What Is Leishmaniasis?

 Leishmaniasis is a type of infection which is caused by protozoal parasites from the Leishmania species. These parasites are spread from person to person through the bite of the female phlebotomine sand fly. This sandfly reside in many tropical and temperate countries.

There are two clinical syndrome of leishmaniasis: visceral or cutaneous. Visceral leishmaniasis (VL)is a type of leishmaniasis that affects the organs of the body. Cutaneous leishmaniasis (CL) on the other hand is the most common form of leishmaniasis; this type infects the skin. A type of cutaneous leishmaniasis is mucocutaneous leishmaniasis (ML) which invades the mucocutaneous membranes.

Leishmania protozoal parasites are microscopic parasites; there are about 21 species of them which affects humans, including the L. donovani complex and the L. Mexicana complex. This parasite is transmitted from person to person by the sandfly. When the sandfly carrier bites a person, it injects small numbers of parasites which are rapidly taken up by mononuclear blood cells. This stage is called the promastigote stage. The parasites then enter the mononuclear cells and enter the amastigote stage and begin to multiply and infect other cells and tissues. These parasites are then taken up by sandflies again; they may also get the parasite from infected animals such as dogs, foxes, or rodents. A less common route of transmission is through blood transfusion or through drug users sharing contaminated needles. Leishmania may also be transmitted from a pregnant mother to her fetus.

There are some people who are at high risk of acquiring the parasites. People who are exposed to infected sandflies are those who can readily become infected with Leishmania. These sandflies are most active after dusk in rural areas. Travelers who go in these places are susceptible to this infection. Examples of these travellers are adventure travelers, Peace Corps workers, missionaries, soldiers, and those with occupational activities that require them to live in rural areas. The immune response towards the parasite is determined by genes. In visceral leishmaniasis, a weak immune response is associated with more severe disease. Those who have weak immune responses include those who are malnourished and those who are infected with the human immunodeficiency virus (HIV). However, in mucocutaneous leishmaniasis, the symptoms appear to be caused in part by an overactive immune response. The inflammatory response is overstimulated, making the parasite more dangerous.

In some people Leishmania may hide in the body for years and slowly begin to multiply if the immune system is suppressed, as what happens in those who have received chemotherapy, use steroids, or are infected with HIV. Leishmania infection may bring about signs and symptoms such as weight loss, low blood counts (pancytopenia), enlargement of the liver and spleen (hepatosplenomegaly), intermittent fever and high levels of immune globulin in the blood (hypergammaglobulinemia). There may be darkness of the skin, a condition known as “kala-zar,” which means “black sickness.” There may be a persistent rash or pigment changes in the skin. The disease may affect the kidneys, the bowels and the lungs, further causing problems. Cutaneous leishmaniasis (CL) can bring about skin sores which may persist for several weeks.

Rapid Diagnostic Tests for Visceral Leishmaniasis

A recent review done by researchers from the Cochrane Infectious Disease Group, co-ordinated through the editorial base in LSTM, conducted an independent review into the effectiveness of rapid diagnostic tests in diagnosing patients with visceral leishmaniasis (VL). The findings were published in The Cochrane Library. The researchers found 24 studies which contained information about five different RDTs, with a total of 4271 participants. An RDT, the rK39 immunochromatographic test gave correct, positive results in 92% of the people with VL and it gave correct, negative results in 92% of the people who did not have the disease. A second RDT, the latex agglutination test gave correct, positive results in 64% of the people with the disease and it gave correct, negative results in 93% of the people without the disease. For the other RDTs evaluated, there are too few studies to assess their accuracy.

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What is Rheumatoid Arthritis?

Rheumatoid arthritis is a medical condition wherein there is pain and swelling of the joints such as that found in the hands, feet and wrists. It can also bring about damage to other parts of the body. Rheumatoid arthritis can bring about a feeling of fatigue and ill-feeling. The symptoms may vary over time and may range from mild to severe. There may be severe pain and difficulty in movement and in the performance of everyday tasks. The symptoms may develop gradually, at first affecting the small joints such as the fingers and toes and later on affecting large joints such as the shoulders and the knees. There may also be accompanying muscle stiffness even early in the course of the disease.

