BRAIN MAPPING

BRAIN MEANDERING PATHWAY 

                                                                      

Maturity, the thinking goes,

comes with age. However, this

the journey from childhood to

adulthood is uneven: some

mental attributes surface faster than others, some are

more pronounced in girls,

and poverty and trauma have

an outsized influence on cognitive development, says one

of the largest studies of its

kind, spanning nearly 9,000

children and young adults

from India.

The C­Veda

The study is part of a long-term project called the ‘Consortium on Vulnerability to

Externalizing Disorders and

Addictions’ (C­Veda). It aims

to follow up on those tested over

decades, and evaluate the effect of biological and environmental risk on cognitive

development.

Brain development progresses from childhood to early adulthood with wide­ranging connections among

neurons in multiple parts of

the brain. This connectivity significantly influences abilities such as temporarily holding chunks of information,

called ‘working memory (for

instance, memorizing a phone

the number before writing it

down) and ‘set shifting’ (iterating multiple ways to solve a

puzzle). These skills are classified as executive functions.

Another category of functions, called social cognition

help mediate relationships.

A consortium of psychiatrists, neurologists, and psychologists from India and the U.K.,

investigating the Role of Environment and Genetics on

brain development analyzed

four kinds of executive functions: verbal working memory, visuo­spatial working memory, response inhibition (the

ability to stop one task and begin another), set­shifting and

two kinds of social cognition:

faux pas recognition (inferring

social cues) and emotion recognition (inferring another’s

state of mind).

They report, in the April

2023 edition of the peer­reviewed Asian Journal of Psychiatry, that ‘working memory’ develops first, followed by

inhibitory control and finally

cognitive flexibility. However,

certain abilities such as visual

and verbal reasoning stabilized by late adolescence and

didn’t rise as people aged, whereas cognitive ability and

emotional cognition continued to develop even after

adolescence, Eesha Sharma,

the lead author of the study, Senior Resident Department of Psychiatry National Institute of Mental Health & Neurosciences Bangalore - 560029. 

The studies, spanning a

range of socio­economic

groups, ages, urbanization

and gender also found that

children who manifested certain traits to a high degree outperformed their peers in that

skill even as they aged, while other traits didn’t constitute a

permanent advantage.

“Response inhibition has a

ceiling. If you are low performing early on, you will

catch up as you grow older. It

was the other way, however,

in verbal working memory. Those who did well in early

childhood continued to significantly outperform their

peers,” said Dr. Sharma, an assistant professor at the National Institute of Mental Health

and Neurosciences, Bengaluru. “However, what all this

means in the real world is a

question that we are still analyzing.”  

Complex abilities

The more ‘complex abilities’ —

response inhibition, cognitive

flexibility, and emotion recognition — are “maximally impacted” by environments

such as poverty or childhood

adversity. “No matter which ability

you are looking at, children in

wealthier households do better,” she said. 

C­Veda expects to map the

brains of those participating

in the study and evaluate and

compare neurologically

development. “If we can generate brain development charts across ages, just like how there are

charts for physical growth, it

could be a valuable tool in

schools and mental health assessments,” Dr. Sharma said.

English Medicines - Things to watch out for

 Allopathic Medicine -Caution

                                

What are the limitations of allopathic medicine?

Risks of Allopathic Medicine

1. Harmful Drug Interactions:

This can happen when a drug reacts with food or supplements a person has taken.

2. Allergic Side Effects:

One does not know that one is allergic to a particular ingredient until the medicine is consumed.

For example, a person who buys a soda at the store and drinks it for gas can cause a reaction if the person is allergic to sodium.

He also takes antacids and eats them. If he is allergic to calcium, magnesium, or aluminum, he will definitely experience allergic reactions.

3. Unexpected Side Effect:

This condition occurs when the medicine works differently than the doctor expected.

A situation like this can happen very rarely in English Medicine.

Most English medicines are chemicals. When these are used carelessly, internal organs like the heart, liver, and kidney are affected.

For example, excessive use of paracetamol can lead to liver damage.

Excessive use of non-steroid pain relievers can lead to complications such as stomach ulcers, kidney failure, and liver damage.

