Kanthan's Birthday Pics - Facebook
Sunday, May 24, 2009
Friday, May 22, 2009
Friday, October 24, 2008
**Deepavali… from Darkness to light**
DEEPAVALI, commonly known as DIWALI, is a major Indian festival spread over 5 days that is very significant in Hinduism known as the "Festival of Lights," it symbolizes the VICTORY OF GOOD OVER EVIL and lamps (diyas) are lit as a sign of celebration and hope for humankind.
"Regardless of the explanations one prefers, what the festival of lights really stands for
today is a reaffirmation of hope, a renewed commitment to friendship and goodwill, and a
religiously sanctioned celebration of the simple — and some not so simple — joys of life."
This year (2008) Deepavali is celebrated over a period of 5 days beginning from the 26th October to the 30th October.
Diwali is one of the most popular and eagerly awaited Hindu festivals around the world.
Hindus regard it as a celebration of life and use the occasion to strengthen family and social
relationships. For Hindus it is one of the most important festivals, and it is a New Year
in some Hindu calendars.
The Deepavali lights represent the time when Shree Raam came back from the forest, and
all in Ayodyhya lit lamps to welcome their most beloved Lord back home after fourteen
years of exile in the forest. Many do believe that when the lamps are lit this helps Mother Lakshmi find her way into people's homes. Celebrations focus on lights and lamps, particularly traditional dipa or deeya (earthen lamp).
Diwali is a colloquial name used in North India, while the festival is formally called Deepavali in South India. The Sanskrit word Deepavali means an array of lights that stands for victory of brightness over darkness. As the knowledge of Sanskrit diminished, the name was popularly modified to Diwali, especially in northern India. In South India, Diwali does not coincide with the beginning of a new year as South Indian Hindus follow a different calendar, where it falls on the night of the new moon in the month of Kartik (this year this day falls on the 28th October).
Hindus find cause to celebrate this festival for different reasons:
• It commemorates the killing of Narakasura, an evil demon who created havoc and
was killed by Lord Krishna Himself. Before Narakasura's death, he requested a boon
from his mother (Mother Earth), that everyone should celebrate his death with
colorful light.
• According to the Skanda Purana, Mother Parvati observed 21 days of austerity
starting from ashtami of shukla paksha (eighth day of the waxing period of moon) to
get half of the body of her dear husband Lord Shiva. This vrat (austerity) is known
as Kedhara Vrata. Deepavali is the completion day of this austerity. This is the day
Lord Shiva accepted Mother Parvati into the left half of his form and appeared as
Ardharishvara.
• Diwali also celebrates the return of Shree Ramachandra, King of Ayodhya, with his
wife Sita and brother Shree Lakshmanji to Ayodhya from a war in which He killed
the demon king Ravana. People light oil lamps along the way to light their path in the
darkness.
• In Bhavishyottara and Brahma Vaivarta Purana, Diwali is associated with Bali
Maharaja, who is allowed to return to earth once a year.
The Five days of Diwali:
Diwali is celebrated over five days in most of India. All the days except Diwali are named
using the designation in the Indian calendar. A lunar half-month is 15 days. Diwali as a newmoon
day marks the last day of a 15-day period. Diwali being festival of lights, across India people celebrate it via symbolic diyas or kandils (colorful paper lanterns) as an integral part of Diwali decorations.
1) Dhan-trayodashi or dhan teras (26th October): Dhan means "wealth" and
Trayodashi means "13th day". Thus, as the name implies, this day falls on the 13th day of
the second half of the lunar month. It is an auspicious day for shopping. This day is of
special importance for traders and business people.
2) Naraka Chaturdasi (27th October): Chaturdasi is the fourteenth day on which
demon Narakasura was killed. (The katha is given below). It signifies the victory of good
over evil and light over darkness. In South India, this is the actual day of festivities.
3) Diwali-Amavasya (28th October): The actual day of Diwali, is celebrated on the
third day of the festival, when the moon completely wanes and total darkness sets in the
night sky. Hindus wake up way before dawn as early as 4h00 in the morning, have a fragrant
oil bath and wear new clothes. They light small lamps all around the house and draw
elaborate rangoli (patterns) outside their homes. They perform pujas (prayer) with offerings to
Shree Sita-Raam/Radha-Krishna/Lakshmi-Narayana, as He liberated the world from the
demon Narakasura on this day. Taking a bath before sunrise, when the stars are still visible
in the sky is equivalent to taking a bath in the Ganga River. Hence, when people greet each
other in the morning, they ask "Have you performed your Ganga Snaanam?” (Well most of us
are not in India so what you can do in this case purchase Ganga Water from your nearest
puja shop and in a bucket pour a cap of Ganga water from the bottle and fill the bucket with
normal water and have a bath… it’s the same thing as bathing in Mother Ganga herself). As
this is a day of rejoicement, many will have very elaborate breakfasts and lunches and meet
family and friends. In the evening, lamps are again lit and Mother Lakshmi is worshipped and
offered special dishes. This being a no moon day (New moon/Amavasya), many will offer
tarpana (offerings of water and sesame seeds) to their ancestors. This is from the Garuda
Purana. Like Christmas in the West, Diwali is very much a time for buying and exchanging
gifts.
4) Govardhan Puja or also called Annakut (29th October), is celebrated as the day
Shree Krishna defeated Lord Indradev. For Annakut a mountain of food (normally halva) is
decorated symbolizing Govardhan Mountain lifted by Lord Krishna. On this day men present
gifts to their wives.
5) Bhayiduj (30th October) — on this day, brothers and sisters meet to express their
love and affection for each other. Most Indian festivals bring together families; Bhaiduj
brings together sisters and brothers, and is a significant festive day for them. This festival
is ancient, and pre-dates 'Raksha Bandhan' another brother-sister festival being celebrated
today.
The celebrations vary in different regions:
• In South India, Naraka Chaturdashi is the main day.
• The main festival in North India is on Amavasya evening with Lakshmi Puja which is
followed by lighting of oil lamps around the house.
