THE BREAST ANATOMY

The Breast Anatomy

The female breasts


The female breasts, also known as the mammary glands, are accessory orgns of reproduction.



Situation One breast is situated on each side of the sternumand extends between the levels of the second and sixth rib. The breasts lie in the superficial fascia of the chest wall over the pectoralis major muscle, and are stabilized by suspensory ligaments.



Shape Each breast is a hemispherical swelling and has a tailof tissue extending towards the axilla (the axillary tail of spence).



Size The size varies with each individual and with the stage ofdevelopment as well as with age. It is not uncommon for one breast to be little or larger than the other.



Gross structure


The axillary tail is the breast tissue extending towards theaxilla.



The areoa is a circular area of loose, pigmented skin about2.5 cm in diameter the centre of each breast. It is a pale pink colour in a fair- skinned woman, darker in a brunett, the colour deepening with pregnancy. Within the area of the areola lie approximately 20 sebaceous glands. In pregnancy these enlarge and are known as montgeomery’s tubercles.



The nipple lies in the centre of the areola at the level of thefourth rib. Aprotuberance about 6mm in length, composed of pigmented erectile tissue.The surface of the nipple is perforarted by small orifices which are the openings of the lactiferous ducts. It is covered with epithelium.



Microscopic structure The breast is composed largely ofglandular tissue, but also of some fatty tissue, and is covered with skin. This glandular tissue is divided into about 18 lobes which are completely separated by bands of fibrous tissue. The internal structure is said to be resemble as the segments of a halved grape fruit or orgnge. Each lobe is a self-contained working unit and is composed of the following structures



Alveoli: Containing the milk- secreting cells. Each alveolus islined by millk-secreting cells, the acini, which extract from the mammary blood supply the factors essential for milk formation. Around each alveolus lie myoepithelial cells, sometimes called ‘basket’ or ‘spider’s cells. When these cells are stimulated by oxytocin they contract releasing milk into the lactifierous duct.



Lactifierous tubules:small ducts which connect the alveoli.



Lactifierous duct:a central duct into which the tubules run.



Amplulla:the widened-out portion of the duct where milk isstored. The ampullae lie under the areola.



Blood supply Blood is supplied to the breast by the internalmammary, the external mammary and the upper intercostals arteries.Venous drainage is through corresponding vessles into the internal mammary and axillary veins.





Lymphatic drainage This is largely into the axillary glands, with some dranage in to the portal fissure of the liver and mediastinal glands. The lymphatic vessels of each breast communicate with one another.



Nerve supply The function of the breast is largely controlledby hormone activity but the skin is supplied by breanches of the thoracic nerves. There is also some sympathetic nerve supply, especially around the areola and nipple.

ORPHAN DRUGS AND TREATMENT OF RARE DISEASES

Orphan Drugs & Treatment of Rare Diseases

Drugs for rare diseases-so-called orphan drugs-can be difficult to research, develop, and market. Proof of drug safety and efficacy in small populations must be established, but doing so is a complex process. Furthermore, because basic research in the pathophysiology and mechanisms of rare diseases receives relatively little attention or funding in both academic and industrial settings, recognized rational targets for drug action may be few. In addition, the cost of developing a drug can greatly influence priorities when the target population is relatively small. Funding for development of drugs for rare diseases or ignored diseases that do not receive priority attention from the traditional industry has received increasing sup-port via philanthropy or similar funding from not-for-profit foundations such as the Cystic Fibrosis Foundation, the Huntington’s Disease Society of America, and the Gates Foundation.

The Orphan Drug Amendments of 1983 provides incentives for the development of drugs for treatment of a rare disease or condition defined as “any disease or condition which (a) affects less than 200,000 persons in the U.S. or (b) affects more than 200,000 persons in the U.S. but for which there is no reasonable expectation that the cost of developing and making available in the U.S. a drug for such disease or condition will be recovered from sales in the U.S. of such drug.” Since 1983, the FDA has approved for marketing more than 300 orphan drugs to treat more than 82 rare diseases.