Steroid medications such as beclomethasone, prednisone, and others are very useful for asthma. However, if consumed regularly, they destroy the body's immune system.

Medicines taken orally or by injection provide faster relief but also cause harm faster.

On the other hand, ointments applied to the skin and drugs absorbed by inhalation have slower results but less harm.

For example, oral asthma medications such as prednisone may provide permanent relief but can have very serious side effects.

On the other hand, oral inhalers such as beclomethasone are less harmful but less effective.

Thus none of the English medicines are without side effects.

Thus the medicine you take to cure one disease can produce other diseases in your body due to its side effects.

So the basic aim of English medicine is that you should always be patient and die dependent on medicine. It is a corporate business strategy.

Arms dealers celebrate when there is always a conflict between countries.

That If you are always patient, celebrations with the drug dealer.

Sleeping pills and anti-anxiety drugs should not be sold without a doctor's prescription. In some pharmacies, these controlled medicines can be obtained without a prescription directly on the counters

This shows the irresponsibility of the pharmacies whose business objective is the main one.

These can cause deadly drug addiction. Due to this, the nervous system is affected when they are eaten regularly.

Disadvantages of allopathic medicines

✊It does not focus on absolute health.

Allopathy treats only a part of the disease but does not completely eliminate the root cause of the disease. Therefore, allopathy is not a holistic approach to best-practice medicine. The disease may recur after allopathic treatment, leading to the expenditure of both money and time.

✊Allopathic medicines can destroy good bacteria.

Allopathic medicines can interact with other medicines and cause adverse effects that reduce the effectiveness of other treatments. They kill normal protective bacteria in the body while allowing bad bacteria to grow.

✋Blind-taken-pill approach

Doctors don't get much attention and information about your nutrition or healthy lifestyle. So they can only offer a little advice on diet and exercise, but they don't care about major lifestyle changes. In emergency situations, the patients are told to take pills or medicine without any basic medical advice.

✊Drugs do not cure disease, they only control it

Medicines prescribed by allopathy often do not cure the disease causing the problem, instead, they suppress the disease for some time or change the function of the body. Long-term use of allopathic medicines may cause some chronic latent side effects which may later become life-threatening.

✊Draconian treatment procedures in allopathy can be dangerous.

Overdoses are very common to hear. But it can cause fatal incidents. These quick-relief drugs can make you addicted, and an overdose of such drugs can lead to organ failure or even death sooner or later.

✊Allopathy does not judge pros and cons

Allopathic medicines are usually prescribed only for the superficial symptoms, not for the underlying symptoms or underlying causes. Different body type medicines are often overlooked by doctors. Quick but temporary relief drugs are the main essence of the allopathic medicine market.

✊Does not examine the entire issue calmly

Most of the time doctors are too busy with hectic schedules and long queues of patients, and they miss correct diagnoses and minute details. There is also a chance of being misdiagnosed and receiving the wrong treatment or wrong allopathic medicines

Outcome (Conclusion)

This is because of the natural human tendency to get rid of problems as quickly as possible. People resort to allopathy to get rid of ailments quickly, even if it is temporary. Due to this haste and impatience, they often undermine and completely ignore the major drawbacks of allopathic medicines, which is why the continued use of such medicines leads to side effects that become long-term problems.

Doctors running inside our bodies- Autocoids

Doctors running inside our body- Autocoid hormones

Autacoids are biological factors (molecules). They act like hormones in specific areas of the body. They are short-lived and act close to their area of synthesis and secretion. The word autacoid comes from the Greek words "autos" (self) and "acos" (relief; ie, medicine).

Consequences & Effects

The effects of autacoids are primarily localized to the area where they are secreted, although sometimes larger quantities are produced depending on need and may be transported by the bloodstream to other sites of circulation. But mostly autocoids like histamine, prostaglandin, and serotonin are not secreted into the bloodstream. They are secreted locally. Autacoids can have systemic effects in many parts of the body when transported through the bloodstream.

Some autocoids are characterized mainly by their effect on specific tissues such as smooth muscle. 

As for vascular smooth muscle autocoids, they are classified into two categories: vasoconstrictors and vasodilators. The vasodilator autocoids are released during exercise. Their main effect is found in the skin, where they facilitate heat loss.

