New Study Shows Women Aren’t The Only Ones Who Can Use Contraception

Gynecology is one of my favorite specialties in medicine. I find it fascinated how the vagina, uterus and ovaries can do such an amazing thing: reproduction. However women aren’t the only things needed for conception, obviously a male is needed too.

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For years, it has been a woman’s job to protect against unwanted pregnancies using birth control and tracking our cycles. However there has recently been a change in events.

A new research study suggests that Men can take birth control shots to prevent pregnancy in their female partners. Researchers are still working to perfect the combination of hormonal contraceptives to reduce the risk of mild to moderate side effects, including depression and other mood disorders.

The hormones contained within the shot work on lowering the sperm count in males.

In the study the men were given injections of 200 milligrams of a long-acting progestogen called norethisterone enanthate (NET-EN) and 1,000 milligrams of a long-acting androgen called testosterone undecanoate (TU) for up to 26 weeks to suppress their sperm counts. The hormones were effective in reducing the sperm count to 1 million/ml or less within 24 weeks in 274 of the participants. The contraceptive method was effective in nearly 96 percent of continuing users. Only four pregnancies occurred among the men’s partners during the efficacy phase of the study.

However the injections gave some side effects that made 20 men leave the study. The men reported side effects including injection site pain, muscle pain, increased libido and acne. Also many mood disorders were reported such as depression.

Despite these side effects more than 75 percent of participants reported being willing to use this method of contraception at the conclusion of the trial.

This shot is not available yet but hopefully within a couple years, this may be an option for contraception.

Thankyou.

Drug Re purposing for Rare Diseases

Medicine is always changing, reforming and altering. In order to provide the best patient care there needs to be new innovation every day, or else not everybody’s needs will be satisfied.

You may wonder what I mean by ‘needs be satisfied’. Well withing British medicine the word ‘needs’ can be extremely broad. However in relation to today’s topic it means from the normal, common diseases to the rare uncommon diseases.

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In the EU if 1 in 2000 people have a particular disease, in order for it to be classified as rare. Also in the UK 3.5 million people live with rare diseases, and due to their rarity, can be chronic and life threatening. Sadly, at the current rate of development, it would take 500 years to formulate new drugs for all of these diseases. However there is something else we can do to speed up this process.

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Drug re purposing is discovering new uses for approved drugs to provide the quickest possible transition from bench to bedside. It works in two ways:  identification of candidate drugs and testing of their effect.  Prior knowledge about drugs and re purposing studies has helped us to follow these two steps.

Re purposing studies have allowed us to form intelligent drug screens, which specifically target a small set of drugs thought to act on the relevant pathway.

For example, the re purposing of one of the first monoclonal antibodies which has been re purposed from cancer into multiple sclerosis, acting to effectively boost the immune system to protect against the disease’s degenerative effects.

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After a re purposing opportunity is identified, the second major component of a re purposing study is the proof of concept. This is the completion of rigorous preclinical and clinical trials to test the effect of the candidate drug in the patient population. This rigorous testing process will hopefully help us cure more diseases than we could have ever dreamed of.

A massive advantage of using re purposed drugs is that its using known substances, that has been shown to be absorbed by the body and also more importantly, safe for human consumption. This means it saves time and money dramatically.

Thankyou.

 

Work Experience 101: Hospital Work Experience

From Tuesday 28th of February until Thursday 2nd March I was given the amazing opportunity to do 3 days of work experience at Derby Royal Hospital on the ‘Hospital Experience Program for Potential Medical Applicants’ AKA HOSPEX.

This work experience was very challenging for me. Although I was only observing, finding my way around the hospital and being thrown into an unfamiliar environment with people I have never met before was amazing growth for me. Overall I gained so much confidence from the experience as I had to be completely independent.

