The Symptoms of Diabetes Publishes Details Information About Diabetes Symptoms

We’ve all seen the movie scenes where a man gasps, clutches his chest and falls to the ground. In reality, a heart attack victim could easily be a woman, and the scene may not be that dramatic. “Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure, ” said Nieca Goldberg, M.D., medical director for the Joan H. Tisch Center for Women's Health at NYU’s Langone Medical Center and an American Heart Association volunteer. “Instead they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.”
Even when the signs are subtle, the consequences can be deadly, especially if the victim doesn’t get help right away.

‘I thought I had the flu’  Even though heart disease is the No. 1 killer of women, women often chalk up the symptoms to less life-threatening conditions like acid reflux, the flu or normal aging.
“They do this because they are scared and because they put their families first,” Goldberg said. “There are still many women who are shocked that they could be having a heart attack.”

A heart attack strikes someone about every 34 seconds. It occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. This happens because the arteries that supply the heart with blood can slowly narrow from a buildup of fat, cholesterol and other substances (plaque).

Watch an animation of a heart attack.
Many women think the signs of a heart attack are unmistakable — the image of the elephant comes to mind — but in fact they can be subtler and sometimes confusing.
You could feel so short of breath, “as though you ran a marathon, but you haven't made a move,” Goldberg said.
Some women experiencing a heart attack describe upper back pressure that feels like squeezing or a rope being tied around them, Goldberg said. Dizziness, lightheadedness or actually fainting are other symptoms to look for.
“Many women I see take an aspirin if they think they are having a heart attack and never call 9-1-1,” Goldberg said. “But if they think about taking an aspirin for their heart attack, they should also call 9-1-1.”
Take care of yourself
Heart disease is preventable. Here are Goldberg’s top tips:

• Schedule an appointment with your healthcare provider to learn your personal risk for heart disease. You can also learn your risk with our Heart Attack Risk Calculator.
• Quit smoking. Did you know that just one year after you quit, you’ll cut your risk of coronary heart disease by 50 percent?
• Start an exercise program. Just walking 30 minutes a day can lower your risk for heart attack and stroke.
• Modify your family’s diet if needed. Check out these healthy cooking tips. You’ll learn smart substitutions, healthy snacking ideas and better prep methods. For example, with poultry, use the leaner light meat (breasts) instead of the fattier dark meat (legs and thighs), and be sure to remove the skin.

Heart Attack Signs in Women

1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
3. Shortness of breath with or without chest discomfort.
4. Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
5. As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

If you have any of these signs, don’t wait more than five minutes before calling for help. Call 9-1-1 and get to a hospital right away.

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Persons with severe symptoms of mental illness are at higher risk for being HIV-infected

People receiving mental health care are up to four times more likely to be infected with HIV than the general population, according to a new study published Feb. 13 in the American Journal of Public Health from researchers at Penn Medicine and other institutions who tested over 1,000 patients in care in Philadelphia and Baltimore. Of that group, several new HIV cases were detected, suggesting that not all patients are getting tested in mental health care settings, despite recommendations to do so from the CDC and the Institute of Medicine.
The study is one of the largest studies to date to estimate HIV prevalence and risk factors among persons receiving treatment in mental health settings and included researchers from the Centers for Disease Control and Prevention (CDC), as well as the University of Maryland and Columbia University Medical Center.