Three Diwali Kathas…
Three of the Kathas (stories) of Diwali show the triumph of Good over Evil, and tell of the
destruction of two monsters that preyed on humanity.
The killing of Narakasura: - Narakasura was the evil king of Pragjyotishpur, near Nepal. He
ruled with a reign of terror, abducted 16,000 daughters of the deva, and stole the earrings
of Aditi, mother of the devas. The devas asked Lord Krishna for help, and after a mighty
battle He killed the demon, freed the girls, and recovered the earrings. The rescue of the
16,000 girls is the origin of the story that Shree Krishna had 16,000 wives. After His
victory Lord Krishna returned very early in the morning and was bathed and massaged with
scented oils. Taking an early morning bath with oil is still a Diwali tradition. To read the full
katha of the Killing of Narakaasura.
The killing of the demon Ravana: - Ravana, who had ten arms and ten heads, was the wicked king of the island of Shree Lanka, who kidnapped the wife of Shree Raam. Shree Raam had been in exile for 14 years because of a disagreement as to whether He or His brother
should be the next king in Ayodhya. After a great battle Shree Raam killed Ravana demon
and recovered Mother Sita. Shree Raam's return with Mother Sita to Ayodhya and His
subsequent coronation as king is celebrated at Diwali. When Shree Raam and Mother Sita first returned to Ayodhya it was a dark moonless night and they couldn't see where they were going. Their people put little lamps outside their houses so that the new king and queen could find Their way, thus beginning the tradition of the festival of lights.
The Katha of Bali Maharaj: - In the Srimad Bhagavatam 8th canto chapters 15-23 narrates
the katha of Bali Maharaj and Lord Vamanadeva. Bali Maharaj was born in a demon
family and due to his penance he ruled over material creation including Mother Lakshmi. In
the absence of Lakshmi Mata the world was deprived of their basic needs and suffered
immensely. The devas approached Lord Vishnu who didn’t need much coaxing to incarnate to
save the world… the Lord incarnated as the son of Aditi-devi and the great sage Kashyapa
Muni. Then the Lord known as Vamana (dwarf) deva approached Bali maharaja for three
steps of land which Bali Maharaja immediately agreed despite being asked not to do so by
his Guru. The Lord first step covered the entire surface of the world, and by extending His
body He covered the entire sky. With His hands He covered all directions, and with His
second footstep He covered the entire upper planetary system. Therefore there was no
vacant place where He could take His third footstep. The Lord accepted Bali Maharaja’s
defeat because he couldn’t deliver on his promise and was sent to planet Sutala. When this
happened Mother Lakshmi and all the Devi's and Deva's were released and order restored.
This happened on Diwali day.
A bit of controversy to end. ..many will worry that they cannot take 5 days off from work...you can choose any of the 5 days. Many will choose the 28th but we got to look at the bigger
picture and that this is a time for joy and celebrations. We should be proud other religions
have one main day while we have 5 main days to celebrate Diwali. It makes you feel great to
be a Hindu now.
How to observe this extremely auspicious day:
After you have taken a bath early in the morning and wearing clean clothes go to your prayer place and offer incense, lamp and flowers (all seven times in a clockwise around the picture of Shree Sita-Raam. After that all the food that has been prepared should be offered first to Shree Sita-Raam. Leave the unoffered food before Their Lordships to bless and after about 10 minutes remove from the prayer place and offer that prashad (blessed food) for all to eat.
Many perform Lakshmi Puja on this day. If one likes to perform this puja visit out website and in the ARTILCES block under Vara Lakshmi Puja we have the full puja method explained. But most importantly enjoy these 5 days. During these five days of Deepavali one should not consume any meat.
Thank you for taking time to read this article. We are trying to reach out not only to Hindus
but to others of other faiths as well. By compiling and publishing these articles we hope
that others will understand what a beautiful and diversified way of life Hinduism (Sanathan
Dharma) really is.
Please do visit our Website to receive more free information about our beautiful culture
www.h4all.org
Compiled (for the upliftment of Sanatan Dharma – the Eternal Religion)
Narottam Das (South Africa)
Phone (+27) 32 9444 108 or (+27) 82 714 1504
E-mail nd@h4all.org
Saturday, September 13, 2008
Introducing DUKE - German Shepherd X
On a happier note our family is excited to have our very first pet in New Zealand which we brought home today (Saturday 13 September). Kanthan and I made every excuse in the book in putting this off, e.g. how sad we were when we had to leave our dog Zelda behind with our maid when we immigrated to New Zealand (tears!!). Also, that we are likely to go on overseas holidays now and again, and how sad to leave our doggie behind – excuses, excuses! We have been searching for the perfect pet for some time now and on Monday night Thanusha finally found the one she wanted on Trademe at the Fins and Feathers Petshop. Our pup Duke (named by Kaveshan) is a German Shepherd crossed with either a Siberian Husky or Rottweiler. He is was born on 21/07/08 and is now 7 weeks old, black with light brown legs and is expected to grow between 35kg - 4okg!! Welcome to our family Duke :-)
What is Pneumonia - From the Free Dictionary
Pneumonia
Definition
Pneumonia is an infection of the lung that can be caused by nearly any class of organism known to cause human infections. These include bacteria, amoebae, viruses, fungi, and parasites. In the United States, pneumonia is the sixth most common disease leading to death; 2 million Americans develop pneumonia each year, and 40,000-70,000 die from it. Pneumonia is also the most common fatal infection acquired by already hospitalized patients. In developing countries, pneumonia ties with diarrhea as the most common cause of death. Even in nonfatal cases, pneumonia is a significant economic burden on the health care system. One study estimates that people in the American workforce who develop pneumonia cost employers five times as much in health care as the average worker.
According to the Centers for Disease Control and Prevention (CDC), however, the number of deaths from pneumonia in the United States has declined slightly since 2001.
