications to reduce inflammation, and other oral medications that help reduce airway reactivity.

If a person takes them consistently, medications alongside preventive efforts can help prevent asthma attacks from occurring.

Summary

Asthma can affect a person’s quality of life and cause serious respiratory distress that can sometimes be life-threatening. Knowing risk factors and triggers for the condition can help a person engage in preventive efforts.

If a person has asthma or concerns about risk factors, it is important that they talk with their doctor about how to consistently and effectively manage their symptoms.

Omega-3 fatty acids are fats commonly found in plants and marine life.

Two types are plentiful in oily fish:

Eicosapentaenoic acid (EPA): The best-known omega-3 fatty acid, EPA helps the body synthesize chemicals involved in blood clotting and inflammation (prostaglandin-3, thromboxane-2, and leukotriene-5). Fish obtain EPA from the algae that they eat.

Docosahexaenoic acid (DHA): In humans, this omega-3 fatty acid is a key part of sperm, the retina, a part of the eye, and the cerebral cortex, a part of the brain.

DHA is present throughout the body, especially in the brain, the eyes and the heart. It is also present in breast milk.

Health benefits

Some studies have concluded that fish oil and omega-3 fatty acid is beneficial for health, but others have not. It has been linked to a number of conditions.

Multiple sclerosis

Fish oils are said to help people with multiple sclerosis (MS) due to its protective effects on the brain and the nervous system. However, at least one study concludedTrusted Source that they have no benefit.

Prostate cancer

One study found that fish oils, alongside a low-fat diet, may reduce the risk of developing prostate cancer. However, another study linked higher omega-3 levels to a higher risk of aggressive prostate cancer.

Research published in the Journal of the National Cancer Institute suggested that a high fish oil intake raises the risk of high-grade prostate cancer by 71 percent, and all prostate cancers by 43 percent.

Post-partum depression

Consuming fish oils during pregnancy may reduce the risk of post-partum depression. Researchers advise that eating fish with a high level of omega 3 two or three times a week may be beneficial. Food sources are recommended, rather than supplements, as they also provide protein and minerals.

Mental health benefits

An 8-week pilot study carried out in 2007 suggested that fish oils may help young people with behavioral problems, especially those with attention deficit hyperactivity disorder (ADHD).

The study demonstrated that children who consumed between 8 and 16 grams (g) of EPA and DHA per day, showed significant improvements in their behavior, as rated by their parents and the psychiatrist working with them.

Memory benefits

Omega-3 fatty acid intake can help improve working memory in healthy young adults, according to researchTrusted Source reported in the journal PLoS One.

However, another study indicated that high levels of omega-3 do not prevent cognitive decline in older women.

Heart and cardiovascular benefits

Omega-3 fatty acids found in fish oils may protect the heart during times of mental stress.

Findings published in the American Journal of Physiology suggested that people who took fish oil supplements for longer than 1 month had better cardiovascular function during mentally stressful tests.

In 2012, researchers noted that fish oil, through its anti-inflammatory properties, appears to help stabilizeTrusted Source atherosclerotic lesions.

Meanwhile, a review of 20 studies involving almost 70,000 people, found “no compelling evidence” linking fish oil supplements to a lower risk of heart attack, stroke, or early death.

People with stents in their heart who took two blood-thinning drugs as well as omega-3 fatty acids were found in one study to have a lower risk of heart attack compared with those not taking fish oils.

The AHA recommend eating fish, and especially oily fish, at least twice a week, to reduce the risk of cardiovascular disease.

Alzheimer’s disease

For many years, it was thought that regular fish oil consumption may help prevent Alzheimer’s disease. However, a major study in 2010 found that fish oils were no better than a placebo at preventing Alzheimer’s.

Meanwhile, a study published in Neurology in 2007 reportedTrusted Source that a diet high in fish, omega-3 oils, fruit, and vegetables reduced the risk of dementia and Alzheimer’s.

Vision loss

Adequate dietary consumption of DHA protects people from age-related vision loss, Canadian researchers reported in the journal Investigative Ophthalmology & Visual Science.

