Medical Sciences India - INTRODUCTION

All India Institute of Medical Sciences was established by an Act of Parliament of 1956, as an autonomous establishment of national importance and its objectives and functions were outlined. By virtue of this Act, the institute awards its own medical degrees, diplomas and different educational distinctions. The degrees and diplomas awarded by the institute underneath the All India institute of Medical Sciences Act are recognized medical qualifications for the aim of the Indian Medical Council Act, are deemed to be included within the initial schedule of that act entitling the holders to constant privileges as those connected to the equivalent awards from different universities of India.


The Institute may be a residential university during which the school members, workers and also the students continue to exist campus. There are eight hostels for undergraduate students (6 for boys and a pair of for girls) with a capability to accommodate 850 students. There are separate hostels for the postgraduate students. The hospital has 1560 beds as well as the beds in Paying wards.

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The prime concern of the Institute is to develop patterns of teaching in undergraduate and postgraduate medical education in all the branches therefore on demonstrate a high commonplace of medical education to any or all medical faculties and allied establishments in India. the opposite necessary objectives of the Institute are to collect in one place academic facilities of the very best order for the coaching of personnel in all the necessary branches of health activities and to achieve self-sufficiency in postgraduate medical education. the academic principles and practices being adopted here are those that are the simplest suited to the wants of the country. Adaptation of education to satisfy the issues of community health may be a major preoccupation. to the present impact the Institute has been making an attempt to initiate a model academic program that is undertaken within the Ballabgarh Community Development Block in collaboration with the Haryana Government. The Institute has additionally been in a position been able to initiate model academic programme in Community drugs at the urban field follow space in Malviya Nagar, New Delhi. stress is laid on the active learning method and on the cultivation of scholarly habits and scientific strategies.

The first batch of undergraduate medical students was admitted to the Institute within the year 1956 and since then the Institute has been admitting fifty students each year to the M.B.B.S. Course. the quantity of scholars to the present course is kept comparatively tiny to confirm an adequate teacher student ratio. The undergraduate curriculum is consistently the topic for discussion at the school and workers Council levels and needed changes within the curriculum are led to, off and on so as to evolve a pattern that is that the most fitted for the Indian wants and conditions.

The undergraduate medical students get sufficient impetus for higher studies because the institute provides facilities for postgraduate degrees in most the branches of medical sciences. At present, the Institute is awarding post-graduate degrees in concerning forty five totally different specialization.

All India Institute of Medical Sciences that may be a leading on-line education portal provides a platform where students or medical aspirants will have on-line tutorials for competitive exams like AIIMS, AIMPT, AFMC etc. The portal intends to supply an elite professional panel, comprising Medical students, graduates and medical coaching skilled who have a standard passion for medical Entrance exams specifically and science normally. The panel can offer on-line steerage to students showing for the AIIMS exam. the largest asset of the venture is that it's free, no subscription value either! This comes as a huge-advantage to the coed community who has been looking for personalised facilitate, however couldn't afford it because of prices or demographics. It additionally breaks all geographic barriers to collect a number of the simplest brains within the business to assist nurture succeeding generation.

Medical Journals

What Causes Cancer ?

Causes of Cancer

Cancer develops over several years and has many causes. Several factors both inside and outside the body contribute to the development of cancer. In this context, scientists refer to everything outside the body that interacts with humans as the “environment.”

Factors Outside the Body (Environmental Factors)