VITAMIN C (ALL INFORMATION)

Vitamin C



Vitamin C is also known as ascorbic acid. It has antioxidant properties and protects foods from oxidation, and it is required for all cell metabolism. It is read-ily destroyed by heat, air, and alkalies, and it is easily lost in cooking water.



Functions.Vitamin C is known to preventscurvy.This is a disease char-acterized by gingivitis (soft, bleeding gums and loose teeth); flesh that is easily bruised; tiny, pinpoint hemorrhages of the skin; poor wound healing; sore joints and muscles; and weight loss. In extreme cases, scurvy can result in death. Scurvy used to be common among sailors, who lived for months on bread, fish, and salted meat, with no fresh fruits or vegetables. During the middle of the eighteenth century, it was discovered that the addition of limes or lemons to their diets prevented this disease.



Vitamin C also has an important role in the formation of collagen, a pro-tein substance that holds body cells together, making it necessary for wound healing. Therefore, the requirement for vitamin C is increased during trauma, fever, and periods of growth. Tiny, pinpoint hemorrhages are symptoms of the breakdown of collagen.



Vitamin C aids in the absorption of nonheme iron (from plant and ani-mal sources and less easily absorbed than heme iron) in the small intestine when both nutrients are ingested at the same time. Because of this, it is called an iron enhancer.



Vitamin C also appears to have several other functions in the human body that are not well understood. For example, it may be involved with the forma-tion or functioning of norepinephrine (a neurotransmitter and vasoconstrictor that helps the body cope with stressful conditions), some amino acids, folate, leukocytes (white blood cells), the immune system, and allergic reactions.



It is believed to reduce the severity of colds because it is a natural antihista-mine, and it can reduce cancer risk in some cases by reducing nitrites in foods.

Vitamin C is absorbed in the small intestine.



Sources.The best sources of vitamin C are citrus fruits, melon, strawber-ries, tomatoes, potatoes, red and green peppers, cabbage, and broccoli.



Requirements.Vitamin C is measured in milligrams. Under normal cir-cumstances, an average female adult in the United States requires 75 mg a day and an average male 90 mg. In times of stress, the need is increased. Regular cigarette smokers are advised to ingest 125 mg or more a day.



It is generally considered nontoxic, but this has not been confirmed. An excess can cause diarrhea, nausea, cramps, an excessive absorption of food iron, rebound scurvy (when megadoses are stopped abruptly), and possibly oxalate kidney stones.



Deficiency.Deficiencies of vitamin C are indicated by bleeding gums, looseteeth, tendency to bruise easily, poor wound healing, and, ultimately, scurvy.

WHAT IS PATHOGEN ?

WHAT IS A PATHOGEN?

In medicine, we define a pathogen as any microorganism capable of causing disease. The emphasis is on disease, not the microorganism. However, from the microbial standpoint, being pathogenic is a strategy for survival and simply one more remarkable example of the extraordinary diversity of the microbial world. Humans, including physicians, proba-bly spend too little time reflecting on the fact that we are home to a myriad of other living creatures. From mouth to anus, from head to toe, every millimeter of our cells that is exposed to the outside world has a rich biological diversity. From the mites that inhabit the eyebrows of many of us to the seething cauldron of over 600 species of bacteria that inhabit our large bowel, we are a veritable garden of microorganisms. Most of these mi-croorganisms are not only innocuous but play a useful, if unseen, role. Not only do they provide us with protection against the few harmful microorganisms that we encounter each day, but they also give us some vitamins and nutrients and help digest our food. We have harbored them so long in our evolution that they are even a necessary part of the de-velopmental pathways required for the maturation of our intestinal mucosa and our innate local immune system.

