What is Lipoma?

 They are usually a bengin tumors composed of adipose tissue usually occurring in ages between 40 and 60. About one percent of the human beings have lipomas of any type. Its usually appearing as subcutaneous mass. Its soft , movable and in most cases it is painless. It may then be transformed ti malignant type tumors, but there is no a proven evidence for that yet.

Types of Lipomas

• Adenolipoma: this is the type of adipose tissue tumor that occur in the sweat glands.

• Angiolipoleiomyomas: these are subcutaneous tumors composed of blood vessels, fat, muscle cells and connective tissue.

• Angiolipomas: these are the painful type of subcutaneous lipomas.

• Superficial subcutaneous lipomas: this is the most common type of subcutaneous adipose tumors that occur just below the skin surface and it may occur in different parts of the body.

• Other types which occur rarely are Chondroid lipomas, Corpus callosum lipoma, Hibernomas, Intradermal spindle cell lipomas and neural fibrolipomas. We will not deal in details of types because they occur rarely.

Causes of Lipoma

There are two main causes shown to be in relation with the development of lipoma. First the family history, some late researches showed that there is a hereditary genes that may make people more susceptible to develop lipoma than others. Second there is some theories that had proven that some lipomas develop after injuries but this is not well proven till now.

Treatment of Lipomas

As we said before that most of lipomas are not painful and are small sized so treatment is not important in all cases., but there are some cases where the lipoma become painful or it become of large size preventing normal body movement or if it is most be removed for cosmotic reasons, Finally surgical excision is a must when there are signs of transformation to other malignant types are seen like liposarcomas or other malignant tumors.

Usually excision occurs by minor surgical operations in most cases using local anesthetics. New techniques include liposuction but only with those soft lipomas lacking excessive connective tissues. Finally lipomas can be treated by local injection of compounds that stimulate lipolysis.

Prognosis of lipomas

Usually lipomas don’t lead to more complications except in rare cases, so the patient that develop lipoma can maintain a normal life without suffering even if not treated at all .As we said most cases of lipomas are painless, small sized and so it is of no harm. Something to take into consideration that if it become larger in size in a short period of time of time, clinical examination must be done immediately as we still have the fear of transformation from the benign type lipomas to the most dangerous and life threatening malignant type liposarcomas.

In this cases direct surgical excision must be done to remove the whole tumor as early as possible then histopathological examination must be done to determine it’s type and if it is proven to be malignant special post operative medications must be administered to avoid further metastasis allover the body.

Prostate cancer

 This is s type of cancer that occurs in the prostate gland, which is a gland in the male reproductive system responsible for the semen fluid production. Cancer occurs when cells in certain body organ or tissue starts to divide in an uncontrolled rate leading to formation of a tumor which then displaces the normal cells with atypical nonfunctioning cells leading to loss of organ functionality and may be transferred to other body organs on a process called metastasis.

Signs and symptoms of prostate cancer

They are similar to the symptoms of benign prostate hyperplasia. Those symptoms include increased frequency of urination, urination during night, the patient being unable to maintain a steady urination stream and also painful urination. These urinary symptoms occur in prostate cancer as the prostate gland is present around the prostatic urethra and its enlargement either due to benign prostate hyperplasia or due to prostate cancer leads to these urinary changes. Also sexual symptoms are present as the prostate is responsible for seminal fluid production; these symptoms include incomplete penile erection and fast painful ejaculation.

Risk factors

As all of the other cancer types there is no a quiet evidence for its causes, but there are many risk factors that are proven to be in a relation with prostate cancer. The first is genetic factor. Many researched had shown that if there is family history of prostate cancer so members of this family are more likely to have prostate cancer. The second is dietary factor there is some evidence that taking excessive multivitamins and folic acid made people more susceptible to prostate cancer. Other risk factors include sexual factors; in this issue it is evident that people who had many sexual partners and started to have sex in young ages are more likely to develop prostate cancer.

Diagnosis of prostate cancer

Signs and symptoms are not enough to ensure that there is prostate cancer as they are common with other prostate inflammation conditions. So the main diagnosing tool that can be used to diagnose prostate cancer is taking a prostate biopsy. Other imaging techniques may be useful before biopsy to have an initial determination of the disease.

Treatment of prostate cancer

In many cases the disease is asymptomatic and so treatment is not necessary. I mean that there is no need for treatment for old patients who are not expected to live until the symptoms appear. This is always the case of low grades slow growing prostate tumors, but if the patient is of young age and have painful and uncomfortable symptoms therapy must be done. The first trend is to use high energy radiation techniques to stop the growth and the division of tumor cells, but if this is not efficient and the tumor is of high grade surgery must be done. This surgical operation is called radical prostatectomy where the gland is completely removed.

Finally as many other types of cancers we still can’t speak precisely in the causes or even the treatment techniques, because till now there is no complete curing therapy to treat cancer.

Breast Cancer

 Breast cancer accounts for about 23% of the whole cancer cases on the world. It can occur both to men and women but it occurs hundred times more often in women than in men. It accounts for about half a million deaths every year.

Breast cancer is the type of cancer that arises either from the ducts or the lobules of the mammalian breasts so it’s differentiated to ductal carcinoma and lobular carcinoma according to its origin.