Exposure to a wide variety of natural and man-made substances in the environment accounts for at least two-thirds of all the cases of cancer in the United States. These environmental factors include lifestyle choices like cigarette smoking,excessive alcohol consumption,poor diet,lack of exercise, excessive sunlight exposure,and sexual behavior that increases exposure to certain viruses.Other factors include exposure to certain medical drugs, hormones, radiation, viruses, bacteria, and environmental chemicals that may be present in the air, water, food, and workplace. The cancer risks associated with many environmental chemicals have been identified through studies of occupational groups that have higher exposures to these chemicals than the general population. The importance of the environment can be seen in the differences in cancer rates throughout the world and the change in cancer rates when groups of people move from one country to another. For example, when Asians, who have low rates of prostate and breast cancer and high rates of stomach cancer in their native countries, immigrate to the United States, their prostate and breast cancer rates rise over time until they are nearly equal to or greater than the higher levels of these cancers in the United States. Likewise, their rates of stomach cancer fall, becoming nearly equal to the lower U.S. rates. Lifestyle factors such as diet, exercise, and being overweight are thought to play a major role in the trends for breast and prostate cancers, and infection with the Helicobacter pylori bacterium is an important risk factor for stomach cancer. Recently, the rapid rise in the rates of colorectal cancer in Japan and China suggests an environmental cause such as lifestyle factors. Different environmental exposures are linked to specific kinds of cancer. For example, exposure to asbestos is linked primarily to lung cancer, whereas exposure to benzidine, a chemical found in certain dyes (see page 17), is associated with bladder cancer. In contrast, smoking is linked to cancers of the lung, bladder, mouth, colon, kidney, throat, voice box, esophagus, lip, stomach, cervix, liver, and pancreas.

Factors Inside the Body

Certain factors inside the body make some people more likely to develop cancer than others. For instance, some people either inherit or acquire the following conditions: altered genes in the body’s cells, abnormal hormone levels in the bloodstream, or a weakened immune system. Each of these factors may make an individual more susceptible to cancer. One of the ways scientists know that genes play an important role in the development of cancer is from studying certain rare families where family members over several generations develop similar cancers. It appears that these families are passing on an altered gene that carries with it a high chance of getting cancer. Several genes that greatly increase a person’s chance of developing certain cancers (e.g., colon, breast, and ovary) have been identified. Only a very small percentage of people in the general population have abnormal copies of these genes. Cancers caused by these genes, known as familial cancers, account for only two to five percent of all cancers. Gene alterations may also contribute to individual differences in susceptibility to environmental carcinogens (cancer-causing substances). For instance, people differ in their ability to eliminate cancer-causing agents from their body to which they have been exposed, or to repair DNA damage that was caused by such agents. These gene alterations may also be passed on in families and account for higher rates of cancer in these families. Higher rates of cancer in families may also be related to shared environmental exposures like diet or exposure to carcinogens at work One of the main objectives of a growing field in cancer research called molecular epidemiology is to identify gene alterations that increase or decrease a person’s chance of developing cancer after an environmental exposure. Interaction of Environmental Factors and Genes Environmental factors such as viruses, sunlight, and chemicals interact with cells throughout our lives. Mechanisms to repair damage to our genes and healthy lifestyle choices (wearing protective clothing for sun exposure or not smoking) help to protect us from harmful exposures. However, over time, substances in the environment may cause gene alterations, which accumulate inside our cells. While many alterations have no effect on a person’s health, permanent changes in certain genes can lead to cancer. The chance that an individual will develop cancer in response to a particular environmental agent depends on several interacting factors—how long and how often a person is exposed to a particular substance, his/her exposure to other agents, genetic factors, diet, lifestyle, health, age, and gender. For example, diet, alcohol consumption, and certain medications can affect the levels of chemicals in the body that break down cancer-causing substances. Because of the complex interplay of many factors, it is not possible to predict whether a specific environmental exposure will cause a particular person to develop cancer. We know that certain genetic and environmental factors increase the risk of developing cancer, but we rarely know exactly which combination of factors is responsible for a person’s specific cancer. This also means that we usually don’t know why one person gets cancer and another does not.

List of Infectious Disease

Infectious diseases, also known as communicable diseases, contagious diseases or transmissible diseases comprise clinically evident illness. "Health is wealth" this is a very common saying and it is so true. If we do not have health then there is no use in possessing wealth. Knowledge about anything is never a waste and especially about health and the various health diseases. This health information knowledge will let help you in protect yourself as well your friends and neighbors. It is important to know the common types of health diseases and their basic cure. Today, everyday we hear about a new disease attacking the city through epidemics. Millions of people all around the world die because of certain disease even before its medicine is invented or discovered.