On the first morning, I was thrown straight in to shadowing a consultant in the renal department. I found it so interesting looking at all the dialysis machines and then doing ward rounds. The Doctors that I was following were all very nice, and they asked me some medical questions, to help me engage into the rounds. For example I got asked ‘How do we know this patient is internally bleeding?’. Honestly I had no idea. I then realized the patient had a really high heart rate and extremely low blood pressure, which to my surprise was actually one of the indicators. This was my first time being surrounded by ALOT of blood. I had no clue how I was going to react. I didn’t think I was squeamish at all, however after about 15 minutes of observing bloods being taken, I felt slightly weird. So I went for a walk outside and then I was completely fine. The consultant told me the first time that he was surrounded by blood he felt extremely squeamish but now as a consultant, it doesn’t bother him at all. From this, I learnt that it is completely fine to not be ‘ok’ with the practicality of being a Doctor at first. The sense of normality comes over time,  also surgery and other things involving blood seem less strange as Doctors are in absolute love with what they’re doing.

I was involved in two theatre sessions whilst I was there. One was removing calcification from the femoral artery, and the other was a fistula repair. Getting into the scrubs was so exciting, and I realized whilst watching the surgery that medicine is right for me and I am completely determined to do it. I was intrigued by all the different roles in the surgical team, and also completely shocked at how calm and relaxed the atmosphere was. Obviously I acknowledge that not all surgeries are like this- however the surgeons were calm and chatting to me as they operated.

I also spent time on a cardiac care unit. I learnt there that fluidity is so important in a medical team; as well as good teamwork. Every role is vital, from the consultant for medical care to the lady who does the tea and coffee rounds for wellbeing and comfort of the patients. Fluidity is important as it prevents patients waiting too long for treatment. If it wasn’t fluid, nothing would get done. Patients would be waiting hours to be taken to operations after they have been prepped, and even the well needed cups of tea would come at the wrong times. In metaphorical terms, a medical team must work as a well oiled machine.

Throughout the experience I learnt a lot about myself. The key thing I learnt is that, I am independent. I loved finding my way around the hospital and making sure I was on time (and time management is tricky for me, as I always find myself late) , confident when speaking to the consultants and making sure I was in the right place at the right time to see all sorts of medical procedures. Also I learnt that my imperfections as an aspiring medic are common and absolutely fine. For example, being squeamish when seeing blood for the first time. Imperfections exist for us to either sort them out, or accept them. I learnt that we do not progress in our skill unless we have imperfections to be fixed. However that one is to be taken with a pinch of salt, as if you have more serious imperfections and make big mistakes, that is not good.

Thank you for reading.

Research Shows ‘One Too Many’ Can Cause Fatal Heart Risk

Alcoholism. How common is it? It is extremely hard to answer that question. As many alcoholics live through their drinking abuse in silence. However just take this statistic: on average, it is estimated that the lives of five other people will be harmed when one individual becomes addicted to alcohol.

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According to Government statistics, more than 1.4 million people are dependent on alcohol in the UK. 33,000 people die each year due to alcohol-related incidents or associated health problems. Alcohol is involved in 15% of road accidents, 26% of drownings, and 36% of deaths in fires. A quarter of accidents at work are drink-related.

Realistically, every body loves and enjoys a drink from time to time, however when this becomes excessive, it can cause problems.

By definition cardiovascular disease  generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Thus possibly leading to death. In the UK it is estimated that 2.3 million people suffer from heart disease. New research examines the link between arterial stiffness – a significant indicator of cardiovascular health – and alcohol consumption over time.

The research was conducted by Darragh O’Neill, Ph.D., who is an epidemiological researcher at University College London in the United Kingdom. He found a link between heart disease and alchol. He found that overconsumption of alcohol can lead to stiffness of the arteries occurs when the walls of the blood vessels lack elasticity, which can negatively impact the artery’s response to variation in blood pressure.

Consistent moderate drinkers at risk were defined as those who consumed between 1-112 grams of ethanol per week, so less than the 14 units. One U.K. alcohol unit is roughly the equivalent to a shot of whiskey or half a pint of beer. So when thinking about it in terms of a night out, that is 7 pints of beer or about 11-14 shots.

Interestingly, after the longditudinal study it was found that after adjusting for several factors including BMI, heart rate, and arterial pressure, the associations were not significant for women, even though 73 percent of the study participants were men. By no means does this mean women are free to drink as much as they like, as there are many other health risks alcohol can lead to.

After vigorous research, they also found that alcoholism could lead to aging of the arteries.