Epilepsy

A 2014 study published in the Journal of Neurology, Neurosurgery & Psychiatry claims that people with epilepsy could have fewer seizures if they consumed low doses of omega-3 fish oil every day.

Schizophrenia and psychotic disorders

Omega-3 fatty acids found in fish oil may help reduce the risk of psychosis.

Findings published in Nature Communications details how a 12-week intervention with omega-3 supplements substantially reducedTrusted Source the long-term risk of developing psychotic disorders.

Health fetal development

Omega-3 consumption may help boost fetal cognitive and motor development. In 2008, scientists found that omega-3 consumption during the last 3 months of pregnancy may improve sensory, cognitive, and motor development in the fetus.

Foods

The fillets of oily fish contain up to 30 percent oil, but this figure varies. White fish, such as cod, contains high concentrations of oil in the liver but less oil overall. Oily fish that are rich in omega-3 fatty acids include anchovies, herring, sardines, salmon, trout, and mackerel.

Other animal sources of omega-3 fatty acids are eggs, especially those with “high in omega-3” written on the shell.

Vegetable-based alternatives to fish oil for omega 3 include:

  • flax
  • hempseed
  • perilla oil
  • spirulina
  • walnuts
  • chia seeds
  • radish seeds, sprouted raw
  • fresh basil
  • leafy dark green vegetables, such as spinach
  • dried tarragon

A person who consumes a healthful, balanced diet should not need to use supplements.

Risks

Taking fish oils, fish liver oils, and omega 3 supplements may pose a risk for some people.

  • Omega 3 supplements may affect blood clotting and interfere with drugs that target blood-clotting conditions.
  • They can sometimes trigger side effects, normally minor gastrointestinal problems such as belching, indigestion, or diarrhea.
  • Fish liver oils contain high levels of vitamins A and D. Too much of these can be poisonous.
  • Those with a shellfish or fish allergy may be at risk if they consume fish oil supplements.
  • Consuming high levels of oily fish also increases the chance of poisoning from pollutants in the ocean.

It is important to note that the FDA does not regulate quality or purity of supplements. Buy from a reputable source and whenever possible take in Omega 3 from a natural source.

The AHA recommend shrimp, light canned tuna, salmon, pollock and catfish as being low in mercury. They advise avoiding shark, swordfish, king mackerel, and tilefish, as these can be high in mercury.

It remains unclear whether consuming more fish oil and omega 3 will bring health benefits, but a diet that offers a variety of nutrients is likely to be healthful.

Anyone who is considering supplements should first check with a health care provider.

“I used to be a full-time patient at this facility,” says Michelle Eze, a drug abuse survivor, as she signs her name in the register for a check-up with her psychiatrist at Karu General Hospital in Abuja, Nigeria’s Federal Capital Territory(FCT).

“I’m so glad I sought help in time as I was dependent on drugs and it cost me so much. It negatively affected the relationship with my family and people around me. I was disowned and left to face this harsh world all by myself. Drug abuse is a problem we should all join hands and fight it.”

Michelle is now a full-time ambassador against drug abuse among women.

One out of every four people who uses drugs in Nigeria is a woman, according to a 2018 report by the United Nations Office on Drugs and Crime (UNODC).

Over 300,000 Nigerians are high-risk drug users

Approximately 376 000 people – or about 0.4% of the Nigerian population aged 15-64 – are reckoned to be high-risk drug users, according to the UNODC report. Nearly 90% of these users regularly take opioids – particularly pharmaceutical opioids such as tramadol codeine, or morphine – while the others take cocaine or amphetamines.

Over 20% of the high-risk drug users inject drugs, with women first injecting on average at 20 years old and men first injecting on average at around 21 years old. HIV prevalence among women who inject drugs is almost seven times higher than among men who inject, according to the 2010 National Agency for the Control of AIDS (NACA) Integrated Biological and Behavioural Surveillance survey.

“At Karu hospital, we receive roughly 15 patients every day and usually at least half of them report to be using one drug or another,” says Pius Wabass, a psychiatric nurse on the Karu General Hospital’s psychiatry ward.

“These patients are often so young – under 40 – and, of late, more women are checking into our facility. The misuse of drugs

has serious health repercussions. Medically, opioids are primarily used for pain relief, including anaesthesia, while amphetamines are powerful stimulators of the central nervous system used to treat some medical conditions.”