Before knowing about the common types of health diseases, we must know about disease. 'Disease' has been defined in many ways but the most commonly accepted one is that "disease is a condition in which the body's normal functioning is affected". It is also said that when a person is affected to any disease then he or she is not just physically disturbed but also mentally and socially.

There are many types of diseases. You can classify them either according to the ways they are spread or according to the cause of their spreading.

Some of the common types of health diseases are:

-    Infectious disease: These types of disease are caused due to microorganisms. These organisms can enter into your body via many different ways. Unhygienic food, water, polluted air are some of the ways through which they can enter your body. Infectious diseases can further be divide into the following ways:

-    Parasitic disease
-    Bacterial disease
-    Viral disease
-    Fungal disease
-       journal of infectious diseases
-       Infectious diseases
-       Lancet infectious diseases
-       Clinical infectious diseases

-    Contagious disease: These diseases are transferred from one person to another through food, water or physical contact. An unhealthy person can pass his or her disease to a healthy person. If a person is coughing and you happen to touch even a drop of the fluid or his hands then you are susceptible to be infected to this disease. That is the reason why doctors suggest relatives and friends to stay away from the patient. One example of contagious disease is swine flu.

-    Genetic disease: Genetic diseases are caused due to the faults or disarrangement in our genes. There is no cure for genetic disease, as these diseases are inborn. You can find out whether the child will have any genetic disease when he or she is in the womb.

-    Hypo or hyper disease: Some diseases are caused due to the deficiency or over intake of certain foods in the body. If you eat excess of vitamin c then your face will turn pale or if you do not take enough of vitamin A then you might fall prey to night blindness.

-    Sexual disease: Some diseases are transferred due to sexual intercourse with multiple partners. Body fluids, which are passed into one another's body during sex, cause these diseases. Through mechanical barriers, you can avoid these diseases. Some are curable while some are not. AIDS is an example of this type of disease.

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Infectious Diseases

There are statistics to show that there is great evidence that non infectious diseases are quite a big cause of death. It is possible to get a non infectious disease though inherited means. It is not possible to catch a non infectious disease so that is a good thing.

Other ways non infectious diseases can be caught is by living unhealthy and having an unhealthy diet. It is also possible to get a non infectious disease thought natural aging.

There are a number of different illnesses that can be inherited. There are some illnesses that can start as early as at birth, the common term for these are congenital, but these types of illness are not usually noticed until a person gets older in life.

It has been calculated that there are up to 200 babies that are born, which will have a damaged or even a missing chromosome. Missing a chromosome in some cases can be the cause of illnesses such as down syndrome, so can be quite serious in some cases. A missing chromosome can even cause a rare mental handicap condition, which can also include a cat like cry, because of a of the ability to only develop a small larynx.

There are a number of disease that can be inherited because of genes, such as albinism, hemophilia, muscular dystrophy and cystic fibrosis. If these are not looked at early some may even develop into something more serious. such as brain damage. Fortunately because of this babies are usually tested routinely, and if anything is wrong the baby can be treated by modifying there diet.

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The medical treatment of infectious diseases falls into the medical field of Infectiology and in some cases the study of propagation pertains to the field of Epidemiology. Generally, infections are initially diagnosed by primary care physicians or internal medicine specialists.

An infectious disease team may be alerted when:
-   The disease has not been definitively diagnosed after an initial workup.
-   The patient is immunocompromised (for example, in AIDS or after chemotherapy).
-   The infectious agent is of an uncommon nature (e.g. tropical diseases).
-   The disease has not responded to first line antibiotics.
-   The disease might be dangerous to other patients, and the patient might have to be isolated

Some reasons advocate the staging laparoscopy in gastric cancer treatment.

Because of the natural progression of this illness the risk of finding peritoneal implants (M1 illness) at the time of laparotomy is 25-37% after an otherwise, unremarkable CT scan.Thinking about the fact that few patients with M1 illness actually create surgical bleeding or significant gastric outlet obstruction prior to death a powerful argument can be made for laparoscoping all patients with advanced gastric cancer.