Most human microbes are commensal; that is, they eat from the same table that we do. These microbes are constant companions and often depend on humans for their exis-tence. Although humans do not appear to be absolutely dependent on microbes for life (at least the cultivatable ones we know), we exist more comfortably with microbes than with-out them. We also encounter transient microbes, which are just passing through or on us, so to speak. Some commensal transient species may be opportunistic pathogens.
These  organisms can cause disease only if one or more of the usual defense mechanisms hu-mans have evolved to restrict microorganisms from their usually sterile internal organs and tissue are breached by accident, by intent (eg, surgery), or by an underlying meta-bolic or an infectious disorder (eg, AIDS). Nevertheless, a small group of microorganisms often causes infection and overt disease in seemingly normal individuals. These are the primary pathogens such as the common cold virus, the mumps virus, the typhoid bacil-lus, gonococcus, the tubercle bacillus, and the treponema of syphilis. Each organism is adapted exclusively to humans; other pathogens such as Salmonella typhimurium, a com-mon cause of human food poisoning, can cause disease both in humans and other ani-mals, birds, and even reptiles.

What is the difference between a commensal, an opportunist, and a primary pathogen? All of these organisms can cause disease under the proper circumstances. One distinction to make between an opportunistic pathogen and a primary pathogen is on the basis of the essentiality of the host for the long-term survival of a microbe. Long-term survival in a primary pathogen is absolutely dependent on its ability to replicate and to be transmitted in a particular host; however, this is not necessarily the case for a number of the opportunistic pathogens that infect humans. The major distinction that emerges is that primary pathogens have evolved the genetic ability to breach human cellular and anatomic barriers that ordinarily restrict or destroy commensal and transient microorgan-isms. Thus, pathogens can inherently cause damage to cells to gain access by force to a new unique niche that provides them with less competition from other microorganisms, as well as a ready new source of nutrients. For microorganisms that inhabit mammals as an essential component of their survival tactic, success can be measured by the capacity to multiply sufficiently to be maintained or be transmitted to a new susceptible host. This is true for commensal and pathogen alike. However, if the pathogen gains a new niche free of competition and rich in nutrients.

DRUG DISCOVERY

Most new drugs or drug products are discovered or developed through the following approaches:



(1) identification or elucida-tion of a new drug target;

 (2) rational design of a new molecule based on an understanding of biologic mechanisms and drug receptor structure;

(3) screening for biologic activity of large numbers of natural products, banks of previously discovered chemical entities, or large libraries of peptides, nucleic acids, and other organic molecules; and

(4) chemical modification of a known active molecule, resulting in a me-too analog. Steps (1) and (2) are often carried out in academic research laboratories, but the costs of steps (3) and (4) usually ensure that industry carries them out.



Once a new drug target or promising molecule has been identi-fied, the process of moving from the basic science laboratory to the clinic begins. This translational research involves the pre-clinical and clinical steps described next.



Drug Screening



Regardless of the source or the key idea leading to a drug candi-date molecule, testing it involves a sequence of experimentation and characterization called drug screening. A variety of assays at the molecular, cellular, organ system, and whole animal levels are used to define the activity and selectivity of the drug. The type and number of initial screening tests depend on the pharmacologic and therapeutic goal. For example, anti-infective drugs may be tested against a variety of infectious organisms, some of which areresistant to standard agents; hypoglycemic drugs may be tested for their ability to lower blood sugar, etc.



The molecule will also be studied for a broad array of other actions to determine the mechanism of action and selectivity of the drug. This can reveal both expected and unexpected toxic effects. Occasionally, an unexpected therapeutic action is seren-dipitously discovered by a careful observer. The selection of com-pounds for development is most efficiently conducted in animal models of human disease. Where good predictive preclinical mod-els exist (eg, antibacterials, hypertension, or thrombotic disease), we generally have good or excellent drugs. Good drugs or break-through improvements are conspicuously lacking and slow for diseases for which preclinical models are poor or not yet available, eg, autism and Alzheimer’s disease.Studies are performed during drug screening to define the pharmacologic profile of the drug at the molecular, cellular,organ, system, and organism levels. The value of these tests is highly dependent on the reproducibility and reliability of the assays. For example, a broad range of tests would be performed on a drug designed to act as an antagonist for a new vascular target for the treatment of hypertension.At the molecular level, the compound would be screened for activity on the target, for example, receptor binding affinity to cell membranes containing the homologous animal receptors (or if possible, on the cloned human receptors). Early studies would be done to predict effects that might later cause undesired drug metabolism or toxicologic complications. For example, studies on liver cytochrome P450 enzymes would be performed to determine whether the molecule of interest is likely to be a substrate or inhibitor of these enzymes or to interfere with the metabolism of other drugs.
Effects on cardiac ion channels such as the hERG potassium channel, possibly predictive of life-threatening arrhyth-mias, are considered.Effects on cell function determine whether the drug is an ago-nist, partial agonist, inverse agonist, or antagonist at the relevant receptors. Isolated tissues, especially vascular smooth muscle, would be used to characterize the pharmacologic activity and selectivity of the new compound in comparison with reference compounds. Comparison with other drugs would also be under-taken in other in vitro preparations such as gastrointestinal and bronchial smooth muscle.

