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Special Supplement 2013

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Medical Health Fitness

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Special Supplement 2013

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Breast Cancer Awareness Month Alzheimerâ&#x20AC;&#x2122;s Disease Awareness Month Lung Cancer Awareness Month Pancreatic Cancer Awareness Month World Diabetes Day International Men's Day World AIDS Day

Dr. Nazia Nausheen Supplement Consultant

Dr. Nazia Nausheen is a Certified Medical Doctor. She also holds a Masters Degree in Business, Specializing in Sales and Marketing.

FROM THE EDITOR Dear Readers... Stay Healthy! We are delighted to welcome you to the Special Medical Supplement. We have compiled this supplement to educate our readers on the various common health conditions and concerns and provided sufficient information for each with precautions. We believe that when you learn as much as possible, you'll stay in control of your health, rather than let your health control you. Enjoy this supplement, We've developed it with you in mind. We seeked the help of Dr. Nazia Nausheen for this project who has very carefuly researched and put together this informative, yet interesting supplement which we are sure you all will enjoy reading and benefet from. I also would like to thank my Sales Manager - Mohammad Altaf, who has played a vital role in conveying the purpose of this supplement to our sponsors and advertisers and gained their confidence and support in making this possible. Please spread the message and awareness with this Special Supplement and lets together save lives and promote a healthy lifestyle.

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DISCLAIMER

JAMEEL ARIF jameelrf@citypageskuwait.com

Extra care has been used to ensure the accuracy of the information contained in this magazine. However, the publisher will not accept responsibility for errors and omissions in the publication. In addition, the views expressed in this magazine are not necessarily those of the publisher. Photos have been altered to comply with the Laws of Kuwait. All rights reserved. No part of this publication including pictures, articles, artworks, and overall design may be reproduced, copied, transmitted, transcribed, stored in a retrieval system, or translated in any language in any form or means (electronic, mechanical, photocopying, recording, or otherwise) without the written permission of the editor or the publisher. Copyright ÂŠ 2013

First Aid and Emergency Treatment at Home

First Aid is the temporary help given to an injured or a sick person before professional medical treatment can be provided. This timely assistance, comprising of simple medical techniques, is most critical to the victims and is, often, life saving. Any layperson can be trained to administer first aid, which can be carried out using minimal equipments. There are several conditions that require first aid but we will discuss only few, more common ones.

Fever Overview

• Fever is higher-than-normal body temperature (Normal temperature is 370C or 98.60F) • Indicates an abnormal process in the body • Fever is a symptom and not disease • Also called 'pyrexia' • Low fever:98.80F to 100.80F • Mild to moderate:1010F to 1030F • High fever:1040F and above

Causes

• Hot weather • Childhood immunization • Bacterial/viral infection • Spending much time in sun • Allergy to medication / food

Symptoms

• Hot flushed face • Lack of interest in food • Nausea • Vomiting • Head and body ache • Constipation • Diarrhea

High fever maybe associated with: • Delirium • Convulsion

Treatment

• Monitor temperature using a thermometer • Remove the excess clothing • Keep the person in a cool place • Give a sponge bath in luke warm 10

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water • Give plenty of fluids • Give prescribed doses of Adol • Do not give aspirin to a person with fever • Do not wrap the person in blankets / warm clothing

Consult a Doctor in case of: • Irregular breathing • Stiff neck • Confusion • Rashes • Persistent sore throat • Vomiting • Diarrhea • Painful urination • Convulsions

Headache

• Withdrawal from caffeine/drugs • Brain related o Aneurysms o Tumors o Meningitis o Encephalitis o Head injury

Treatment

• Most headaches are treated with pain killers • Common medicationsacetaminophen/Panadol/aspirin • Tension headache treated by lowering body temperature- This is achieved by taking a cool shower • If recurrent, keep a headache diary This helps to identify the cause • Chronic use of painkillers causes 'rebound headaches' • Complementary treatments like chiropractic care is proved to be quiet effective

Consult a doctor Overview

• A condition where pain occurs in the head • Most common of pain complaints • Majority of headaches are harmless, require no treatment • Some are indications of an underlying disorder

Causes

• Tension • Fever • High blood pressure • Migraine • Straining the eye • Sinus infection • Dehydration • Ice cream • Thunder

• If headache is recurrent and persistent • If headache occurs with o Fever/convulsions o Memory loss/confusion o Loss of consciousness o Stiff Neck

Nose Bleed Overview

• A nose bleed occurs when a small vein, along the lining of nose, bursts • Most nosebleeds look scary, but are harmless • Can be treated at home • Common in children/elderly

First Aid and Emergency Treatment at Home

Causes

• Dryness • Nose picking • Blowing nose with force • Use of medications, like aspirin • Introducing objects into nose (mostly children) • Injuries • Allergies • Infections • High BP • Atherosclerosis • Blood-clotting disorders

• The bleeding is caused by an injury • You get nosebleeds often

Prevention

• Keep fingernails short • Quit smoking • Open your mouth while sneezing • Use a humidifier at night in case of dry weather

Choking Overview

• Occurs when foreign object is lodged in windpipe (trachea) a. Anterior Nosebleed • This blocks oxygen supply to brain • Affects lower part of nose septum or • In adults, choking occurs due to food wall that separates nostrils • In children it also occurs on • The wall or septum contains blood swallowing an object vessels • Choking could be fatal, if first aid not • These can be broken by blow to nose/ given fingernail Causes • The bleeding starts from front of nose • Swallowing a large piece of food • It flows outward when patient is • Swallowing food that is not well sitting/standing chewed • Occurs during dry season/harsh • Eating food quickly winter • Eating and talking at the same time b. Posterior Nosebleed • Wearing dentures • The bleeding starts deep within the • Walking / playing with food in mouth nose

Types

• It flows down the back of the mouth & throat • This happens even when the person is sitting/standing • Occurs in old people/those with high BP/injuries • This type of bleeding is severe/ requires medical help

Treatment

If your nose bleeds: • Sit down and lean forward • Using your thumb & index finger, squeeze soft part of nose • This part is between end of nose and the bridge of nose • Continue holding till bleeding stops• Do not stop in-between • If bleeding continues, hold for another 10 minutes • If the patient is a child, divert attention by TV/Stories • Avoid picking, blowing or rubbing nose for 2 days • Place an ice pack on the bridge of nose

Consult a Doctor if:

• The bleeding continues for more than 15 minutes

Symptoms

• Hands will grasp throat • Breathlessness • Noisy breathing • Inability to cough • Skin, nails and lips may turn blue • Loss of consciousness

Treatment

• Heimlich maneuver can be used • It forces the diaphragm up to the lungs • Creates an artificial cough Heimlich Maneuver on a standing person • Stand behind the person • Form a fist with one hand • Place fist below ribcage, thumb inward • Hold the fist with other hand • Keep arms off ribcage • Give four inward and upward thrust • Repeat till the object is ejected • Same method is used for a child too Heimlich Maneuver On an Unconscious Person

• If person is lying down, straddle the person with your knees • Place heel of one hand above waistline • Place other hand over the first • Give four inward and upward thrust • Repeat till object is coughed out Heimlich Maneuver On an Infant • Place the infant face down across your forearm (resting your forearm on your leg) and support the infant’s head with your hand. • Give four forceful blows to the back with the heel of your hand. • repeat this several times until the obstructing object is coughed out • If it does not work, turn the baby • Place two fingers an inch below the imaginary line connecting nipples • Give four thrusts to the chest to a depth of 1 inch to bring out the object • Repeat if required

Prevention

• While eating, concentrate on the task • Do not eat quickly, without chewing • Supervise children while they eat • Give easily chewable, soft food to children • Do not leave tiny objects within the reach of children

Animal bites Overview

• Domestic pets cause more bites • Dogs more likely to bite and cats are more infectious • Risk of rabies with non-immunized pets / stray / wild animals

Symptoms

• Skin break • Bruise / puncture • Cuts • Bleeding • Swelling and redness of the area • Oozing of fluid

Treatment

For minor wounds: If the bite barely breaks the skin and there's no danger of rabies, treat it as a minor wound. Wash the wound thoroughly with soap and water. Apply an antibiotic cream to prevent infection and cover the bite with a clean bandage For deep wounds: If the animal bite creates a deep puncture of the skin The Medical Supplement 2013

First Aid and Emergency Treatment at Home

or the skin is badly torn and bleeding, apply pressure with a clean, dry cloth to stop the bleeding and see your doctor For infection: If you notice signs of infection, such as swelling, redness, increased pain or oozing, see your doctor immediately For suspected rabies: If you suspect the bite was caused by an animal that might carry rabies — including any wild or domestic animal of unknown immunization status, see your doctor immediately

•Object should cling to the cotton bud •If object is removed, flush eyes with saline/warm water •If object cannot be removed, see a doctor •If object is embedded, do not touch •Cover the eyes with paper cups and tape it •Consult doctor immediately

the hands, feet, face, groin or buttocks, or a major joint, which requires emergency medical attention.

2nd-degree burn When the first layer of skin has been burned through and the second layer of skin (dermis) also is burned, the injury is called a second-degree burn. •Blisters develop Steps to Avoid •Skin takes on an intensely reddened, •Avoid rubbing eyes splotchy appearance •Do not remove an embedded object •There is severe pain and swelling. Prevention •Do not try to remove a large object If the second-degree burn is no larger •Avoid keeping wild animals as pets Consult a doctor than 3 inches (7.6 centimeters) in •Choose a pet that is friendly to •When the object cannot be removed diameter, treat it as a minor burn. If the children burned area is larger or if the burn is on •When object is embedded •Train the pet to obey commands the hands, feet, face, groin or buttocks, •When the person's vision is affected •Vaccinate your pet or over a major joint, treat it as a major •When the scratching sensation persists burn and get medical help immediately. •When children are around, pets •When pain persists even after removing Treatment supervision is required object •Avoid leaving infants alone with pets For minor burns: including first-degree Prevention burns and second-degree burns limited •Wear protective eye gear at work, if to an area no larger than 3 inches (7.6 centimeters) in diameter, take the necessary •Wear protective gears while playing following action: •Cool the burn. Hold the burned area sports Overview under cool (not cold) running water •Any object that lodges itself in the eye for 10 or 15 minutes or until the pain subsides. If this is impractical, immerse •Small objects will be washed out by the burn in cool water or cool it with cold tears / blinking compresses. Cooling the burn reduces •Others need medical attention swelling by conducting heat away from What are burns? Causes •Burns are injuries due to heat, the skin. Don't put ice on the burn. •Dust •Cover the burn with a sterile gauze chemicals, electricity, or radiation •Debris •Common heat injuries are due to fire, bandage. Don't use fluffy cotton, or other material that may get lint in •Sand hot liquids, or steam the wound. Wrap the gauze loosely •Contact lens •Burns due to heat / chemicals - through to avoid putting pressure on burned skin contact •Eye lash skin. Bandaging keeps air off the burn, •Severe burns may affect muscles, fat reduces pain and protects blistered skin. •Make up and bones •Take an over-the-counter pain reliever. •Flying objects like glass •Older people and children are These include aspirin, ibuprofen (Advil, Symptoms particularly vulnerable others), or acetaminophen (Tylenol, •Itching others). Use caution when giving aspirin Categories of burns •Irritation To distinguish a minor burn from to children or teenagers. Though aspirin •Pain a serious burn, the first step is to is approved for use in children older determine the extent of damage to body than age 2, children and teenagers •Sensitivity to bright light tissues. The three burn classifications of recovering from chickenpox or flu-like •Blurry vision first-degree burn, second-degree burn symptoms should never take aspirin. Treatment and third-degree burn will help you Talk to your doctor if you have concerns. Minor burns usually heal without •Wash hands before helping the victim determine emergency care. further treatment. They may heal with •Seat the person in a well lit area pigment changes, meaning the healed •Gently examine the eye 1st-degree burn area may be a different color from •Pull lower eyelid downward The least serious burns are those in the surrounding skin. Watch for signs which only the outer layer of skin is of infection, such as increased pain, •Ask the person to look upward redness, fever, swelling or oozing. If •Then hold upper eyelid while person burned, but not all the way through. infection develops, seek medical help. •The skin is usually red looks down Avoid re-injuring or tanning if the burns •Often there is swelling •If object is floating try flushing it out are less than a year old — doing so may •Otherwise, touch the object with wet •Pain sometimes is present cause more extensive pigmentation cotton bud Treat a first-degree burn as a minor burn changes. Use sunscreen on the area for unless it involves substantial portions of at least a year.