When they act as local hormones, they have a paracrine (cellular interaction) effect. That is, the cells communicate with each other through these hormones.

Categories:-

1. Eicosanoids, (prostaglandins) 

2. Angiotensin, 

3. Neurotensin,

 4.NO (Nitric Oxide),

 5. Kinins,

 6. Histamine,

 7. Serotonin,

 8. Endothelins and 

 9. Palmitoylethanolamide

are some notable autocoids.

Side Effects of Blocking Autocoids:-

Disabling autocoids is like trying to silence a crying baby without caring what the problem is.

Most of the time our body solves small problems through autocoids, but sometimes when the problems are not solved our body will cry out the pains that speak through autocoids. In this case, if the autacoid secretions are blocked by taking an autocoid blocker, the pain will temporarily stop. But the problem is not solved. It stays inside the body.

Let's take histamine as an example as seen in the table above. Side effects of using histamine blockers are described in the table. Similarly, the effects of disabling other autocoids are also explained in the table.

Conclusion

In 2015, a new definition of autocoids was proposed, which helps to describe autocoid medicine more specifically: '"Autocoids are modulating factors, produced in specific areas. They affect the function of cells and/or tissues in specific areas, they are produced on demand, and then by the same cells and/or tissues they are metabolically destroyed.

Toxicities of non-steroidal anti-inflammatory drugs

Patterns of toxicity and dangerous overdoses of acute non-steroidal anti-inflammatory drugs (NSAIDs). 

Summary

Nonsteroidal anti-inflammatory drugs (NSAIDs) are most widely used for their analgesic, anti-inflammatory, and antipyretic properties. 

Most patients with acute NSAID overdose are asymptomatic or have minor self-limiting gastrointestinal symptoms. However, among these patients with severe NSAID overdose, serious side effects have been reported more frequently. It also includes seizures, metabolic acidosis, coma, and acute renal failure.

There appears to be some difference between NSAIDs in terms of relative risk of these complications; Mefenamic acid in particular is commonly associated with seizures. Although management of these serious side effects is often straightforward, there are no specific antidotes for acute NSAID toxicity.

Background

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of structurally diverse drugs with a common mode of action (reversible inhibition of cyclooxygenase). They are widely used for their analgesic, antipyretic and anti-inflammatory properties; Also available as prescription and over-the-counter medications; and are also available as stand-alone pharmaceutical products, combination pain reliever products, and cough and cold products.

Pathology of acute NSAID poisoning

Fig-2
COX-1--Permanent
COX-2--Transient

NSAID pain medications are commonly consumed in high doses in many parts of the world. A 2009 annual report from the American Association of Poison Control Centers' National Poison Data System (NPDS) showed that analgesics were the most common type of drug overdose in adult patients (10%) and the second most common type in pediatric patients (9%).

Acetaminophen (Panadol, or Paracetamol) and its derivatives were found to be used in acute doses (42%) as common pain relievers.

NSAIDs account for 33% of acute consumption of analgesics. Ibuprofen (Brufen) was the most common NSAID taken in high doses (81%), followed by naproxen (11%). This data has not changed significantly over the last decade.

Pharmacology

Fig-2

Many of the toxic effects of NSAID therapy result from the reversible inactivation of the group of enzymes known as cycloxygenase 1 & 2 by NSAIDs (Figure-1,2).

The enzymes act on the thermoregulatory center in the hypothalamus to produce fever. They are also involved in regulating inflammation-regulating secretions and promoting the sensitivity of pain fibers.

Therefore NSAID inhibition of these effects is responsible for any adverse side effects of NSAID therapy as antipyretic (antipyretic), anti-inflammatory, and analgesic.

However, prostaglandins play an integral role in maintaining gastrointestinal mucosal integrity and renal blood flow and also play an important role in balancing platelet aggregation. The side effects of disabling these are responsible for many of the side effects seen in the therapeutic use of NSAIDs - particularly dyspepsia, gastric/small bowel ulceration, and renal failure. 

NSAIDs cause adverse effects in the gastrointestinal tract by inhibiting the formation of cytoprotective prostaglandins in the stomach.