Zafirlukast medicine for asthma

Zafirlukast: Uses, Side Effects, Dosage

Zafirlukast belongs to a group of medicines called leukotriene receptor antagonists.

 Zafirlukast is a prescription medication for the prevention of asthma attacks. It works by blocking the action of leukotrienes, a natural substance that causes inflammation and narrowing of the airways.

Leukotrienes are chemicals that your body releases when you breathe in an allergen (such as pollen). These chemicals cause lung inflammation and muscle constriction in the airways, which can lead to asthma symptoms.

Zafirlukast Uses

Zafirlukast is used for the chronic treatment of asthma and for the prevention of asthma attacks in adults and children from 5 years of age.

Medical treatment of chronic asthma
Preventing exercise-induced asthma
Relieving the symptoms of allergic rhinitis.
For the treatment of asthma
Note

It only starts after 3 to 14 days of treatment. Therefore, it should not be used to treat an acute asthma attack, since immediate relief is required.

Do not give this medication to a child younger than 5 years without medical advice.

Mechanism

Zafirlukast blocks the action of leukotrienes, chemicals that are released by the body as part of the inflammatory response.

Leukotrienes work in many parts of the body. In the lungs, they act in two ways, resulting in a narrowing of the airways. They cause a contraction of the muscles of the respiratory tract, making them narrower. In addition, leukotrienes cause inflammation of the lining of the respiratory tract, resulting in increased mucus production and additional constriction of the respiratory tract.

Precautions


Don’t take this medicine if you have

Allergy to zafirlukast or any other part of zafirlukast.
Allergy to any drugs in this class.
Liver disease.
Do not breast-feed while you take zafirlukast
Do not give this medicine to a child younger than 5 years without a doctor’s advice
Zafirlukast Side effects

Medications and their potential side effects can affect people in different ways. You will find below some of the side effects associated with this medicine. The fact that an adverse reaction is detected here does not mean that all people taking this medicine will experience this effect or an adverse effect.

The most common health side effects include:

Dizziness
Headache
Abdominal pain
Sore throat
Nausea
Diarrhea
Respiratory infections
Rhinitis
Other health side effects and adverse effects include:

Liver failure
Eosinophilia
Vasculitis
Fever
Back pain
Bleeding
Pregnancy and breastfeeding

Some medications should not be used during pregnancy or breastfeeding. However, other medications can be used safely during pregnancy or breastfeeding if the benefits to the mother outweigh the risks to the fetus. If you are pregnant or planning to become pregnant, always inform your doctor before taking any medication.

Interaction

Do not take this medicine with any of the following medications:

Pimozide
Cisapride
Aspirin
Carbamazepine
Phenytoin
Cyclosporine
Dofetilide
Erythromycin or clarithromycin
Diltiazem,
Felodipine,
Nifedipine,
Tolbutamide
Warfarin
Quinidine, or
Verapamil
Theophylline
Dosage

It is usually taken twice a day on an empty stomach, 1 hour before or 2 hours after a meal.

The recommended dose for the treatment of asthma is 10 mg twice daily in children aged 5 to 11 years and 20 mg twice daily in persons over 12 years of age.
Food reduces the absorption of this medicine.