Pain associated with rheumatoid arthritis is often throbbing and aching which is often worse during mornings or after periods of inactivity. Pain is not felt after activity but while resting. There may also be stiffness of the joints especially in the morning and may last for even an hour. There may also be warmth and redness in the affected joint; this may be due to inflammation and may cause the joints to swell and become hot, tender to touch and painful. Rheumatoid arthritis can also cause inflammation around the joints, such as rheumatoid nodules, and in other parts of the body. It can cause inflammation of the tear glands, salivary glands, the lining of the heart and lungs, and the blood vessels.

The condition may affect anyone but it is most common among women and among those who are within the age range of 40 to 70 years old. The cause of it unknown yet it is considered to be an autoimmune disease, which is caused by the immune system attacking the cells that line your joints, making them swollen, stiff and painful. Over time, this can damage the joint itself, the cartilage and nearby bone. The attack is usually on the synovium, a thin membrane of cells that line the joints. The attack of the immune system can cause inflammation which can lead to the release of chemicals that further thicken the synovium and bring damage to the bones, tendons, ligaments and cartilage. These chemicals that make the joint lose its normal shape and alignment and thus can lead to its destruction.

Rheumatoid arthritis often runs in families. It is caused by faulty genes which are passed down from one generation to another. It may also be due to hormones; this may be the reason why this condition is more common in women than men. Rheumatoid arthritis may be due to the effects of estrogen which is a hormone predominant among females. Estrogen may be involved in the development and progression of the condition. Other risk factors for this condition include tobacco smoking and too much alcohol consumption.

There is no real treatment for rheumatoid arthritis; medications may be given to relieve symptoms or slow progress of the condition while surgery may be done to correct joint problems. Supportive treatments may be given such as physiotherapy, massage or acupuncture. If untreated, rheumatoid arthritis may give rise to complications such as carpal tunnel syndrome and inflammation of other areas of the body such as the lungs, heart and eyes.

Rheumatoid Arthritis and Heart Disease

A recent study has shown that patients with rheumatoid arthritis can twice as likely as the average person to develop heart problems. To better pinpoint rheumatoid arthritis patients’ heart disease risk, an international team that includes Mayo researchers has created a heart disease risk calculator tailored to rheumatoid arthritis. This new method is the Transatlantic Cardiovascular Risk Calculator for Rheumatoid Arthritis, or ATACC-RA, which is said to be more effective for rheumatoid arthritis patients than standard heart disease risk calculators such as the Framingham and SCORE risk assessment tools. For example, of 314 rheumatoid arthritis patients studied who eventually developed heart problems, Framingham classified 54 percent, or 168 people, as high risk; ATACC-RA identified 201, or 64 percent, as high risk. The researchers involved in the creation of this calculator are experts from all over the world.

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What is Giant Cell Arteritis?

Giant cell arteritis is a medical condition wherein there is inflammation of the blood vessels of the human body particularly the medium and large-sized arteries located in the head and neck. This condition is also called temporal arteritis because this affects the arteries around the temples. Giant cell arteritis is said to be the most common types of vasculitis, a condition which gives rise to inflammation of the arteries and veins.

Giant cell arteritis can give rise to various signs and symptoms such as aching and soreness in and around the temples, jaw muscle pain while eating, and vision loss. These can often develop suddenly, but may follow vague symptoms such as weight loss and prolonged tiredness. The most common symptom is a mild to severe headache, although some people also experience jaw pain and vision problems. These symptoms usually develop quickly though some people may report feeling more general symptoms such as weight loss or feeling tired all the time, for several weeks or months before more symptoms appear.

Most patients with giant cell arteritis may also experience mild to severe headache which may be sudden in onset. This headache mostly affects the front or the side of the head or temples but can also affect the back or the top of the head, or behind the ears. These areas may also feel tender. This headache may be unique to giant cell arteritis and may not be relieved by doses of painkillers such as paracetamol. The scalp may also feel sore and tender to touch. The arteries in the temples, also known as the temporal arteries, may be visibly swollen.