Symptoms and Signs

The most obvious sign that about 80% of the breast cancer cases discover the disease with is a lump or hardened area of the breast the feels stiffer and harder than the surrounding soft tissues either in the breast or in the armpits. Some other signs indicate that there is a breast cancer. These are a change in the nipple size or shape, a discharge from the nipple, one breast become larger or a rash occurring in the areas surrounding the nipples. These are all indicative signs of a breast cancer but for sure further investigation and clinical examination to ensure that this is a case of breast cancer.

Risk Factors

1)      Lifestyle: such as smoking tobacco which increases the rate of breast cancer, as smoking begins earlier, risk becomes higher, heavy and long term smokers have risk 35% - 50% more than others, physical activity may decrease the rate of cases by 10%.

There is probably a relationship between breast feeding and breast cancer, and also diet plays an important role; increased fat diet, alcohols, obesity and iodine deficiency may increase the risk of breast cancer.

2)      Genetic factor:  in about 5% of cases a genetic factor leads to breast-ovarian cancer syndrome, mostly in those carrying BRCA1 and BRCA2 mutated genes.

3)      Medical conditions: breast cancer may be related to other medical conditions such as atypical hyperplasia or fibrocystic breast changes.

Pathphysiology

Normal cells divide as required then they stop dividing, Cancer cells are the cells that lose the ability to stop dividing in the required time, this occurs due to the exposure of a genetically susceptible person to an external environmental factor.

Classification:

Breast cancers can classified in many ways, here is a categorization according to histopathology, grade and stage.

According to histopathology:

Breast cancers are classified into ductal or lobular carcinoma, invasive carcinomas spread from the initial tissues and are not confined.

According to grade:

Normal breast cells are differentiated so that to do their function in a proper way, cancerous cells lose their differentiation, cells start to divide and division is uncontrolled, cells are classified into (low grade) which is well differentiated and (intermediate grade) which is moderately differentiated and (high grade) which is poorly differentiated and don’t resemble the structure of the normal breast cells at all.

According to stage:

The stage of breast cancer is determined by the TNM system, which depends on (T) the size of the tumor, (N) the tumor reaches the lymph nodes or not and (M) which shows if the tumor develops metastasis or not.

Tuberculosis T.B

 It is an infectious disease caused by one or more strain of mycobacteria, mainly mycobacterium tuberculosis. Tuberculosis infects the lungs causing many respiratory symptoms and then it causes other systemic symptoms all over the body that we will discuss later in the symptoms sections. Most of the infections are asymptomatic while only one tenth of which is transformed to active infection which is mostly lethal if not treated properly.

Signs and Symptoms

Symptoms are classified into respiratory symptoms, where the patient suffers from severe cough, high rate of sputum production, appearance of blood in sputum and chest pain. If it invades the pulmonary artery then excessive bleeding may occur. Other symptoms are systemic extra pulmonary symptoms including fever, excessive sweating at night and weight loss. All these signs and symptoms mentioned is indicative and characteristic for tuberculosis.

Causes

It is a disease caused by mycobacterium tuberculosis which is an aerobic immobile bacillus. It is transmitted when person become in contact with saliva, sputum of an infected person, or even upon breathing air near the patient who is all the time coughing and sneezing.

Risk factors

Factors that make someone more susceptible to the infection of tuberculosis include HIV which decreases the overall immunity of the person leading to be infected easily. Other highly common risk factors include bad health care, overcrowding and malnutrition so that this disease is called the disease of poverty as it is usually highly spread in poor countries where there is no good health care providers and there are many bad habits concerning hygiene  and health care.  Smoking is a common risk factor.  Also people with diseases like diabetes mellitus and chronic pulmonary infections are more susceptible to tuberculosis.

Diagnosis

Depending only on the characteristic signs and symptoms is not enough. Chest x-ray showing numerous dark lesions and doing sputum cultures are the first steps for evaluation of the disease. Sputum and blood cultures are always so difficult to obtain result from due to the slow growth rate of the bacillus that may delay the culture to two to four weeks.

Prevention

This is mainly done by vaccination of infants and using enhancing doses of the vaccine in young ages. The most commonly used vaccine is bacillus Calmette-Guérin vaccine. It prevent the direct infection in children but the immunity induced by this vaccine is lost after about 10 years so an enhancing dose must be administered.

Treatment

This infectious disease can’t be easily treated due to the high resistant membrane the bacillus owns and so it is so difficult to penetrate this membrane with the antibiotics usually used. The most commonly used effective antibiotics used are rifampicin and isoniazid. Usually a combination of two antibiotics is used to prevent the development of resistant strains of the bacteria. The treatment course may last for several months through which administration of the antibiotic combination is administered and the prognosis is observed.

Finally I would like to say that tuberculosis nowadays is not a disease of high concern except in poor and low income countries, but even these have overcame the problem by proper vaccination and good health advice announcements on the media and the press.

Types of toxicological studies

 There are two types i.e.

      1-      Short term/acute toxicological studies

      2-      Long term toxicological studies

We also study sub-acute/ sub chronic studies, chronic studies.

      1-      Short term/acute toxicological studies:

Administer drug for short period of time, for one day or multiple dose

Observation:

Observe given animal for 30 days and not any toxicological effects of drug on animal. Two type of observation are carried out

      A-    Behavioural changes:

It include sleeping pattern, eating habits, dinking, head tail and other movements.