Therefore, it should be taken 1 hour before or 2 hours after meals

Vigora 100 को कैसे, कब इस्तेमाल करें

1.विगोरा 100  क्या है?

                                         इसे इरेक्टाइल डिसफंक्शन (नपुंसकता) में दिया जाता है। विगोरा 100 का सेवन फास्फोडिस्ट्रस 5 (PDE 5) एंजाइम के प्रवाह को रोककर टिश्यू को रिलैक्स करता है तथा रक्तसंचार को आसान बना देता है। यह दोनों ही चीज़े स्तम्भन में सहयोगी हैं।

• इसे सभी वयस्क पुरुषों (18-85 वर्ष) के द्वारा ली जा सकती है 
• यह सेक्स पॉवर / इरेक्शन को ज्यादा देर तक रखती है। यह उत्तेजना / कामेच्छा libido को नहीं बढ़ाती पर इरेक्शन होने में मददगार है।                                                                                                           
• शुरू में कम मात्रा 50 मिलीग्राम ली जानी चाहिए और यदि ज़रूरत हो तब मात्रा बढ़ी मात्रा इस्तेमाल करनी चाहिए! 
• ज्यादा मात्रा तब लेनी चाहिए जब कम मात्रा लेने पर इरेक्शन पर कोई प्रभाव नहीं पड़ता   
• आपको बता दें इस दवा को लेने से भी शरीर पर कई तरह के दुष्प्रभाव आम भाषा में नुकसान होते हैं। इसलिए यदि आवश्यक हो तो ही इसका प्रयोग करें तथा यदि किसी अन्य स्वास्थ्य समस्या के लिए कोई दवा लेते हैं, तो उस दवा का इसके साथ इंटरेक्शन क्या होता है यह भलिभांति समझ लें। 
•    

2.विगोरा 100  टेबलेट किस प्रकार से लाभ पहुचती है     

सिल्डेनाफिल Sildenafil पुरुष पेनिस की रक्त नलिकाओ (ब्लड वेसल्स) की मांसपेशियों को रिलेक्स कर लिंग का रक्त प्रवाह बढ़ता हैं। यह इरेक्शन में केवल तभी मदद करता है जब व्यक्ति यौन उत्तेजित हो। इसक्र साथ ही यह यह फेफड़े में रक्त वाहिनियों को चौड़ा और शिथिल करता है जिससे फेफड़ों में रक्तदाब कम हो जाता है। 

3.विगोरा 100 इन पैक में उपलब्ध है 

• 1     Vigora  50 Mg Tablet 
• 2   विगोरा Vigora  100 Mg Tablet 
• 3   Vigora Force 50 Mg/30 Mg Tablet 

4. विगोरा 100  के सेवन विधि और मात्रा 

•   विगोरा 100 का एक दिन में एक बार ही सेवन करना चाहिये है। 
•   इसे एक बार में एक से जादा न लें। यह आपके लिए नुकसानदेह साबित हो सकता है 
•     आप इसे सादे पानी के साथ लें सकते है। 
•     इसे सेक्स करने से करीब एक 30 से 60 मिनिट पहले लें। 
• इसे लेने के बाद इसका असर 4-5 घंटे तक रहता है लेकिन तीन घंटे बाद इसका असर कम होने लगता है
• हेवी meal के साथ इसको लेने पर इसका अवशोषण धीमा हो जाता है 
• अल्कोहल का सेवन करने पर दवा का असर कम होता है। 
• ध्यान दे इसको डॉक्टर द्वारा निर्देशित रूप में ही लें 
• 5.विगोरा 100  के संभावित साइड इफेक्ट्स 
• सिर दर्द, चक्कर आना 
• अपच, एसिडिटी 
• लूज़ मोशन 
• शरीर गर्म महसूस होना 
• आँखों में जलन 
• पेशाब का इन्फेक्शन, पेशाब में जलन, बार बार पेशाब की इच्छा 
• मांसपेशियों में दर्द 
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