Less commonly, patients with giant cell arteritis may also feel jaw pain (jaw claudication) and visual disturbances. This jaw pain may be evident upon chewing or talking. The pain stops when the jaw is rested; the pain may be referred to the tongue.

People with giant cell arteritis may also experience vision problems in the form of partial or, less often, complete vision loss in one or both eyes. This feels like shade covering your eye. If this is left untreated, this can progress to total blindness. There may also be episodes of double vision before blindness occurs. Other associated signs and symptoms are mild fever, fatigue, loss of appetite, weight loss and depression.

Giant cell arteritis may give rise to complications such as visual impairment, abdominal aorta aneurysm, and cardiovascular disease. There may be loss vision in one eye to total blindness. Abdominal aortic aneurysm can result from inflammation which can lead to the weakening in the walls of one of the major blood vessels in the body, known as the abdominal aorta. This is the main blood vessel that is responsible for taking blood from the heart and distributing it to the rest of the body. Giant cell arteritis can also predispose one to have cardiovascular disease or diseases of the heart or blood vessels, which can further lead to heart attacks and stroke.

Giant cell arteritis usually affects adults which are over the age of 50 and is three times more common in women than in men. It is also seven times more common in white people than in black people.

Giant Cell Arteritis Can Be Diagnosed Through Cranial Ultrasound

A recent study presented recently at the European League Against Rheumatism Annual Congress (EULAR 2014), shows that cranial ultrasound has a greater sensitivity than temporal artery biopsy, and a comparable specificity in the diagnosis of Giant Cell Arteritis (GCA). The researchers have found out that cranial ultrasound was the strongest predictor for a diagnosis of GCA when results were evaluated against a confirmed clinical diagnosis at three months. The results suggest that cranial ultrasound may soon replace TAB in the assessment of patients with a suspected diagnosis of GCA in routine clinical practice. This study was done by researchers from the Centre for Translational Inflammation Research, University of Birmingham, UK.

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What is Osteoarthritis?

Osteoarthritis is a medical condition which may affect the joints and may bring about unpleasant signs and symptoms. These signs and symptoms vary from person to person and may differ between affected joints. These symptoms are due to mild inflammation of the tissues in and around the joints, damage to the cartilage which is the strong and smooth surface the lines bones and joints and bony growths that develop around the edge of the joints. All these physical changes can lead to pain, stiffness and difficulty doing certain activities.

Common sites affected by arthritis are knees, hips, spine and small joints of the hands and base of the big toe. However, almost any joint can be affected. These joints are affected by pain and stiffness, leading to difficulty in moving the affected joints or doing certain activities. Sometimes, in milder forms of osteoarthritis there may be few on no symptoms at all as the pain can come in episodes. The symptoms may develop slowly into severe osteoarthritis. Other symptoms may include joint tenderness, increased pain and stiffness when you have not moved your joints for a while, joints appearing slightly larger than usual, a grating or crackling sound or sensation in your joints, limited range of movement in your joints and weakness and muscle wasting.

Osteoarthritis can affect both knees over time unless the arthritis is the result of an injury or another condition affecting only one knee. The knees may feel pain upon walking particularly when walking uphill or going up stairs. Sometimes, your knees may ‘give way’ beneath you or make it difficult to straighten your legs. You may also hear a soft, grating sound when you move the affected joint.

Osteoarthritis in the hips

Osteoarthritis in your hips can bring about difficulty in moving your hip joints. Patients may find it hard to put on their shoes and socks or get in and out of a car. There is usually pain in the groin or outside the hip, which is worse when you move the hip. There may also be referred pain in the knee because of the transmission of pain signals. In most cases, pain will be at its worst when walking, although it can also affect the person during rest. Severe pain may warrant consult to an orthopaedic surgeon, in which case a joint replacement operation may be needed.

Osteoarthritis may also affect the spine; the areas of the spine most likely to be affected are the neck and the lower back as these are the most mobile parts of the spine. This condition may also affect the neck so that the ability to turn the head is affected. Other symptoms include muscle spasm in the neck, and pain from the neck can sometimes be felt in the shoulders and arms. Osteoarthritis may also affect the three main areas of the hand: the base of the thumb, the joints closest to the fingertips and the middle joints of the fingers. The fingers may become stiff, painful and swollen and bumps may appear in the finger joints.