The researchers finally concluded that excessive drinking can increase risk of cardiovascular disease, especially in men. They also found that constant heavy drinking can affect the arteries, thus interfering with blood flow. So I can conclude from this, that maybe its about time people really started looking into how MUCH they are actually drinking.

Thankyou.

 

Work Experience 101: Residential Care Home

In January, I began my work experience in a local care home. Since then for a few hours each week I have been volunteering at the care home, and joining the care assistants with their day to day jobs.

Before this I had never worked in a care home before. I had no clue what to expect, as the grandparents I have left aren’t in care homes, but in residential villages, which means they have a lot more independence that a care home resident. At first I was nervous, as the care home is small and there are not many care assistants and above all things I was scared the residents wouldn’t like me! However that was completely the opposite of the actual truth; the residents were all so lovely and just accepted me as a normal care assistant.

As I am only 17 and not qualified I am not allowed to take part in any personal care activities, however my activities include, helping to make tea, talking to and interacting with the residents, helping them move around the care home safely (giving assistance when getting up and down into chairs) and observing drugs rounds.

So far I have learnt a lot at the care home. Something, really special I learnt was that even in old age, despite many health problems and lists of medications that some of the residents have, it is still possible for happiness to exist. I learnt this through my various conversations with the residents. For example some of the residents like to know about what I do at school, how my friends are and comically the question I get asked most often is if I have a boyfriend or if any boys are catching my eye, which always brings a smile to my face. These may feel like simple things to converse about, but the engagement in the conversation and the smile on the resident’s face when we talk about these things really is special. I have learnt that the elderly find happiness in the simplest of things which is truly inspiring. Consequently, I believe that is an attribute that we all should aspire to have.

Even though I thoroughly enjoy my work, the experience has taught me what it is like to interact with someone that has dementia first hand. It is a harsh truth that dementia can reduce a person’s quality of life, thus it has taught me that awareness must be raised for types of dementia in the elderly. Also, in care homes, it is not uncommon for residents to come and go quickly. It is a sad thing to acknowledge however it is one of the realities of being human, that one day we will eventually die, whether we want to or not. When a member of the elderly is put into a care home, or a hospice, my experience has taught me that it is important to favor increasing the quality of life not the quantity of it. I learnt this through seeing a resident who had severe dementia, diabetes, and was very immobile due to other health problems. When her time came it was sad however the reassurance that I (and I’m sure the family) found was that the resident had a poor quality of life when they were alive, and maybe death was not such a bad thing for them.

Something I learnt about myself on this care home experience is that I love communicating with the residents which could be applied to real life patients. I was really interested in getting insight into the daily struggles and stresses that some people face with dementia, and the resilient approach to life, which was displayed by some of the residents. This has further inspired my pursuit of a medical career.

I absolutely love working in the residential home, and I am finding it so valuable, and it spurs on my inspiration and dream to study medicine.

Thank you.

How Can Gut Bacteria Increase/ Decrease a Baby’s Risk of Being Asthmatic?

“Children with this type of yeast called Pichia were much more at risk of asthma,” said Brett Finlay, a microbiologist at UBC. “This is the first time anyone has shown any kind of association between yeast and asthma.”

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A study done at the Univeristy of Columbia has found a yeast in the gut of new babies in Ecuador, that appears to give us the indication that they will develop asthma in childhood. A type of yeast bacteria called Pichia has some how, and god knows how, has been linked to asthma. They examined four gut bacteria in Canadian children that, if present in the first 100 days of life, it meant that the child would not develop asthma. After this initial study,  the researchers repeated the experiment using fecal samples and health information from 100 children in a rural village in Ecuador.

Whilst gut bacteria was shown to play a role in preventing asthma, the presence of microscopic Pichia bacteria was heavily linked to having asthma, instead of helping to prevent it. If the microscopic fungus bacteria is presented early on in the infant’s life- that is when it poses a risk. Canada and Ecuador both have high rates of asthma with about 10 per cent of the population suffering from the disease. (Which is probably why the study was done there.)

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However on  a more positive tangent, four bacteria have been found that can decreases a baby’s risk of asthma.  The same researcher’s analyzed fecal samples from 319 children involved in the analysis of the gut bacteria . The samples revealed lower levels of four specific gut bacteria in three-month-old infants who were at an increased risk for asthma.