Description
Anatomy of the lung
To better understand pneumonia, it is important to understand the basic anatomic features of the respiratory system. The human respiratory system begins at the nose and mouth, where air is breathed in (inspired) and out (expired). The air tube extending from the nose is called the nasopharynx. The tube carrying air breathed in through the mouth is called the oropharynx. The nasopharynx and the oropharynx merge into the larynx. The oropharynx also carries swallowed substances, including food, water, and salivary secretion, which must pass into the esophagus and then the stomach. The larynx is protected by a trap door called the epiglottis. The epiglottis prevents substances that have been swallowed, as well as substances that have been regurgitated (thrown up), from heading down into the larynx and toward the lungs.
A useful method of picturing the respiratory system is to imagine an upside-down tree. The larynx flows into the trachea, which is the tree trunk, and thus the broadest part of the respiratory tree. The trachea divides into two tree limbs, the right and left bronchi. Each one of these branches off into multiple smaller bronchi, which course through the tissue of the lung. Each bronchus divides into tubes of smaller and smaller diameter, finally ending in the terminal bronchioles. The air sacs of the lung, in which oxygen-carbon dioxide exchange actually takes place, are clustered at the ends of the bronchioles like the leaves of a tree. They are called alveoli.
The tissue of the lung which serves only a supportive role for the bronchi, bronchioles, and alveoli is called the lung stroma.
Function of the respiratory system
The main function of the respiratory system is to provide oxygen, the most important energy source for the body's cells. Inspired air (the air you breath in) contains the oxygen, and travels down the respiratory tree to the alveoli. The oxygen moves out of the alveoli and is sent into circulation throughout the body as part of the red blood cells. The oxygen in the inspired air is exchanged within the alveoli for the waste product of human metabolism, carbon dioxide. The air you breathe out contains the gas called carbon dioxide. This gas leaves the alveoli during expiration. To restate this exchange of gases simply, you breathe in oxygen, you breathe out carbon dioxide
Respiratory system defenses
The healthy human lung is sterile. There are no normally resident bacteria or viruses (unlike the upper respiratory system and parts of the gastrointestinal system, where bacteria dwell even in a healthy state). There are multiple safeguards along the path of the respiratory system. These are designed to keep invading organisms from leading to infection.
The first line of defense includes the hair in the nostrils, which serves as a filter for large particles. The epiglottis is a trap door of sorts, designed to prevent food and other swallowed substances from entering the larynx and then trachea. Sneezing and coughing, both provoked by the presence of irritants within the respiratory system, help to clear such irritants from the respiratory tract.
Mucus, produced through the respiratory system, also serves to trap dust and infectious organisms. Tiny hair like projections (cilia) from cells lining the respiratory tract beat constantly. They move debris trapped by mucus upwards and out of the respiratory tract. This mechanism of protection is referred to as the mucociliary escalator.
Cells lining the respiratory tract produce several types of immune substances which protect against various organisms. Other cells (called macrophages) along the respiratory tract actually ingest and kill invading organisms.
The organisms that cause pneumonia, then, are usually carefully kept from entering the lungs by virtue of these host defenses. However, when an individual encounters a large number of organisms at once, the usual defenses may be overwhelmed, and infection may occur. This can happen either by inhaling contaminated air droplets, or by aspiration of organisms inhabiting the upper airways.
Conditions predisposing to pneumonia
In addition to exposure to sufficient quantities of causative organisms, certain conditions may make an individual more likely to become ill with pneumonia. Certainly, the lack of normal anatomical structure could result in an increased risk of pneumonia. For example, there are certain inherited defects of cilia which result in less effective protection. Cigarette smoke, inhaled directly by a smoker or second-hand by a innocent bystander, interferes significantly with ciliary function, as well as inhibiting macrophage function.
Stroke, seizures, alcohol, and various drugs interfere with the function of the epiglottis. This leads to a leaky seal on the trap door, with possible contamination by swallowed substances and/or regurgitated stomach contents. Alcohol and drugs also interfere with the normal cough reflex. This further decreases the chance of clearing unwanted debris from the respiratory tract.
Viruses may interfere with ciliary function, allowing themselves or other microorganism invaders (such as bacteria) access to the lower respiratory tract. One of the most important viruses is HIV (Human Immunodeficiency virus), the causative virus in AIDS (acquired immunodeficiency syndrome). In recent years this virus has resulted in a huge increase in the incidence of pneumonia. Because AIDS results in a general decreased effectiveness of many aspects of the host's immune system, a patient with AIDS is susceptible to all kinds of pneumonia. This includes some previously rare parasitic types which would be unable to cause illness in an individual possessing a normal immune system.
The elderly have a less effective mucociliary escalator, as well as changes in their immune system. This causes this age group to be more at risk for the development of pneumonia.
Various chronic conditions predispose a person to infection with pneumonia. These include asthma, cystic fibrosis, and neuromuscular diseases which may interfere with the seal of the epiglottis. Esophageal disorders may result in stomach contents passing upwards into the esophagus. This increases the risk of aspiration into the lungs of those stomach contents with their resident bacteria. Diabetes, sickle cell anemia, lymphoma, leukemia, and emphysema also predispose a person to pneumonia.
Genetic factors also appear to be involved in susceptibility to pneumonia. Certain changes in DNA appear to affect some patients' risk of developing such complications of pneumonia as septic shock.
Pneumonia is also one of the most frequent infectious complications of all types of surgery. Many drugs used during and after surgery may increase the risk of aspiration, impair the cough reflex, and cause a patient to underfill their lungs with air. Pain after surgery also discourages a patient from breathing deeply enough, and from coughing effectively.
Radiation treatment for breast cancer increases the risk of pneumonia in some patients by weakening lung tissue.
Causes and symptoms
The list of organisms which can cause pneumonia is very large, and includes nearly every class of infecting organism: viruses, bacteria, bacteria-like organisms, fungi, and parasites (including certain worms). Different organisms are more frequently encountered by different age groups. Further, other characteristics of an individual may place him or her at greater risk for infection by particular types of organisms:
Pneumonia is suspected in any patient who has fever, cough, chest pain, shortness of breath, and increased respirations (number of breaths per minute). Fever with a shaking chill is even more suspicious. Many patients cough up clumps of sputum, commonly known as spit. These secretions are produced in the alveoli during an infection or other inflammatory condition. They may appear streaked with pus or blood. Severe pneumonia results in the signs of oxygen deprivation. This includes blue appearance of the nail beds or lips (cyanosis).