Biomarkers in Severe Osteoarthritis

A recent study has identified a correlation between the presence of biomarkers in the blood, known as micro RNAs (miRNAs), and the development of severe osteoarthritis (OA) of the knee or hip joint. The findings suggest that miRNAs may be used as biomarkers to predict severe OA disease in individuals. In this study, researchers examined the serum samples of people with OA, through which they identified three potential miRNA markers. The 816 patients were followed over 15 years and measured for the presence of the 374 miRNAs and the occurrence of OA, using joint replacement (known as arthroplasty), as a definitive outcome of severe OA in the knee or hip.

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What is Sjogren’s Syndrome?

Sjogren’s syndrome is a medical condition which is also considered an autoimmune disease. It is brought about by an attack of the body's immune system into its own cells. In this particular medical condition, the immune system attacks the glands that secrete fluid, such as the tear and saliva glands. This in turn can have various effects such as inflammation of the glands and reduction of tear and saliva production. These changes cause the main symptoms of Sjogren’s syndrome which is dry mouth and dry eyes. In women there may be dryness of the vagina, making it prone to infections.

Sjogren’s syndrome can present with various symptoms such as dry mouth and dry eyes especially in older people. In affected women, there may dryness of the vagina which can give rise to painful intercourse. Along with dryness of mouth, there may be tooth decay, tooth loss, dry cough, difficulty swallowing and chewing, hoarse voice, difficulty speaking, swollen salivary glands, repeated fungal infections of the mouth, and coated or white tongue. Dry eyes can be accompanied by a burning or stinging sensation in your eyes, itchy eyes, a sandy feeling in your eyes, irritated and swollen eyelids, sensitivity to light or photophobia, tired eyes and mucus discharge from the eyes. Symptoms can worsen upon exposure to a windy or smoky environment. Other symptoms of Sjogren’s syndrome include dry skin, tiredness and fatigue, muscle pain, joint pain, stiffness and swelling, vasculitis (inflammation of blood vessels) and difficulty in concentrating, remembering and reasoning.

Sjogren’s syndrome is either classified as primary or secondary. Primary Sjogren’s syndrome usually develops by itself and not as the result of another condition while secondary Sjogren’s syndrome usually develops in combination with another autoimmune condition, such as lupus or rheumatoid arthritis.

The cause of Sjogren’s syndrome is still unknown however some experts attribute it to genetic, environmental and possibly hormonal factors. There are some people who are at high risk for this condition. Primary Sjogren's syndrome is usually triggered by a combination of genetic and environmental factors. Some people are born with genes which make them vulnerable to this condition. Estrogen as a female hormone can also be a factor because Sjogren’s syndrome is common among women and this condition usually starts at the time of menopause when there are low levels of estrogen in the body. Falling estrogen levels can also contribute to dryness. On teh other hand, secondary Sjogren's syndrome can occur later in the course of other autoimmune conditions, such as rheumatoid arthritis or lupus.

Sjogren’s syndrome usually affects women within the age range of 40-60 years old. In the early stages, this medical condition may present with vague symptoms so that early diagnosis may be difficult. Some complications of Sjogren’s syndrome include the development of non-Hodgkin's lymphoma which is a cancer of the lymph glands, giving birth to children with lupus or heart abnormalities and others.

Sjogren’s Syndrome and Heart Attacks

A recent study presented at the European League Against Rheumatism Annual Congress (EULAR 2014) has shown that patients with Sjogren’s syndrome may have an increased risk for heart attacks particularly in the first year following diagnosis. There was also a trend towards an increased risk for stroke. According to the researchers, this is the first general population-based cohort study comparing the relative risk of heart attacks and strokes in patients with new Sjogren’s syndrome with age, sex, and entry-matched controls. They concluded that inflammation as what is behind Sjogren’s syndrome is responsible for the development of cardiovascular diseases and that there is a need for increased monitoring for coronary artery disease in all patients with Sjogren’s syndrome.