Foreign object in the eye

Burns

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First Aid and Emergency Treatment at Home

Caution •Don't use ice. Putting ice directly on a burn can cause a person's body to become too cold and cause further damage to the wound. •Don't apply egg whites, butter or ointments to the burn. This could cause infection. •Don't break blisters. Broken blisters are more vulnerable to infection.

Head Trauma Overview

•Head trauma is an injury that affects the brain / skull •Injuries range from minor to serious •Head injury may be 'closed' or 'penetrating' • 'Closed'- when head hits against a blunt object, these injuries lead to 3rd-degree burn concussion The most serious burns involve all layers •'Penetrating' - an object penetrates of the skin and cause permanent tissue skull and enters brain damage. Fat, muscle and even bone Causes may be affected. Areas may be charred •Road traffic accidents black or appear dry and white. Difficulty •Accidents at home / work inhaling and exhaling, carbon monoxide •Assault poisoning, or other toxic effects may occur if smoke inhalation accompanies •Fall •Sports the burn.

Treatment

For major burns: it requires immediate medical assistance, while at home follow these steps: 1.Don't remove burned clothing. However, do make sure the victim is no longer in contact with smoldering materials or exposed to smoke or heat. 2.Don't immerse large severe burns in cold water. Doing so could cause a drop in body temperature (hypothermia) and deterioration of blood pressure and circulation (shock). 3.Check for signs of circulation (breathing, coughing or movement). If there is no breathing or other sign of circulation, begin CPR. 4. Elevate the burned body part or parts. Raise above heart level, when possible. 5.Cover the area of the burn. Use a cool, moist, sterile bandage; clean, moist cloth; or moist cloth towels. 6.Get a tetanus shot. Burns are susceptible to tetanus. Doctors recommend you get a tetanus shot every 10 years. If your last shot was more than five years ago, your doctor may recommend a tetanus shot booster.

Prevention

•Install smoke alarm in your home •Employ 'children friendly' safety measures at home •Avoid synthetic clothing while cooking •Carry out fire drills at home and work place

•Immobilize the patient •If unconscious, treat it like a spinal injury •Keep the head in alignment with spine •Get immediate medical help

Consult a Doctor

Adults •Severe head or facial bleeding •Bleeding or fluid leakage from the nose or ears •Severe headache •Change in level of consciousness for more than a few seconds •Black-and-blue discoloration below the eyes or behind the ears •Cessation of breathing •Confusion •Loss of balance •Weakness or an inability to use an arm or leg •Unequal pupil size Symptoms •Slurred speech •Loss of consciousness - for short or •Seizures long duration Children •Bleeding •Any of the signs or symptoms for adults •Vomiting •Persistent crying •Fluid discharge from nose •Refusal to eat •Loss of hearing, vision, taste, smell •Bulging in the soft spot on the front of •Speech-related problems the head (infants) •Irregular heart beat •Repeated vomiting •Seizures Steps to Avoid •Paralysis •Avoid shaking or moving a person who •Coma has head injuries •Change in personality •Avoid washing the wound or removing debris •Mental health-related problems •Do not remove helmet in case of head Treatment injury For mild injury: •Do not pick up a fallen child with head •Apply ice to injured area to minimize injury swelling •The size of the bump is not related to the severity of injury •Observe the patient carefully for signs of bleeding Overview For moderate to severe injury: •Heat stroke is the most severe of all •Check the patient's breathing pattern heat-related illness •If necessary do Cardio Pulmonary •Heat stroke could be life-threatening Resuscitation (CPR) Causes •In case of bleeding, press area with a •Cooling mechanism of the body fails clean cloth due to •If the cloth soaks, place a fresh cloth a. Excessive humidity over the first one b. Extreme heat •Do not remove debris from the wound c. Activity in the hot sun •If person is vomiting turn on the side •Internal body temperature rises, and lower the head leading to stroke •To minimize spine injury - hold head, Risk Factors neck and body in one line •Dehydration

Heat stroke

The Medical Supplement 2013

First Aid and Emergency Treatment at Home

•It can cause premature ageing/cancer •Common in children/young adults

during 10 am to 4 pm when UV rays are the strongest •Use sun-block creams during exposure Causes to sun •Ultraviolet rays from sun during •Select a suitable SPF number for the outdoor activities sun block cream •Tanning beds •Sun Blocks should be reapplied every •Traveling to places at high altitude 2-3 hours Symptoms Risk factors •Avoid tanning beds The main sign of heat stroke is highly •Light-skinned people raised body temperature, greater than •Recent exposure to sun 1040F •Prior skin injury •Head ache •Infections like Herpes, Porphyria •Dizziness •Certain Medications like antibiotics, What is a Cut? •Confusion anti-psoriatic drugs •An injury due to opening in the skin •Disorientation Symptoms Minor Cuts / Scrapings •Fatigue The skin injury begins within 30 minutes •No treatment is required •Hot dry skin of exposure to the sun •Care required to prevent infection •Skin is moist, if stroke is due to exertion •Redness of the skin Treatment for Minor Cuts •Rapid / shallow breathing •Irritation •Clean wound with water •Rapid heartbeat •Blisters •Avoid soap •Absence of sweating •Pain •Remove dirt/debris in the wound •Fluctuating blood pressure •Skin burning •Apply antibiotic ointment •Irritability •Skin loss •Dress/ bandage the wound •Confusion •Dehydration •Change dressing daily •Lack of consciousness / coma •Flu-like symptoms •Minor cuts bleeding stops in10 min •Infection Treatment •Apply gentle pressure if bleeding •Fever •Remove the person to a shady place persists •Cool the person by sponging with wet •If very severe, shock leading to death Deep cuts may occur towel •May bleed heavily •Apply ice packs in armpits and groin Treatment •May expose underlying tissues •Water with electrolyte, fruit / vegetable Self-Help Treatment for Deep Cuts juice should be given •Get out of the sun •May require stitching •Victim must be rested •Cover the exposed area Requires Tetanus Toxoid shot (TT) if: •Seek medical assistance if necessary •Take a cool bath a. Cut is dirty or has debris Prevention •Use a cool compress and apply to sun b. TT taken 5 years ago •Avoid outdoor activity during excessive burnt area for 20 minutes Consult a doctor in case of: heat •Apply aloe-based solution a. Delayed wound- healing •Drink plenty of fluids when working •Avoid using oils, bath salts, perfumed b. Pus Discharge outdoors lotions etc c. Fever •During outdoor activity, splash your •Avoid scrubbing/shaving body frequently with water Points to note •Use a gentle towel •Wear light weight, light- colored, loose•Do not try to clean a major wound •Stay out of the sun while sun burnt fitting clothes •Do not remove deeply- lodged debris •Protect yourself from the sun by Consult a Doctor •Do not breathe on an open wound In case of: wearing sun glasses and hat •Do not push back exposed body parts •Pain •Infants & older people •People who work outdoor for long hours •Obesity •Impairment in sweat gland function •Cardiovascular disorder •Medications

Cuts

Sunburn

•Headache/confusion •Blisters •Nausea/vomiting Overview •Sunburn is a burn of the skin results •Loss of consciousness •Sunburn being present along with from overexposure to the sun •Normal exposure results in the other medical condition Prevention production of Vitamin D •Most of us become sun burnt at some •Wear hats, long-sleeved dress, long pants while out in the sun time in life •Try to avoid exposure to sun especially •Sunburn causes a lot of discomfort 14

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Gastroenteritis Overview

•Gastroenteritis is inflammation of stomach and intestines •Can affect any one, any age, any time •Symptoms prominent in children •Depending on cause, it may last for a

First Aid and Emergency Treatment at Home

day or a week

Causes

•Bacteria contaminated food / water •Viral infection •Stress •Irregular/ improper diet •Tobacco or substance abuse •Reaction to a new food •Reaction to medication

Symptoms

•Vomiting •Nausea •Diarrhea •Cramps/Abdominal pain •Dehydration •Weakness •Low grade Fever/Chills, sometimes

Treatment

•Adequate rest is advised •Drink plenty of fluids to prevent dehydration •Gradually eat easy -to-digest food •Avoid dairy products •Avoid eating if nauseated •Do not give water to a child with gastroenteritis either give other prescribed rehydration liquids or give a mixture of salt and glucose in water •Consider nursing the baby •Consider acetaminophen for relief of discomfort but avoid acetaminophen in case of liver disease •Avoid aspirin

Consult a doctor If

•Vomiting persists for more than two days •Diarrhea persists more than several days •Diarrhea turns bloody •Fever is 1010F (38.30C) or higher •Lightheadedness or fainting occurs with standing •Confusion develops •Worrisome abdominal pain develop