Moreover in order to pick patients that will most likely benefit from neoadjuvant treatment, distant metastases must be ruled out preoperatively. In the neoadjuvant treatment setting, staging must correctly identify (1) incurable tumors with distant metastatic illness and (2) high-risk tumors with serosal infiltration. Patients with stage M1 gastric cancer have no significant chance of cure, and ought to be offered some type of palliative therapy .
If the patient is due to get preoperative chemotherapy LUS is used to choose the extent of stomach wall invasion and lymph node involvement prior to treatment. These procedures identify patients with locally advanced illness (serosal invasion or obvious nodal metastases) that are at high risk for local recurrence and candidates for neoadjuvant chemotherapy trials.

Determining the pretreatment T stage is important since it is of prognostic value, and more basically verified than N stage. For T1 gastric cancers, resection alone is regarded as the treatment of choice. In T3 cancer the risk of recurrence is high and trials of neoadjuvant chemotherapy can clearly be justified. For T2 tumors decisions regarding investigational treatment may need further refinement: tumors confined to the muscularis propria, have better survival than tumors invading the subserosa. Published reports to date support the combined use of EUS or LUS as the most correct methods to assess T stage ( 2 ).

In the Yano's study only patients with T3 or T4 tumors were enrolled.With the advanced gastric cancer important findings that decide the operative indication are an unresectable T4 tumor, paraaortic node metastasis, and peritoneal dissemination. An unresectable T4 lesion and paraaortic node metastasis can be diagnosed by dynamic CT.Surgical laparoscopy offers high accuracy for detecting intraabdominal small metastases. Laparoscopic inspection is better than macroscopic examination under open laparotomy for several reasons. The subphrenic space and Douglas pouch, where peritoneal metastasis is often observed but direct observation under laparotomy misses small metastatic nodules, can be observed by laparoscopy depending on the magnifying power. Therefore, staging laparoscopy ought to be performed for patients at high risk for peritoneal metastasis, such as patients with type 4 tumors, undifferentiated tumors, or tumors in over three regions.
Several studies showed that preoperative chemotherapy induced down-staging of the disease and resulted in a higher healing resection rate for surgically staged unresectable cancer. Correct staging is necessary in advanced cases not only to settle on neoadjuvant treatment but also on whether to proceed with salvage surgical procedure after neoadjuvant treatment. A second staging laparoscopy effectively determined whether patients ought to undergo salvage surgical procedure after neoadjuvant therapy, in cases where peritoneal metastasis was the only reason for noncurability.
Staging laparoscopy also makes it feasible to perform abdominal lavage for cytologic, immunohistochemical, or molecular biologic detection of intraabdominal free cancer cells. The positive cytology of free cancer cells in the abdominal lavage liquid is an independent prognostic factor for T2 & T3/4 patients with no apparent
peritoneal seeding in the coursework of surgical procedure. Recent work with immunohistochemical staining suggests that patients with intraabdominal free cancer cells are at high risk for later diffuse metastasis. Evaluation of free tumor cells or tumor markers in the lavage liquid is a clue to detecting invisible peritoneal micrometastasis. Cancer Treatment planning for patients with positive cytology ought to be determined in future trials ( 3 ).

Siewert affirms that beyond any doubt surgical laparoscopy constitutes a step forward in surgical methodologies and contributes to improved preoperative staging, for peritoneal carcinomatosis. It ought to be used if therapeutic benefits can be gained, as is true for neoadjuvant chemotherapy. Otherwise, benefits and risks must be evaluated carefully. Irresponsible usage of surgical laparoscopy is not beneficial for the doctor or for the patient.In fact in addition to the morbidity and mortality related to surgical procedures, dissemination of tumor cells as a consequence of biopsies or other tumor manipulations could occur. Port-site metastases following diagnostic laparoscopy have been well described in the literature ( 4 ).

Luis F. Onate-Ocana et al define a three group staging method: stage I, no serosal involvement; stage II, serosal involvement; stage III, adjoining organ invasion; & stage IV, distant disease found at laparoscopy.The proposed staging method is a simplification of the TNM staging & is not intended to be a substitute. It ought to be regarde as a tool for the choice of the best therapeutic option for the specific patient & also for pretherapeutic stratification of risk factors in the setting of new randomised clinical trials ( 5, 6 ).