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What is Obstructive Sleep Apnea?

Obstructive sleep apnea is a medical condition wherein there are breathing pauses during sleep. There are two breathing interruptions in sleep apnea: apnea and hypopnoea. Apnea is a breathing interruption wherein the   muscles and soft tissues in the throat relax and collapse sufficiently to cause a total blockage of the airway for 10 seconds or more. Hypopnea, on the other hand, is caused by a partial blockage of the airway causing a reduction in airflow of 50% or more.

There are many causes of sleep apnea. One is the collapse of the muscles and the soft tissues of the back of the throat due to excess weight or fat in the neck or other risk factors. These muscles support the tongue, tonsils and soft palate. When there is relaxation of the muscles of the throat, the airways can become totally blocked or narrowed. Oxygen supply in the brain is then interrupted and forces the person to wake up from deep sleep so that the airways may reopen and the person can breathe normally.

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Obstructive sleep apnea can especially affect people who have certain risk factors such as being overweight, being male, being 40 years of age or more, having a large neck, taking sedative medications, having an unusual inner-neck structure, having excess folds in the inner lining of the mouth, alcohol consumption, being menopausal, having a family history of obstructive sleep apnea, diabetes and nasal congestion. Excess weight can increase the bulk of soft tissue in the neck which can then place a strain on the throat muscles. Excess abdominal fat can also lead to breathing difficulties.

Being male as well as being 40 years of age or more can also place you at risk for obstructive sleep apnea. A large neck of greater than 45 cm or 18 inches can also increase the risk for obstructive sleep apnea. Unusual inner neck structures such as an unusually narrow airway, unusually large tonsils or tongue, or a small lower jaw can push the tongue backwards and cause OSA. During menopause, the changes in hormone levels during the menopause may cause the throat muscles to relax and cause obstructive sleep apnea.

At night, people with obstructive sleep apnea may have repeated episodes of apnea and hypopnea. During apnea, the body suffers from lack of oxygen, causing the person to wake up from deep sleep and enter into a lighter phase of sleep or a brief period of wakefulness, in order to restore normal breathing. Repeated episodes of apnoea and hypopnoea can occur. Such events may occur more than once a minute throughout the night. These episodes make the person feel very tired each day while having no memory of breathlessness during the night.

Other sleep apnea symptoms include feeling very sleepy during the day, waking up with a sore or dry throat, poor memory and concentration, headaches (particularly in the morning), irritability and a short temper, anxiety, depression, lack of interest in sex and impotence (inability to get or maintain an erection).

Sleep Apnea and Diabetes Are Related

A large study recently has established the relationship between sleep apnea and diabetes. This study involved more than 8,500 Canadian patients who were followed-up after 67 months. The researchers have demonstrated a link between obstructive sleep apnea (OSA) and the development of diabetes, confirming earlier evidence of such a relationship from smaller studies with shorter follow-up periods. The findings of this study were published in the online issue of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine. The study included 8,678 adults with suspected OSA without diabetes at baseline who underwent a diagnostic sleep study between 1994 and 2010 and were followed through May 2011 using provincial health administrative data to examine the occurrence of diabetes. Sleep apnea severity was assessed with the apnea-hypopnea index (AHI), which indicates severity based on the number of apneas (complete cessation of airflow) and hypopneas (partial cessation of airflow) per hour of sleep. Patients were classified as not having OSA (AHI < 5), or having mild (AHI 5-14.9), moderate (AHI 15-30) or severe (AHI>30) OSA. About 11.7% of these patients developed diabetes.

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What is Prostate Cancer?

Prostate cancer is a type of cancer which mostly affects men. This cancer originates in the prostate, a gland present in the male reproductive system. This organ is located under the urinary bladder and in front of the rectum. The urethra which is the passageway of the urine and semen goes through the prostate. The prostate is made up of tiny glands which produce a fluid that forms a part of the semen. This seminal fluid functions to protect and nourish the sperm. After orgasm, the seminal vesicles secrete a milky fluid that contains semen; this fluid passes through the prostate gland.

The prostate is also involved with urine control using prostate muscle fibers. The muscle fibers in the prostate release and contract to control the flow of urine through the urethra.