The invading organism causes symptoms, in part, by provoking an overly-strong immune response in the lungs. In other words, the immune system, which should help fight off infections, kicks into such high gear, that it damages the lung tissue and makes it more susceptible to infection. The small blood vessels in the lungs (capillaries) become leaky, and protein-rich fluid seeps into the alveoli. This results in less functional area for oxygen-carbon dioxide exchange. The patient becomes relatively oxygen deprived, while retaining potentially damaging carbon dioxide. The patient breathes faster and faster, in an effort to bring in more oxygen and blow off more carbon dioxide.
Mucus production is increased, and the leaky capillaries may tinge the mucus with blood. Mucus plugs actually further decrease the efficiency of gas exchange in the lung. The alveoli fill further with fluid and debris from the large number of white blood cells being produced to fight the infection.
Consolidation, a feature of bacterial pneumonias, occurrs when the alveoli, which are normally hollow air spaces within the lung, instead become solid, due to quantities of fluid and debris.
Viral pneumonias and mycoplasma pneumonias do not result in consolidation. These types of pneumonia primarily infect the walls of the alveoli and the stroma of the lung.
Severe acute respiratory syndrome (sars)
Severe acute respiratory syndrome, or SARS, is a contagious and potentially fatal disease that first appeared in the form of a multi-country outbreak in early February 2003. Later that month, the CDC began to work with the World Health Organization (WHO) to investigate the cause(s) of SARS and to develop guidelines for infection control. SARS has been described as an "atypical pneumonia of unknown etiology;" by the end of March 2003, the disease agent was identified as a previously unknown coronavirus.
The early symptoms of SARS include a high fever with chills, headache, muscle cramps, and weakness. This early phase is followed by respiratory symptoms, usually a dry cough and painful or difficult breathing. Some patients require mechanical ventilation. The mortality rate of SARS is thought to be about 3%.
As of the end of March 2003, the CDC did not have clearly defined recommendations for treating SARS. Treatments that have been used include antibiotics known to be effective against bacterial pneumonia; ribavirin and other antiviral drugs; and steroids.
Diagnosis
For the most part, diagnosis is based on the patient's report of symptoms, combined with examination of the chest. Listening with a stethoscope will reveal abnormal sounds, and tapping on the patient's back (which should yield a resonant sound due to air filling the alveoli) may instead yield a dull thump if the alveoli are filled with fluid and debris.
Laboratory diagnosis can be made of some bacterial pneumonias by staining sputum with special chemicals and looking at it under a microscope. Identification of the specific type of bacteria may require culturing the sputum (using the sputum sample to grow greater numbers of the bacteria in a lab dish.).
X-ray examination of the chest may reveal certain abnormal changes associated with pneumonia. Localized shadows obscuring areas of the lung may indicate a bacterial pneumonia, while streaky or patchy appearing changes in the x-ray picture may indicate viral or mycoplasma pneumonia. These changes on x ray, however, are known to lag in time behind the patient's actual symptoms.
Treatment
Prior to the discovery of penicillin antibiotics, bacterial pneumonia was almost always fatal. Today, antibiotics, especially given early in the course of the disease, are very effective against bacterial causes of pneumonia. Erythromycin and tetracycline improve recovery time for symptoms of mycoplasma pneumonia. They, do not, however, eradicate the organisms. Amantadine and acyclovir may be helpful against certain viral pneumonias.
A newer antibiotic named linezolid (Zyvox) is being used to treat penicillin-resistant organisms that cause pneumonia. Linezolid is the first of a new line of antibiotics known as oxazolidinones. Another new drug known as ertapenem (Invanz) is reported to be effective in treating bacterial pneumonia.
Definition
Pneumonia is an infection of the lung that can be caused by nearly any class of organism known to cause human infections. These include bacteria, amoebae, viruses, fungi, and parasites. In the United States, pneumonia is the sixth most common disease leading to death; 2 million Americans develop pneumonia each year, and 40,000-70,000 die from it. Pneumonia is also the most common fatal infection acquired by already hospitalized patients. In developing countries, pneumonia ties with diarrhea as the most common cause of death. Even in nonfatal cases, pneumonia is a significant economic burden on the health care system. One study estimates that people in the American workforce who develop pneumonia cost employers five times as much in health care as the average worker.
According to the Centers for Disease Control and Prevention (CDC), however, the number of deaths from pneumonia in the United States has declined slightly since 2001.
Description
Anatomy of the lung
To better understand pneumonia, it is important to understand the basic anatomic features of the respiratory system. The human respiratory system begins at the nose and mouth, where air is breathed in (inspired) and out (expired). The air tube extending from the nose is called the nasopharynx. The tube carrying air breathed in through the mouth is called the oropharynx. The nasopharynx and the oropharynx merge into the larynx. The oropharynx also carries swallowed substances, including food, water, and salivary secretion, which must pass into the esophagus and then the stomach. The larynx is protected by a trap door called the epiglottis. The epiglottis prevents substances that have been swallowed, as well as substances that have been regurgitated (thrown up), from heading down into the larynx and toward the lungs.
A useful method of picturing the respiratory system is to imagine an upside-down tree. The larynx flows into the trachea, which is the tree trunk, and thus the broadest part of the respiratory tree. The trachea divides into two tree limbs, the right and left bronchi. Each one of these branches off into multiple smaller bronchi, which course through the tissue of the lung. Each bronchus divides into tubes of smaller and smaller diameter, finally ending in the terminal bronchioles. The air sacs of the lung, in which oxygen-carbon dioxide exchange actually takes place, are clustered at the ends of the bronchioles like the leaves of a tree. They are called alveoli.
The tissue of the lung which serves only a supportive role for the bronchi, bronchioles, and alveoli is called the lung stroma.