Most NSAIDs act through both types of cyclooxygenase (COX-1 and COX-2) and are generally (UNSPECIFIED). In the early 1990s, two isoenzymes of cyclooxygenase (COX-1 and COX-2) were identified. COX-1 is present permanently in most tissues throughout the body. At the same time, COX-2 is transiently produced by inflammatory factors.

In light of this, recently developed NSAIDs have been designed to act more specifically on the COX-2 isoenzyme. However, several recent studies have shown that therapeutic use of NSAIDs that act specifically through COX-2 (eg, rofecoxib, celecoxib) is associated with cardiovascular disease.

Digestion, absorption, assimilation, and metabolism

NSAIDs are rapidly absorbed orally, with peak blood levels occurring within 2 hours of ingestion of stable releasing preparations. While delayed release and enteric coated preparations (Delayed Release, and Enteric Coated Preparations) usually reach peak concentrations within 2-5 hours of ingestion.

Super therapeutic doses have been approved to modify the kinetics of many NSAIDs, including naproxen and mefenamic acid. That's because those doses prolong absorption and delay peaking.

NSAIDs are weakly acidic and are more than 90% protein bound (>90% Albumin Bound), so their minimum volume of distribution is approximately 0.1-0.2 L/kg. Metabolism occurs mainly by oxidation and conjugation in the liver, less than 10%-20% of NSAIDs are excreted through the kidneys without any metabolic changes.

MECHANISMS OF TOXICITY

The mechanism of toxicity of excessive NSAIDs appears to be mainly a result of over-inhibition of COX-1 and decreased prostaglandin synthesis. The metabolic acidosis seen in acute NSAID toxicity is not related to COX inhibition, but rather to the accumulation of acidic waste products of acidic metabolites. The gastrointestinal tract, kidneys, and central nervous system (CNS) are mainly affected by therapeutic use and overdose.

Gastrointestinal (GI) disorders occur in two different ways. Prostaglandin inhibition reduces gastric mucosal viscosity and bicarbonate synthesis decreases gastric blood flow and improves acid production. The gastric effects of NSAIDs are also known to be due to direct cytotoxic or tissue damage to the mucous gland. Nausea and mild upper gastric discomfort with chronic use upper gastrointestinal discomfort,  gastric/ and anterior small bowel ulceration, gastrointestinal bleeding

leads to vulnerability.

Renal reactions seen with the therapeutic use of NSAIDs and NSAID overdose are related to the vasodilating effects of prostaglandins on the renal arteries. In patients with normal physiologic control of renal blood flow, NSAID renal damage is unlikely at therapeutic doses because the role of prostaglandins in protecting renal blood flow is minimal.

However, in patients with low blood volume (eg, associated with excessive vomiting) or high levels of angiotensin (eg, patients with heart failure or cirrhosis), prostaglandins contribute to maintaining adequate renal blood flow. In such patients, inhibition of prostaglandins, which help maintain glomerular filtration rates, can be harmful and lead to renal failure. Chronic NSAID use can lead to cellular interstitial nephritis.

Excess anionic release in the blood and metabolic acidosis is known to follow an overdose of NSAIDs. Acidity can also be increased by vomiting and alcohol consumption.

Inhibition of COX-1 also affects platelet aggregation by reducing thromboxane-A2 formation. This has implications for patients receiving concomitant anticoagulant (anticoagulant-prevention of blood clotting) or antiplatelet therapies, therefore creating an increased risk of excessive bleeding in these patients.

Patterns of NSAID Overdose Toxicity

Acute poisoning and death resulting from acute toxicity of NSAIDs are extremely rare. Most cases are asymptomatic or produce only minor gastrointestinal symptoms.

However, several reports of mefenamic acid overdose have been reported, with serious overdoses of this drug inducing seizures.

Very large NSAID overdoses have resulted in significant clinical events in some patients, including renal failure, acid/base disturbances, and CNS toxicity. It is important to note that deaths from single NSAID infusions have also been reported.

Lung Cancer-3-Treatments-a

a-Surgeries

LUNG CANCER

Surgery for small non-cellular lung cancer 

Surgery to remove cancer may be an option for non-early stage small cell lung cancer (NSCLC). This provides an excellent opportunity to cure the disease. However, lung cancer surgery is a complex surgery that can have serious consequences, so it should be performed by a surgeon with experience in lung cancer surgery.