Fainting Overview

until the signs and symptoms are •Uncomfortable pressure, fullness or squeezing pain in the center of the chest relieved and the cause is known. •Prolonged pain in the upper abdomen Common Causes •Discomfort or pain spreading beyond •Anxiety the chest to the shoulders, neck, jaw, •Emotional upset teeth, or one or both arms •Stress •Shortness of breath •Severe pain •Lightheadedness, dizziness, fainting •Skipping meals •Sweating •Standing up too fast •Nausea •Standing for a long time in a crowd A heart attack generally causes chest •Some medications pain for more than 15 minutes, but it •Diabetes can also have no symptoms at all. Many people who experience a heart attack •Blood Pressure have warning signs hours, days or weeks Symptoms in advance. Before fainting, a person may experience Treatment the following: If you or someone else may be having a •Nausea heart attack: •Giddiness •Seek immediate medical assistance. •Excessive sweating Don't tough out the symptoms of a heart attack for more than five minutes. •Dim vision If you don't have access to emergency •Rapid heart beat or palpitations medical services, have a neighbor or a Treatment friend drive you to the nearest hospital. If you feel faint: Drive yourself only as a last resort, if •Lie down or sit down. To reduce the there are absolutely no other options, chance of fainting again, don't get up and realize that it places you and others at risk when you drive under these too quickly. circumstances. •Place your head between your knees if While waiting for medical assistance you sit down. you can do the following: If someone else faints: •Try to relax •Position the person on his or her back. If the person is breathing, restore blood •Loosen tight clothes flow to the brain by raising the person's •Take medicines: If you think you're legs above heart level — about 12 inches having a heart attack and your doctor (30 centimeters) — if possible. Loosen has previously prescribed nitroglycerin belts, collars or other constrictive for you, take it as directed. Do not take clothing. To reduce the chance of anyone else's nitroglycerin, because fainting again, don't get the person up that could put you in more danger. too quickly. If the person doesn't regain Pain subsides within 3 min of medicine consciousness within one minute, seek intake. immediate medical assistance. •Begin CPR if the person is unconscious. •Check the person's airway to be sure If you're with a person who might be it's clear. Watch for vomiting. having a heart attack and he or she is •Check for signs of circulation unconscious, seek medical help such as (breathing, coughing or movement). If calling 112. You may be advised to begin absent, begin CPR and seek immediate cardiopulmonary resuscitation (CPR). medical assistance. Continue CPR until If you haven't received CPR training, help arrives or the person responds and doctors recommend skipping mouth-tomouth rescue breathing and performing begins to breathe. only chest compressions (about 100 per If the person was injured in a fall minute). The dispatcher can instruct associated with a faint, treat any bumps, you in the proper procedures until help bruises or cuts appropriately. Control arrives. bleeding with direct pressure.

•Fainting occurs when the blood supply to your brain is momentarily inadequate, causing you to lose consciousness. •A fainting spell is usually very brief •Fainting can have no medical Symptoms significance, or the cause can be a serious disorder. Therefore, treat loss of Someone having a heart attack may consciousness as a medical emergency experience any or all of the following:

Heart Attack

Prevention

•Routine health check-up •Avoid stress •Quit smoking •Eat sensibly •Control blood pressure / diabetes •Control weight The Medical Supplement 2013

DIABETES MELLITUS

Diabetes Mellitus

Basics, Myths & Facts

Myths about Diabetes:

Diabetes is a disease in which your blood glucose, or sugar levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose to get into your cells to give them energy. With type 1 diabetes, your body does not make insulin occurs at a younger age or childhood. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. Obesity or being overweight predisposes to type 2 Diabetes. Over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestational Diabetes. A blood test can show if you have Diabetes. Exercise, weight control and sticking to your meal plan can help control your diabetes. You should also monitor your glucose level and take medicine if prescribed. 16

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Fact: The answer is not so simple. Type 1diabetes is caused by genetics and unknown factors that trigger the onset of the disease; type 2 diabetes is caused by genetics and lifestyle factors.

There are many myths about diabetes that make it difficult for people to believe some of the hard facts.These myths can create a picture of diabetes that is not accurate and Being overweight does increase your risk full of stereotypes and stigma. Get the facts about diabetes and learn how for developing type 2 diabetes, and a diet you can stop diabetes myths and misconcep- high in calories from any source contributes to weight gain. Research has shown tions. that drinking sugary drinks is linked to type 2 diabetes. Myth 1: Diabetes is not that serious of a It is recommended that people should limit disease. their intake of sugar-sweetened beverages Fact: If you manage your diabetes properly, you can prevent or delay diabetes complications. However, diabetes causes more deaths a year than breast cancer and AIDS combined. Two out of three people with diabetes die from heart disease or stroke.

to help prevent diabetes. Sugar-sweetened beverages include beverages like: •regular soda •fruit drinks •energy drinks •sports drinks

Myth 2: If you are overweight or obese, you •sweet tea will eventually develop type 2 diabetes. These will raise blood glucose and can proFact: Being overweight is a risk factor for de- vide several hundred calories in just one veloping this disease, but other risk factors serving! such as family history, ethnicity and age also •Just one 12-ounce can of regular soda has play a role. Unfortunately, too many people about 150 calories and 40 grams of carbodisregard the other risk factors for diabetes hydrate. This is the same amount of carboand think that weight is the only risk factor hydrate in 10 teaspoons of sugar! for type 2 diabetes. Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal Myth 4: People with diabetes should eat special diabetic foods. weight or only moderately overweight. Fact: A healthy meal plan for people with diabetes is generally the same as a healthy Myth 3: Eating too much sugar causes dia- diet for anyone – low in fat (especially satubetes. rated and trans fat), moderate in salt and sugar, with meals based on whole grain

DIABETES MELLITUS

Fact: If eaten as part of a healthy meal plan, or combined with exercise, sweets and desserts can be eaten by people with diabetes. They are no more "off limits" to people with diabetes than they are to people without diabetes. The key to sweets is to have a very small portion and save them for special occasions so you focus your meal on more Myth 5: If you have diabetes, you should eat healthful foods. only small amounts of starchy foods, such as bread, potatoes and pasta. Fact: Starchy foods can be part of a healthy Myth 7: You can catch diabetes from somemeal plan, but portion size is key. Whole one else. foods, vegetables and fruit. Diabetic and "dietetic" foods generally offer no special benefit. Most of them still raise blood glucose levels, are usually more expensive and can also have a laxative effect if they contain sugar alcohols.

grain breads, cereals, pasta, rice and starchy vegetables like potatoes, yams, peas and corn can be included in your meals and snacks. Wondering how much carbohydrate you can have? A place to start is about 4560 grams of carbohydrate per meal, or 3-4 servings of carbohydrate-containing foods. However, you may need more or less carbohydrate at meals depending on how you manage your diabetes. You and your health care team can figure out the right amount for you. Once you know how much carbs to eat at a meal, choose your food and the portion size to match.

serious complications. Myth 9: If you have type 2 diabetes and your doctor says you need to start using insulin, it means you're failing to take care of your diabetes properly. Fact: For most people, type 2 diabetes is a progressive disease. When first diagnosed, many people with type 2 diabetes can keep their blood glucose at a healthy level with oral medications. But over time, the body gradually produces less and less of its own insulin and eventually oral medications may not be enough to keep blood glucose levels normal. Using insulin to get blood glucose levels to a healthy level is a good thing, not a bad one.

Fact: No. Although we donâ&#x20AC;&#x2122;t know exactly why some people develop diabetes, we know diabetes is not contagious. It can't be caught like a cold or flu. There seems to be some genetic link in diabetes, particularly type 2 diabetes. Lifestyle factors also play a Myth 10: Fruit is a healthy food. Therefore, it part. is ok to eat as much of it as you wish.

Fact: Fruit is a healthy food. It contains fiber Myth 8: People with diabetes are more likely and lots of vitamins and minerals. Because to get colds and other illnesses. fruits contain carbohydrates, they need to be Fact: You are no more likely to get a cold or included in your meal plan. Talk to your dietianother illness if you have diabetes. How- tian about the amount, frequency and types ever, people with diabetes are advised to of fruits you should eat. get flu shots. This is because any illness can make diabetes more difficult to control, and Myth 6: People with diabetes can't eat people with diabetes who do get the flu are sweets or chocolate. more likely than others to go on to develop

The Medical Supplement 2013

KNOW YOUR VITAMINS

Know Your Vitamins

What is a vitamin? A vitamin is an essential substance needed for growth and development. Our body either cannot produce enough of it on its own or not at all, so it has to get it (tiny amounts) from food. Here we will discuss some important vitamins and their role in our body.

Vitamin

Vitamin A (Beta Carotene)

Vitamin B1 (Thiamine)

Vitamin B2 (Riboflavin)

What the Vitamin does

Effects of Vitamin deficiency

Food sources

Vitamin A does much more than help you see in the dark. It stimulates the production and activity of white blood cells, takes part in remodeling bone, helps maintain the health of endothelial cells (those lining the body’s interior surfaces), and regulates cell growth and division.

Night blindness, dry skin, poor bone and teeth growth and development.

Liver, milk, butter, cheese, egg yolk, fish liver oils, carrots, dark green leafy vegetables, red palm oil, some yellow and red fruits like apricots, melon, and pumpkin.

Used by the body to help convert carbohydrates into energy. Helps to keep the normal function of the nervous system, muscles heart and digestion.

Less concentration, loss of appetite, weakness, exhaustion and fatigue. Its deficiency results in ‘Beri Beri’ symptoms include swelling, tingling, or burning sensation in the hands and feet, confusion, trouble breathing because of fluid in the lungs, and uncontrolled eye movements called nystagmus.

Wheat germ, wholemeal, wheat flour and bread, yeast, legumes, nuts, duck, oatmeal, fortified breakfast cereals, white bread if flour enriched, and other meats.

In addition to producing energy for the body, riboflavin also works as an antioxidant by fighting damaging particles in the body known as free radicals. Free radicals can damage cells and DNA, and may contribute to the aging process, as well as the development of a number of health conditions, such as heart disease and cancer.

Fatigue, slowed growth, digestive problems, cracks and sores around the corners of the mouth, swollen magenta-colored tongue, eye fatigue, swelling and soreness of the throat, and sensitivity to light.

Liver, kidney, milk, yoghurt, cheese, wheat germ, meats, mushroom, broccoli, avocado, fortified white flour and breakfast cereals.

Symptoms of mild deficiency include indigestion, fatigue, canker sores, vomiting, and depression. Severe deficiency can cause a condition known as pellagra. Pellagra is characterized by cracked, scaly skin, dementia, and diarrhea. Niacin deficiency also causes burning in the mouth and a swollen, bright red tongue.

Liver, kidney, meat, fish, peanuts, bran, legumes, wholemeal wheat, and coffee.

Riboflavin is also needed to help the body change vitamin B6 and folate into forms it can use. It is also important for body growth and red blood cell production.

Vitamin B3 (Niacin)

Helps to release energy from carbohydrates. needed for healthy skin, hair, eyes, and liver. They also help the nervous system function properly.

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KNOW YOUR VITAMINS

Vitamin B6 (Pyridoxine)

In addition to release energy from carbohydrates it helps the body make several neurotransmitters, chemicals that carry signals from one nerve cell to another. It is needed for normal brain development and function, and helps the body make the hormones serotonin and norepinephrine, which influence mood, and melatonin, which helps regulate the body clock.