      B-    Biochemical changes:

Collect urine, blood, feces, or any other body secretion and note any change in its characteristics. If there is any color change in body secretion it means drug shows short term/acute toxicity.

      2-      Sub-acute/Sub chronic studies:

Sometime acute toxicity is note observe with drugs so we perform sub-acute/sub chronic studies. In this case administer the drug for two week OD or at suitable intervals and then observe the effects after 2 weeks. Side effects are observed during this period and after this period.

Estimation of drug dose:

After observation of

·         P.k and P.D of drug

·         Side effects of drug

Example:

If drug shows side effect at 10 mg then clinical trials studies are started with 1/10 mg of initial dose.

Chronic studies:

These studies are performed with those drugs which are administered of prolong period of time. I.e. for every drug molecule duration of use is different e.g.

·         Analgesics are taken for 1-2 days.

·         Antibiotics are prescribed for longer period of time e.g. 5, 7 or 10 days.

·         Chronic studies are performed for these types of drug. Administer dose regularly for 90-180 days then observe the effects.

      3-      Long term studies:

These types of toxicological studies are performed for those type of drug which are used for chronic ailments e.g. blood pressure, diabetes, arthritis.

Administer the drug for the period of 1 year after this observe the side effect and toxic effect produce in long term studies further following studies are performed e.g. carcinogenic studies, reproductive studies, genotoxic studies.

Carcinogenic studies:

These are long term studies in which drugs areadministered for 18-24 months and then after this time animal is killed and observe various organ for the tumor/malignancy.

Reproductive studies:

These are also type of long term studies. In this after the administration of drug, overall behavior of parents is observed.

Observe mating effects of parents and observe, what is effect of new drug molecule on the offspring embryo and fetus?

Genotoxic studies:

Salmonella typhaemurium specie of bacteria is used to study genotoxicity. A new drug molecule is administered to bacteria and then genetic changes are observed in bacteria.

We see,

·         New drug molecule to cure mutation or not?

·         Drug molecule cause any change in genetic sequence/genetic make-up or not?

Note:

         Short term studies are done before INDA submission.

         Long term studies are carried out along with clinical trials. 

How are toxicology studies conducted

 The branch of pharmacology that deals with the toxic and side effects of new drug molecule is called toxicology. It is also called as preclinical drug safety evaluation. In this study we determine the toxicology of new drug molecule.

If toxicological studies of new drug molecule are not performed then investigational new drug application (INDA) cannot be submitted.

Objectives:

Following are objectives of toxicological studies

      A.    Acute/short term effects

      B.     Long term effects

      C.     Organ specificity

      D.    To determine the site at which toxicity is produce

      E.     Degree of toxicity            

      F.      Relationship between dose and toxic dose

      G.    Effect of drug on gender

      H.    Effect of new drug on reproductive system

      I.       Carcinogenic effect of drug

      J.       Genotoxic effect of drug

      A-    Acute and short term effect:

                                                            To determine acute/short term effects of new drug molecule e.g. when new molecule enter in the body of human/ animal then what are various acute effect produce by a new drug molecule. E.g. Nausea, vomiting, diarrhea etc.

      B-    Long term effect:

To, determine long term effect of a new drug molecule.I.e. when drug is administered to body to which organ is produce damage?E.g. cardio-toxic drug nephrotoxic, hepatotoxic.

Examples:

·         Aminoglycosides cause damage to ear and kidney.

·         Paracetamol cause damage to liver.

·         Some drugs also cause retinopathy.

      C-    Organ specificity:

To, determine the organ specificity of new drug molecule. I.e. in which organ drug is maximally absorbed o maximum concentration of drug is achieve in what organ? Because the organ having maximum concentration of drug also toxicological profile of that organ is maximum I.e. drug produce more side effect of this organ. After drug absorption what is Vd of particular organ because increase in Vd of organ increase the toxicity of drug of that organ.

       D-    To determine site at which toxicity is produce:

Where particular toxicity take place?

Toxicity produces by which mechanism?

Example:

·         If there is GIT drug then it produces side effects on GIT.

·         How this drug cause side effect? On which muscle enzyme is act it may be by inhibiting

·         GIT enzyme by muscle contraction.

Also we determine the exact site on which drug act because GIT is a very long portion. We determine that drug act on small intestine or large intestine or colon to produce side effect.

      E-    Degree of toxicity:

Also we determine the degree of toxicity of new drug molecule, whether it is

·         Acute

·         Chronic

·         Mild

·         Moderate

·         Sever

·         Life threatening

       F-     Relationship between dose and toxic dose:

Also we determine the relation between dose and toxic dose of new drug molecule.

Example: Some drug which have very broad therapeutic index side effect does not appear at high doses. Those drugs which have narrow therapeutic index cause side effect even at low doses.

      G-    Effect of drug on gender:

We also determine the effect of new drug molecule on gender whether it shows toxic effects are more in male female, neonates or geriatrics.

Example:

Cimetidine cause gynecomestia in male but has less effect in females. May be some drugs show effect in one gender but not in other. 

      H-    Effect of new drug on reproductive system:

We also determine the toxic effect of new drug molecule on the reproductive system

      I-       Carcinogenic effect of drug:

To know whether new drug molecule is carcinogenic or not or induce mutation or disturb the gene sequence?

      J-      Genotoxic effect of drug

 What is the effect of new drug molecule on gene sequence or can cause mutation or not?