If your doctor thinks cancer can be cured by surgery:

 💥Lung function tests will be done to see if you have enough healthy lung tissue after surgery.

 💥Tests will be done to check the function of your heart and other organs and to ensure that you are healthy enough for surgery.

💥Your doctor should check if cancer has already spread to the lymph nodes between the lungs. This is often before surgery.

💥Is performed with mediastinoscopy or another technique described in lung tests.

Types of lung surgery

Different functions may be used to treat (and possibly cure) NSCLC. Through any of these operations, nearby lymph nodes are also removed to detect the spread of cancer. These activities require general anesthesia (you are in a deep sleep) and in general,

💥Thoracotomy: This surgery is performed by incision between the ribs on the side or back of the chest. (This treatment is called thoracotomy).

💥Pneumonectomy: This surgery removes the entire lung. This may be necessary if the tumor is near the center of the chest.

💥Lobectomy: The lung is made up of 5 lobes (3 on the right and 2 on the left). In this surgery, the entire flap containing the tumor (or tumors) is removed. If this can be done, this is often the preferred surgical method for NSCLC.

💥Segmentectomy or wedge resection: In these surgeries, only part of the flap is removed. This approach can be used if a person does not have sufficient natural endurance.

💥Sleeve resection:: This surgery can be used to treat some cancers of the large airways in the lungs. The large airway with the tumor is similar to the sleeve of a shirt with a stain a few inches above the wrist, and the sleeve resection is like cutting the top and bottom (tumor) across the sleeve (airway) and then sewing the cuff. This surgery can be performed by a surgeon instead of a pneumonectomy to preserve more lung function on the re-compressed sleeve.

The surgery recommended by your doctor depends on the size and location of the tumor and how well your lungs are functioning.

If a person's lungs are healthy enough, only then doctors will often seek to perform a comprehensive surgery (for example, a lobectomy instead of a segmentectomy) as it may provide a better chance of curing cancer.

When you wake up after surgery, a tube (or tubes) will come out of your chest and attach to a special container to allow excess fluid and air to escape. The pipe (s) will be removed once the liquid drain and air leakage are sufficiently reduced. Generally, you should stay in the hospital for 5 to 7 days after surgery.

Video-Assisted Thoracic Surgery (VATS): -

Video-assisted chest surgery (VATS), also known as thoracoscopy, is a procedure often used by physicians to treat early-stage lung cancer. It uses small incisions, usually performed with a small period of hospital stay, and has fewer complications than thoracotomy.

Most experts recommend treating only the early stages of lung cancer in this way. The healing rate after this surgery is the same as for surgery with a large incision. But it is important that the surgeon who performs this procedure is experienced because it requires more skill.

Robot-assisted thoracic surgery (RATS)

In this approach, thoracoscopy is performed using a robotic system. The surgeon sits on a control panel in the operating room and moves the robotic arms to operate through several small incisions in the patient's chest.

RATS is similar to VATS in terms of lower pain, blood loss, and recovery time.

To the surgeon, this robotic system of moving tools may offer greater efficiency and greater accuracy than basic VATS treatment. However, the most important factor for the success of both types of breast surgery is the experience and skill of the surgeon.

Possible risks and side effects of lung surgery

Surgery with potential risks for lung cancer can have many major and serious side effects, which is why these treatments are not a good idea for everyone. While all surgeries have certain risks, these depend on the size of the surgery and the overall health of the person, and the severity of the surgery.

Possible complications during and after surgery include anesthesia, excessive bleeding, blood clots in the legs or lungs, wound infections, and pneumonia. Rarely, some people cannot survive the surgery.

Lung cancer usually takes weeks to months to recover from surgery. If the surgery is done with a thoracotomy (a long incision in the chest) the surgeon will have to stretch the ribs to go to the lungs, so the area near the incision will be painful for some period of days after the surgery.

Your activity may be limited to at least one or two months. People with VATS instead of thoracotomy have less pain after surgery and heal faster.