These four, extremely vital gut bacteria nicknamed FLVR (Faecalibacterium, Lachnospira, Veillonella, Rothia) are usually naturally  transmitted to the baby from their environments, but some do not, either because of the circumstances of their birth or other factors. An interesting factor the researchers found was that there were fewer differences in FLVR levels among one-year-old children, this tells us that the first three months are a critical time period for a baby’s developing immune system, if the baby does not receive these bacteria, it could have a major impact on their health.

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“This discovery gives us new potential ways to prevent this disease that is life-threatening for many children. It shows there’s a short, maybe 100-day window for giving babies therapeutic interventions to protect against asthma,” said co-lead researcher Dr. Stuart Turvey, pediatric immunologist, BC Children’s Hospital, director of clinical research and senior clinician scientist at the Child & Family Research Institute, Aubrey J. Tingle Professor of Pediatric Immunology at UBC. The next plan of action for the reasearchers is to do a further study with a larger number of children to confirm these findings and reveal how these bacteria influence the development of asthma.

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Thank you.

The Mechanincal Brain

As neuroscience being a huge interest if mine, for this week’s blog post I have decided to write about how exactly technology has impacted it. When we think back to centuries ago, and think about how they wouldn’t have an electric scanning machine or any other electrical equipment, the question ‘How did they actually do it?’ pops into my head. Yet that is another story. Today I am focusing on the present day and how us have humans have formulated new technical equipment that is used everyday to save lives.

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One of the main ways in which technology has impacted neuroscience is through the various different uses of brain scans. One of the main forms of brain scanning is through Computed Tomography (CT). A CT scanner circles the head so that x-rays penetrate the brain from many directions. The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or transferred to a CD or DVD. Ct scans can be used to help assess head injuries, severe headaches, dizziness, and other symptoms of aneurysm, bleeding, stroke and brain tumors. However Ct scans aren’t to be over used as it has been stated ‘Researchers at the National Cancer Institute estimate that 29,000 future cancer cases could be attributed to the 72 million CT scans performed in the country in 2007.’ Says Carina Storrs a health writer whose work has appeared in Popular Science, The Scientist and Health.com, among other publications. Suggesting Ct scans have been said to contribute to cancer.

Magnetic resonance imaging is a test that uses a magnetic field and pulses of radio wave energy to make pictures of organs and structures inside the body. It is used to find problems such as tumours, bleeding, injury, blood vessel diseases, or infection. MRI also may be done to provide more information about a problem seen on an X-ray, ultrasound scan, or CT scan. MRI can look at the brain for tumours, an aneurysm, bleeding in the brain, nerve injury, and other problems, such as damage caused by a stroke. MRI can also find problems of the eyes and optic nerves, and the ears and auditory nerves. This has made it possible for us to understand neurosurgery by telling us things like, where the aneurysm is that needs to be clipped and what it looks like.  

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 A scan that is similar to MRI is fMRI (functional magnetic resonance imaging). Functional magnetic resonance imaging, or fMRI, is a technique for measuring brain activity. It works by detecting the changes in blood oxygenation and flow that occur in response to neural activity – when a brain area is more active it consumes more oxygen and to meet this increased demand blood flow increases to the active area. FMRI is used as appose to MRI as it shows not only the brain, yet the activity. This has contributed majorly to neuroscience as it means that Doctors and neurologists can really pin point what part of the brain is responsible for a certain action. As obviously the area with more oxygen in it at a particular time will be responsible for whatever the particular person is doing at a specific time.

Besides the various scanning techniques, technology can also be used for treatment for neurological illness. Repetitive transcranial magnetic stimulation (rTMS) creates magnetic pulses to the scalp delivered through a coil at a rhythmic repetition rate. These pulses are used to stimulate different parts of the brain in order to enhance a particular action. At the current stage of development, this type of technique is not a cure for any kind of brain or memory disorder as we do not fully understand it and long term side effects are yet to be discovered. However, it does suggest that researchers are onto something big and further investigation into the uses of transcranial magnetic stimulation could eventually be used to treat a variety of conditions ranging from Alzheimer’s disease, traumatic brain injury, schizophrenia, and even common memory loss caused by aging. “This opens up a whole new area for treatment studies where we will try to see if we can improve function in people who really need it,” Dr J Voss exclaims in an article for The Medical Daily.