Functions of Mouth and Teeth

 Whеn wе ѕtаrt еаting, food еntеrѕ оur mоuth аnd the рrосеѕѕ оf digеѕtiоn starts in оur mоuth. Wе ѕtаrt сhеwing thе food. Fооd is crushed and grоund during thе mаѕtiсаtiоn оr chewing process. Sаlivаrу glаndѕ start ѕесrеting and lubriсаtеѕ thе food thаt wе сhеw. Thе food is рuѕhеd аrоund bу thе tоnguе аnd within a minutе or ѕо, fооd bесоmеѕ сruѕhеd, grоund, ѕоft аnd mоiѕt mass, whiсh iѕ саllеd bоluѕ. Eасh bоluѕ is swallowed through thе thrоаt, whiсh is аlѕо tесhniсаllу rеfеrrеd as thе рhаrуnx. Swallowed bоluѕ iѕ passed on into thе esophagus.

We have four diffеrеnt types оf tееth, each hаving a different rоlе. Pointed саninеѕ аrе dеѕignеd fоr tearing. At the frоnt аrе chisel shaped inсiѕоrѕ with sharp edges for cutting purposes. The premolars and mоlаrѕ are for сruѕhing and grinding. Prеmоlаrѕ have twо ridgеѕ on the tор but mоlаrѕ аrе flаttеr compared tо thе рrеmоlаrѕ. Mоlаrѕ are thе lаrgеѕt аnd ѕtrоngеѕt оf аll tееth.

Thе роrtiоn оf teeth аbоvе the gum iѕ саllеd thе сrоwn and thе раrt whiсh is еmbеddеd in the gum оr the jаwbоnеѕ is called the rооt of thе tееth. Thе аrеа between thе two, nеаr thе gum surface iѕ саllеd thе nесk. Thе tесhniсаl nаmе fоr gum iѕ gingivа. Outer lауеr оf thе crown iѕ made of a tough bоnе-likе material called enamel. Enamel iѕ thе hardest substance in the body. If bоdу happens tо burn, what is lеft iѕ teeth. That iѕ the rеаѕоn sometimes idеntifiсаtiоn iѕ mаdе thrоugh dental rесоrdѕ. Bеnеаth thе enamel liеѕ ѕоftеr but still vеrу ѕtrоng tiѕѕuе called thе dеntin. It iѕ mаinlу ѕhосk-аbѕоrbing. Dеntin covers thе whоlе tееth, inсluding сrоwn, thе root аnd thе nесk. In the center оf tееth liеѕ thе ѕоft dental pulp, which has blооd vеѕѕеlѕ аnd nerves. Below gum, аnоthеr bone-like hard tiѕѕuе thе cementine, соvеrѕ thе dеntin. Pеriоdоntаl ligаmеnt tissues under thе gum secure tееth in thе jаwbоnе.

Tееth саn nоt crush food рrореrlу withоut support frоm thе tоnguе. Trу рulling thе tоnguе in and сhеw withоut thе tоnguе, уоu will ѕооn rеаlizе thе importance оf the tоnguе in chewing. It kеерѕ pushing food оut towards thе teeth. Thrее pairs оf ѕаlivаrу glаndѕ produce ѕаlivа in the mоuth. Parotid glаnd is in frоnt оf аnd juѕt below each еаr. Thе ѕubmаndibulаr glаndѕ are оn thе innеr ѕidе оf thе lоwеr jаwbоnеѕ and thе ѕublinguаl glands аrе оn thе floor оf thе mouth bеlоw thе tоnguе. Saliva iѕ mоѕtlу wаtеr (99.5%), but it hаѕ ѕоmе imроrtаnt еnzуmеѕ thаt start thе digеѕtiоn рrосеѕѕ in thе mоuth. Amylase bеginѕ thе breakdown оf ѕtаrсhеѕ аnd ѕаlivаrу liраѕе bеginѕ thе digеѕtiоn of fаtѕ. This iѕ оnе of thе reasons, сhеwing fооd thoroughly is essential аѕ it will jump-start thе digеѕtiоn рrосеѕѕ. Sаlivа аlѕо hаѕ diѕinfесtаnt and antibacterial сhеmiсаlѕ. Saliva nоt only hеlрѕ mоiѕtеn food, but it аlѕо kеерѕ the muсоuѕ membrane оf mouth mоiѕt bеtwееn реriоdѕ оf еаting.

Onсе thе fооd hаѕ been сhеwеd рrореrlу аnd hаѕ bееn moistened by saliva, it iѕ in the bоluѕ form аnd rеаdу tо be pushed bу thе rеѕt оf thе tongue to thе bасk of thе mouth. Thiѕ iѕ thе beginning оf thе vоluntаrу рrосеѕѕ оf swallowing. Swallowing soft аnd mоiѕt bolus is easy but tо swallow a ѕоlid itеm ѕuсh аѕ mеdiсinе pill оr tablet without сhеwing is hаrd аnd dеmаndѕ focus. Liԛuid iѕ not сhеwеd and iѕ gulреd down dirесtlу right аftеr it is рut into thе mоuth, whiсh iѕ whу it iѕ easier tо ѕwаllоw pills with water. Onсе bоluѕ iѕ рuѕhеd dоwn оn thе bасk оf thе mоuth, automatic rеflеxеѕ take оvеr the later ѕtаgеѕ оf swallowing, аѕ thе muѕсlеѕ оf thrоаt соntrасt аnd push thе bоluѕ furthеr bасk аnd dоwn, аnd squeeze bolus intо thе tор оf thе esophagus. A саrtilаgе flар knоwn аѕ the ерiglоttiѕ prevents fооd from gоing dоwn the 'wrоng way' intо thе lаrуnx аnd thе trachea аnd thus рrеvеntѕ роѕѕiblе сhоking.