Rosin et al. define important technical aspects regarding diagnostic laparoscopy. The first controversial issue is its timing: it can be a separate procedure, or performed immediately before the planned healing surgical procedure. Another unresolved debate is the extent of the procedure: it ranges from inspection only, with biopsy of suspicious lesions, to extensive dissection, use of LUS, and peritoneal citology sampling ( 7 ).

Asbestosis and Symptoms

Asbestosis

It often takes years of exposure for asbestosis to surface but it can quickly worsen,  if exposure continues.Basically put, asbestosis is a breathing disorder caused by inhaling high levels of asbestos.  The buildup of these fibers in the lungs causes scarring of lung tissue & makes it difficult to breathe.

Who Gets Asbestosis?

Those at the highest risk for developing the disorder probably worked with asbestos or asbestos-containing products on a every day basis for at least 8 to 10 years.Miners may create the disorder in less time.

Asbestosis is  always job-related & plenty of of the victims are older individuals who were exposed to asbestos at work before the United States began to regulate its use in the mid-1970s.  This naturally-mined material was used extensively in the construction & manufacturing businesses,  as pipe insulation, in fire-retardant materials, as floor & ceiling tiles, & in brake & clutch linings.

Symptoms

Shortness of breath
Decreased tolerance for physical activity
Coughing
Chest pain
Finger clubbing, in some cases
Diagnosis

When thinking about a diagnosis of asbestosis, your doctor will probably inquire as to your exposure to asbestos.  He/she may also ask whether any fellow employees have been affected by the disease.  Your doctor may then order tests to confirm the diagnosis, including pulmonary function tests, CT scans, and chest x-rays.

When destroy and scarring caused by inhaled asbestos fibers lead to stiffness in your lung tissue so that your lungs cannot contract and expand normally, you will start experience symptoms of the disorder, which may include:

Treatment
The affects of asbestosis cannot be reversed but progression can be halted and symptoms treated.  Above all us, further exposure to the toxic material ought to be eliminated.  If you smoke, it's necessary to cease immediately.  Doctors may also treat you with medications that expand or relax blood vessels, and/or blood-thinners that prevent blood clots from forming and obstructing narrowed vessels.

Asbestos Lung Cancer

Asbestos is the name given to a fibrous mineral present in ore-bearing rock mined from an open pit or an underground mine. Asbestos is a group of naturally occurring fibrous minerals. The fibres can be breathed in to the lungs where they stay for plenty of years. These minerals, present in soil and rocks in plenty of parts of the world, are made of magnesium, silicon, and other elements. Some asbestos fibers are curly (or "serpentine"). The most common asbestos in industrial use, known as chrysotile, or white asbestos, has curly fibers. Other asbestos fibers are straight and needle-like (or "amphibole"). These include amosite, crocidolite, tremolite, actinolite, and anthophyllite. Asbestos fibers are resistant to heat and plenty of chemicals. As a result, asbestos has been used as an insulating material since ancient times. Since the industrial revolution, asbestos was used to insulate factories, schools, homes, and ships, to make automobile brake and clutch parts, roofing shingles, ceiling and floor tiles, cement, and textiles, and hundreds of other products. Asbestos was a common building material, but now they know that long term exposure to this mineral may cause illnesses like cancer. These substances form fibers with varying shapes and sizes and are found throughout the earth. There are three often obtainable types of asbestos; chrysotile (white asbestos), amosite (brown asbestos), and crocidolite (blue asbestos). All three have been associated with cancerous and non-cancerous lung illness.