If your lungs are in good condition (except for cancer) and a flap or even the entire lung is removed, you may return to normal after a while. If you have another lung disease such as emphysema or chronic bronchitis (which is common among long-term smokers), shortness of breath may occur with some activity after surgery.

Surgery for lung cancer that has spread to other organs:

If the lung cancer has spread to your brain and there is only one tumor, you may benefit from removing the tumor. This surgery should only be considered if the tumor in the lung has been removed or treated (with radiation and/or chemotherapy).

Surgical removal of a tumor in the brain is called a craniotomy. It should only be done if the tumor is removed without damaging vital parts of the brain.

Lung cancer-2

Patient Education: Risks, Symptoms, and Diagnosis of Lung Cancer 

Lung cancer is a serious disease that affects many people and their families. Lung cancer is the leading cause of cancer death in the United States. Cigarette smoke causes most lung cancers, but there are a number of factors that can cause lung cancer.

If a person has lung cancer, tests can determine the type of lung cancer and whether it has spread. If cancer is suspected, X-rays, imaging scans, and blood tests should be done. A biopsy is a procedure that removes small tissue from a tumor so it can be examined and examined under a microscope.

When cancer spreads, it is called "metastasis". Cancer status is determined by the size of the tumor and whether it has spread to the lymph nodes or other parts of the body. The condition worsens as the tumor enlarges or metastasizes. One of the guiding factors in treatment options is the stage of the disease.

This article will discuss the risks of developing lung cancer, the different types of lung cancer, the symptoms, and testing for people with lung cancer. Finally, this article will review the steps taken to determine each stage of the disease.

Some additional risk factors

Age: -

The risk of developing lung cancer increases with age. Lung cancer can occur in young people, although it is more common in people under 40 years of age. After the age of 40, the risk of developing lung cancer slowly increases each year.

Family and genetic risk: -

Some people have a genetic predisposition to lung cancer. Anyone with a first-degree relative (parent or sibling) who has been diagnosed with lung cancer is at risk of developing lung cancer.

Lung Disease and Other Cancers:- 

People with another type of cancer may be at risk of developing lung cancer.

This is especially true for those who use tobacco-related cancers, such as throat cancer, or who have received radiation therapy for the chest area. In addition, people with chronic obstructive pulmonary disease (COPD) or pulmonary fibrosis (PULMONARY FIBROSIS) have a higher risk of developing lung cancer.

Screening tests for lung cancer

Lung cancer screening is not recommended for those at low risk.

For those at high risk, screening for lung cancer with a low-level computed tomography (CT) scan can reduce the risk of death from lung cancer. This applies to people between the ages of 50 and 80, and those with a history of 20 pack-years of cigarette use (e.g., 1 pack per day for 20 years, or 2 packs per day for 10 years), and those who have quit or quit smoking in the last 15 years.

Symptoms of lung cancer:-

When lung cancers are small and early in the stage, the person may feel normal and have no symptoms. If cancer develops into advanced stages, most people will experience one or more symptoms.

However, the symptoms of lung cancer may be similar to the symptoms of other common problems. If you are worried about your symptoms, talk to your doctor or nurse.

The most common symptoms of lung cancer are:-

● Cough - A new cough that is getting worse or worsening may be a sign of lung cancer.

● Blood in the cough - the medical term for this is "hemoptysis". Anyone with a bloody cough, whether it is frozen, streaked, or rusty in color, should see a doctor as soon as possible for an evaluation.

●Shortness of breath - especially if it comes on quickly, is a major symptom if you feel difficulty breathing.

●Chest infections (such as bronchitis or pneumonia) do not heal with treatment or return quickly after treatment.

●Shortness of breath (a whistling sound when you breathe).

● Dull, sharp, or stabbing chest pain.

●Voice hoarseness.

●Headache and swelling in the face, arms, or neck.

● Pain in the arms, shoulders, and neck - This can be caused by a tumor in the upper part of the lungs (called a pancreatic tumor). Other symptoms include weakness of the arm muscles (due to pressure on the nerve that triggers the arm), drooping eyelids, and blurred vision.