"These findings paint a recent picture of HIV infection rates in the community, and reinforce how important it is to identify patients and get them into appropriate infectious disease care in a timely manner while being treated for mental illness," said lead author Michael B. Blank, PhD, associate professor in Psychiatry at the Perelman School of Medicine. "With such a high-risk group, it's imperative to be routinely testing patients to improve care and reduce transmissions to others. Historically, though, HIV testing is often not implemented in mental health care."
For the study, researchers provided rapid HIV testing to 1,061 individuals (621 men and 436 women) seeking treatment for symptoms, including depression, psychosis, and substance abuse, at university-based inpatient psychiatry units, intensive case-management programs, and community mental health centers from January 2009 to August 2011. About 0.3 percent of the general population is HIV infected, and CDC estimates a much higher prevalence of 1.4 percent in Philadelphia and 1.3 percent in Baltimore, since both cities are HIV epicenters.
The research team found that 4.8 percent of the mental health patients receiving care (51 individuals) were infected with HIV, which is about four times the base rate in each city and about 16 times the base rate for the United States population. Thirteen of the 51 infected patients reported that they did not know they were HIV positive, which represents an important failure in our public health system since they were already receiving ongoing mental health care. These results suggest that even in areas in the U.S. where prevalence is lower those with mental illness may be at substantially higher risk and should be routinely tested.
Results of the study also showed that persons with more severe symptoms of mental illness were at higher risk for being HIV-infected. HIV prevalence was also higher among the groups most likely to be infected in the general population, including African American, gay or bisexual men, and those infected with Hepatitis C, which is often an indicator of past injection drug use.
Previous studies have found that people with serious mental illness are at an increased risk for being infected with HIV, but many were from the 1990s and early 2000s and produced wide variations in risk, most likely because of small sample sizes, differences in sampling frames, and inadequate adjustment for confounding effects of factors associated with the disease. What's more, the demographics of the HIV epidemic have shifted in the past decade, and the degree to which HIV prevalence among persons with mental illness has changed remains unclear.
Both CDC and the Institute of Medicine recommend routine HIV screening be conducted in all clinical settings, including mental health settings, to increase identification of those infected and strengthen access to care. However, little progress has been made toward integrating HIV testing into mental health care, said Blank.

"There are barriers to testing, be it funding, system-level barriers or access to rapid HIV testing, that need to be addressed in order to have a wider adoption," said Blank, who also serves as the co-director of the recently-established Penn Mental Health AIDS Research Center, alongside co-author David S. Metzger, PhD, director of the HIV/AIDS Prevention Research Division at Penn Medicine, and chair of Psychiatry Dwight L. Evans, MD.
"The results of this important study highlight the need for research into integrated treatments for people with complex, co-occurring conditions like HIV and mental illness," said Dr. Evans.
The health care system's approach to these patients may also play a role in the health disparities that are observed in them. Mental illness and HIV often times go hand in hand; however, today's system is not fully equipped to treat these co-morbidities in tandem. In order to achieve optimal outcomes, patients would be better served with a more integrated approach, rather than today's fragmented one.
Better integration of HIV testing in mental health settings is one example, the authors assert, that can help to relieve significant health burdens and even economic costs associated with these chronic illnesses. More specifically, it will help identify those who do not know they are HIV-positive, as well as improve linkage to and, presumably, retention in HIV medical care.

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5 Miscarriage Symptoms Every Pregnant Woman Should Know

Pregnancy is that happy moment in a woman’s life that brings with it a number of questions and queries. But, sometimes a problem-prone pregnancy can lead to an unfortunate miscarriage. Medical attention during pregnancy is as important as a healthy diet and rest.  Read on to know about the early signs of miscarriage, so that you can get immediate medical attention.

Dr. Jaydeep Tank, Gynaecologist, IVF Specialist, Programme Director and Board Member, Profert IVF Fertility Clinic, Mumbai says, “There are several signs of an impending miscarriage. However, these signs can also indicate other unrelated problems that are not connected to the pregnancy itself. Therefore, when a pregnant lady faces any problems out of the ordinary, it is best that she report to her doctor to establish a diagnosis”.

A miscarriage is the loss of foetus which usually happens at the early stages of pregnancy. The first 20 weeks of pregnancy are crucial and most miscarriages happen at that time. It is a fast and spontaneous effect that enables the women to act against it. If you are a first-time mom awaiting your little bundle of joy, there are some early signs of miscarriage you should be aware of.

“More than 80% of miscarriages occur within the first three months of pregnancy. Miscarriages are less likely to occur after 12 weeks gestation; these are termed second trimester miscarriages. In addition, women may be at increased risk for miscarriage as they get older. Some studies show that the risk of miscarriage is 12% to 15% for women in their 20s and rises to about 25% for women at age 40. The increased incidence of chromosomal abnormalities contributes to the age-related risk of miscarriage,” explains Dr. Tank.

Dr Kunal Doshi, Gynaecologist, Mumbai adds, “Miscarriages seldom happen post the second trimester and thus it is important for the new mom to take good care in the first few months of her pregnancy.”