Efforts to respond to drug use in Nigeria

As countries including Nigeria make efforts to respond to drug use among the population, health experts note that there are some factors that affect women more than men. A lot of factors have been identified as putting women at increased risk, some are psychological, cultural, social and economic aspects of their lives. Another issue is the general perception that drug use is a male issue and women users are often reluctant to seek help. The Federal Ministry of Health (FMOH) is now addressing this.

“The FMoH has taken up this challenge and currently working with all stakeholders to respond to drug use among young people, especially women,” explains Dr Jimoh Salaudeen from the Food and Drug Division, FMOH. As part of the response, a women-specific drug treatment programme has been established at the federal neuropsychiatric hospital in Kware in Sokoto State and the ministry hopes to replicate such centres across the country.”

Dr Salaudeen continues: “There is a strong linkage between opioid use disorders and health conditions such as preterm births, stillbirths, poor foetal growth, maternal death and neonatal abstinence syndrome. This is why the Ministry of Health has prioritized sexual reproductive health, particularly for women, within the context of drug treatment and harm reduction.”

Working assiduously to reduce drug demand and harm in Nigeria

The FMOH, with the support of WHO, established the National Technical Working Group (NTWG) on drug demand and harm reduction in Nigeria in May 2019.

“The NTWG is working under the leadership of the Minister of Health and is actively engaged in implementing a comprehensive public health response to the challenge of drug use in the country,” says Dr Rex Mpazanje, WHO Cluster Coordinator for Communicable and Non Communicable Diseases.Close

“This effort also includes bringing together different stakeholders at the national and state level for a concerted response. This includes advocacy, capacity building and resource mobilization to ensure promotion of evidence-based prevention activities and the availability of drug treatment and harm reduction programmes at community level.”

Target 3.5 of the United Nations 2030 Sustainable Development Goals (SDGs) is to strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol. WHO Nigeria will continue to support to the Government of Nigeria in achieving this goal.

The behavioural medicine unit of the Karu General Hospital, Abuja. Many drug abuse patients are treated here.

As the world marks the 2019 World Aids Day today, stigmatisation and discrimination against Persons Living With HIV/AIDS (PLWHAs) remain the twin factors frustrating a successful fight against the dreaded scourge.

Not only have they prevented people from coming forward to know their status and consequently commence early treatment where result turns out positive, these factors also pose a threat to meeting the 2030 global target to end AIDS.

For PLWHAs, the constant psychological trauma they contend with at treatment centres and in communities where they live further makes life difficult. In fact, the reality of living with a life-threatening ailment finds expression daily in the discriminating and stigmatising behaviours directed at them within their environment.

For instance, “You this dead woman, a living corpse, leave my house!” was how Funmi Okafor, a mother of four children was welcomed as she returned home from the hospital after receiving the news that she tested positive to Human Immunodeficiency Virus (HIV), after weeks of constant sickness that defied treatment.

Okafor, who was squatting with a friend, (alongside her kids) after the death of her husband, met her belongings outside, drenched in rainwater, while her friend stood by the door post yelling at her to move away with her children.

With nowhere else to put up, she was forced to move into an incomplete building as her new home.

The mother of four’s journey to this sad realisation started when she noticed rashes on her body, while she was constantly ill and began to lose weight in the process.

With the constant illness, which she thought was malaria fever (as many people would think first), she, however, decided to visit a nurse, whom she told about her constant “malaria fever.”

The nurse took her blood sample to the laboratory to carry out malaria, typhoid, and HIV tests. And on confirming the cause of Okafor’s ailment, the nurse, due to lack of knowledge about patient’s right to confidentiality, refused to inform Okafor that she tested positive to HIV, but rather spread the news around the community where she lived in Edo state.

Determined to know the ailment that has caused her to emaciate, with rashes all over her body, Okafor visited a general hospital, where after the test she was pronounced HIV positive.

“I went to a nurse and told her that I had malaria fever. She took my blood sample to the laboratory. But instead of her disclosing my condition to me, she told my friend, who spread the rumour around. I still was not aware of my status because she did not disclose it to me. It was only after I went to the general hospital that I knew my condition.