Symptoms of serious deficiency include muscle weakness, nervousness, irritability, depression, difficulty concentrating, and short-term memory loss

Chicken, turkey, tuna, salmon, shrimp, beef liver, milk, cheese, lentils, beans, spinach, carrots, brown rice, bran, sunflower seeds, wheat germ, and wholegrain flour.

The Medical Supplement 2013

KNOW YOUR VITAMINS

Know Your Vitamins Vitamin

Vitamin B9 (Folate/Folic acid)

Vitamin B12

Vitamin C (Ascorbic Acid)

Vitamin D

Vitamin E

Vitamin K

What the Vitamin does

Effects of Vitamin deficiency

Food sources

It is crucial for proper brain function and plays an important role in mental and emotional health. It aids in the production of DNA and RNA, the body's genetic material, and is especially important when cells and tissues are growing rapidly, such as in infancy, adolescence, and pregnancy. Folic acid also works closely with vitamin B12 to help make red blood cells and help iron work properly in the body.

Anemia, poor growth, tongue inflammation, gingivitis, loss of appetite, shortness of breath, diarrhea, irritability, forgetfulness, and mental sluggishness.

Brussels sprouts, fortified breakfast cereals, spinach, asparagus, beetroot, orange, avocado, melon, potato, cauliflower, peas, wholemeal bread, parsnip, dried beans, and kidney.

Important for metabolism. It helps in the formation of red blood cells and in the maintenance of the central nervous system.

Anemia, loss of balance, numbness or tingling in the arms and legs, weakness

Dairy products, eggs, cereals, soy based products, liver,beef, and clams.

Important in the production of collagen in the body - helps the connective tissues and organs. Can act as an anti oxidant to help protect the body from free radical.

Scurvy (though rarely seen today) which causes bleeding and inflamed gums, loose teeth and poor wound healing.

Citrus fruits (oranges, grapefruits, lemons, limes), berries, melons, tomatoes, potatoes, green peppers, and leafy green vegetables.

Helps to promote the absorption of calcium and phosphorus levels in the body. Helps to maintain and form strong and healthy bones.

Rickets and osteomalacia. Rickets results in soft bones and skeletal deformities.

Cod liver oil (best source), liver,

An antioxidant that protects your cells against the effects of free radicals, which are potentially damaging by-products of energy metabolism. Vitamin E is also important in helping your body make red blood cells, and it helps the body to use vitamin K.

Intestinal disorders - cystic fibrosis, pancreatitis, and cholestasis. Prevent the absorption of dietary fats and fat-soluble nutrients.

Margarine, nuts and seeds, peanuts and peanut butter, vegetable oils, wheat germ, wholegrain and fortified cereals.

Helps to control blood clotting in the body and is essential for synthesizing the liver protein that controls the clotting.

A shortage of this vitamin may result in nosebleeds, internal hemorrhaging.

Broccoli, brussels sprouts, cabbage, leafy green vegetables, mayonnaise, soybean, canola, and olive oils.

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high-fat fish, egg yolk, fortified cereals, fortified milk, and sunlight.

THE HOT LIST IFTARS

Baghdad Street â&#x20AC;&#x201C; Building 38 same as Boushahri Seema Pharmacy, Opposite Suleiman Al-Luhaib Mosque - Tel : 1888877

www.boushahricp.com

21 Boushahri_clinic

The Medical Supplement 2013

INTERVIEW

Faten Gharzeddine is a certified dietitian. She holds a Bachelor of Science degree in Nutrition and Dietetics from the American University of Beirut. She is an advocate of incorporating healthy food and physical activity into people’s daily lifestyles and raising awareness about nutrition for a better quality of life. The concept of dieting has been around for quite some time, whether it is to lose weight, gain muscle mass, or simply become healthier. Although detox is a type of diet, it is completely different from a regular diet, because its main aim is not weight loss (that is just a great added bonus in detoxing), but instead this diet works to cleanse your system and give it a good polish. What is a detox? Detox is the process of eliminating harmful substances - namely toxins - from your body. Detox diet utilizes the special components and qualities found in certain food items to naturally cleanse the human body. Why does the body need to detoxify? By nature, the human body already has an excellent system to get rid of toxins via the skin, liver, lungs, kidneys and digestive system. However, the natural detoxification system is tough on our bodies, especially in this day and age where toxins are accumulating beyond the body’s capacity to deal with them – whether this is due unhealthy lifestyle choices like bad eating habits or smoking, or the alarming levels of pollution or the high levels of daily stress in our lives. These factors can all take a toll on our filtration systems. If these systems are not provided with a healthy balance of different kinds of antioxidants, the accumulation of toxins can slow down the whole body’s processes. How can a detox diet help the body in the cleansing process? In a Detox Diet, your body will get balanced healthy quantities of antioxidant rich foods to optimize it’s capacity of getting rid of toxins, whilst also boosting your immune system and increasing your energy levels. A detox diet can help to reverse the effects of stress, pollution and incorrect habits by bringing the antioxidant levels in 22

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your body up, thereby amplifying the I. Pretox: effectiveness of the body’s ability to Pretox is the first phase of the program remove toxins. where the body is prepared for the detox process by flushing out all the What are the components of a previous pollutants using fluids and certain vegetables and fruits. This stage healthy detox diet? The Detox Diet includes all the is necessary for the detox to work. important elements for a complete II. Detox: and healthy cleansing process without This phase provides the person with putting the body’s internal system a complete cleansing with all the in any danger due to starvation and nutritional components that are part malnutrition. Every single item found of a balanced healthy diet. The phase in a balanced detox menu should be includes complex carbohydrates as the packed with high antioxidant value to main source of energy, lean proteins to clean your body from all toxins. The protect your body from muscle loss, and body needs a mix of different kinds of healthy fats to keep cells functioning antioxidants to be able to flush out all correctly. toxins. Each type of antioxidant works in different body tissues and in different parts of the cells, meaning that variety is very important when detoxifying. What are the benefits of following a Detox Program? A balanced detox diet has multiple positive effects on your digestive and immune system. It will boost your metabolism; you will feel more energetic with a good mood. In addition, you will notice a drastic change in your skin, hair and nails. What are the phases of a balanced Detox Diet program? A balanced Detox Program should be divided into 3 different phases, Pretox, Detox and Protox with different purposes. For a better detoxing procedures, none of these phases should be canceled.

INTERVIEW

Faten Y. Gharzeddine Head of Dietitians, Diet Center-Kuwait

The Medical Supplement 2013

INTERVIEW

III. Protox: Protox is the last phase of the program where you are slowly reintroduced to normal healthy food over a period of 3 days. At the end, I would like to emphasize on the importance of increased physical activities. A healthy lifestyle is not only enjoying healthy eating habits, it is a combination between food and physical activities. It is highly recommended to exercise minimum 3 days a week for 30 minutes since it will help you preserve and increase muscle mass, which will consequently enhance fat burning. Get ready to challenge your bad eating habits and the stress you are surrounded with, Follow a balanced detox plan for at least 3 times per year, it will filter your body periodically and prevent the accumulation of toxins. 24

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The Medical Supplement 2013

PREGNANCY CARE

Top 10 Tips For Eating Right During Pregnancy Sarah Paksima BirthKuwait is a nonprofit organization operating as part of The Voluntary Health Association. For more information, visit their website: www.birthkuwait. com or Instagram: @ birthkuwait

You are what you eat. Well this is true for your unborn baby. What you eat is what your baby will eat. Now more than ever it is so important to get the proper nutrition. You may want to eat for two but put the breaks on and remember you only need an extra 300-500 calories a day for your growing baby. You may want to throw caution to the wind and indulge in everything you NEVER eat but your pregnancy is NOT the time for careless eating. Poor food choices can leave you tired, uncomfortable, add unnecessary pounds, leave your baby malnourished, and slow your postnatal recovery. 26

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1.) Don't Skip Breakfast: You've been asleep for several hours, which means you haven't given your body or your baby fuel in a lengthy period of time. Your baby needs the nutrients and so do you. Aim for a combination of whole grain carbohydrates, healthy fats and lean protein, and some vitamins. A good example would be: An Egg, a piece of whole wheat toast with a little bit of butter and a glass of milk with an orange, grapefruit, or nectarine.

to stay hydrated when you are pregnant. Dehydration can cause preterm labor. Carry a bottle of water with you at all times. If you are exercising try to have 6-8oz of water for every 15 min of exercise that you do. Stay away from sodas, they are filled with empty calories, sugar, and do not hydrate your body.

6.) Don't Diet: Weight gain during pregnancy is inevitable. This is not the time to cut calories. Although you don't want to 2.) Eat 5-6 Small Meals A Day: As your overindulge, restricting calories is not good belly grows you will get full faster from less either. An average weight gain should be food. So you will need to eat more often to between 25 and 35 pounds. get enough calories for you and your growing baby. Try eating 3 small meals and 2 snacks. 7.) Get Your Fiber: Eating fiber is important to "keep things moving" during 3.) Eat a Variety of Foods: During pregnancy. Progesterone relaxes your pregnancy you may have times where you stomach muscles, slowing digestion. Fiber can only stomach a few things or where you helps to start things flowing again. Good are only craving 1 type of food. This is normal sources of fiber include fruits, vegetables, and canâ&#x20AC;&#x2122;t really be avoided, but when you are whole grains and legumes. feeling good try to eat a variety of foods-try to eat as many colors each day as you can. 8.) Get Your Vitamin D: Vitamin D helps Whole grains, lean meats, seeds, nuts and your body absorb calcium which is very beans; a large variety of different fruits and important for women in general but even vegetables (such as orange pumpkin, green more so during pregnancy. The baby needs beans, red beets, yellow squash, etc.); plain calcium for it's growing bones, if you're not yoghurt or milk. This will help you get ALL getting enough the baby will take it from of the vitamins and minerals that you and the your bones. This can lead to osteoporosis baby need. for mom later on. Good sources of vitamin D include spinach, kale, dairy products, 4.) Avoid The Unsafe Foods: This one prenatal vitamins and the sun. shouldn't be to hard as long as you know what the unsafe foods are. Raw fish is a 9.) Omega-3 Fatty Acids: Babies born to no-no, also avoid fish high in mercury like moms who ate plenty of Omega-3 Fatty swordfish, tile-fish, and albacore tuna and Acids during their third trimester have better any unpasteurized food. The list of foods visual, cognitive and motor development that are considered unsafe is different in each compared to those born to moms who didn't country, so consult with your own doctor. eat enough Omega-3s. You can get Omega3s from certain eggs, flaxseed, walnuts, 5.) Water, Water, Water: Itâ&#x20AC;&#x2122;s very important supplements, and salmon.

PREGNANCY CARE

10.) Don't Eat Empty Calories: Dessert is ok during pregnancy and of course there will be times when you are CRAVING the junk but remember everything in moderation. Donâ&#x20AC;&#x2122;t fill yourself up on empty calories when you could be giving your baby and your body much needed nourishment.

