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Cardiovascular Disease (CVD)

Damage to the heart and blood vessels is collectively known as cardiovascular disease and people with diabetes have a higher chance of developing it. The term cardiovascular disease (CVD) includes heart disease, stroke and all other diseases of the heart and circulation.

Cardiovascular problems
Your major blood vessels consist of arteries which carry blood away from your heart, and veins which return it. Damage to these vessels is referred to as macro vascular disease.
Capillaries are the tiny vessels where the exchange of oxygen and carbon dioxide takes place. When damage occurs to these vessels it’s referred to as micro vascular disease. When fatty materials such as cholesterol form deposits on the walls of the vessels (known as plaque), furring up the artery and reducing the space for blood to flow, this is described as arteriosclerosis or atherosclerosis. If the plaque ruptures the artery walls, blood cells (called platelets) try to repair the damage, but this will cause a clot to form. Over time, the walls of the blood vessels lose their elasticity. This can contribute to the development of high blood pressure or hypertension, which can cause more damage to the blood vessels.
The force of the blood being pumped from the heart can make the clot break away from the artery wall and travel through the system until it reaches a section too narrow to pass through. If this happens the narrow section will become partially or completely blocked.
Blockage of an artery leads to the part of the body it supplies being starved of the oxygen and nutrients it needs. This is the cause of heart attack or strokes (affecting the brain).
Narrowing of the blood vessels can affect other parts of the body, such as the arms or legs. This is called peripheral vascular disease (PVD). PVD may produce intermittent claudication (pain in the calf muscle). If left untreated, amputation of the limb may eventually be necessary.
What causes cardiovascular disease?
Blood vessels are damaged by high blood glucose levels, high blood pressure, smoking or high levels of cholesterol. So, it is important for people with diabetes to manage these levels by making lifestyle changes such as eating a healthy diet, taking part in regular activity, reducing weight if you are overweight and stopping smoking.
Steps you can take to help prevent CVD
  • If you smoke, ask for help to stop.
  • Eat a healthy, balanced diet.
  • Be more physically active.
  • If you are overweight, try to get down to a healthy weight. Any weight loss will be of benefit.
  • Take your medication as prescribed.
  • Get your blood glucose levels, blood pressure and blood cholesterol checked at least once a year and aim to keep to the target agreed with your healthcare team.
  • If you have any chest pain, intermittent pain when walking, impotence or signs of a stroke, such as facial or arm weakness or slurred speech, you should contact your doctor as soon as possible.
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Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is used to describe progressive lung diseases including chronic bronchitis, refractory (non-reversible) asthma, emphysema, and some forms of bronchiectasis. This disease is described by increasing breathlessness.

COPD can build up for years without noticeable shortness of breath. You begin to see the symptoms in the more developed stages of the disease. That’s why it is important that you talk to your doctor as soon as you note any of these symptoms. You can consult with the doctor and tell about taking a spirometry test.

Symptoms of COPD
The main signs and symptoms of COPD are:
  • increased breathlessness
  • a persistent chesty cough with phlegm – some people may dismiss this as just a "smoker's cough" 
  • frequent chest infections
  • persistent wheezing
  • Tightness in the chest


Without treatment, the symptoms usually get slowly worse. There may also be periods when they get suddenly worse, known as a flare-up or exacerbation.

When to get medical advice
You should contact to doctor if you have persistent symptoms of COPD, particularly if you're over 35 and smoke or used to smoke. One should not ignore the symptoms. If they're caused by COPD, it's best to begin treatment as soon as possible, before your lungs become significantly damaged.

Your doctor will ask about your symptoms and whether you smoke or have smoked in the past. Doctor can arrange a breathing test to help diagnose COPD and rule out other lung conditions, such as asthma.

Chronic = it’s a long-term condition and does not go away
Obstructive = your airways are narrowed, so it’s harder to breathe out quickly
Pulmonary = it affects your lungs
Disease = it’s a medical condition

What are the risk factors and common causes of COPD?
In most of the cases, COPD are caused by inhaling pollutants; that includes smoking (cigarettes, pipes, cigars, etc.), and second-hand smoke.

Fumes, chemicals and dust found in many work environments are contributing factors for many individuals who develop COPD.

Genetics can also take part in a role in an individual’s development of COPD—even if the person has never smoked or has ever been exposed to strong lung irritants in the workplace.

Treatment of COPD

There is currently no cure for chronic obstructive pulmonary disease (COPD), but treatment can help slow the progression of the condition and manage the symptoms.

Treatments include:
  • stopping smoking – if you have COPD and you smoke, this is the most important thing you can do
  • inhalers and medications – to help make breathing easier
  • pulmonary rehabilitation – a specialised programme of exercise and education
  • surgery or a lung transplant – although this is only an option for a very small number of people


Your doctor will discuss the various treatment options with you.
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Chikungunya

Chikungunya is a viral disease transmitted to humans by infected mosquitoes. It causes fever and rigorous joint pain. Other symptoms contain muscle pain, headache, nausea, tiredness and rash.

Signs and symptoms
Chikungunya is described by an sudden start of fever frequently accompanied by joint pain. Other signs and symptoms include muscle pain, headache, nausea, fatigue and rash. The joint pain is often very unbearable, but usually lasts for a few days or may be extended to weeks. Most patients get well fully, but in some cases joint pain may continue for some months, or even years.

Transmission
The virus is transmitted from human to human by the bites of infected female mosquitoes. These mosquitoes can be found biting throughout daylight hours, though there may be peaks of activity in the early morning and late afternoon.

Treatment
There is no specific antiviral drug treatment for chikungunya. Treatment is directed mainly at relieving the symptoms, including the joint pain using anti-pyretics, optimal analgesics and fluids. 

Prevention and Control
Prevention and control relies greatly on reducing the number of natural and artificial water-filled container habitats that support breeding of the mosquitoes. During outbreaks, insecticides may be sprayed to kill flying mosquitoes, applied to surfaces in and around containers where the mosquitoes land, and used to treat water in containers to kill the immature larvae.

For guard during outbreaks of chikungunya, clothing which minimizes skin exposure to the day-biting vectors is recommended. For those who sleep during the daytime, mainly young children, or sick or older people, insecticide-treated mosquito nets afford good protection. Mosquito coils or other insecticide vaporizers may also reduce indoor biting.

Basic precautions should be taken by people travelling to risk areas and these include use of repellents, wearing long sleeves and pants and ensuring rooms are fitted with screens to prevent mosquitoes from entering.
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