Function of the respiratory system
The main function of the respiratory system is to provide oxygen, the most important energy source for the body's cells. Inspired air (the air you breath in) contains the oxygen, and travels down the respiratory tree to the alveoli. The oxygen moves out of the alveoli and is sent into circulation throughout the body as part of the red blood cells. The oxygen in the inspired air is exchanged within the alveoli for the waste product of human metabolism, carbon dioxide. The air you breathe out contains the gas called carbon dioxide. This gas leaves the alveoli during expiration. To restate this exchange of gases simply, you breathe in oxygen, you breathe out carbon dioxide
Respiratory system defenses
The healthy human lung is sterile. There are no normally resident bacteria or viruses (unlike the upper respiratory system and parts of the gastrointestinal system, where bacteria dwell even in a healthy state). There are multiple safeguards along the path of the respiratory system. These are designed to keep invading organisms from leading to infection.
The first line of defense includes the hair in the nostrils, which serves as a filter for large particles. The epiglottis is a trap door of sorts, designed to prevent food and other swallowed substances from entering the larynx and then trachea. Sneezing and coughing, both provoked by the presence of irritants within the respiratory system, help to clear such irritants from the respiratory tract.
Mucus, produced through the respiratory system, also serves to trap dust and infectious organisms. Tiny hair like projections (cilia) from cells lining the respiratory tract beat constantly. They move debris trapped by mucus upwards and out of the respiratory tract. This mechanism of protection is referred to as the mucociliary escalator.
Cells lining the respiratory tract produce several types of immune substances which protect against various organisms. Other cells (called macrophages) along the respiratory tract actually ingest and kill invading organisms.
The organisms that cause pneumonia, then, are usually carefully kept from entering the lungs by virtue of these host defenses. However, when an individual encounters a large number of organisms at once, the usual defenses may be overwhelmed, and infection may occur. This can happen either by inhaling contaminated air droplets, or by aspiration of organisms inhabiting the upper airways.
Conditions predisposing to pneumonia
In addition to exposure to sufficient quantities of causative organisms, certain conditions may make an individual more likely to become ill with pneumonia. Certainly, the lack of normal anatomical structure could result in an increased risk of pneumonia. For example, there are certain inherited defects of cilia which result in less effective protection. Cigarette smoke, inhaled directly by a smoker or second-hand by a innocent bystander, interferes significantly with ciliary function, as well as inhibiting macrophage function.
Stroke, seizures, alcohol, and various drugs interfere with the function of the epiglottis. This leads to a leaky seal on the trap door, with possible contamination by swallowed substances and/or regurgitated stomach contents. Alcohol and drugs also interfere with the normal cough reflex. This further decreases the chance of clearing unwanted debris from the respiratory tract.
Viruses may interfere with ciliary function, allowing themselves or other microorganism invaders (such as bacteria) access to the lower respiratory tract. One of the most important viruses is HIV (Human Immunodeficiency virus), the causative virus in AIDS (acquired immunodeficiency syndrome). In recent years this virus has resulted in a huge increase in the incidence of pneumonia. Because AIDS results in a general decreased effectiveness of many aspects of the host's immune system, a patient with AIDS is susceptible to all kinds of pneumonia. This includes some previously rare parasitic types which would be unable to cause illness in an individual possessing a normal immune system.
The elderly have a less effective mucociliary escalator, as well as changes in their immune system. This causes this age group to be more at risk for the development of pneumonia.
Various chronic conditions predispose a person to infection with pneumonia. These include asthma, cystic fibrosis, and neuromuscular diseases which may interfere with the seal of the epiglottis. Esophageal disorders may result in stomach contents passing upwards into the esophagus. This increases the risk of aspiration into the lungs of those stomach contents with their resident bacteria. Diabetes, sickle cell anemia, lymphoma, leukemia, and emphysema also predispose a person to pneumonia.
Genetic factors also appear to be involved in susceptibility to pneumonia. Certain changes in DNA appear to affect some patients' risk of developing such complications of pneumonia as septic shock.
Pneumonia is also one of the most frequent infectious complications of all types of surgery. Many drugs used during and after surgery may increase the risk of aspiration, impair the cough reflex, and cause a patient to underfill their lungs with air. Pain after surgery also discourages a patient from breathing deeply enough, and from coughing effectively.
Radiation treatment for breast cancer increases the risk of pneumonia in some patients by weakening lung tissue.
Causes and symptoms
The list of organisms which can cause pneumonia is very large, and includes nearly every class of infecting organism: viruses, bacteria, bacteria-like organisms, fungi, and parasites (including certain worms). Different organisms are more frequently encountered by different age groups. Further, other characteristics of an individual may place him or her at greater risk for infection by particular types of organisms:
Pneumonia is suspected in any patient who has fever, cough, chest pain, shortness of breath, and increased respirations (number of breaths per minute). Fever with a shaking chill is even more suspicious. Many patients cough up clumps of sputum, commonly known as spit. These secretions are produced in the alveoli during an infection or other inflammatory condition. They may appear streaked with pus or blood. Severe pneumonia results in the signs of oxygen deprivation. This includes blue appearance of the nail beds or lips (cyanosis).
The invading organism causes symptoms, in part, by provoking an overly-strong immune response in the lungs. In other words, the immune system, which should help fight off infections, kicks into such high gear, that it damages the lung tissue and makes it more susceptible to infection. The small blood vessels in the lungs (capillaries) become leaky, and protein-rich fluid seeps into the alveoli. This results in less functional area for oxygen-carbon dioxide exchange. The patient becomes relatively oxygen deprived, while retaining potentially damaging carbon dioxide. The patient breathes faster and faster, in an effort to bring in more oxygen and blow off more carbon dioxide.
Mucus production is increased, and the leaky capillaries may tinge the mucus with blood. Mucus plugs actually further decrease the efficiency of gas exchange in the lung. The alveoli fill further with fluid and debris from the large number of white blood cells being produced to fight the infection.