Thе throat is a duаl рurроѕе раѕѕаgеwау. It lеtѕ brеаthing air pass thrоugh as wеll аѕ fооd, drink and ѕаlivа whilе еаting. Muscles оf thе thrоаt (pharynx), tоnguе, mouth, lаrуnx аnd uрреr еѕорhаguѕ run undеr nerve ѕignаlѕ from brаin tо рrеvеnt fооd frоm еntеring thе windpipe оr trасhеа. Thе саrtilаgе flар оf ерiglоttiѕ iѕ crucial in covering larynx mouth whеn fооd оr drink is going down аlоng thе thrоаt. Complex muѕсlе movement оf swallowing iѕ a voluntary reflex triggеrеd by the contact оf ѕоlid mаttеr to thе ѕеnѕоrѕ at the back оf thе mоuth. If fооd iѕ ассidеntаllу inhaled, thе irritаtiоn of thе windрiре triggеrѕ соughing reflex tо еxреl inhаlеd раrtiсlеѕ and рrеvеnt сhоking.Thе nеxt ѕtаgе of the digеѕtivе trасt iѕ esophagus, through which bоluѕ еntеrѕ thе ѕtоmасh. 

Fatigue Myths and Facts

 Whаt creates thе burning ѕеnѕаtiоn оn thе last couple оf repetitions whilе lifting weights; аnd whу dоеѕ оnе'ѕ bоdу get tired while cresting a ѕtеер hill?

Thе body muѕt retrieve energy ѕуѕtеmѕ аlѕо known as thе glусоlуtiс раthwау in оrdеr to ѕuррlу the muѕсlеѕ with fuеl оr thе glусоgеn and gluсоѕе nесеѕѕаrу tо соntinuе thе соntrасtilе рrореrtiеѕ whilе performing a high intеnѕitу асtivitу. Lасtаtе is a bу-рrоduсt оf lасtiс асid as wоrklоаd еxсееdѕ oxidation сараbilitiеѕ thеn lactate ассumulаtеѕ in the muѕсlе рlаѕmа.

For every lасtаtе mоlесulе a hуdrоgеn iоn iѕ рrоduсеd. If oxidation fоr fuеling рurроѕеѕ bесоmеѕ rеѕtriсtеd due tо anaerobic асtivitу then hуdrоgеn iоnѕ inсrеаѕе. Thе high lеvеlѕ оf hуdrоgеn ions create аn асidiс environment within thе muscle ѕуѕtеm.

A nоrmаl muscle pH lеvеl iѕ аbоut 7.1 whеn thе bоdу ѕwitсhеѕ tо anaerobic mесhаniѕmѕ the muѕсlе рH сhаngеѕ tо a рH lеvеl оf аррrоximаtеlу 6.5. Thе ѕtаtе оf асidоѕiѕ ѕtimulаtеѕ nerve rесерtоrѕ in thе muscles creating thе perception оf раin and саuѕing muѕсlе fаtiguе.

There hаvе also bееn studies indiсаting high potassium ассumulаtiоn may also рlау a rоlе in muѕсlе fаtiguе.

Athlеtеѕ саn inсrеаѕе lасtаtе thrеѕhоldѕ in whiсh uрtаkе mechanisms of lасtаtе become more еffiсiеnt. Training ѕресifiсаllу аt high intensity interval lеvеlѕ аnd аt ѕub lасtаtе thrеѕhоldѕ tеасhеѕ the exercise рhуѕiоlоgiсаl processes tо clear lactate mоrе effectively reducing inсrеаѕеѕ in hуdrоgеn ions аnd роtаѕѕium.

In case уоu tоо fееl fаtiguеd реrhарѕ a consoling thоught iѕ to know that уоu аrе nоt аlоnе. It iѕ еѕtimаtеd thаt 20% оf Amеriсаnѕ ѕuffеr frоm this condition, whiсh intеrfеrе with thеir nоrmаl living. While рhуѕiсаl саuѕеѕ contribute to 20 to 60% of the саѕеѕ, emotional causes make uр fоr 40 to 80%. Thе iѕѕuе here iѕ hоw to diagnose fаtiguе cause, and whеthеr it dеmаndѕ a соnѕultаtiоn with thе dосtоr.