The Medical Supplement 2013

NUTRITION

Health Benefits of

Pears provide a very good source of fiber and are also a good source of vitamin B2, C, E, copper, and potassium. They also contain a significant amount of pectin, which is a water soluble fiber. Pears are actually higher in pectin than apples. This makes them effective in helping to lower cholesterol levels and in toning the intestines. They are often recommended by health care practitioners as a hypoallergenic fruit that is high in fiber. They are less likely to produce an adverse response than other fruits. Pears are often recommended as a safe fruit to introduce to infants. Pears are an extraordinary source of dietary fiber when the skin is eaten along with the flesh. Pears are also an excellent source of vitamin C and vitamin E, both powerful antioxidants and essential nutrients.

Pears are a member of the rose family of plants (Rosaceae), which, in addition (of course) to roses, contains a long list of fruits including apples, apricots, cherries, chokeberry, crabapples, loquats, peaches, plums, quinces, raspberries, serviceberries, and strawberries as well as the tree nut, almonds. The many different varieties of pears commonly found belong to the same category known as European Pear (Pyrus communis). These pears typically have a rounded body that tapers into a neck of various lengths. They are distinct from (but closely related to) the fruit we commonly call "pear apple." Pear apples are completely round with no necks, and while they remind of us of apples in shape, their skins make us think they are pears. Contrary to popular belief, pear apples are not a cross between apples and pears. Pear apples belong to a second category of pear, broadly referred to as Asian pear. Included in this second category are Chinese pear, Japanese pear, and Korean pear (Pyrus pyrifolia) as well as Siberian/Manchurian pear (Pyrus ussuriensis). When these categories are combined, they account for more than 3,000 varieties of pears that people enjoy worldwide.

variety found in cans. Bartletts are yellow/green and speckled, and sometimes called Williams pears •Bosc: cinnamon brown-skinned pears with long tapered necks with a honey-like but complex flavor •Comice: round, short pears with either green and red coloring, or sometimes almost completely red with especially soft and juicy flesh •Concorde: tall, skinny, and golden/green pears with flesh that is firmer and more dense than many other varieties •Forelle: red/green and speckled like a trout, and thus the name, meaning "trout" in German. A small-sized pear that yellows as it ripens. •Green Anjou: a widely available, compact, and short-necked pear. It doesn't change color much while ripening. •Red Anjou: very much like its green counterpart, except a rich reddish maroon in color and higher in anthocyanins (which is the main reason for its rich red color)

•Red Bartlett: very much like its yellow/green counterpart, except with an all-round bright red skin, they sometimes feature light Pears are found in a variety of colors, including many different vertical striping, and like Red Anjou, they are rich in anthocyanins shades of green, red, yellow/gold, and brown. Many varieties fail •Seckel: smallest of the commonly eaten pears, usually yellow/ to change color as they ripen, making it more difficult to determine green or olive green in color, and mixed with broad patches of red ripeness. •Starkrimson: bright crimson red color, more narrow-necked that The list below describes some of the more commonly enjoyed Red Anjou, but equally rich in anthocyanins and especially gorgeous varieties of pears: in a salad. •Bartlett: best known of the pear varieties and most often the 28

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NUTRITION

The Medical Supplement 2013

NUTRITION

What's New and Beneficial About Pears • For nutritional reasons, we're often advised to consume the skins of fruits. However, it's less often that research provides strong evidence in support of this advice. Recent studies have shown that the skin of pears contains at least three to four times as many phenolic phytonutrients as the flesh. These phytonutrients include antioxidant, anti-inflammatory flavonoids, and potentially anti-cancer phytonutrients like cinnamic acids. The skin of the pear has also been show to contain about half of the pear's total dietary fiber. • In recent studies measuring risk of type 2 diabetes in U.S. women, pears have earned very special recognition. Researchers now know that certain flavonoids in food can improve insulin sensitivity, and of special interest in this area have been three groups of flavonoids (flavonols, flavan-3-ols, and anthocyanins). All pears contain flavonoids falling within the first two groups, and red-skinned pears contain anthocyanins as well. Intake of these flavonoid groups has been associated with decreased risk of type 2 diabetes in both women and men. However, a new analysis of the Nurses' Health Study has shown that among all fruits and vegetables analyzed for their flavonoid content, the combination of apples/pears showed the most consistent ability to lower risk of type 2 diabetes. We believe that this special recognition given to pears as a fruit that can help lower risk of type 2 diabetes in women is likely to be followed by future studies showing this same benefit for men. • You've no doubt heard someone say that cloudy fruit juices containing fruit pulp provide better nourishment than clear fruit juices that have had their pulp removed through filtering. Scientists have now proven that statement to be correct with respect to pear juice. With their pulp removed, pear juices were determined to lose up to 40% of their total phenolic phytonutrients, and to have significantly reduced antioxidant capacity. "Cloudy" pear juices (technically referred to as "high turbidity" juices) emerged as the superior juice type in terms of nutrient content as well as antioxidant benefits. 30

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17 Amazing Health Benefits Of Pears 1. Fights against free radicals: The presence of vitamin C, vitamin K and copper in pears fights against free radicals that damage our body cells.

2. Prevents heart diseases: Pears benefits include the presence of fiber, which reduces the cholesterol in the body and thereby protects us from heart diseases. Daily intake of fiber rich food like pears can reduce the risk of stroke by up to 50%.

3. Prevents cancer: High content of fiber present in pears binds to the carcinogenic cells by removing them and prevents colon cancer. A pear a day can prevent breast cancer by upto 34% in women after menopause.

4. No allergic reactions: Pears when compared with other fruits have less chance of allergenic reactions when eaten and thus are one of the few fruits that can be given to infants.

5. Controls blood sugar level: Even though it is slightly sweet, with low glycerin index and high fiber content pears helps in controlling the sugar levels in the blood and prevents diabetes.

6. Boosts immune system: High content of anti-oxidants like vitamin C and copper helps in boosting the immune system of the body to fight against various diseases.

7. Prevents osteoporosis: Bone problems are very common these days. So in order to keep those bones healthy and prevent osteoporosis, it is very important to maintain the pH of the body and eat recommended amount of calcium daily. pH of the body can be maintained through diet by consuming fruits and vegetables daily. The boron rich pears can help to absorb the calcium consumed easily.

8. Increases energy levels: The high glucose content in pears gives you instant energy when you feel weak. It gets absorbed very quickly by the body and converts into energy.

9. Digestion: A medium sized pear contains around 20-25% of the recommended daily intake of fiber. Since its fiber is insoluble, it moves through the colon easily and prevents colon polyps. The high fiber content helps and improves digestion.

10. Pregnancy: Folic acid is very important for a pregnant woman to keep the baby safe from birth defects. Folic acid present in pears can help you in this issue and it is recommended to use it regularly during the pregnancy.

11. For weaning children: For weaning children, it is always recommended to give pears because it is hypoallergenic and is a low acidic fruit. So it doesn’t create any digestion

NUTRITION

related problems. This fruit can be peeled, heated and then pureed. The peel also can be fed but it is very important to take care that it doesnâ&#x20AC;&#x2122;t have any harsh edges that can hurt children. Pears should not be given to children with diarrhea.

12. Against gallbladder, colitis, arthritis, gout: Pears help to prevent gallbladder problems, colitis, arthritis and gout if taken regularly.

13. Blood pressure: Anti-carcinogen glutathione and antioxidants present in pears help in controlling the blood pressure.

14. Fever: Pears help in curing fever easily with its cooling effects. 15. Inflammation: Pears have antiinflammation properties which help to reduce inflammation of arthritis and other such problems.

16. Shortness of breath: During summers shortness of breath is quite common due to heat in both children and adults. So it is recommended to take pears during those hot days.

17. Throat problems: Pears prevent throat problems during summers. So it is good to take a pear a day or a glass of its juice will do the work. To get all the benefits of pears, take them regularly during the hot summer days. The Medical Supplement 2013

FITNESS

Balancing Your Hormones Through Exercise Camilla Ayrton

Educator, Coach and Leader

How do you do this using your exercise?

www.camillaayrton.com 1. Lift heavy and lift often.

Hormones.... Wah wah wah,,, I know, bore off already Cam! This may seem like one of the most uninteresting topics EVER, however by the time you've read this you WILL understand the importance of them and how to augment your training to balance them to facilitate the results YOU want. Hormones rule your life; obesity rates have doubled since 1980 and in the April 2007 issue of The American Psychologist it was shown that up to 66 percent of individuals following the caloric model of weight loss end up fatter two years later. Basically exercise more and eat less doesn't work if you are looking to lose fat and look great due to the effect of hormones. Science lesson: IGF-1 and Human Growth Hormone (HGH) are two important hormones which do numerous things such as stimulating systemic body growth and growth-promoting effects on almost every cell in the body, especially skeletal muscle, cartilage, bone, liver, kidney, nerves, skin, hematopoietic cell, and lungs. In recent years in the United States, some doctors have started to prescribe growth hormone in HGH-deficient older patients to increase vitality. This is all very cool but what does it mean for our bodies and goals? Well, interesting question. If you wish to be stronger, stay young, lose fat and increase your muscle mass (tone for the ladies) and basically receive a level of wellness you want to and need to stimulate IGF-1 and HGH. 32

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If you are a beginner with your exercise program going to the gym to lift heavy things around 3x per week is optimal, and each session should last between 45 minutes to one hour. Understandably, if this is too much to start with and you are left unable to put your car into drive or walk down the stairs start at a lower intensity/duration! At the end of the day if you can't train again within a couple of days you've probably gone a bit too hard and the intensity should be lowered until your body is ready. If, on the other hand, you are a physically active person your body will sustain higher levels of loading. In this instance go crazy! Do what it says on the tin - lift heavy and lift often. Do so in a way, however, that enables your body to recover - take adequate rest and sleep well (see point number three). 2. Use total body compound movements. I like to also call this 'loaded movement'; every day we move and we load our bodies with different stressors - shopping bags, gym bags, boxes, files, laptop bags and numerous tablets and phones etc. When you bend down to pick up your kids and throw them in the air for a game this is loaded movement. To ensure that you can do all of these things safely, comfortably and most of all in an enjoyable way prepare your body by doing similar movements in the gym with resistance. Movements recruiting many muscles congruently will prepare your body to work effectively when you need it and increase the bad boys IGF-1 and HGH. Ask your fitness trainer to show you compound movements such as squats, deadlifts, bench press, lunges and various over head press movements such as

FITNESS

a clean and press. 3. Sleep well. 8hrs a night minimum per night and as many hours before midnight as possible. When you sleep your body regenerates and this is paramount to obtaining adaptation. You will get short term results when you load movements, you will get long term adaptation when you load movements and allow the body to recover and grow back stronger. Your body will adapt to the exercises (lose fat and build muscle) that you do only if you allow it to recover (nutrition is also important but that's another article). In a world where there is a culture to stay up late and reduce sleep as much as possible to get the millions of things done that we need to it's often seen as a competition;

twitch muscle fibers' which naturally stimulate HGH within your body getting you one final step closer to your goal of fat loss and muscle gain (again, toning for the ladies). The other fantastic selling point on this type of exercise is that it is very quick so even the busiest of bees can fit it into their schedule. Yes, even you! Right now get your phone out and open the calendar app. Add three appointments with yourself over the next week or two when you can commit to 20 minutes of activity. I'm not joking, do it now!! (Strict British lady tendencies coming out...). I'm serious, get your phone out!!!!!! Balance your hormones, balance your body, achieve results and most of all, achieve the mack-daddy "long term adaptation". Whilst you are training aim to increase the hormones IGF-1 and HGH by doing one, some or all of the above; lift heavy and often, use total body movements, sleep more, avoid sugar two hours post workout and finally try a short but intense HIIT workout. If you need advice or assistance of check out your gym, find a reputable trainer to coach you towards your goals in a safe way or go have a google.