Symptoms of miscarriage:

1. Cramps: There can be signs of strong cramping in your lower abdomen or the pelvic region and this is an early sign of miscarriage. “Cramps in the stomach during pregnancy are usually a sign of an underlying problem and must be checked with the doctor,” advises Dr. Doshi.  However, slow cramping is normal. You should be careful if the cramping is accompanied by heavy breathing. If you face heavy cramping and bleeding you need to go see a doctor immediately.


2. Bleeding: Though many women experience intermitted spotting all throughout the pregnancy, heavy bleeding indicates signs of miscarriage. This situation needs immediate medical attention.
“The cardinal sign of miscarriage is bleeding per vaginum. The problem may not indicate that the woman is aborting or miscarrying but any bleeding should be bought to the notice of the doctor,” says Dr. Tank.

3. Pain: A sharp pain in the abdomen is a sign of miscarriage in the early days of pregnancy. The pain may even spread and will be felt in the lower back or pelvic region. Contact your doctor and tell her all the symptoms. Preferably you should also go for a check-up just to make sure all is well. “Pain in the abdomen and pelvic regions could also indicate trouble,” says, Dr. Doshi.

4. Blood clots: When blood clots pass through the vagina in the early days of pregnancy, it is a sure sign of miscarriage and if you are able to spot this sign you should get medical help as soon as possible as it will help save the foetus.

5. Movement of foetus: The foetus usually begins to move in the fourth month of pregnancy. This is the time when the mother feels her baby moving and developing. If that movement has stopped, and there is no further development, it can be a sign of miscarriage. Contact your gynecologist immediately.

Timely prediction and awareness of the symptoms of miscarriage can save the foetus and even help it develop into a healthy child. About half of the women who experience early signs of miscarriage and get medical attention are able to carry the baby to the full term. Another well known fact is that women who go through one or two miscarriages can carry babies to their full term without any problem in future too.

Although Dr. Tank believes otherwise and says, “It is a myth that most miscarriages are preventable. Miscarriages can be avoided only in certain cases. Irrespective of the treatment, some miscarriages may still proceed and lead to an aborted baby.”

He continues, “A very large majority of miscarriages are due to chromosomal abnormality of the foetuses and since this genetically programmed into the foetus at the time of fertilisation, it is inevitable.”

According to Dr. Tank, around 10-15 % miscarriages are in the second trimester and these may be due to anatomical problems of the uterus or the cervix like cervical insufficiency where the mouth of the womb is weak and cannot hold the pregnancy back. Corrective measures could be taken in selected cases for these problems.

Miscarriages happen due to hormonal changes, infection or any health problem with the mother. It can also be due to unhealthy lifestyle habits of the mother like smoking, malnutrition, drug use, mother’s age and many more.

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Diarrhea in adults

diarrhea

Diarrhea in adults over the age of 18 years is a common problem for otherwise healthy people, and is experienced by everyone on occasion. There are times, however, when diarrhea is more serious, and needs to be evaluated and treated by physicians and nurses. This note will let you know when to look for medical help.

Diarrhea means different things to different people, but a clear change in number of daily bowel movements, and very loose or watery bowel movements is usually what patients notice first. In 90 percent of cases the problem goes away by itself, and most of those adults have infections due to bacteria or viruses that come from unclean food or water. Diarrhea also can occur when one has a cold or flu, and commonly occurs when one is travelling either in the United States or abroad. Sometimes new medicines such as antibiotics or even chewing too much sugar-free gum or eating magnesium in dietary supplements cause diarrhea, and those things should be avoided.

An adult with diarrhea should look for medical help if:

• Diarrhea is of very high volume, where the patient may be losing much water from the body.

• Diarrhea lasting longer than five days or sooner if stool numbers are increasing each day.

• Diarrhea that contains blood. This may indicate an infection requiring medical treatment.

• Diarrhea with fever, severe abdominal pain or vomiting lasting longer than one or two days. Again, the problem here may be excessive fluid loss.

• Diarrhea occurs in old or sick people, or anyone with longstanding diseases of other kinds.

In patients having a few days of diarrhea that seems to be getting better, it is sometimes worthwhile to replace fluids at home. This can be done safely by mixing half a teaspoon of table salt and six teaspoons of table sugar (or honey) with a quart or liter of clean water, and drinking this over a period of one or two hours. This can be repeated if diarrhea continues, and is safe for nearly everyone, even with other illnesses. It is also useful for the person with diarrhea to carefully clean the toilet, wash their hands with soap and water after each bowel movement, not prepare food for others in the family, and not to share towels with others.