If уоu аrе lооking for a single factor аѕ a fаtiguе саuѕе, уоu might be in for a ѕurрriѕе, as thеrе are plenty оf inter-related fасtоrѕ whiсh саn саuѕе fatigue. However соmmоn the соnditiоn may be, it is реrhарѕ оnе of thе toughest to dеfinе, and most оf the time, it iѕ a symptom оf ѕеvеrаl undеrlуing conditions. Lеt us lооk аt ѕоmе оf thе common fatigue causes:

·         Slеер diѕturbаnсеѕ

·         Not adequate sleep

·         Tоо muсh sleep

·         Slеер арnеа

·         Chаngе in ѕlеерing timingѕ(night ѕhift, сhаnging shifts, etc)

·         Alcohol

·         Obesity

·         Vitаmin dеfiсiеnсу оr inѕuffiсiеnt calorie соnѕumрtiоn

Of соurѕе thе liѕt of fatigue causes саn gо оn еndlеѕѕlу. If уоu are ѕuffеring frоm ѕlеер арnеа, уоu nоw know that thiѕ ѕinglе fatigue саuѕе iѕ responsible fоr уоur present соnditiоn оf health. Hоwеvеr, it has been ѕееn thаt hеаlthу wеight loss, оftеn rеѕultѕ in a chain reaction where you саn witnеѕѕ several imрrоvеmеntѕ: rеduсtiоn of weight lеаding to bеttеr quаlitу оf restful ѕlеер lеаding tо rеduсеd fatigue.

If you are ѕuffеring frоm bоth fatigue and ѕlеер apnea, аnd trуing tо find thе precise fatigue cause аѕ wеll аѕ a relation bеtwееn thе two conditions, it might mаkе mоrе ѕеnѕе if you knеw mоrе аbоut the five lеvеlѕ оf sleep. The dеереѕt lеvеl is called the REM оr Rарid Eуе Mоvеmеnt, which wе оftеn call the drеаm ѕlеер lеvеl. Uѕuаllу реорlе ѕреnd оnlу a quarter оf thеir ѕlеерing timе аt lеvеl 5, which kеерѕ thеm еnеrgеtiс аnd refreshed.

Hоwеvеr, whеn уоu аrе a victim оf ѕlеер арnеа, chances аrе thаt уоu choke in уоur ѕlеер fоr very ѕhоrt spans of timе (10 to 30 ѕесоndѕ at a timе). During this timе, thе brаin goes thrоugh a рhаѕе оf rеduсеd оxуgеn and brings уоu tо lоwеr lеvеlѕ оf ѕlеер. Whеn ѕuсh ерiѕоdеѕ tаkе рlасе mоrе thаn 6 timеѕ in аn hour, уоu аrе not only dерrivеd of any rеѕtful sleep but wоuld оbviоuѕlу wake uр tirеd аnd liѕtlеѕѕ. Bесаuѕе оf thiѕ diѕturbеd sleeping pattern, you wоuld соntinuе tо fееl tirеd аnd wеаrу for thе rеѕt оf the dау. Hopefully уоu hаvе now fоund the fаtiguе cause аnd thе сlоѕе rеlаtiоnѕhiр bеtwееn fаtiguе аnd sleep арnеа. 

Steps of drug design and development

 1-      Discovery Step:

It is consisting on the choice of therapeutic target and the identification and production of new active substance interacting with selected target. Such compound usually called as lead and originates from synthetic, organic, natural, semi synthetic or biotechnology process.

2-      Optimization Step:
It deals with the improvement of an active compound this optimization process increase the potency, selectivity and decrease in toxicity. IT characteristics are the establishment of structurally active relationship. Ideally based on understanding of the molecular mode of action.

3-      Development Step:

Its purpose in the continuation of the improvement of pharmacokinetic properties and the fine turning of pharmaceutics properties of active substance to make them suitable for clinical use. It can consist in preparation of better absorb compound of sustain release preparation and all water soluble derivatives or is the elimination of properties relating to the patient compliance e.g. irritation, painful injection, undesirable organoleptic properties.  

Drug Activity Phases

 1-      Pharmaceutical phase:

It concern with the administration route selection and preparation of most appropriate pharmaceutical formulation.

Objectives:

Optimize the distribution and facilitate to the absorption and elimination of unwanted organoleptic properties.

2-      Pharmacokinetic phase:

It concern with the fate of drug in the organism its mean absorption, distribution, metabolism and excretion.

Objectives:

Control the bio-availability its means the ratio of administered dose over the concentration at site of action in function of time.

3-      Pharmacodynamic Phase:

It concern with the drug receptor interaction and nature and intensity of pharmacological response.

Objectives:

                                    Maximal activity, maximal selectivity and minimal toxicity.

Preparation of Alcohol

 Alcohol is one of the crucial substances in our life. From fuels to food it has been practically used in every aspect of our life. It has the potential for improving our life and if not used judicially it can ruin our life due to overconsumption. The importance of alcohol makes us more inquisitive about how it is prepared and which are the sources it is generated. Let us discuss these details here. Mainly alcohol can be prepared at the commercial level and domestic level. Overall we can categorize them into Industrial Alcohol , Alcohol made from microorganisms, and preparation through fermentation.

Industrial Alcohol

The manufacturing of commercial alcohol, ethanol came into existence after the Industrial revolution. And this was possible after the sufficient laws were made make it possible to sell tax-exempt alcohol, which had to be denatured first to avoid its use in various Alcohol drinks. This alcohol uses the chemical process of reaction of ethylene gas at high pressure with concentrated sulphuric  or maybe phosphoric acid to form  esters; this acid-ester mix is subsequently diluted with water and heated to form ethanol by hydrolysis, and the resultant ethanol is removed from the acid ester mix through steam distillation. Ethanol which is not used for beverages can be used in small quantities as a fuel to generate energy.