Consolidation, a feature of bacterial pneumonias, occurrs when the alveoli, which are normally hollow air spaces within the lung, instead become solid, due to quantities of fluid and debris.
Viral pneumonias and mycoplasma pneumonias do not result in consolidation. These types of pneumonia primarily infect the walls of the alveoli and the stroma of the lung.
Severe acute respiratory syndrome (sars)
Severe acute respiratory syndrome, or SARS, is a contagious and potentially fatal disease that first appeared in the form of a multi-country outbreak in early February 2003. Later that month, the CDC began to work with the World Health Organization (WHO) to investigate the cause(s) of SARS and to develop guidelines for infection control. SARS has been described as an "atypical pneumonia of unknown etiology;" by the end of March 2003, the disease agent was identified as a previously unknown coronavirus.
The early symptoms of SARS include a high fever with chills, headache, muscle cramps, and weakness. This early phase is followed by respiratory symptoms, usually a dry cough and painful or difficult breathing. Some patients require mechanical ventilation. The mortality rate of SARS is thought to be about 3%.
As of the end of March 2003, the CDC did not have clearly defined recommendations for treating SARS. Treatments that have been used include antibiotics known to be effective against bacterial pneumonia; ribavirin and other antiviral drugs; and steroids.
Diagnosis
For the most part, diagnosis is based on the patient's report of symptoms, combined with examination of the chest. Listening with a stethoscope will reveal abnormal sounds, and tapping on the patient's back (which should yield a resonant sound due to air filling the alveoli) may instead yield a dull thump if the alveoli are filled with fluid and debris.
Laboratory diagnosis can be made of some bacterial pneumonias by staining sputum with special chemicals and looking at it under a microscope. Identification of the specific type of bacteria may require culturing the sputum (using the sputum sample to grow greater numbers of the bacteria in a lab dish.).
X-ray examination of the chest may reveal certain abnormal changes associated with pneumonia. Localized shadows obscuring areas of the lung may indicate a bacterial pneumonia, while streaky or patchy appearing changes in the x-ray picture may indicate viral or mycoplasma pneumonia. These changes on x ray, however, are known to lag in time behind the patient's actual symptoms.
Treatment
Prior to the discovery of penicillin antibiotics, bacterial pneumonia was almost always fatal. Today, antibiotics, especially given early in the course of the disease, are very effective against bacterial causes of pneumonia. Erythromycin and tetracycline improve recovery time for symptoms of mycoplasma pneumonia. They, do not, however, eradicate the organisms. Amantadine and acyclovir may be helpful against certain viral pneumonias.
A newer antibiotic named linezolid (Zyvox) is being used to treat penicillin-resistant organisms that cause pneumonia. Linezolid is the first of a new line of antibiotics known as oxazolidinones. Another new drug known as ertapenem (Invanz) is reported to be effective in treating bacterial pneumonia.
Shortness of Breath - From the Free Dictionary
Shortness of Breath
Definition
Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. It is a symptom of a variety of different diseases or disorders and may be either acute or chronic.
Description
The experience of dyspnea depends on its severity and underlying causes. The feeling itself results from a combination of impulses relayed to the brain from nerve endings in the lungs, rib cage, chest muscles, or diaphragm, combined with the patient's perception and interpretation of the sensation. In some cases, the patient's sensation of breathlessness is intensified by anxiety about its cause. Patients describe dyspnea variously as unpleasant shortness of breath, a feeling of increased effort or tiredness in moving the chest muscles, a panicky feeling of being smothered, or a sense of tightness or cramping in the chest wall.
Causes and symptoms
ACUTE DYSPNEA. Acute dyspnea with sudden onset is a frequent cause of emergency room visits. Most cases of acute dyspnea involve pulmonary (lung and breathing) disorders, cardiovascular disease, or chest trauma.
PULMONARY DISORDERS. Pulmonary disorders that can cause dyspnea include airway obstruction by a foreign object, swelling due to infection, or anaphylactic shock; acute pneumonia; hemorrhage from the lungs; or severe bronchospasms associated with asthma.
CARDIOVASCULAR DISEASE. Acute dyspnea can be caused by disturbances of the heart rhythm, failure of the left ventricle, mitral valve (a heart valve) dysfunction, or an embolus (a clump of tissue, fat, or gas) that is blocking the pulmonary circulation. Most pulmonary emboli (blood clots) originate in the deep veins of the lower legs and eventually migrate to the pulmonary artery.
TRAUMA. Chest injuries, both closed injuries and penetrating wounds, can cause pneumothorax (the presence of air inside the chest cavity), bruises, or fractured ribs. Pain from these injuries results in dyspnea. The impact of the driver's chest against the steering wheel in auto accidents is a frequent cause of closed chest injuries.
OTHER CAUSES. Anxiety attacks sometimes cause acute dyspnea; they may or may not be associated with chest pain. Anxiety attacks are often accompanied by hyperventilation, which is a breathing pattern characterized by abnormally rapid and deep breaths. Hyperventilation raises the oxygen level in the blood, causing chest pain and dizziness.
Chronic dyspnea
PULMONARY DISORDERS. Chronic dyspnea can be caused by asthma, chronic obstructive pulmonary disease (COPD), bronchitis, emphysema, inflammation of the lungs, pulmonary hypertension, tumors, or disorders of the vocal cords.
HEART DISEASE. Disorders of the left side of the heart or inadequate supply of blood to the heart muscle can cause dyspnea. In some cases a tumor in the heart or inflammation of the membrane surrounding the heart may cause dyspnea.
NEUROMUSCULAR DISORDERS. Neuromuscular disorders cause dyspnea from progressive deterioration of the patient's chest muscles. They include muscular dystrophy, myasthenia gravis, and amyotrophic lateral sclerosis.
OTHER CAUSES. Patients who are severely anemic may develop dyspnea if they exercise vigorously. Hyperthyroidism or hypothyroidism may cause shortness of breath, and so may gastroesophageal reflux disease (GERD). Both chronic anxiety disorders z of physical fitness can also cause episodes of dyspnea. Deformities of the chest or obesity can cause dyspnea by limiting the movement of the chest wall and the ability of the lungs to fill completely.