The prostate's epithelial cells produce a protein called PSA (prostate-specific antigen). PSA helps in keeping semen in the liquid state. Some of the PSA leaks out in the bloodstream and gets detected by tests. If the PSA levels in the blood are high, this means that there is a prostate problem or there may be prostate cancer.

The growth of the prostate is affected by male hormones. Growth of the prostate may continue even at an older age and may cause the urethra to collapse. Enlargement of the prostate is termed as benign prostatic hyperplasia. This condition must be treated, although this does not really mean cancer.

Prostate cancer usually starts in the cells of the prostate gland and is known as adenocarcinoma. The cancer gradually grows at a slow rate. Cancer changes the size and the shape of the cells of the prostate gland; the changes are described as either low-grade or high-grade. The higher the grade, the more abnormal the cells are. Cancer confined to the prostate gland cells is known as Prostatic intraepithelial neoplasia (PIN). About half of men who have reached 50 years of age have PIN. The most common system for determining the cancer stage and its spread is the TNM (Tumor/Nodes/Metastases). This system involves defining the size of the tumor, how many lymph nodes are involved, and whether there are any other metastases. Another way of grading the tumor through biopsy is through the Gleason System grading which goes from 2 to 10.

The symptoms of prostate cancer includes frequent urination, difficulty in urination, bloody urine, painful urination, painful ejaculation, and difficulty in maintaining an erection. Advanced prostate cancer may bring about symptoms such as bone pain (commonly in the spine, pelvis, or ribs), pain in the proximal part of the femur, leg weakness (if cancer has spread to the spine and compressed the spinal cord), urinary incontinence (if cancer has spread to the spine and compressed the spinal cord) and fecal incontinence (if cancer has spread to the spine and compressed the spinal cord).

Risk factors for prostate cancer include older age, genetics, poor diet, use of anti-inflammatory medicines, obesity, sexually transmitted disease, use of Agent Orange, and presence of Enzyme PRSS3.

New Prostate Cancer Diagnosis

Recently, researchers from Adelaide have found out that seminal fluid (semen) contains biomarkers for prostate cancer. The results of this study are published in journal Endocrine-Related Cancer. The said markers can show not only whether a man has prostate cancer, but also the severity of the cancer. In this study, the researchers collected samples from 60 men and discovered that a number of small ribonucleic acid (RNA) molecules called microRNAs in seminal fluid are increased in those with prostate cancer. The study showed that some of these microRNAs were surprisingly accurate in detecting cancer.

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What is Nasopharyngeal Carcinoma?

Nasopharyngeal carcinoma is quite an uncommon type of cancer arising from the epithelium of the nasopharynx. About half of these cancers occur in children. It is said that this type of cancer is brought about by Epstein-Barr virus (EBV) infection, because this type of virus can infect epithelial cells and transform them into malignant cells.

The symptoms of this cancer are vague and do not reveal themselves early in the course of the disease. These signs and symptoms may only come about once the disease has spread to the regional lymph nodes. This may further bring about enlargement and extension of the tumor in the nasopharynx and may cause nasal obstruction in the form of congestion, nasal discharge and bleeding. There may also be changes in hearing due to blockage of the eustachian tube or direct extension into the ear; cranial nerve palsies may also result due to the extension of the tumor into the base of the skull. Other symptoms include headaches and neck swelling. This neck mass may consist of painless firm lymph node enlargement and may be bilateral. The most common nodes involved are the jugulodigastric, and upper and middle jugular nodes in the anterior cervical chain.

Epstein-Barr virus (EBV) can infect epithelial cells in the nasopharynx and can transform them into cancerous cells. Genetic and environmental factors have been implicated in the development of this disease. Nasopharyngeal cancer may have a genetic etiology because it is often shared within specific ethnic groups, within first degree relatives, within those with A2 HLA haplotypes and within those with cytogenetic abnormalities identified within tumor samples. The environment may also play a role because of the distribution of the disease, bimodal age distribution, and association seen in patients who consume a large amount of preserved foods and/or salted fish.