“The day I was supposed to be placed on drugs, it rained heavily, and by the time I returned to where I squatted with my children, my host had thrown out all my belongings. After yelling at me and calling me names, I packed what was left of my property and moved,” she recalled.

Before long, Okafor became the butt of jokes in the community where she lived in Edo State, and others avoided contact or any relationship with her. Since she could not stand being ostracised like that, she relocated to Lagos with her children.

She lamented: “It is not easy to cope with life when you are HIV positive. My father and husband are late, while my mother and siblings are in the village. But I was almost alone in the world before I relocated to Lagos because everyone started deserting me,” she said.

CHINWE IKE was pregnant when she discovered that she was HIV positive. She felt like taking her life and for several nights thoughts of suicide assailed her, especially because she did not know what the virus was all about, as people kept saying different things about it.

At the early stage of her pregnancy in 2006, she was on admission to a hospital for one week before she was transferred to another hospital for further treatment.

However, when she went into labour, her HIV status was confirmed in a private hospital, and the doctor in charge of the case requested that she invited a trusted relative over, who would thereafter break the news to her in a calm manner, and get her to accept her condition.

“I decided to invite my friend, who is a nurse instead of a relative. Unfortunately, after she heard of my condition, she went about scandalising me to the extent that my landlady came to me one day and asked me to leave her house. It was afterward that I discovered that it was that my nurse friend that fed everyone with details of my HIV status. Since my landlady insisted that I should leave her apartment, I did,” she said.

Ike added that it was after she left the compound before she started understanding many things about the disease, her rights as a Person Living With HIV (PLWHA). “Just because I did not know anything I had to leave the compound because they were threatening to kill me. Since then I have been living with that stigma and picking up the pieces of my life.

“It is 13 years now and I am still alive. My friend told me then that I had dug my grave, but after some years, I went back to my former neighbourhood for them to see that I am still alive, and when they saw me, most of them were surprised. However, because of the scandal, I lost my job as a secretary/cashier at a company located at the Alaba International Market, Lagos.”

Since 2001 that Chika Nnoroka discovered that she and her 18-month-old son were HIV positive, she has faced extreme stigmatisation and discrimination, not only in her community but also at medical facilities.

She narrated, “The stigmatisation and discrimination got so intense that I did not believe that I and my son would survive. People were keeping away from us, even the doctors and nurses were all stigmatising people living with HIV to the extent that most of us were finding it difficult to go to the facility to access treatment.”

Nnoroka said women were more vulnerable to HIV/AIDS stigmatisation, as many that have lost their husbands were being denied by their family members and friends. Their rights and privileges are also denied.

“By the time I got information from the doctor that there was a treatment to suppress the virus, I was a little bit relieved, but I was afraid for my little son, who just came into this world. I was not bothered about myself,” she said.

Chika’s son, who is now a 20-year-old, is waxing strong with the help of the drugs.

Misconceptions On Mode Of Transmission
Okafor, who has lived with the virus for 19 years said, “most people think that all women living with HIV are prostitutes. My husband was the one that deflowered me; you can contract HIV/AIDS from anywhere.

“I want people to change the narrative that ladies living with HIV/AIDS are wayward, I believe that is why people do not want to come out to check their status or speak up that they have the virus.”

Okafor who narrated how she contracted the virus said, “It was late but the symptoms in my husband’s body showed that he had HIV and he lied to me that it was severe cough. His close friend was the one who disclosed to me that my husband was HIV positive and that his family is keeping it away from me. He said I should go and check myself if I also have the virus.

“I did my test and found out that I was positive. My husband was never a womaniser; I suspect he contracted HIV when he was stabbed him in the chest. He had internal bleeding in his lungs and the hospital asked us to get nine pints of blood, this was during the early 1980s. I strongly believe that it was then that he contracted the disease.”

Ike on her part said: “I am somebody that does not flirt around, I contracted HIV through my husband. It was when I got married to him that I discovered that I had the virus. Initially, I could not believe that I was down with that kind of health problem.”

