Acne Vulgaris: an Understanding
Acne is chronic inflammatory disease of pilosebaceous glands. It is mainly characterized by seborrhea, formation of comedones, papules and pustules. Less commonly symptom like nodules, deep pustules and in some cases scarring is seen.
Four factors are involved in pathogenesis (1) Seborrhea (increase sebum production) (2) Hyper cornification of pilosebaseous duct (3) Colonization of pilosebaseous duct by P. acne (propionobacterium acne) and (4) Inflammation.
Categories: Acne Tags: Atopic dermatitis, Cornification, Seborrhea
The Global Magnitude of the Problem of Cancer
Cancer afflict all the communities throughout the world. At present more than 11 million people are diagnosed with cancer and more than 7 million people die due to cancer every year, throughout the world. More than 30 million people are living with cancer at present. In term of incidence, the most common cancers are Lung cancer (12.3% of all cancer), breast cancer (10.4%) and colorectal cancer (9.4%). In terms of death from cancer the most common cancers is Lung cancer (17.8% of all deaths due to cancer).
For a disease, the relationship of incidence to mortality rate is an indication of prognosis. Similar incidence and mortality rate is indication of essentially fatal condition. That is why lung cancer accounts for most deaths from cancer (1.1 million) in the world annually, because its incidence and mortality rate is similar and it is invariably associated with poor prognosis. On the other hand for breast cancer appropriate management can be effective in avoiding fatal out come. That is why although it is second in term of incidence but in terms of mortality it is ranked 5th .
Categories: Cancer Tags: Helicobacter pylori, Lung cancer, Surveillance Epidemiology and End Results (SEER)
Cancer control (Secondary prevention)
Secondary prevention comprises the following measures:
(1) Cancer registration:
Cancer registration is a sine qua non for any cancer control programme. It provides a base for planning the necessary services and for assessment of the magnitude of the problem of cancer. Cancer registries are of two types: hospital-based and population based registries.
(a) Hospital-based registries: The hospital-based registry includes all patients treated by a particular institution, both inpatients and out patients. Registries collect data as recommended by WHO in the “WHO Handbook for Standardized Cancer Registersâ€. If follow-up is long-term, hospital-based registries can be of considerable value in the evaluation of diagnostic and treatment programmes and also for research. Since hospital population will always be a selected population, the use of hospital-based registries for epidemiological purposes is limited.
(b) Population-based registries: The best thing to do is to set up a “hospital-based cancer registry†and extend it to a “population-based cancer registryâ€. 2-7 million is the optimum size of base population for population based registry. The aim is to cover the complete cancer situation in a given geographic area. The data from such registries alone can provide the incidence rate of cancer and serve as a useful tool for initiating epidemiological enquiries into causes of cancer, surveillance of time trends and planning and evaluation of operational activities in all main areas of cancer control.
(2) Early detection of cases:
Cancer screening is the main weapon for early detection of cancer at a pre-invasive (in situ) or pre malignant (cancerous) stage. Effective screening programmes have been developed for cervical cancer (Papanicolaou smear, known as pap smear), breast cancer (mammography) and oral cancer. Like primary prevention, early diagnosis has to be conducted on a large scale. But it is possible to increase the efficiency of screening programmes by focusing on high-risk groups. but there is no point in detecting cancer at an early stage unless facilities for treatment and after care are available. Early detection programmes will require mobilization of all available resources and development of a cancer infrastructure starting at the level of primary health care, ending with complex cancer centers or institutions at state or national levels (tertiary health care).
(3) Treatment:
Treatment facilities should be available to all cancer patients. Some of the cancers are amenable to surgical removal, while some others respond favorably to radiation or chemotherapy or combination of both. Since most of the known methods of treatment have only complementary effect on the ultimate outcome of the patient, multi-modality approach to cancer control has become a standard practice in cancer centers. In the developed countries cancer treatment is geared to high technology. For those who are beyond the curable stage, the goal must be to provide pain relief. A largely neglected problem in cancer care is the management of pain. The WHO has developed guidelines on relief of cancer pain “Freedom from cancer pain†is now considered a right for cancer patients.
Categories: Cancer Tags: Cancer registries, Cancer screening
Cancer control (Primary Prevention)
Cancer control consists of a series of measures based on present medical knowledge in the fields of prevention, early detection through screening and population education, diagnosis, treatment, after care and rehabilitation, aimed at reducing the number of new cases, increasing the number of “cures†and reducing the invalidism due to cancer.
The basic approach to the control of cancer is through primary prevention and secondary prevention. It is estimated that at least one third of all cancers are preventable. If we analyze the causes of cancer it is seen that environmental factors are the most important in causation of cancer which are modifiable. Genetic factors which are not modifiable are responsible in small number of cases of cancer.
Categories: Cancer Tags: Danger signals, Energy balance, Personal hygiene, Screening for Cancer
Causes of cancer
Cancer is a chronic disease. As with any other chronic diseases, cancer has a multifactorial etiology (cause). Carcinogens are the substances which can cause cancer to humans.
1. Environmental factors: Environmental factors are responsible for at least 90 per cent of all human cancers. The major environmental factors identified include the following:
a. Tobacco: Tobacco in various forms of usage (e.g. smoking, chewing, sniffing) is the major environmental cause of cancers of lungs, larynx, mouth, pharynx, esophagus, bladder, pancreas and also kidney. It has been estimated that cigarette smoking is responsible for more than one million premature deaths every year throughout the world in the form of cancer, respiratory problems and also in many other way. There is hardly any organ system which is not affected adversely due to cigarette smoking.