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Consequently there has also been research into how stem cells can be used to remake different parts of the brain. The nervous system is a complex organ made up of nerve cells (also called neurons) and glial cells, which surround and support neurons. Neurons send signals that affect numerous functions including thought processes and movement. As you can probably fathom, the nervous system is extremely complicated and it seems impossible that stem cells can be used to help neurodegenerative diseases by recreating nervous system tissue. New neurons in the adult brain arise from slowly-dividing cells that appear to be the remnants of stem cells that existed during foetal brain development. It’s marvelous as these findings suggest that the brain may contain a built-in mechanism to repair itself. Unfortunately as far as we know, these new neurons are only generated in a few sites in the brain and turn into only a few specialized types of nerve cells. Although there are many different neuronal cell types in the brain.  The discovery of these cells has spurred further research into the characteristics of neural stem cells from the foetus and the adult. Hopefully scientists over time use this information to recreate these stem cell regenerating sites, so diseases like Alzheimer’s can be combatted as the brain will counteract the loss of grey matter in the brain.

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As you can see, technology is a huge contributor to neuro science. It can be used to detect and even go as far as treating neurodegenerative diseases. However, neuroscience is still very new in the research of medicine. We still have a lot more theories that we need to develop and treatments for certain diseases may take a lot more time to formulate and create than we would want. Subsequently, researchers are trying their best and very eager to find out more about the complexity that we call the brain.

Thankyou.

Neonatal Abstinence Syndrome Numbers Double

Neonatal abstinence syndrome is a group of problems that occur in a newborn who was exposed to addictive opiate drugs while in the mother’s womb. It is the result of the sudden discontinuation of fetal exposure to substances that were used or abused by the mother during pregnancy. Tolerance, dependence and withdrawal of these drugs may occur as a result of repeated administration of drugs or even after short-term high-dose use—for example, during mechanical ventilation in intensive care units. Neonatal abstinence syndrome may also occur when a pregnant woman takes drugs such as heroin, codeine, oxycodone (Oxycontin), methadone or buprenorphine.

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Symptoms depend upon the drug the mother was taking, how long she took it for and how much she took. Common symptoms may include: Blotchy skin coloring (mottling), diarrhea, excessive crying or high-pitched crying, excessive sucking, fever, hyperactive reflexes, increased muscle tone, irritability, poor feeding, rapid breathing,  seizures,  sleep problems, slow weight gain, stuffy nose, sneezing and/or sweating. It may seem like there are a lot of symptoms, however as I said the symptoms are completely independent of what drug was taken by the mother.

The seemingly never-ending list of symptoms can be used to generate a scoring system based on the severity of each symptom. This is how neonatal abstinence syndrome diagnosed.

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Treatment for NAS once again depends upon the drug involved, the infants overall health and abstinence score and whether the baby was born full term or premature. In mild cases, a waiting game of just giving the baby an extra bit of TLC can be effective. This may include gently rocking the baby to calm it, wrap it in blankets and keep the noise and lights down to help it sleep more gently. Babies with more  severe symptoms need medicines such as methadone and morphine to treat withdrawal symptoms. Unfortunately these  babies may need to stay in the hospital for weeks or months after birth. The main motive behind this treatment is to prescribe the infant a drug similar to the one the mother used during pregnancy and slowly decrease the dose over time. This helps wean the baby off the drug and relieves some withdrawal symptoms.

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I have gathered some shocking stats from: http://www.medicalnewstoday.com/articles/293318.php   – These stats show how much of a problem and how common NAS truly is.

  • The researchers found that during the 4-year period, the number of babies born with NAS almost doubled, from 3.4 births per 1,000 in 2009 to 5.8 births per 1,000 in 2012 – the equivalent to one baby born with NAS every 25 minutes. – Even though these stats are outdated, it is crazy to think that so many babies were born with this at some point, and how much of a problem it became.
  • The rise in abstinence syndrome mirrors the rise we have seen in opioid pain reliever use across the nation.This quote shows that maybe the over use of certain pain relievers may be to blame for the rise in NAS.