According to the World Health Organisation (WHO), HIV can be transmitted through close contact with specific body fluids of persons living with the virus. Apart from fluids such as blood, semen, and breast milk; unprotected sex, body piercing equipment, or sharp objects are also vehicles of transmission. Transmission can also be done through mother-to-baby during pregnancy and through contaminated blood transfusion.

‘Cost’ Of Drugs Limiting Access To Treatment
With many of the people living with the virus jobless, and without hope of employment, affording the drugs for treatment and other medical procedures becomes difficult.

Ike said: “These drugs that we are taking are to sustain our lives and we have to eat well before taking them. What I am emphasising on is that the government should help us because right now, we are paying for drugs, and not everyone can afford it. We pay N2, 000 for consultation; N1, 000 for drugs and almost N3, 000 for laboratory. Not everybody that is HIV positive can afford it, so we are begging the government to help people living with HIV, by making drugs and treatment procedures free. It is laughable when we are told that the drugs are free of charge, and when we get to the hospital we are told to pay for the procedures that I have mentioned.

Implications
Findings by The Guardian reveal that because of rising stigmatisation, many people living with HIV/AIDS are staying away from hospitals, while those who suspect their status do not make themselves available for examination. Because of all these, and the inability of many to access treatment early, more people are getting infected and dying from the virus.

This is also why some cases have remained undetected, a development that poses more danger to the country, as those who are unaware of their status could infect others, thereby increasing the spread of the virus.

Ike, who revealed an earlier encounter, which nearly ended her life said: “When I went to a laboratory to do another test to confirm my status, the lab scientists told me that people with the virus can neither get married nor have children. With that impression, I refused to go to the hospital or any other institution for treatment. I concluded that I would commit suicide at home one day.”

Ike who lost her husband to the virus continued: “Because of this stigmatisation people find it difficult to disclose their HIV status because once they do, the news spreads so fast and then sooner than later they are shut out of their families and the society. Where I reside now, I have kept my HIV status a big secret.

“Some people do not even believe that there is something like a discordant couple, where either of the partners is negative, while the other is positive. The reality is that when two people are dating and then one discloses his or her HIV status to the other, the relationship breaks up immediately because they do not believe that those who are positive can have children who are HIV negative,” she explained.

Ike added that her refusal to take treatment cost her two-month-old her life after she developed cough and died. This made her summon courage and head to head to the hospital for treatment.

A new study adds to the evidence that sleep deprivation has a significant effect on our day-to-day functioning. The authors warn that if we have slept poorly overnight, we are twice as likely to commit errors, some of which may well be very costly.

Having a good night’s sleep is key to maintaining both physical and cognitive health. Our bodies know this instinctively, and researchers have proved many a time that this is true.

For example, at Medical News Today, we have covered studies showing that sleep protects vascular health, helps maintain brain health, and may even give the immune response a boost.

Conversely, poor sleep may lead to cardiovascular disease, contribute to depression, and increase a person’s risk of diabetes.

Some researchers have also warned that sleep loss can affect aspects of our memory and visual perception so severely that driving after a sleepless night can be as dangerous as drunk driving.

Following on from such evidence, researchers from Michigan State University’s Sleep and Learning Lab in East Lansing have conducted further research on sleep, attention, and higher order cognitive functioning.

Their findings, which feature in the Journal of Experimental Psychology: General, show that sleep loss has an important effect not just on how well we can maintain our focus, but also on how well we can follow complex procedures — an aspect that they refer to as “placekeeping.”

For their study, the investigators recruited 138 participants, whom they split into two groups: 77 people stayed in the laboratory overnight and had no sleep, while the remaining 61 participants slept at home.

The evening before, all of the volunteers took part in two tasks. The first one measured their reaction time to a particular stimulus, and the second one assessed their place keeping abilities — that is, how well they were able to follow the particular steps of a complex process even with repeated interruptions.

On the morning after, each participant had to repeat these tasks to see how their performance compared with that of the previous evening. The researchers found that the participants who had experienced sleep deprivation struggled significantly.

“Our research showed that sleep deprivation doubles the odds of making place keeping errors and triples the number of lapses in attention, which is startling,” says study co-author Kimberly Fenn.