Old me - "I only slept 6 hours last night" Mike, my step dad (also ex-marine and complete workaholic) "sleep is for when you're dead, work harder. I never sleep more than 4!" Forget the competition!! This is when our body clears hormones such as cortisol which stores fat and combined with the use of the bad boys, (IGF-1 and HGH) rebuilds muscle tissue allowing your body to make long term adaptations, I.e. Build muscle (again, tone for the girls) and burn fat. Make a change each week; get to bed 15 minutes earlier and have a cup of calming chamomile tea before bed. 4. Avoid sugar for two hours after your workout. Consuming sugar (especially fructose) within 2 hours post workout will cause your hypothalamus to release somatostatin, which will decrease your production of HGH. Simple sugars that are high-glycemic also spike insulin levels. Not only does this lead to body fat storage, but it severely decreases the release of growth hormone. If you are hungry post workout take a protein shake or if you're off liquid foods (also good for leaning out) then munch on some preprepared chicken and nuts. 5. Use HIIT (High Intensity Interval Training). For example take 30s effort followed by 30s rest for 20 minutes to a near maximal capacity whilst you're working. This type of training will stimulate the use of 'fast The Medical Supplement 2013

INTERVIEW

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INTERVIEW

Dr. Vanya Lukina Dermatology, Laser and Cosmetology Bushahri Specialized Polyclinic

Meet the very experienced Dermatologist - Dr. Vanya Lukina, working at Bushahri Specialized Polyclinic and here she answers some of the most commonly asked questions related to dermatology: What are the risks of sun tanning? Although the sun is the only reliable way to generate vitamin D, there are some risks from sun tanning as follows: -- Sunburn --Premature Aging /or photoaging --Skin Cancer --Actinic or Solar Keratoses --Immune System Suppression

Do you recommend fake eye lashes? False eyelashes and extensions, as well as their adhesives, must meet the safety and labeling requirements for cosmetics. Check the ingredients to make sure you are not allergic to the adhesives.

What is the disadvantage of eyebrow tattoo? Many individuals choose to undergo permanent tattoo as an aesthetic choice.

well as preventive approach is to start using Botox injections. In the 40s the facial skin shows increased frown and smile lines from muscle activity, loss of firmness and some plumpness of the lips may be lost. In addition to Botox someone can consider hyaluronic acid or other injectable fillers for lower facial lines and lips.

What is the appropriate age for a girl to start LHR? The accepted minimum age for a girl to begin laser hair removal can be as young as 14 years old as long as she has begun her menstrual cycle already and has regular monthly cycles for at least 2 consecutive years.

How to prevent freckles to appear on skin? 1- sun avoidance 2- sun protection 3- treatment with skin care products 4- treatment procedures

People who have lost their eyebrows due to medical condition may choose to have "eyebrows" tattooed on.

What is the appropriate time for Vitamin D suplement for us and how?

Some risks:

Vitamin D is an essential ingredient for optimizing health and preventing disease.

- spread of infections through the use of unsterilized equipment - infections from contaminated tattoo inks - allergic reactions to permanent tattoo pigments - dissatisfaction and desire to remove tattoo, which can be very difficult, involving several treatments and complete removal without scarring may be impossible.

When can you start to inject filler and botox? Botox and injectable fillers are useful armamentarium in the faith with the ageing. Every one of us is different regarding the skin type and the way in which our skin ages. Signs of ageing are dependant mostly by factors such as how well oneâ&#x20AC;&#x2122;s skin has been protected and the climate in which the person live, as well as lifestyle habits such as smoking. In the 30s, a problem that can occur is creasing of the skin from repeated muscle activity, the start of the central frown line, forehead lines and crowâ&#x20AC;&#x2122;s feet. At that age an ideal treatment, as

It's almost impossible to get adequate amounts of vitamin D from food alone, including fortified milk and fatty fish. The sun is is the only reliable way to generate Vitamin D in enough quantity in the body. Prepare your skin and build up tolerance gradually. Start early in the year, or early in the morning before the sun is strongest and slowly increase the amount of time you spend in the sun. People with dark skin pigmentation may need 20 - 30 times as much exposure to sunlight as fair-skinned people, to generate the same amount of Vitamin D. In terms of Vitamin D needs,general recommendation suggests going outside in summer unprotected by sunscreen/except for the face, which should always be protected, wearing minimal clothing from 10 am to 3 pm two to four times a week for 10 -15 minute In the winter or if you don't get enough healthy sun exposure or to fulfill your daily needs take supplements with Vitamin D after consulting your needs with a doctor, because they vary for different age groups. The Medical Supplement 2013

BREAST CANCER

Breast Cancer

know your risk Except for skin cancers, breast cancer is the most common cancer in women, but it can be successfully treated. Screening tests can find cancer early, when chances for survival are highest.

Know your risk •Talk to both sides of your family to learn about your family health history

Get screened •Talk with your doctor about which screening tests are right for you if you are at a higher risk •A mammogram is an X-ray of the breast. It is the best screening tool used today to find breast cancer early. A mammogram can find cancer in its earliest stages, even before a lump can be felt. All women age 36

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40 and older should have a mammogram every year. If you are younger than age 40 with either a family history of breast cancer or other concerns, talk with your health care provider about when to start getting mammograms or other screening tests, like MRI, and how often to have them •Adult women of all ages should perform breast self-exams at least once a month •Have a clinical breast exam at least every 3 years starting at age 20, and every year starting at age 40 •Have a mammogram every year starting at age 40 if you are at average risk

BREAST CANCER

Know what is normal for you

•Having your first child after age 35

See your health care provider if you notice any of these breast changes: •Lump, hard knot or thickening inside the breast or underarm area •Swelling, warmth, redness or darkening of the breast •Change in the size or shape of the breast •Dimpling or puckering of the skin •Itchy, scaly sore or rash on the nipple •Pulling in of your nipple or other parts of the breast •Nipple discharge that starts suddenly •New pain in one spot that doesn't go away

Make healthy lifestyle choices •Add exercise into your routine •Limit menopausal hormone use •Breastfeed, if you can

Are you at risk? Most women have more than one known risk factor for breast cancer, yet will never get the disease. Some risk factors are things that you do not have any control over, while others can be changed. What are the most common risk factors for? Simply being female and growing older. But remember, there is no one cause of breast cancer. If you are concerned about your risk, talk with your health care provider.

Here is a list of some known risk factors: •Being a woman •Getting older •Having an inherited mutation in the BRCA1 or BRCA2 breast cancer gene •Lobular carcinoma in situ (LCIS) •A personal history of breast or ovarian cancer •A family history of breast, ovarian or prostate cancer breast

density

•Having a previous biopsy showing atypical hyperplasia •Starting menopause after age 55 •Never having children

•Being overweight after menopause or Systemic therapy (adjuvant therapy) gaining weight as an adult •Postmenopausal hormone use (current Systemic therapy aims to get rid of cancer or recent use) of estrogen or estrogen plus cells that may have spread from the breast to other parts of the body. It uses drug progestin Over the past 20 years, progress in both therapies (either in injections or pill form) early detection and treatment has led to that travel throughout the body to get rid improved survival for people of all ages and of cancer cells. Systemic therapy includes races, and with all stages of breast cancer. chemotherapy, hormone therapy and Between 1990 and 2009, breast cancer targeted therapy. Because systemic therapy mortality (death) declined by 33 percent is an adjunct to (or in addition to) breast surgery, these treatments are often called among women. adjuvant therapy.

Breast cancer treatment

•Maintain a healthy weight

•Having high mammogram

(axillary nodes). It also helps to ensure the •Radiation exposure, frequent X-rays in cancer does not recur (come back) to that area. It involves surgery, with or without youth radiation therapy to the breast area. •High bone density

The goal of treating early breast cancer is to get rid of the cancer and keep it from coming back. Treatment for early breast cancer includes some combination of surgery, radiation therapy, chemotherapy, hormone therapy and targeted therapy. These treatments are designed to remove the cancer from the breast and destroy any small amounts of cancer that might still be in the body.

Your breast cancer treatment plan

How does your age affect your treatment plan? No matter your age, your treatment plan depends on many factors, such as the type of breast cancer you have and the characteristics of the tumor. Your overall health and any other health conditions you may have also play a role in your treatment plan. For example, if you have heart disease, some medications used to treat breast cancer can cause more harm than good. All of these things help tailor your treatment plan.

Your breast cancer treatment plan is based on both medical and personal choices. It is The importance of following your tailored to:

•Your specific type of breast cancer (the breast cancer treatment plan Completing your breast cancer treatment biology of the tumor) plan (called adherence or compliance) is very •The stage of the breast cancer important. People who complete the full •Other medical issues course of treatment have a higher chance of •Your personal preferences survival. Adherence may be hard, but there Because of the differences between tumors are things you can do to make it easier. and between people, your treatment plan First, talk to your health care provider if you may differ from another person’s, even are having trouble following your treatment though you both have breast cancer. Each plan. If you are suffering from side effects, treatment option has risks and benefits to tell your provider right away. He/she may be consider with your own values and lifestyle. able to help. Having fewer side effects can Treatment for breast cancer can be thought help you complete your treatment plan. of in two areas: local therapy and systemic Adherence can be especially hard for longtherapy. term treatments, such as hormone therapy. Planning ahead can help you juggle your Local therapy treatment and daily life. For example, if you Local therapy removes the cancer from a have trouble remembering to take your pills, limited (local) area, such as the breast, chest a daily pillbox or setting an alarm on your wall and lymph nodes in the underarm area watch or cell phone may help. The Medical Supplement 2013

LUNG CANCER

Lung Cancer what you need to know

Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale. Lung cancer is the leading cause of cancer deaths, among both men and women. Lung cancer claims more lives each year than do colon, prostate, ovarian and breast cancers combined. People who smoke have the greatest risk of lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes you've smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer.