Diagnosis
Patient history
The patient's history provides the doctor with such necessary information as a history of gastroesophageal reflux disease (GERD), asthma, or other allergic conditions; the presence of chest pain as well as difficulty breathing; recent accidents or recent surgery; information about smoking habits; the patient's baseline level of physical activity and exercise habits; and a psychiatric history of panic attacks or anxiety disorders.
ASSESSMENT OF BODY POSITION. How a person's body position affects his/her dyspnea symptoms sometimes gives hints as to the underlying cause of the disorder. Dyspnea that is worse when the patient is sitting up is called platypnea and indicates the possibility of liver disease. Dyspnea that is worse when the patient is lying down is called orthopnea, and is associated with heart disease or paralysis of the diaphragm. Paroxysmal nocturnal dyspnea (PND) refers to dyspnea that occurs during sleep and forces the patient to awake gasping for breath. It is usually relieved if the patient sits up or stands. PND may point to dysfunction of the left ventricle of the heart, hypertension, or narrowing of the mitral valve.
Physical examination
The doctor will examine the patient's chest in order to determine the rate and depth of breathing, the effort required, the condition of the patient's breathing muscles, and any evidence of chest deformities or trauma. He or she will listen for wheezing, stridor, or signs of fluid in the lungs. If the patient has a fever, the doctor will look for other signs of pneumonia. The doctor will check the patient's heart functions, including blood pressure, pulse rate, and the presence of heart murmurs or other abnormal heart sounds. If the doctor suspects a blood clot in one of the large veins leading to the heart, he or she will examine the patient's legs for signs of swelling.
Diagnostic tests
BASIC DIAGNOSTIC TESTS. Patients who are seen in emergency rooms are given a chest x ray and electrocardiogram (ECG) to assist the doctor in evaluating abnormalities of the chest wall, also to determine the position of the diaphragm, possible rib fractures or pneumothorax, irregular heartbeat, or the adequacy of the supply of blood to the heart muscle. Also, the patient may be given a breathing test on an instrument called a spirometer to screen for airway disorders.
The doctor may order blood tests and arterial blood gas tests to rule out anemia, hyperventilation—from an anxiety attack—, or thyroid dysfunction. A sputum culture can be used to test for pneumonia.
SPECIALIZED TESTS. Specialized tests may be ordered for patients with normal results from basic diagnostic tests for dyspnea. High-resolution CT scans can be used for suspected airway obstruction or mild emphysema. Tissue biopsy performed with a bronchoscope can be used for patients with suspected lung disease.
If the doctor suspects a pulmonary embolism, heor she may order ventilation-perfusion scanning to inspect lung function, an angiogram of blood vessels, or ultrasound studies of the leg veins. Echocardiography can be used to test for pulmonary hypertension and heart disease.
Pulmonary function studies or electromyography (EMG) are used to assess neuromuscular diseases. Exercise testing is used to assess dyspnea related to COPD, anxiety attacks, poor physical fitness, and the severity of lung or heart disease. The level of acidity in the patient's esophagus may be monitored to rule out GERD.
Treatment
Treatment of dyspnea depends on its underlying cause.
Acute dyspnea
Patients with acute dyspnea are given oxygen in the emergency room, with the following treatments for specific conditions:
Chronic dyspnea
The treatment of chronic dyspnea depends on the underlying disorder. Asthma can often be managed with a combination of medications to reduce airway spasms and removal of allergens from the patient's environment. COPD requires both medication, lifestyle changes, and long-term physical rehabilitation. Anxiety disorders are usually treated with a combination of medication and psychotherapy. GERD can usually be managed with antacids, other medications, and dietary changes. There are no permanent cures for myasthenia gravis or muscular dystrophy.
Tumors and certain types of chest deformities can be treated surgically.
Alternative treatment
The appropriate alternative therapy for shortness of breath depends on the underlying cause of the condition. When dyspnea is acute and severe, oxygen therapy is used either in the doctor's office or in the emergency room. For shortness of breath with an underlying physical cause like asthma, anaphylactic shock, or pneumonia, the physical condition should be treated. Botanical and homeopathic remedies can be used for acute dyspnea, if the proper remedies and formulas are prescribed. If the dyspnea has a psychological basis (especially if it is caused by anxiety), acupuncture, botanical medicine, and homeopathy can help the patient heal at a deep level.
Definition
Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. It is a symptom of a variety of different diseases or disorders and may be either acute or chronic.
Description
The experience of dyspnea depends on its severity and underlying causes. The feeling itself results from a combination of impulses relayed to the brain from nerve endings in the lungs, rib cage, chest muscles, or diaphragm, combined with the patient's perception and interpretation of the sensation. In some cases, the patient's sensation of breathlessness is intensified by anxiety about its cause. Patients describe dyspnea variously as unpleasant shortness of breath, a feeling of increased effort or tiredness in moving the chest muscles, a panicky feeling of being smothered, or a sense of tightness or cramping in the chest wall.
Causes and symptoms
ACUTE DYSPNEA. Acute dyspnea with sudden onset is a frequent cause of emergency room visits. Most cases of acute dyspnea involve pulmonary (lung and breathing) disorders, cardiovascular disease, or chest trauma.
PULMONARY DISORDERS. Pulmonary disorders that can cause dyspnea include airway obstruction by a foreign object, swelling due to infection, or anaphylactic shock; acute pneumonia; hemorrhage from the lungs; or severe bronchospasms associated with asthma.
CARDIOVASCULAR DISEASE. Acute dyspnea can be caused by disturbances of the heart rhythm, failure of the left ventricle, mitral valve (a heart valve) dysfunction, or an embolus (a clump of tissue, fat, or gas) that is blocking the pulmonary circulation. Most pulmonary emboli (blood clots) originate in the deep veins of the lower legs and eventually migrate to the pulmonary artery.