“Sleep-deprived individuals need to exercise caution in absolutely everything that they do and simply can’t trust that they won’t make costly errors. Oftentimes — like when behind the wheel of a car — these errors can have tragic consequences,” she warns.

Although it may not come as a surprise that lack of sleep reduces a person’s ability to focus, the researchers note that their recent study shows that sleep deprivation actually affects higher cognitive functioning, interfering with memory recall to a large extent.

“Our findings debunk a common theory that suggests that attention is the only cognitive function affected by sleep deprivation,” says first author Michelle Stepan.

“Some sleep deprived people might be able to hold it together under routine tasks, like a doctor taking a patient’s vitals. But our results suggest that completing an activity that requires following multiple steps, such as a doctor completing a medical procedure, is much riskier under conditions of sleep deprivation.”

Michelle Stepan

“After being interrupted [as they were performing complex tasks], there was a 15% error rate in the evening, and we saw that the error rate spiked to about 30% for the sleep deprived group the following morning,” notes the first author.

“The rested participants’ morning scores were similar to the night before,” she adds. This finding, the investigators argue, should serve as a warning to people who experience sleep loss not to underestimate the effect that it can have on their daily lives.

“There are some tasks people can do on autopilot that may not be affected by a lack of sleep. However, sleep deprivation causes widespread deficits across all facets of life,” Fenn emphasizes.

Everyone, including people in excellent shape, can experience pain in their chest during exercise. The many potential causes range from benign to potentially life-threatening.

Everyone who exercises regularly should recognize the symptoms that can accompany chest pain when the underlying issue is serious.

Read on to learn more about the causes of chest pain during exercise and how to treat and prevent them.

Causes

Serious conditions, such as heart attacks, and less serious issues, such as muscle strains and asthma, can lead to chest pain during exercise.

Heart attack

Myocardial infarction is the medical term for a heart attack. A heart attack occurs when the coronary arteries become blocked. The blockage causes the heart to lose oxygen. If a person does not receive treatment, the heart muscle can die.

A heart attack can cause pain in the jaw, back, chest, and other parts of the upper body. The pain may go away and return, or it may last longer than a few minutes.

Other symptoms of a heart attack include:

  • pressure or pain in the chest
  • sweating
  • nausea
  • dizziness
  • anxiety
  • shortness of breath

Heart attack symptoms can vary. Both men and women are likely to report chest pain, but women are more likely to experience:

  • back pain
  • nausea
  • vomiting
  • jaw pain
  • shortness of breath

If a person experiences any symptoms of a heart attack, they should seek immediate medical attention.

According to the American Heart Association, the most common risk factors for a heart attack include:

  • Age. People ages 65 and older are most at risk.
  • Sex. Men have a much higher risk, even when they are younger, than women.
  • Genetics. African-Americans and people with a family history of heart disease are more vulnerable to heart attacks and heart disease.

Angina pectoris

Angina pectoris, or angina, is a pain that stems from the heart. The main cause of angina is a lack of blood flow to the area. When this occurs, a person may feel tightness, pain, or pressure in their chest.

Some additional symptoms of angina include:

  • tightness in the arms or jaw
  • shortness of breath
  • fatigue
  • nausea

Exercise and stress can cause angina, and people often mistake this pain for a heart attack. A person should seek immediate medical attention if they experience any symptoms of a heart attack.

According to the American College of Cardiology, women are three times more likely than men to experience throat discomfort and jaw tightness or pain because of angina.

Women may also experience sharper pain, while men are more likely to experience feelings of pressure associated with angina.

Hypertrophic cardiomyopathy (HCM)

According to the American Heart Association, HCM is a common condition that can affect nearly anyone.

HCM occurs when the cells of the heart muscle enlarge, causing the walls of the ventricles to thicken.

HCM can also result if the wall dividing the left and right sides of the heart grows and puts pressure on the ventricles.

In either case, the heart has to work harder to pump blood, and a person may experience:

  • dizziness
  • shortness of breath
  • chest pain
  • fainting

In some people, HCM presents no symptoms. In rare cases, a person may experience sudden cardiac arrest during physical activities.

Asthma

Asthma is a common condition that affects the airways in the lungs.