Nasopharyngeal carcinoma is often treated with radiation therapy. Chemotherapy may also be given in advanced cases and may improve survival of patients. However, radiotherapy may bring about some side effects in the later stages such as xerostomia, hypothyroidism, fibrosis of the neck with complete loss of range of motion, trismus, dental abnormalities, and hypoplasia of irradiated muscular and bony structures. Other complications include abnormalities of the endocrine system and growth retardation, which may be due to radiotherapy. There may also be sensorineural hearing loss whoch may occur after chemotherapy. Renal toxicity can occur in patients receiving cisplatin. Other complications include dental caries as a result of poor dental hygiene, osteonecrosis of the mandible (rare), secondary malignancies and radiation myelitis (uncommon). The survival rates after both radiation therapy and chemotherapy are said to be 50-80%.

New Mechanisms Leading to Treatment of Nasopharyngeal Carcinoma Identified

A recent study done by researchers from the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore, National University Cancer Institute Singapore (NCIS) and National University Hospital Singapore (NUH) have discovered a distinct mutational signature and nine significantly mutated genes associated with nasopharyngeal cancer. The results of this study are said to pave the way for future novel therapies for this disease. This is said to be the first successful comprehensive genomic study of nasopharyngeal carcinoma. This new study has published online in the journal Nature Genetics on 23 June 2014.

In this study data were obtained from genomic DNA and proteins of over 100 nasopharyngeal cancer patients in Singapore through advanced biological technologies. The research revealed that many genes are mutated and dysfunctional in the nasopharyngeal tumour cells, and some of them cause and exacerbate the disease. The analysis also showed enrichment of genetic lesions which affect several important cellular processes and pathways. Furthermore, a number of novel druggable candidates, which are proteins that have the ability to bind with drugs with a high affinity, were uncovered through this comprehensive study.

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What is Low Back Pain?

Low back pain is a common problem affecting a lot of people nowadays, young and old alike. This problem can bring about ache, tension or stiffness on the back. Back pain is often triggered by bad posture while sitting or standing, bending awkwardly, or lifting incorrectly. Most cases of back pain are not serious and may get better in a few weeks. It can usually be treated by exercise and medications.

There are various causes of back pain, considering that the back is a complex area made up of muscle, joints, bones and nerves. The exact cause of back pain can be difficult to pinpoint. Most causes of back pain are not serious however and are often caused by sprains, minor strains, minor wounds or squeezed nerves. It can be caused by everyday activities either at home or at work or it may develop gradually over time. Its causes may include bending awkwardly or for long periods, lifting, carrying, pushing or pulling incorrectly, slouching in chairs, twisting, over-stretching, driving in a hunched position or driving for long periods without taking a break and overuse of the muscles, usually due to sport or repetitive movements (repetitive strain injury). In some cases, the cause may be unknown.

Not all people have recurring low back pain; only those with risk factors are prone to develop it. Those who are at risk for developing back pain include those who are overweight, those who smoke, those who are pregnant, those who use long term medications that weaken bones such as corticosteroids, and those who experience stress which may cause tension in the back muscles. Those who have depression are also at risk for having back pain since this can lead to weight gain.

Back pain is commonly felt in the lower back but it may also be felt in your spine from the neck to the hips. Some types of back pain and its relations include neck pain, whiplash, shoulder pain, frozen shoulder, ankylosing spondylitis, slipped disc and sciatica. Back pain may bring about symptoms such as soreness, tension and stiffness of the back. The pain may also radiate in the front of the body, the side or the back of the leg. Back pain may also be felt after lifting something heavy or twisting your back awkwardly or it can develop gradually as a result of years of poor posture. Occasionally, it may occur for no apparent reason. It may become worse at night, during activity or after prolonged sitting. It may also be due to a trapped or injured nerve in an area of your back behind your rib cage; in this case, there may also be pain in other areas such as the chest, arms and legs.

Upper or middle back pain may also occur in the base of your neck to the bottom of your rib cage. This area is known as the thoracic spine. It may bring about other signs and symptoms such as weakness in your arms or legs or a numb or tingling sensation in your arms, legs, chest, or abdomen (stomach area). It may also lead to loss of bowel or bladder control.