●General Health Symptoms - Although there are no symptoms related to lung, breathing, or chest, there are common signs that indicate lung cancer. These include:

●Indescribable weight loss

●Fatigue or lethargy

●A condition in which bone or joint pain does not go away or worsens

Early testing and diagnosis:-

If you have symptoms that indicate lung cancer, your doctor will ask specific questions about your symptoms and get a physical exam. Yours

 If the test results are still related to the disease, additional tests, including a blood test and X-rays or scans, may be ordered.

If a chest x-ray, computed tomography (CT) scan, or positron emission tomography (PET) scan shows abnormalities that may indicate cancer, additional tests may be performed to remove the tumor and usually a biopsy.

A biopsy can be performed in one of the following ways:-

● Bronchoscopy is a flexible tube with a camera and other small instruments inserted through your mouth or nose and then inserted into the trachea 

●Endobronchial ultrasound bronchoscopy (EBUS) is a technique that combines flexible trachea and ultrasound to first look at the lymph nodes in the chest and then take biopsies from the enlarged lymph node.

●CT-guided microscopic needle biopsy is performed by inserting a thin needle through the skin to detect the tumor by CT scan and remove a small sample of tissue.

 ●An injection aspiration is performed by inserting a needle into a tumor or lymph node that can be felt under the skin or seen by ultrasound.

● Thoracentesis is the insertion of a needle and small catheter into a fluid collection in the chest to remove fluid and see through a microscope.

● If the tumor is small or other biopsy procedures are not conclusive, surgery may be required to remove it completely. The most common surgical procedures are mediastinoscopy. It is used to biopsy the lymph nodes in the center of the chest.

●Video-assisted thoracoscopic surgery:-

It is a less invasive route for biopsy of lung tissue; And thoracotomy, which is a major surgery to remove large areas of lung tissue or tumors.

Advanced screening for lung cancer

In addition to looking at the tumor with a microscope, some lung cancers can be tested for abnormal proteins called biomarkers or mutations in their DNA.

Common biomarkers of lung cancer include projected cell death ligand-1 (PD-L1) exposure, epithelial growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) transplants, and c-ROS oncogene 1 (ROS).

Types of lung cancer

There are different types of lung cancers; Based on how cancer cells look under the microscope. However, two main types are used to determine the best treatment approach.

 ●85 to 90 percent of people with lung cancer are diagnosed with non-small cell lung cancer (NSCLC). There are subtypes of NSCLC, the most common of which are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.

● Small cell lung cancer (SCLC) is found in about 10 to 15 percent of the population

The reason for classifying lung cancer in this way is that the two types grow differently and metastasize. Small cell and non-small cell cancers also have different treatments for surgery, radiation, and chemotherapy.

Non-Small Cell Lung Cancer (NSCLC)Stage: -

Once lung cancer is diagnosed, the next step is to carefully measure the size of the tumor, determine its exact location and look for evidence of its spread. This process is called staging.

Determining the stage of lung cancer is complicated because various tests and procedures are used when determining the stage.

Staging tests focus on confirming the presence or absence of tumors in specific areas of the body.

Staging can be done using a combination of computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, and positron emission tomography (PET) scan.

If suspicious findings are found, a biopsy may be needed to confirm the presence of metastasis. More than one biopsy or invasive procedure is often required to fully diagnose lung cancer.

Factors used to exclude a stage for small non-cellular cancer: (NSCLC)

●Tumor size and location. This is called the "T" factor.

●Does the tumor occupy the lymph nodes and tissues inside the chest? This is called the "N" factor.

●Whether the tumor has spread to areas outside the chest (for example, lung cancer can spread to the bones, liver, adrenal glands, or elsewhere). This is called the "M" factor.

Factors T, N, and M are linked into groups that determine the overall cancer stage.

NSCLC Levels I to IV. Low numbers (stages I and II) indicate that the tumor is small or has not been found to spread beyond the chest High numbers (stages III and IV) indicate that the tumor is large or metastasized.

Small Cell Lung Cancer Stage (SCLC):-

The technical position for SCLC is similar to that of NSCLC. However, treatment options are usually determined by a simplified system. This is because SCLC has different development patterns and different forecasts.

SCLC is generally classified as a "defined" or "comprehensive" disease. This system helps to determine which treatment is most effective.