Chronic diarrhea that goes on for months or even years is a completely different problem and needs a careful evaluation by a physician.

To emphasize, diarrhea is not often a sign of serious disease and usually clears up on its own. A physician or hospital emergency clinic should be consulted if one notices any problems in the list above.

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Codeine

What is codeine?

Codeine is in a group of drugs called narcotic pain medicines.

Codeine is used to treat mild to moderately severe pain.

Codeine may also be used for purposes not listed in this medication guide.

Important information about codeine

Codeine may be habit-forming and should be used only by the person it was prescribed for. Never share codeine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol.

Never take codeine in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Codeine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop using codeine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using codeine.

Before taking codeine

Do not use codeine if you have ever had an allergic reaction to a narcotic medicine (examples include, methadone, morphine, OxyContin, Darvocet, Percocet, Vicodin, Lortab, and many others). You should also not take codeine if you are having an asthma attack or if you have abowel obstruction called paralytic ileus.

Codeine may be habit-forming and should be used only by the person it was prescribed for. Never share codeine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

If you have any of these other conditions, you may need a codeine dose adjustment or special tests:

• asthma, COPD, sleep apnea, or other breathing disorders;
• liver or kidney disease;
• underactive thyroid;
• curvature of the spine;
• a history of head injury or brain tumor;
• epilepsy or other seizure disorder;
• low blood pressure;
• gallbladder disease;
• a pancreas disorder;
• an intestinal disorder;
• Addison's disease or other adrenal gland disorders;
• enlarged prostate, urination problems;
• mental illness; or
• a history of drug or alcohol addiction.

FDA pregnancy category C. It is not known whether codeine will harm an unborn baby. Codeine may cause addiction or withdrawal symptoms in a newborn if the mother takes this medicine during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. Codeine can pass into breast milk and may harm a nursing baby. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Do not use codeine without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the effects of this medicine.

How should I take codeine?

Take codeine exactly as prescribed. Never take codeine in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Take this medicine with a full glass of water.

Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking codeine. Do not use a stool softener (laxative) without first asking your doctor.

Take codeine with food or milk if it upsets your stomach. Do not stop using codeine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using codeine. Store at room temperature away from moisture and heat. Keep track of the amount of medicine used from each new bottle. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

After you have stopped using this medication, flush any unused pills down the toilet.

What happens if I miss a dose?

Since this medicine is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of codeine can be fatal.

Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.

What should I avoid while taking codeine?

Do not drink alcohol while you are taking codeine. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol. Codeine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Codeine side effects

Get emergency medical help if you have any of these signs of an allergic reaction to codeine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:

• slow heart rate, weak pulse, fainting, shallow breathing;
• feeling like you might pass out;
• confusion, agitation, hallucinations, unusual thoughts or behavior;
• feelings of extreme happiness or sadness;
• seizure (convulsions); or
• problems with urination.

Less serious codeine side effects include:

• feeling dizzy or drowsy;
• nausea, vomiting, stomach pain,;
• constipation;
• sweating; or
• mild itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Codeine Dosing Information

Usual Codeine Adult Dose for Cough:

Initial dose: 15 mg orally every 6 hours as necessary.
May titrate up to 20 mg every 4 hours.
Maximum 120 mg/day.

Usual Adult Dose for Pain:

Initial dose: 30 mg orally, IM, subcutaneously, or IV every 6 hours as necessary. May titrate dose to achieve desired analgesic effect. Doses up to 60 mg orally, IM, subcutaneously, or IV every 4 hours have been used.

Usual Geriatric Codeine Dose for Cough:

Initial dose: 10 mg orally every 6 hours as necessary.
May titrate cautiously up to 20 mg every 4 hours.
Maximum 120 mg/day.

Usual Geriatric Dose for Pain:

Initial dose: 15 mg orally, IM, subcutaneously, or IV every 6 hours as necessary. May titrate dose to achieve desired analgesic effect. Doses up to 60 mg orally, IM, subcutaneously, or IV every 4 hours have been used.

Usual Pediatric Dose for Cough:

2-6 years: 2.5 to 5 mg orally every 4 to 6 hours.
Maximum 30 mg/day.