Symptoms Lung cancer typically doesn't cause signs and symptoms in its earliest stages. Signs and symptoms of lung cancer typically occur only when the disease is advanced. Signs and symptoms of lung cancer may include: •A new cough that doesn't go away •Changes in a chronic cough or "smoker's cough" •Coughing up blood, even a small amount •Shortness of breath •Chest pain •Wheezing •Hoarseness •Losing weight without trying •Bone pain •Headache

Causes Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there 38

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may be no clear cause of lung cancer.

How smoking causes lung cancer Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately. At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop.

Types of lung cancer Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have. The two general types of lung cancer include: •Small cell lung cancer. Small cell lung cancer occurs almost exclusively in heavy smokers and is less common than non-small cell lung cancer.

•Non-small cell lung cancer. Non-small cell lung cancer is an umbrella term for several types of lung cancers that behave in a similar way. Non-small cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.

Tests and diagnosis Testing healthy people for lung cancer Doctors aren't sure whether people with no signs or symptoms of lung cancer should undergo screening for the disease. Some studies show that lung cancer screening may save lives by finding cancer earlier, when it may be treated more successfully. But other studies find that lung cancer screening often reveals more benign conditions that require invasive testing and expose people to unnecessary risks. Screening for lung cancer is controversial among doctors. Studies are ongoing to determine what types of tests may be helpful and who would benefit from lung cancer screening. In the meantime, talk with your doctor if you're concerned about your risk of lung cancer. Together you can determine strategies to reduce your risk and decide whether screening tests are

LUNG CANCER

a needle through your chest wall and into the lung tissue to collect suspicious cells. A biopsy sample may also be taken from lymph nodes Tests to diagnose lung cancer: or other areas where cancer has spread, such If there's a reason to think that you may have as your liver. lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. In order to diagnose Treatments: lung cancer, your doctor may recommend: You and your doctor choose a cancer •Imaging tests. An X-ray image of your lungs treatment plan based on a number of factors, may reveal an abnormal mass or nodule. A such as your overall health, the type and stage CT scan can reveal small lesions in your lungs of your cancer, and your preferences. Options typically include one or more treatments, that might not be detected on an X-ray. including surgery, chemotherapy, radiation •Sputum cytology. If you have a cough and therapy or targeted drug therapy. are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells. Home Remedies: appropriate for you.

•Tissue sample (biopsy). A sample of abnormal cells may be removed in a procedure called a biopsy. Your doctor can perform a biopsy in a number of ways, including bronchoscopy, in which your doctor examines abnormal areas of your lungs using a lighted tube that's passed down your throat and into your lungs; mediastinoscopy, in which an incision is made at the base of your neck and surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to guide

Many people with lung cancer experience shortness of breath at some point in the course of the disease. Treatments, such as supplemental oxygen, and medications are available to help you feel more comfortable, but they aren't always enough. To cope with shortness of breath, it may help to: •Try to relax. Feeling short of breath can be scary. But fear and anxiety only make it harder to breathe. When you begin to feel short of breath, try to manage the fear by choosing an activity that helps you relax. Listen to music, meditate or say a prayer.

•Find a comfortable position. It may help to lean forward when you feel short of breath. •Focus on your breath. When you feel short of breath, focus your mind on your breathing. Instead of trying to fill your lungs with air, concentrate on moving the muscles that control your diaphragm. Try breathing through pursed lips and pacing your breaths with your activity. •Save your energy for what's important. If you're short of breath, you may become tired easily. Cut out the nonessential tasks from your day so that you can save your energy for what needs to be done. •Lower the room temperature. A cooler room may make it feel easier to breathe. •Sit near a window. Sitting or lying down in a way that allows you to look out a window can help you feel less confined when you're feeling short of breath. •Aim a fan toward your face. A fan that blows on your face may make it feel easier to breathe. •Eat several small meals each day. Rather than a few larger meals, eat several small meals throughout the day. •Get enough sleep so that you wake feeling rested. If you're having trouble sleeping, talk to your doctor about medications or other methods that may make sleep easier. Tell your doctor if you experience shortness of breath or if your symptoms worsen.

The Medical Supplement 2013

INTERVIEW

Dr. Yasser El Batanouny Dr. Yasser El Batanouny received his medical degree from Al Azhar University and completed his Masters in laser Otolaryngology at Al Azhar University. After finishing his MD in Otoplasty at Al Azhar University Cairo-Egypt, he started working at Cairo University Hospital where he got extensive experience in all ENT procedures with considerable experience in Otoplasty, Rhinoplasty (Surgical Rhinoplasty (Closed or open) and Non Surgical Rhinoplasty by filler injection), and endoscopic sinus surgery. He believes in individualized and personalized treatment plans for plastic surgery before starting any procedure. He is now working at Yiaco Apollo Medical Center, Kuwait for about 1 year. Recently, we had the opportunity to meet with Dr. Yasser so he could illustrate his experience and shed some light on some very common concerns related to Rhinoplasty and Otoplasty.

E.N.T. DEPARTMENT 40

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INTERVIEW

What is Rhinoplasty? Rhinoplasty is an operation to improve the appearance of the nose. It can also be used to improve breathing. A successful Rhinoplasty requires careful preoperative planning. Each part of the nose, including the dorsum (or "bridge" of the nose), the tip, the nostrils and their relationship and proportions to each other must be carefully analyzed. The effect that a manipulation of one part will have on the appearance of another must be predicted and calculated. Rhinoplasty is truly a combination of art and science. A Rhinoplasty can be performed in one of two ways. Our preferred approach is the "Closed" approach. Another approach is referred to as the "Open" approach. Both are valuable techniques. Each has its advantages and disadvantages. The choice of which approach to use depends on the findings during an examination. Ultimately, the goal is to create a natural and aesthetically pleasing and balanced result. Now non surgical Rhinoplasty can be a great option in many cases.

mind, meaning that they have to be physically healthy as well as emotionally being appropriately motivated for surgery.

How old do I have to be to get a Rhinoplasty? The most critical step is that a patient must be emotionally mature enough to know for sure that they want to change their nose and the way in which they want it to change. So in a perfect world plastic surgeons prefer to wait to do rhinoplasties on teenagers until their nose has stopped growing.

What is the difference between an open and a closed Rhinoplasty? A closed Rhinoplasty is done through incisions hidden within the nose. An open Rhinoplasty has a visible scar that goes across the columella, the piece of skin that separates the nose into two nostrils.

Will my nose look ‘natural’ after a Rhinoplasty?

A nose should look natural after a Rhinoplasty, meaning it should look as if you could have been born with it. There Non invasive alternative to traditional Rhinoplasty is done should be no telltale signs of surgery. through injection of facial filler. It can be used to pump out wrinkles, fill out areas of the nose to correct minor Will I be black and blue after my Rhinoplasty and if deformities, help build up a flat bridge or upturn a droopy so, for how long? tip and in revision Rhinoplasty to help repair failed nose job. There is typically black and blue under the eyes if the bones need to be broken, which is usually necessary if the nose is What are the benefits of a non-surgical nose job? wide or if there is a big bump that needs to be removed. •It is a fast and no downtime procedure. Some patients have much more of a pronounced tendency to •Lower cost of surgery, lower potential complication and bruise, and some do not. lower risk Keep lots of cold compresses over the eyes and cheeks for •The procedure does not need general anesthesia (local the first couple of days after surgery as well as keeping your anesthesia applied). Patient remains awake. head up can help reduce bruising. •Filler injected in small amounts, gives quick results, little or no healing time

What is a non-surgical nose job?

What type of material is used in non-surgical Rhinoplasty ? Facial filler is used and is well determined by the medical condition or the kind of nose job needed for patient. It may be longer-lasting dermal filler such as Radiesse or hyaluronic acid filler such as Juvederm.

Who is a good candidate for a Rhinoplasty? Any person is a good candidate for a Rhinoplasty if there is a feature in their nose that they wish to change. They need to be healthy both in body and The Medical Supplement 2013

INTERVIEW

Will I have a splint on my nose after my Rhinoplasty How painful is the recovery from a Rhinoplasty? and if so, for how long? A Rhinoplasty is not a very painful procedure. You will be

If the surgery needs to break the bone in the nose to narrow sore and feel stuffy but pain medications can help to alleviate it then there will be a splint on the nose for five to seven days your pain. So pain itself should not be a barrier to getting a Rhinoplasty if it is otherwise something you would really want after surgery. to do.

Will I have packing in my nose after surgery?

Patients donâ&#x20AC;&#x2122;t like packing because it makes their nose seem How soon can I go to work? stuffy and it can be difficult to breathe. But if the surgery Most patients will go to work after the splint comes off at five needs to take a cartilage graft from your septum then a special to seven days after surgery, though there may still be bruising as long as seven days. Some patients will go back to work packing with breathing tubes within it is used. after just a few days if they donâ&#x20AC;&#x2122;t mind being seen with a splint on their nose.

What kind of anesthesia will be used for my procedure?

When can I drive?

General anesthesia is used because there is no anxiety or possibility of the patient experiencing any pain during surgery. You can drive when you are off of all narcotic pain medications and feel totally unrestricted by your discomfort such that you could make any movement you might need to safely drive Do I need to go to an aftercare facility after my your car.

surgery?

When can I travel by airplane?

Rhinoplasty patients are medically able to go home the night You should wait about a week before traveling by airplane of surgery provided there is someone who will be responsible after a Rhinoplasty to be sure that there is no swelling that for helping to take care of them. can cause difficulty clearing your ears during a flight. 42

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INTERVIEW

How long does the swelling last? Swelling increases after surgery, usually peaking about 5-6 days after surgery. After that, the swelling will subside, rapidly at first, and then gradually. After one month, you’ll think the swelling is gone, but it will still go down more at three months, and even more at six months and even a year, though at that point changes are subtle.

When do the stitches need to be removed?

refer to them as “Dumbo” ears. From the side only the edge of the ear may be visible, with what should be the side of the ear facing forward. From behind it can look as if the ears are rotated forward with too much of the back of the ear being visible.

Will my ears be smaller after having Otoplasty surgery?

They will look less protuberant and they may look smaller but The sutures will come out in 4-6 days after surgery if you have the actual size of the ear will not change. an open Rhinoplasty. But in a closed Rhinoplasty, the stitches are inside the nose and dissolve on their own.

What is an Otoplasty?

Will my hearing be worse once I’ve had Otoplasty surgery?

Hearing is not affected by operating on the outer ear in an An Otoplasty is a procedure to reshape prominent ears, Otoplasty surgery. usually helping the ears to lay closer against the head and creating a better configuration of all the curves that make up Is it true that younger patients have softer, more the ears.

malleable ear cartilage than adults?

What is the ideal age to have an Otoplasty?

Yes, with normal aging, the ear cartilage becomes more fibrous and less pliable.