People with asthma have inflamed airways that tighten in response to triggers, including exercise. The medical term for this is exercise-induced bronchoconstriction.

A person with a family history of asthma is more likely to develop it. People with asthma may experience:

  • wheezing
  • coughing
  • chest tightness
  • shortness of breath

Muscle strain and injuries

According to a research paper published in 2013, nearly half of all reported cases of muscle strains in the chest involve the intercostal muscles. These help a person breathe and stabilize the chest.

Common symptoms of muscle strains in the chest include:

  • sharp pain
  • bruising
  • swelling
  • pain while breathing
  • difficulty moving the area

The most common cause of a muscle strain is overuse. As a result, people who regularly exercise the chest muscles are more likely to experience a strain or tear.

The risk of chest muscle strains varies by age group:

  • Older adults are more likely to get this type of strain from a fall.
  • Children are least likely to develop this strain.
  • Adults are most likely to sustain this strain from exercise, sports, or high-impact crashes.

When to see a doctor

Speak to a doctor about any new, unidentified, or worsening chest pain. A doctor can help determine the underlying cause and recommend a treatment plan, which may include lifestyle changes.

Seek emergency medical treatment for any symptoms of a heart attack. Chest pain is the most common symptom, and certain other symptoms, such as nausea, are more common in women than men.

A person with exercise-induced asthma should seek specific treatment. A doctor may be able to prescribe medication and suggest other ways to reduce symptoms. This may enable a person to continue exercising or participating in sports.

Prevention and precautions

Not all chest pain is preventable. However, there are some general tips for preventing some causes of chest pain, such as heart attacks, strains, and asthma.

A person may be able to prevent chest pain by:

  • eating a balanced diet
  • exercising regularly
  • avoiding tobacco smoke and alcohol
  • managing high blood pressure with medications
  • avoiding activities that increase the risk of physical injury
  • controlling asthma with medications

Outlook

A range of conditions, from muscle strains to heart attacks, can cause chest pain during exercise.

Anyone who experiences this pain should consult a healthcare provider about the best course of treatment. Some causes of chest pain can be serious.

Many people can prevent chest pain by making lifestyle changes and following a doctor’s treatment plan.

If any symptoms of a heart attack occur, seek immediate medical attention.

People with high blood pressure taking medication for their condition are more likely to benefit from the therapy if they have good oral health, according to new research in the American Heart Association’s journal Hypertension.

Findings of the analysis, based on a review of medical and dental exam records of more than 3,600 people with high blood pressure, reveal that those with healthier gums have lower blood pressure and responded better to blood pressure-lowering medications, compared with individuals who have gum disease, a condition known as periodontitis. Specifically, people with periodontal disease were 20 percent less likely to reach healthy blood pressure ranges, compared with patients in good oral health. Considering the findings, the researchers say patients with periodontal disease may warrant closer blood pressure monitoring, while those diagnosed with hypertension, or persistently elevated blood pressure, might benefit from a referral to a dentist.

“Physicians should pay close attention to patients’ oral health, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care,” Pietropaoli said. “Likewise, dental health professionals should be aware that oral health is indispensable to overall physiological health, including cardiovascular status,” said study lead investigator Davide Pietropaoli, D.D.S., Ph.D., of the University of L’Aquila in Italy. The target blood pressure range for people with hypertension is less than 130/80 mmHg according to the latest recommendations from the American Heart Association/American College of Cardiology.

In the study, patients with severe periodontitis had systolic pressure that was, on average, 3 mmHg higher than those with good oral health. Systolic pressure, the upper number in a blood pressure reading, indicates the pressure of blood against the walls of the arteries. While seemingly small, the 3mmHg difference is similar to the reduction in blood pressure that can be achieved by reducing salt intake by 6 grams per day (equal to a teaspoon of salt, or 2.4 grams of sodium), the researchers said.

The presence of periodontal disease widened the gap even farther, up to 7 mmHg, among people with untreated hypertension, the study found. Blood-pressure medication narrowed the gap, down to 3 mmHg, but did not completely eliminate it, suggesting that periodontal disease may interfere with the effectiveness of blood pressure therapy.