6-12 years: 5 to 10 mg orally every 4 to 6 hours.
Maximum 60 mg/day.

Usual Pediatric Codeine Dose for Pain:

>=1 years: 0.5 mg/kg or 15 mg/m2 orally, IM, or subcutaneously every 4 to 6 hours as needed.

What other drugs will affect codeine?

Do not take codeine with any other narcotic pain medications, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.

Before taking codeine, tell your doctor if you are using pentazocine (Talwin), nalbuphine (Nubain), butorphanol (Stadol), or buprenorphine (Buprenex, Subutex). If you are using any of these drugs, you may not be able to use codeine, or you may need dosage adjustments or special tests during treatment.

This list is not complete and other drugs may interact with codeine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

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FDA warns Arth-Q dietary supplement contains undeclared ibuprofen, making it dangerous: Food and Drug recalls

The FDA is warning consumers to throw out a dietary supplement called Arth-Q, marketed for arthritis sufferers as "all natural," because it actually contains ibuprofen. The hidden drug ingredient makes the supplement dangerous for people who don't know they're taking the drug. (Plain Dealer file)

CLEVELAND, Ohio -- The Food and Drug Administration is warning that an arthritis pain supplement called Arth-Q contains ibuprofen as a hidden drug ingredient, posing the risk of side effects and drug interactions to people who take the supplement. The FDA's warning is part of a larger effort to bring attention to dietary supplements and conventional foods that contain hidden drug ingredients, which the agency says is a growing problem. Many of the products are sold as weight loss aids or for sexual enhancement and body-building. Arth-Q, which is sold online at various websites, including Amazon.com, is advertised as "100 percent natural." It is labeled in English but also promoted in the Korean community as “알쓰큐” or “알쓰Q,” according to the release.

 Related stories Weight loss supplement OxyElite recalled due to liver damage, one death Cleveland woman hospitalized with liver damage after taking OxyElite FDA warns consumers of hidden drug ingredients in weight loss supplements Johnson & Johnson recalls infant's Motrin drops FDA testing of the supplement revealed the drug ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), which is used for pain relief. NSAIDs increase the risk of cardiovascular events such as heart attacks and congestive heart failure, as well as gastrointestinal bleeding. Taking the supplement may increase the risk of adverse events, especially if a consumer is already taking NSAIDs, the agency said. Consumers should stop taking Arth-Q and dispose of it immediately. If you have experienced an adverse event, contact your doctor. Negative side effects may include signs of bleeding such as unusually dark stools or urine, stomach pain, or increased bruising.

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Bird Flu (H5N1) Symptoms

The avian influenza hemagglutinin binds alpha 2-3 sialic acid receptors while human influenza hemagglutinins bind alpha 2-6 sialic acid receptors. This means that when the H5N1 strain infects humans it will replicate in the lower respiratory tract, and consequently will cause viral pneumonia. There is as yet no human form of H5N1, so all humans who have caught it so far have caught avian H5N1. In general, humans who catch a humanized Influenza A virus (a human flu virus of type A) usually have symptoms that include fever, cough, sore throat, muscle aches, conjunctivitis, and, in severe cases, breathing problems and pneumonia that may be fatal. The severity of the infection depends to a large part on the state of the infected person's immune system and whether the victim has been exposed to the strain before (in which case they would be partially immune). No one knows if these or other symptoms will be the symptoms of a humanized H5N1 flu.

 The reported mortality rate of highly pathogenic H5N1 avian influenza in a human is high; WHO data indicates that 60% of cases classified as H5N1 resulted in death. However, there is some evidence that the actual mortality rate of avian flu could be much lower, as there may be many people with milder symptoms who do not seek treatment and are not counted.

 In one case, a boy with H5N1 experienced diarrhea followed rapidly by a coma without developing respiratory or flu-like symptoms. There have been studies of the levels of cytokines in humans infected by the H5N1 flu virus. Of particular concern is elevated levels of tumor necrosis factor-alpha, a protein that is associated with tissue destruction at sites of infection and increased production of other cytokines. Flu virus-induced increases in the level of cytokines is also associated with flu symptoms including fever, chills, vomiting and headache. Tissue damage associated with pathogenic flu virus infection can ultimately result in death.

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