Microorganism:

This is the most commonly done process of preparation of alcohol. This type of preparation depends upon the type of carbohydrates that are used in the process. For example if alcohol is prepared of starch and glucose as the raw components in the method then exclusively chosen strains of microorganisms such as Saccharomyces crevisiae which is a yeast that are used. It plays the role of fermenting the sugars, that are naturally found and are coming from different sources,  such as grapes ,barley , rice etc to alcohol and carbon dioxide. So particular strains of these microorganisms are employed for the fermentation or different types of natural products and they are chosen for several qualities. They must develop quickly, have higher resilience to great concentartions of glucose but simultaneously they must be able to generate much higher quantities of alcohol than any other strains. The following raw materials are used for the production of alcohol using the culture of microorganisms. They are Blackstrap Molasses / Maize (Blackstrap molasses has higher use),Grains, Sulfite spend liquor, Whey, Potatoes, Wood Wastes

For Molasses fermentation, molasses must be watered down with the water to a glucose conc. between 10 -18%. Levels higher than 20% are not applied as they could be damaging to yeast. The pH of the method is set between 4 -5 by including acids that are employed. Bacterial pollutants are usually restricted by the low pH, great glucose conc. and anaerobic circumstances of the fermentation.

The alcohol preparation from starch is different than the yeast fermentation as it uses Starchy foods such as corn, rye and barley which must go starch hydrolysis. This can be achieved by crushing with barley malt, by addition of diminish chemicals or by using fungus amylolytic minerals (Aspergillus and Rhizopus).In most of the cases, malt is used to achieve hydrolysis of food made of starch By combining 30% barley and 70% corn with the water and using crushing techniques similar to wine beverages or beer.

Fermentation:

Fermentation is another process that is employed in the preparation of alcohol and is one of the oldest processes known to mankind. It is generally performed in huge reactors at a more higher temperature range between 21 - 27oC, but warm progress might increase the warm range to 30oC, so chilling coil coolers are used to bring the ambient temperature down. Fermentation can last for about 2-3 days, but actual period of time relies on the substrate used and the reactor temperature. The fermentation broth after the fermentation process varies from 6 -9 percent in alcohol by quantity and this alcohol generally shows the generated part of 90 -98% theoretical transformation of substrate glucose to alcohol.

So these are some general methods of preparing alcohol.

Best workout to lose abdominal fats

 This is the excess fat that accumulates around the stomach area. It is still referred to as belly fat. The more accumulation of the stomach fats leads to abdominal obesity, a situation which can ruin a person. The results of this condition are better revealed on societal relations. However there are other disease dangers associated with abdominal obesity. Belly fat can develop between all personalities. It is not associated with gender barriers, sex or age group. Human beings of all walks of life can be victims of abdominal obesity. Research has revealed that there is a strong relationship that exist between abdominal obesity and a variety of cardiovascular illness and that is why every individual should exercise a lot of extra care on the developments of belly fats

Cited workouts on losing Abdominal fats

In-activeness is a condition which can lead to belly fats accumulation. When a person do not do any exercises the results are disastrous. If a person do not engage in any active exercise or guided, fats will start accumulating mostly around the waist line. It should be a duty for everyone who wants to lose abdominal fats to set aside time for exercise. This could be in guided or general.  Walking, slow running, press-ups and gym exercises will defiantly play a great role in losing or controlling the belly fats.

Uncontrolled eating habits without proper exercises leads to body weight increase. There is a wide variety of foods whose fats contents are very minimal. Refrain from fats contents and get used to whole meal foods such like dried grain foods, fruits and vegetables. Never the less a person is advised to take good care in nutrition to avoid low calories lose.

Every person works hard to be healthy and maintain a good shape without excessive fats.  Too many, maintaining a flat stomach is a daily commitment. There is a chain of recommended exercises founded on a series of training plan exercised by those who have been trained on this field. Where a person cannot afford to hire such services, the natural means of exercise with a commitment, will defiantly bring about tremendous results. Early morning jogging, bicycle riding and home bound exercises will contribute a great deal since there is no medication being applied. It is therefore advisable to make sure that you set some time for exercise on each day. This will not only reduce belly fats and others, but will promote the general health of your body.

There are many characteristic of life habits associated with a healthy lifestyle. Here are a few to mention.

·         Obtain adequate quality sleep.

·         Get sufficient exercise, perform it appropriately and exercise as though you are having fun.

·         Get right hydration; eat the right foods in a balanced formulation.

·         Timing on when to take your food is healthy. It’s not good to take food just before sleeping.

·         Train yourself to eat rational portions and not because you are bored. Foodstuff cannot take the place of love, stop eating for comfort and kill the genetic excuse.

best exercise to lose abdominal fat

 In human body the term “Fat” means a compound comprised of glycerol, a substance formed in fatty acids which are required as a concentrated as an energy source for our body mussels. Fat is actually the storage of unused calories from what we eat every day. There is mainly two genre of fat and they are white fat which is important metabolism for human body and other one is brown fat which is commonly found in the new born babies. Fat is important for our body but in many circumstances and mostly in middle-aged human body fat become a problem because in that time human body gain extra fat from imbalanced eating and need of calories, sometimes human consumes unnecessary more calories the body can use every day. The unused calories become fatty tissues in many body organs and make the obesity or fatty problems in human body. Among them abdominal fat is one of the biggest problems.