 ●Limited disease - This refers to SCLCs on one side of the chest and lymph nodes.

●Comprehensive disease - This refers to SCLC, which spreads to the opposite side of the chest or to distant places outside the chest.

LUNG CANCER-1

What are the risk factors for lung cancer? 

Research has identified a number of risk factors that may increase the risk of developing lung cancer.

1 . Smoke

Tobacco smoke is a mixture of toxic compounds of more than 7,000 chemicals. Many of them contain deadly poisonous chemicals. At least 70 of those toxins are known to cause cancer in humans or animals.

Cigarette smoking is one of the leading risk factors for lung cancer. In the United States, cigarette smoking accounts for 80% to 90% of lung cancer deaths. The use of other tobacco products such as cigars or pipes also increases the risk of lung cancer.

Cigarette smokers are 15 to 30 times more likely to die of lung cancer than non-smokers. Smoking or occasionally smoking a few cigarettes a day also increases the risk of lung cancer. The more years a person smokes, and the more cigarettes they smoke each day, the greater the risk.

People who quit smoking have a lower risk of lung cancer than those who continue to smoke. But their risk is higher than non-smokers. Stopping smoking at any age can reduce the risk of lung cancer.

Cigarette smoking can cause cancer anywhere in the body. Cigarette smoking causes cancer of the mouth and throat, esophagus, stomach, colon, rectum, liver, pancreas, larynx, trachea, kidneys and pelvis (central part of the kidney), bladder, and cervix and can cause severe myeloma.

2. Second stage (SECOND WAY) smoking

Inhaling smoke from other people's cigarettes, pipes, or cigars (secondhand smoke) can cause lung cancer in the opposite person. When a person inhales second smoke, it causes the same effects as when he smokes. In the United States, one in four non-smokers, including 14 million children, was exposed to second-way smoke from 2013 to 2014.

3. Radon

Radon is the second leading cause of lung cancer in the United States after smoking. Radon is a gas naturally emitted by the decomposition of certain radioactive metals. It is formed in rocks, soil, and water. It cannot be seen, tasted, or smelled. When radon enters homes or buildings through cracks or holes, it can get trapped and exposed to air inside the home.

People who live or work in these homes and buildings breathe high levels of radon. In the long run, radon can cause lung cancer.

Radon is a radioactive gas that is formed naturally when radioactive metals such as uranium, thorium, or radium decompose in rocks, soil, and groundwater. People breathe radon into the air coming through cracks and gaps in buildings and houses to control primary radon respiration.

The U.S. estimates that radon causes about 21,000 lung cancer deaths each year. Evaluated by the Environmental Protection Agency (EPA). The risk of lung cancer due to radon exposure is higher in smokers than in non-smokers.

However, the EPA estimates that more than 10% of radon-related lung cancer deaths occur among non-cigarette smokers. About one in every 15 households in the United States has a high radon level (1/15). Learn how to test radon in your home and how to reduce radon levels if it is high.

What are the symptoms of radon in your home?

1. A persistent cough may be a sign that you have radon poisoning.

2. Continuous cough.

3. Voice obstruction

4. Breathing.

5. Blood in the cough.

6. Chest pain.

7. Frequent 8. Infections such as bronchitis and pneumonia.

9. Anorexia.

4. Other Products factors

Examples of materials found in some workplaces that increase risk include asbestos, arsenic, diesel emissions, and silica and chromium. In many of these products, smokers have an even higher risk of developing lung cancer.

5. Personal or hereditary background of lung cancer

If you are a survivor of lung cancer, there is a risk of developing another lung cancer if you smoke. The risk of lung cancer may be higher if your parents, brothers or sisters, or children have lung cancer. This may be true, because if they also smoke or work or live in the same place where radon and other substances that can cause lung cancer are exposed.

6. Radiation Therapy to the Chest

Survivors of breast cancer treatment may have a higher risk of lung cancer.

7. Diet

Scientists are studying different foods and diets to alter the risk of developing lung cancer. We still have a lot to know.

We know that smokers increase their risk of lung cancer when they take beta carotene supplements.

Furthermore, arsenic and radon in drinking water (mainly from private wells) may increase the risk of lung cancer.