TRAUMA. Chest injuries, both closed injuries and penetrating wounds, can cause pneumothorax (the presence of air inside the chest cavity), bruises, or fractured ribs. Pain from these injuries results in dyspnea. The impact of the driver's chest against the steering wheel in auto accidents is a frequent cause of closed chest injuries.
OTHER CAUSES. Anxiety attacks sometimes cause acute dyspnea; they may or may not be associated with chest pain. Anxiety attacks are often accompanied by hyperventilation, which is a breathing pattern characterized by abnormally rapid and deep breaths. Hyperventilation raises the oxygen level in the blood, causing chest pain and dizziness.
Chronic dyspnea
PULMONARY DISORDERS. Chronic dyspnea can be caused by asthma, chronic obstructive pulmonary disease (COPD), bronchitis, emphysema, inflammation of the lungs, pulmonary hypertension, tumors, or disorders of the vocal cords.
HEART DISEASE. Disorders of the left side of the heart or inadequate supply of blood to the heart muscle can cause dyspnea. In some cases a tumor in the heart or inflammation of the membrane surrounding the heart may cause dyspnea.
NEUROMUSCULAR DISORDERS. Neuromuscular disorders cause dyspnea from progressive deterioration of the patient's chest muscles. They include muscular dystrophy, myasthenia gravis, and amyotrophic lateral sclerosis.
OTHER CAUSES. Patients who are severely anemic may develop dyspnea if they exercise vigorously. Hyperthyroidism or hypothyroidism may cause shortness of breath, and so may gastroesophageal reflux disease (GERD). Both chronic anxiety disorders z of physical fitness can also cause episodes of dyspnea. Deformities of the chest or obesity can cause dyspnea by limiting the movement of the chest wall and the ability of the lungs to fill completely.
Diagnosis
Patient history
The patient's history provides the doctor with such necessary information as a history of gastroesophageal reflux disease (GERD), asthma, or other allergic conditions; the presence of chest pain as well as difficulty breathing; recent accidents or recent surgery; information about smoking habits; the patient's baseline level of physical activity and exercise habits; and a psychiatric history of panic attacks or anxiety disorders.
ASSESSMENT OF BODY POSITION. How a person's body position affects his/her dyspnea symptoms sometimes gives hints as to the underlying cause of the disorder. Dyspnea that is worse when the patient is sitting up is called platypnea and indicates the possibility of liver disease. Dyspnea that is worse when the patient is lying down is called orthopnea, and is associated with heart disease or paralysis of the diaphragm. Paroxysmal nocturnal dyspnea (PND) refers to dyspnea that occurs during sleep and forces the patient to awake gasping for breath. It is usually relieved if the patient sits up or stands. PND may point to dysfunction of the left ventricle of the heart, hypertension, or narrowing of the mitral valve.
Physical examination
The doctor will examine the patient's chest in order to determine the rate and depth of breathing, the effort required, the condition of the patient's breathing muscles, and any evidence of chest deformities or trauma. He or she will listen for wheezing, stridor, or signs of fluid in the lungs. If the patient has a fever, the doctor will look for other signs of pneumonia. The doctor will check the patient's heart functions, including blood pressure, pulse rate, and the presence of heart murmurs or other abnormal heart sounds. If the doctor suspects a blood clot in one of the large veins leading to the heart, he or she will examine the patient's legs for signs of swelling.
Diagnostic tests
BASIC DIAGNOSTIC TESTS. Patients who are seen in emergency rooms are given a chest x ray and electrocardiogram (ECG) to assist the doctor in evaluating abnormalities of the chest wall, also to determine the position of the diaphragm, possible rib fractures or pneumothorax, irregular heartbeat, or the adequacy of the supply of blood to the heart muscle. Also, the patient may be given a breathing test on an instrument called a spirometer to screen for airway disorders.
The doctor may order blood tests and arterial blood gas tests to rule out anemia, hyperventilation—from an anxiety attack—, or thyroid dysfunction. A sputum culture can be used to test for pneumonia.
SPECIALIZED TESTS. Specialized tests may be ordered for patients with normal results from basic diagnostic tests for dyspnea. High-resolution CT scans can be used for suspected airway obstruction or mild emphysema. Tissue biopsy performed with a bronchoscope can be used for patients with suspected lung disease.
If the doctor suspects a pulmonary embolism, heor she may order ventilation-perfusion scanning to inspect lung function, an angiogram of blood vessels, or ultrasound studies of the leg veins. Echocardiography can be used to test for pulmonary hypertension and heart disease.
Pulmonary function studies or electromyography (EMG) are used to assess neuromuscular diseases. Exercise testing is used to assess dyspnea related to COPD, anxiety attacks, poor physical fitness, and the severity of lung or heart disease. The level of acidity in the patient's esophagus may be monitored to rule out GERD.
Treatment
Treatment of dyspnea depends on its underlying cause.
Acute dyspnea
Patients with acute dyspnea are given oxygen in the emergency room, with the following treatments for specific conditions:
Chronic dyspnea
The treatment of chronic dyspnea depends on the underlying disorder. Asthma can often be managed with a combination of medications to reduce airway spasms and removal of allergens from the patient's environment. COPD requires both medication, lifestyle changes, and long-term physical rehabilitation. Anxiety disorders are usually treated with a combination of medication and psychotherapy. GERD can usually be managed with antacids, other medications, and dietary changes. There are no permanent cures for myasthenia gravis or muscular dystrophy.
Tumors and certain types of chest deformities can be treated surgically.
Alternative treatment
The appropriate alternative therapy for shortness of breath depends on the underlying cause of the condition. When dyspnea is acute and severe, oxygen therapy is used either in the doctor's office or in the emergency room. For shortness of breath with an underlying physical cause like asthma, anaphylactic shock, or pneumonia, the physical condition should be treated. Botanical and homeopathic remedies can be used for acute dyspnea, if the proper remedies and formulas are prescribed. If the dyspnea has a psychological basis (especially if it is caused by anxiety), acupuncture, botanical medicine, and homeopathy can help the patient heal at a deep level.
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