Proposed Standards for Chronic Low Back Pain Research

According to a Task Force report in the June 15 issue of Spine, the journal published by Lippincott Williams & Wilkins, standardized research methods are needed to make greater progress toward reducing the high burden and costs of chronic low back pain. The report introduces a set of proposed research standards to help in comparing the results of chronic low back pain studies. Key issues included defining the problem of chronic low back pain, assessing its impact on patients’ lives, identifying the minimum dataset that should be collected in chronic low back pain research, and defining the best outcomes to evaluate treatment effectiveness.

The Task Force recommends that chronic low back pain be defined as back pain lasting at least three months, and causing pain on at least half of days over the past six months. The definition does not include ratings of pain severity. The Task Force also recommends focusing on how back pain is affecting patients’ lives. The recommendations suggest a nine-item “Impact Score,” incorporating ratings of pain intensity, interference with normal activities, and functional ability. A minimum set of data should be gathered in any study of chronic low back pain.

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What is Tuberculosis?

Tuberculosis or TB is an infection which is caused by a type of bacteria called Mycobacterium tuberculosis. This disease can affect the lungs as well as other organs of the body such as those in the central nervous system, lymphatic system, and circulatory system. After infection, the bacteria multiply in the lings creating cavitary lesions and creating pneumonia. During this time, the person may have chest pain and cough which may bring about blood. In addition, lymph nodes near the heart and lungs become enlarged. As the bacteria try to spread to other parts of the body they are interrupted by the body’s immune system. The body's immune system causes the formation of scar tissue or fibrosis around the bacterium, which helps fight the infection and prevents it from spreading within the body and to other people. If bacteria penetrate through the tissue, the infection becomes active which leads to the development of pneumonia and damage to kidneys, bones, and the meninges that line the spinal cord and brain.

Tuberculosis is classified as either latent or active. Latent TB means that the bacteria are inactive but present in the body; during this stage the patient has no symptoms and is not contagious.    Active TB on the other hand means that bacteria are active inside the body and are making the patient ill. This stage is contagious.

Tuberculosis is an infection caused by the Mycobacterium tuberculosis, a bacterium that is spread from person to person through the air. Once Mycobacterium tuberculosis enters the body, three things may happen to it. Either the bacterium is destroyed because the body has a strong immune system or the bacterium enters the body and remains as latent TB infection in which the patient has no symptoms and cannot transmit it to other people; or the patient becomes ill with TB.

Tuberculosis may bring about a lot of signs and symptoms such as unexplained weight loss, fatigue, shortness of breath, fever, night sweats, chills and loss of appetite. Lung symptoms may include coughing that lasts for 3 or more weeks, coughing up blood, chest pain, painful breathing and pain when coughing.

Tuberculosis is often diagnosed by a blood or skin test, a sputum test, and a chest X-ray. One simple skin test to diagnose tuberculosis is the Mantoux test. In this test, a small amount of purified protein derivative (PPD) tuberculin is injected into the forearm. After 48 to 72 hours, a doctor or nurse looks for a reaction at the injection site; a hard, raised red bump usually indicates a positive test for TB. Other tests include the IGRAs (interferon-gamma release assays) which measure how the patient’s immune system reacts to Mycobacterium tuberculosis.

Those who are at high risk for acquiring tuberculosis include individuals who live with others who have active TB infections, poor or homeless people, young children, nursing home residents, alcoholics and intravenous drug users, anybody who suffers from malnutrition and patients with HIV/AIDS or other immune system problems.

New Test for Tuberculosis Can Detect Latent Infection

A recent discovery is a screening process for tuberculosis (TB) infections in Canadian prisons which can eliminate false positives. This screening process are interferon-gamma release assays (IGRA) that will detect a pre-existing TB infection, or latent TB, that might not present itself for many years, or until the body becomes weakened by another source. The IGRA test was developed in the last 10-15 years and diagnoses a latent TB infection. The body’s immune system is provoked with a small amount of protein from the TB virus and if the body has previously been infected then a reaction will occur and the patient’s blood will test positive for TB. This eliminates the disadvantages of PPD testing.

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