The most common way for asbestos fibers to enter the body is through breathing. In fact, asbestos containing material isn't usually thought about to be harmful unless it is releasing dust or fibers in to the air where they can be inhaled or ingested. Lots of of the fibers will become trapped in the mucous membranes of the nose & throat where they can then be removed, but some may pass deep in to the lungs, or, if swallowed, in to the digestive tract. One time they are trapped in the body, the fibers may cause health issues. The most serious hazard of exposure to asbestos is cancer, & it takes less exposure to asbestos to cause cancer than to cause asbestosis. Three kinds of cancer are  strongly related to asbestos: lung cancer & mesothelioma. In addition, asbestos also causes cancer of the throat, stomach, esophagus, & bowel. Lung cancer caused by asbestos exposure is the same kind of cancer as that caused by smoking. It is hard to diagnose early, it spreads quickly, & can seldom be cured.

Exposure to asbestos is unlikely to cause any short term (acute) effects beyond irritation of the nose or throat. It is the long-term (chronic) effects that are debilitating & deadly. Every kind of asbestos causes cancer, & every kind of asbestos may cause asbestosis. People are exposed to asbestos chiefly through inhalation of fibers in the air they breathe. This may occur in the course of mining & processing of asbestos, in the course of the production of asbestos-containing products, or in the course of the installation of asbestos insulation. It may also occur when older asbestos-containing materials start to break down. In any of these situations, asbestos fibers tend to generate a dust composed of small particles that can float in the air. In addition, asbestos can enter the body through ingestion. This may occur when people consume contaminated food or liquids (such as water that flows through asbestos cement pipes). It may also occur when people cough up asbestos they have inhaled, then swallow their saliva. Lots of people are exposed to  low levels of naturally occurring asbestos in outdoor air due to erosion of asbestos-bearing rocks. Relatives members of asbestos workers are also potentially exposed to higher levels of asbestos because the fibers are carried home on the workers' clothing, & can then be inhaled by others in the household. Inhalation of asbestos fibers has been proven to cause lung cancer.

Lung cancer in asbestos-exposed & unexposed individuals is similar in both the type of cancer & its signs & signs. The link between cigarette smoking, asbestos & cancer of the lung itself does not apply to cancer of the lining of the lung (see malignant mesothelioma section below). Diagnosis & treatment of lung cancer is a complex topic & a pulmonary specialist ought to be involved in the workup of a suspected lung cancer. Exposure to asbestos fibers, either at home or in the workplace, is also thought about a risk factor for lung cancer. Studies show that compared to the general population, asbestos workers are three times more likely to die from lung cancer. Asbestos workers who smoke increase their risk of getting lung cancer by 50-100 times. The risk of asbestos-related abnormalities & sickness usually increases with increasing levels of exposure. This dose-response relationship is less clear for mesothelioma, where even short-term occupational exposures or secondary household exposures (e.g., household contacts of asbestos workers) have been associated with the occurrence of this malignancy. As asbestos exposures have declined in the workplace due to regulatory control, cases of extreme interstitial sickness have also decreased. Mesothelioma is a speedy spreading cancer that is  always caused by exposure to asbestos. It can take 30 or 40 years after exposure to create. Mesothelioma usually starts in the membrane that wraps around the lungs, called the pleura. The cancer cells cause a build-up of fluid between the pleura & the lungs, which in turn causes pressure on the lungs. The signs are shortness of breath & a dry, painful cough. The cancer may finally grow in to the chest wall. Often times, the cancer can create in the lining of the abdomen, the membranes of the heart or reproductive organs. Among lots of recently screened cohorts, pleural changes are more prevalent than interstitial changes. There is small proof that general environmental exposures are associated with significant sickness except in several regions of the world with endemic mesothelioma due to exposures from naturally-occurring deposits of asbestos.

Lung cancer causes the largest number of deaths related to asbestos exposure. The incidence of lung cancer in individuals who are directly involved in the mining, milling, manufacturing & use of asbestos & its products is much higher than in the general population. The most common signs of lung cancer are coughing & a alter in breathing. Other signs include shortness of breath, persistent chest pains, hoarseness, & anemia. The association between lung cancer & asbestos exposure is now well established. In the case of smokers who have had significant asbestos exposure, the risk of lung cancer is extraordinarily high. Lung cancer in asbestos exposed workers is thought to occur at a slightly earlier age than other lung cancers & are more common in the lower lobes.