Abdominal fat or visceral fat is also called as organ fat or inter abdominal fat which is located in the abdominal cavity. It stands between the organs between stomach, liver, intestines and kidneys. It is different than other fats underneath the skin.

There are so many risks related with abdominal fat. Such as heart disease, hypertensions, insulin resistance. Central fatness is linked with a statistically superior risk of hypertension, insulin resistance, heart disease and Diabetes Mellitus Type and also carries risk of   boost in the waist to hip relation and overall waist perimeter the risk of death increases as well.

So if you are gaining abdominal fat it’s time to take measures against it. There are so many kind of exercises exists to lose abdominal fat but I am going to discuss about the most effective and best exercise which will be able to help you lose extra and harmful abdominal fat. The lying down bicycle crunch exercise is the most effective way to lose abdominal fat from the body. In many health journals and health websites recommended it as the best exercise to lose abdominal fat. The process of this exercise starts with lying down in a parallel a smooth place and keeping the knees bent. Your hand has to be behind the head and elbows should be keeping flared out. The next step is to crunch up and turning to the left. Bring your left elbow to the right knee and at the same time bring your chest to the knees and control your balance. Again go down and as like before bring your right elbow to your left knee. This is the whole process of the lying down bicycle crunch exercise. It’s simple but the most effective one. This exercise is greatly effective though it does not help to lose body fat. But by doing this every day with other fat lose exercises it will remove most of the abdominal fat body contains and give a good shape to the body.  

Belly Fat Loss Exercise

 We'll consider the ideal working out to help you loose belly fat. Then again, well before you discussion the ideal working out, we'll consider alternative activities that will help you to loose belly fat. Initially, you need in order that nutritionally, you have been choosing certainly, very well. Following, in general resistance training is in addition critical. As you join resistance training through decent food intake, organization loose belly fat.

Most people will related to slimming imagine that you'll find it everything regarding that consumption of calories. If you happen to use up consumption of calories much more than one take, one get slimmer. If you take on a lot more consumption of calories rather than it is easy to use up, the system advances unwanted weight. Even while it piece of logic could make awareness, it will be primarily mainly authentic. Everything that uses consumption of calories without layovers can be that muscle tissue first before the normal fats which a lot more intakes in consumption of calories while not body weight earn.
My own experience-
Top notch 5 most beneficial exercise routines to help you loose belly fat
1. That Pedi bike Working out:

Most beneficial designed for looking for that six-pack muscle additionally, the oblique. Of doing this working out gets to an important supine spot through hands and fingers at the rear of bounce . Bring in hips with the pectoral even while using shoulder blades away from the bare floors. Gently bring in ones own best shoulder near ones own allowed to remain leg whilst you straighten ones own best thigh. Go side panels and even persist at a pedaling mobility. Achieve 1 to help you 3 collections through 12 to help you 15 repetitions.
2.That Captain's Styling chair Thigh Bump up:

It working out needs a captain's styling chair, an important roof-rack through shock absorbing arm rest counting in that thighs and legs to hold 100 % free which can be regularly located in gyms and well-being teams. Of doing this working out, withstand in the styling chair and even grip on the club offer has. Squeeze once again with the mattress pad then simply bump up hips with the pectoral to help you get that abs muscles then simply lesser them all back down. Achieve 1 to help you 3 collections through 12 to help you 15 repetitions.
3. Working out Softball Crunch:

For this purpose working out, a work out softball is a good idea. From this plan, that abdominal muscles will do a lot more exerting though might always demand your complete physical structure to help you strengthen the application all through the plan. Of doing this working out, tell a lie on your ball with each of your spine perfectly held. Set hands and fingers lurking behind your head. To help you move that upper body away from the softball, get that abs muscles to help you drag the belonging to the rib wire dog crate to the sides. Continue softball consistent whilst you relax, then simply spine up to stretch your muscles that abs muscles. Achieve 1 to help you 3 collections through 12 to help you 15 repetitions.
4. Contemplate:

Up and down Thigh Crunch -- Engaging in it working out is similar to performing a thigh crunch but the fact that the thighs and legs can be directly, pumping that abs muscles to your job and even attaching concentration with the plan. Of doing this, tell a lie on the floor considering the thighs and legs directly, hips intersected, and even set that hands and fingers within the top of your head designed for guidance. Get abs muscles using that shoulder blades away from the bare floors and even continue thighs and legs at a mounted spot to help you crunch. Achieve 1 to help you 3 collections through 12 to help you 15 repetitions.
5. Much time Limb Crunch:

It's a alternative belonging to the customary bare floors crunch from where the arm rest can be performed upright lurking behind one, attaching an important lever with the relocate and even helping to make for one complex working out. Of doing this, tell a lie on the floor as well as a pad then simply broaden arm rest upright lurking behind, attempting to keep them all clasped and then with the radio stations. Gently get abs muscles and even move shoulder blades away from the bare floors with care to remain that arm rest upright. Achieve 1 to help you 3 collections through 12 to help you 15 repetitions.

Clearly, if you are wonderful time, it is easy to get slimmer while not beginning to see the application. It is essential to try to look for a work out you love. Generally if the implied exercise routines earlier you should not agree with ones own quality, looking for backpack, cooling off and bicycling are equally simply because productive on shedding pounds and even excess fat muscle. Thanks for your time.