“Patients with high blood pressure and the clinicians who care for them should be aware that good oral health may be just as important in controlling the condition as are several lifestyle interventions known to help control blood pressure, such as a low-salt diet, regular exercise and weight control,” Pietropaoli said.

While the study was not designed to clarify exactly how periodontal disease interferes with blood pressure treatment, the researchers say their results are consistent with previous research that links low-grade oral inflammation with blood vessel damage and cardiovascular risk.

Untreated or poorly controlled hypertension can lead to heart attacks, strokes and heart failure, as well as kidney disease. Hypertension is estimated to claim 7.5 million lives worldwide.

Red, swollen, tender gums or gums that bleed with brushing and flossing are tell-tale signs of inflammation and periodontal disease. So are teeth that look longer than before, a sign of receding gums, and teeth that are loose or separating from the gum line.

Co-authors on the research included Rita Del Pinto, M.D., PhD candidate; Claudio Ferri, M.D.; Mario Giannoni, M.D., D.D.S.; Eleonora Ortu, D.D.S., Ph.D.; and Annalisa Moaco, D.D.S., M.Sc., of the University of L’Aquila, Italy; and Jackson Wright Jr., M.D., Ph.D., of Case Western Reserve University.

heart-with-headphones
heart-with-headphones
“Music can pierce the heart directly; it needs no mediation,” wrote scientist Oliver Sacks. Medical research lends credibility to his observation, as classical music is known to lower heart rate and blood pressure. However, a new study shows that a little “mediation” from antihypertensive drugs goes a long way in helping the heart to find its natural, healthy rhythm.

Combining the soothing power of music with the beneficial effects of antihypertensive drugs seems to create a beautiful synergy that lowers the heart rate and blood pressure of people with hypertension.

This is the main result of a new study carried out by an international team of researchers. Their results are now published in the journal Scientific Reports.

“The inexpressible depth of music,” as Sacks called it in his book Musicophilia, has been shown before to have healing effects on the heart. Studies have suggested that music can lower the blood pressure, reduce the heart rate, and ease the distress of people living with heart conditions.

The comforting effects of music do not stop here. Music therapy was shown to help the heart to contract and push blood throughout the body, classical and rock music makes your arteries more supple, and listening to music during surgery helps to lower the heart rate to a more calming pace.

Given all of these intriguingly positive effects of music on the heart, could it be that music can also boost the positive effects of blood pressure medication?

This question puzzled the researchers — who were led by Vitor Engrácia Valenti, a professor in the Speech Language Pathology Department at the São Paulo State University in Brazil. So, they set out to investigate.

Adele and Enya boost hypertension drugs

Prof. Valenti and his colleagues investigated the effects of instrumental music on the heart rate and blood pressure of people with “well-controlled hypertension.” These were 37 participants who had been taking antihypertensive medication for a minimum of 6 months and a maximum of 1 year.

After taking their usual blood pressure medication, the participants listened to music for 60 minutes using earphones. The next day, they took their medication as usual, but they sat in silence with the earphones turned off for the same amount of time.

The songs that they listened to included instrumental piano versions of Adele’s “Someone Like You” and “Hello,” as well as an instrumental version of “Amazing Grace” by Chris Tomlin and “Watermark” by Enya.

The team took heart rate variability measurements at 20, 40, and 60 minutes after the participants took the blood pressure medication.

The heart rates of the music-listening participants dropped significantly 60 minutes after taking blood pressure medication, whereas when they did not listen to music, the heart rates did not slow down at all.

The effects of medication on blood pressure were also “more intense” when the participants were subjected to instrumental music.

We found that the effect of antihypertension medication on heart rate was enhanced by listening to music.”

Vitor Engrácia Valenti

The scientists speculate on the potential mechanisms that might explain the results. Referring to some of their previous research, they say, “We’ve observed classical music activating the parasympathetic nervous system and reducing sympathetic activity.”

The sympathetic nervous system is responsible for speeding up the heart rate and increasing the blood pressure, whereas the parasympathetic one does the opposite.

So, in addition to triggering the parasympathetic nervous system, the researchers hypothesize that music also stimulates gastrointestinal activity, which, in turn, might facilitate and speed up the absorption of blood pressure drugs.