As you can see NAS is a rising problem. However we can prevent it by using drugs non-medically, using drugs not prescribed to you and using alcohol or tobacco during pregnancy.

Thank you for reading.

Antimicrobials: why is everyone so worried?

‘Overuse and misuse of antibiotics is increasing the problem of antibiotic resistance. We are all part of the problem and the solution.’

Antimicrobials are a category of drugs that include antibiotics, antivirals, antifungals, and antiparasitics. When we regularly, and overly expose the body to antimicrobials, the harmful bacteria in our bodies can build a resistance, so they can survive an attack from these drugs. When this happens the antimicrobials will no longer be effective and will not kill the organisms/bacteria that they used to.

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In the present day, less and less new antimicrobials are being produced. Also the time it is taking for bacteria to become resistant to new antibiotics is getting shorter. This means we are forced to use stronger drugs in order to combat bacteria, which means when a more serious illness comes along, we will have no antibiotics to treat it with, as the bacteria have already become resistant to that particular antimicrobial.

Over prescription of these drugs has meant that the bacteria have had more and more chance to become resistance to the antibiotic. This involves giving out antibiotics when they are not needed. Also not taking the drug at the correct times and dosages that were recommended by your Doctor can also cause resistance. This gives the bacteria time in your system to become resistant.

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Without antibiotics, simple medical procedures such as delivering a baby or appendectomy, would prove much harder without antimicrobials. The procedures would include a much higher risk of infection, and we obviously would have nothing to treat it with.

In order to combat antimicrobial resistance, it is important to remember that you should not ask for antibiotics for viral infections, like a common cold or flu. You should only take antibiotics when your doctor recommends, and you should not pass left overs of antibiotics on to friends or family, throw any left over drugs away. It is possible to transfer antimicrobial resistant bacteria to others, therefore you must  practice good hygiene.

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If not dealt with this could become an international problem. Reduce, replace, rethink.

Thanks, Sophie.

Asthma… What is it?

Sadly, for many, asthma is just an excuse to miss PE. A good excuse, though real (severe)  sufferers of asthma can feel like they are running a marathon when climbing a set of stairs.

Asthma by definition is common, long term, inflammatory disease of the airways (bronchial tubes) and lungs. Symptoms may include, wheezing, breathlessness, a tight chest, and coughing. People may have some symptoms and not others, and some may be more prominent than others. For some people, these symptoms only occur occasionally, however for others symptoms may be more persistent.

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There are different types of asthma:

  • Occupational Asthma is caused by the work you do. Symptoms become apparent when you’re an adult, and they tend to improve on day’s you are not at work. This asthma is common if you work in industries such as a bakery, laboratory, or car manufacturer.
  • Adult onset Asthma is when diagnosis is given in adulthood and is not due to your job. The asthma may have been brought on by smoking, obesity or sometimes female hormones after a stressful event could bring it on. Triggers of adult asthma may include things like laughing or getting excited.
  • Difficult to control or severe asthma, is pretty much what it says on the tin. These people usually fall into two groups. Group 1 is a group where symptoms can be controlled with the right medicine. Treatment for this group involves, learning how to take a dosage of medicine properly for Asthma and learning how to control your triggers. Group 2 is for sufferers who don’t respond to conventional Asthma medicines. They are usually referred to a specialized asthma service for their ongoing care and treatment because their asthma is more complex, they have severe asthma.
  • Childhood asthma is when asthma is diagnosed during childhood. Many sufferers find their asthma disappears as they get older. However if the child has moderate asthma the symptoms are likely to return in later life.
  • Seasonal asthma is when people on experience symptoms at certain times of the year. Triggers of this type of asthma can be things such as a high pollen count.

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For many asthmatics, asthma attacks are common. When symptoms get worse than usual for a period of time, it is possible the person is having an asthma attack. Common features of asthma attacks are that your inhaler isn’t helping or lasting over four hours, you’re too breathless, or its difficult to talk eat or sleep. Your breathing may picking up speed and you do not feel as if you are inhaling properly.

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If you are around a person having an asthma attack, sit them up, and give them their inhaler. They can have a maximum of 10 puffs and if symptoms do not relieve after that call for an ambulance.

Thank you for reading.