By age five, the ear has nearly reached its ideal size. It is also around the time that teasing may begin. If a parent has any concerns that would be a good time to speak with their How long does it take to recover following Otoplasty pediatrician or a plastic surgeon. surgery? A dressing is worn around the ears and head for one week. There will be bruising and swelling as well. It is most It is very common for an adult to get an Otoplasty. Their important to protect them from bending or other trauma parents may not have noticed it, perhaps no one knew surgery and we recommend wearing a headband at bedtime for 2-3 was an option, or perhaps the parents felt that it didn’t bother weeks. the child. Some parents think it is one of the features that make a child cute and that they will outgrow it. Is this surgery safe?

Can adults get an Otoplasty?

What anesthesia is used for Otoplasty? General anesthesia is the preferred anesthesia for children, but adults can be very comfortable with local anesthesia.

What are prominent ears?

Otoplasty surgery is considered to be very safe. Anesthesia and preventative antibiotics are used.

How long one should wait after cosmetic surgery before going for swimming?

One must have completely healed skin before swimming. A “Prominent ears” is a catch all term plastic surgeons use to protective swim cap is advised for the first 6-8 weeks. Diving, describe ears that can be improved with an Otoplasty. From as well as swimming in crowded pools, should be avoided to front view the ears may point widely out, which is why some reduce risk of trauma.

The Medical Supplement 2013

THE HOT LISTDISEASE ALZHEIMER'S IFTARS

Alzheimer’s Disease are you familiar with the term? Alzheimer's is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks. It's the most common cause of dementia — a group of brain disorders that results in the loss of intellectual and social skills. In Alzheimer's disease, the connections between brain cells and the brain cells themselves degenerate and die, causing a steady decline in memory and mental function. Symptoms At first, increasing forgetfulness or mild confusion may be the only symptoms of Alzheimer's disease that you notice. But over time, the disease robs you of more of your memory, especially recent memories. The rate at which symptoms worsen varies from person to person. If you have Alzheimer's, you may be the first to notice that you're having unusual difficulty remembering things and organizing your thoughts. Or you may not recognize that anything is wrong, even when changes are noticeable to your family members, close friends or co-workers. Brain changes associated with Alzheimer's disease lead to growing trouble with: Memory

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Everyone has occasional memory lapses. It's normal to lose track of where you put your keys or forget the name of an acquaintance. But the memory loss associated with Alzheimer's disease persists and worsens, affecting your ability to function at work and at home. People with Alzheimer's may: •Repeat statements and questions over and over, not realizing that they've asked the question before •Forget conversations, appointments or events, and not remember them later •Routinely misplace possessions, often putting them in illogical locations •Eventually forget the names of family members and everyday

ALZHEIMER'S THE HOT LISTDISEASE IFTARS

objects Disorientation and misinterpreting spatial relationships

People with Alzheimer's disease may lose their sense of what day it is, the season, where they are or even their current life circumstances. Alzheimer's may also disrupt your brain's ability to interpret what you see, making it difficult to understand your surroundings. Eventually, these problems may lead to getting lost in familiar places. Speaking and writing

Those with Alzheimer's may have trouble finding the right words to identify objects, express thoughts or take part in conversations. Over time, the ability to read and write also declines. Thinking and reasoning

Alzheimer's disease causes difficulty concentrating and thinking, especially about abstract concepts like numbers. It may be challenging to manage finances and balance checkbooks. These difficulties may progress to inability to recognize and deal with numbers. Making judgments and decisions Responding effectively to everyday problems, such as food burning on the stove or unexpected driving situations, becomes increasingly challenging. Planning and performing familiar tasks

Once-routine activities that require sequential steps, such as planning and cooking a meal or playing a favorite game, become a struggle as the disease progresses. Eventually, people with advanced Alzheimer's may forget how to perform basic tasks such as dressing and bathing. Changes in personality and behavior

Brain changes that occur in Alzheimer's disease can affect the way you act and how you feel. People with Alzheimer's may experience: •Depression •Social withdrawal •Mood swings •Distrust in others •Irritability and aggressiveness •Changes in sleeping habits •Wandering •Loss of inhibitions •Delusions, such as believing something has been stolen Causes Scientists believe that for most people, Alzheimer's disease results from a combination of genetic, lifestyle and environmental factors that affect the brain over time. Less than 5 percent of the time, Alzheimer's is caused by specific genetic changes that virtually guarantee a person will develop the disease. Although the causes of Alzheimer's are not yet fully understood, its effect on the brain is clear. Alzheimer's disease damages and kills brain cells. A brain affected by Alzheimer's disease has many fewer cells and many fewer connections among surviving cells than does a healthy brain. As more and more brain cells die, Alzheimer's leads to significant brain shrinkage. Complications Memory loss, impaired judgment and other cognitive changes caused by Alzheimer's can complicate treatment for other health conditions. A person with Alzheimer's disease may not be able to: •Communicate that he or she is experiencing pain — for example, from a dental problem •Report symptoms of another illness •Follow a prescribed treatment plan

•Notice or describe medication side effects As Alzheimer's disease progresses to later stages, brain changes begin to affect physical functions, such as swallowing, balance, and bowel and bladder control. These effects can increase vulnerability to additional health problems such as: •Pneumonia and other infections. Difficulty swallowing may cause people with Alzheimer's to inhale (aspirate) food or liquid into their airways and lungs, which can lead to pneumonia. Inability to control emptying of the bladder (urinary incontinence) may require placement of a tube to drain and collect urine (urinary catheter). Having a catheter increases your risk of urinary tract infections, which can lead to more-serious, life-threatening infections. •Injuries from falls. People with Alzheimer's become increasingly vulnerable to falling. Falls can lead to fractures. In addition, falls are a common cause of serious head injuries Treatments and drugs Drugs

Current Alzheimer's medications can help for a time with memory symptoms and other cognitive changes. Creating a safe and supportive environment

Adapting the living situation to the needs of a person with Alzheimer's is an important part of any treatment plan. You can take these steps to support a person's sense of well-being and continued ability to function: •Remove excess furniture, clutter and throw rugs. •Install sturdy handrails on stairways and in bathrooms. •Ensure that shoes and slippers are comfortable and provide good traction. •Reduce the number of mirrors. People with Alzheimer's may find images in mirrors confusing or frightening. Exercise

Regular exercise is an important part of everybody's wellness plan — and those with Alzheimer's are no exception. Activities like a daily 30-minute walk can help improve mood and maintain the health of joints, muscles and your heart. Exercise can also promote restful sleep and prevent constipation. Make sure that the person with Alzheimer's carries identification if she or he walks unaccompanied. People with Alzheimer's who develop trouble walking may still be able to use a stationary bike or participate in chair exercises. Nutrition

People with Alzheimer's may forget to eat, lose interest in preparing meals or not eat a healthy combination of foods. They may also forget to drink enough, leading to dehydration and constipation. So it is advisable to offer them: •High-calorie, healthy shakes and smoothies. You can supplement milkshakes with protein powders (available at grocery stores, drugstores and discount retailers) or use your blender to make smoothies featuring your favorite ingredients. •Water, juice and other healthy beverages. Try to ensure that a person with Alzheimer's drinks at least several full glasses of liquids every day. Avoid beverages with caffeine, which can increase restlessness, interfere with sleep and trigger frequent need to urinate. Prevention Right now, there's no proven way to prevent Alzheimer's disease. Research into prevention strategies is ongoing. The strongest evidence so far suggests that you may be able to lower your risk of Alzheimer's disease by reducing your risk of heart disease. Many of the same factors that increase your risk of heart disease can also increase your risk of Alzheimer's disease. Important factors that may be involved include high blood pressure, high blood cholesterol, excess weight and diabetes. The Medical Supplement 2013

OSTEOPOROSIS

OSTEOPOROSIS According to a recent research report, the lack of sufficient vitamin D intake is becoming a growing problem in Kuwait and entire Gulf region and due to lack of exposure to sunlight there is an increased risk of the debilitating bone disease osteoporosis and associated bone fractures. Unfortunately, the Gulf is synonymous now with bad lifestyle choices which increase the risk of contracting osteoporosis, such as lack of physical activity, bad diet, and reduced sun exposure due to the extremely hot summers. So I thought it is necessary to discuss this increasingly growing health problem in a little more detail. Osteoporosis, means "porous bone", is a disease in which the bones gradually become weak and brittle. So brittle that a fall or even mild stresses like bending over can cause fracture. Osteoporosisrelated fractures most commonly occur in the hip, wrist or spine.

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OSTEOPOROSIS

Causes: Your bones are in a constant state of renewal â&#x20AC;&#x201D; new bone is made and old bone is broken down. When you're young, your body makes new bone faster than it breaks down old bone and your bone mass increases. Most people reach their peak bone mass by their early 20s. As people age, bone mass is lost faster than it's created. How likely you are to develop osteoporosis depends partly on how much bone mass you attained in your youth. The higher your peak bone mass, the more bone you have "in the bank" and the less likely you are to develop osteoporosis as you age.

Risk Factors

osteoporosis than do their more-active counterparts. Any weight-bearing exercise Hormone levels: Osteoporosis is more is beneficial for your bones, but walking, common in people who have too much or running, jumping, dancing and weightlifting too little of certain hormones in their bodies. seem particularly helpful for creating healthy Examples include: bones. draw from as they age.

Sex hormones: The reduction of estrogen levels at menopause is one of the strongest risk factors for developing osteoporosis. Women may also experience a drop in estrogen during certain cancer treatments. Men experience a gradual reduction in testosterone levels as they age. Some treatments for prostate cancer reduce testosterone levels in men. Lowered sex hormone levels tend to weaken bones. Thyroid problems: Too much thyroid hormone can cause bone loss. This can occur if your thyroid is overactive or if you take too much thyroid hormone medication to treat an underactive thyroid.

There are a variety of factors that can put you at risk for developing osteoporosis. These include both controllable and uncontrollable factors. It is important to discuss your risk factors with your healthcare provider. Other glands: Osteoporosis has also been Together, you can develop a plan to protect associated with overactive parathyroid and your bones adrenal glands.

Uncontrollable Risk Factors:

Controllable Risk Factors:

Some risk factors for osteoporosis are out of Low calcium intake: A lifelong lack of calcium your control, including: plays a major role in the development of Gender: Women are much more likely to osteoporosis. Low calcium intake contributes to diminished bone density, early bone loss develop osteoporosis than men. and an increased risk of fractures. Age: The older you get, the greater your risk Steroids and other medications: Long-term of osteoporosis. use of corticosteroid medications, such as Family history: Having a parent or sibling prednisone and cortisone, interfere with the with osteoporosis puts you at greater risk, bone-rebuilding process. Osteoporosis has especially if you also have a family history of also been associated with medications used to combat or prevent: Seizures, Depression, fractures. Cancer, Gastric reflux, etc. Frame size: Men and women who have small body frames tend to have a higher risk Sedentary lifestyle: People who spend because they may have less bone mass to a lot of time sitting have a higher risk of

Tobacco use: The exact role tobacco plays in osteoporosis isn't clearly understood, but researchers do know that tobacco use contributes to weak bones. Weight-loss surgery: A reduction in the size of your stomach or a bypass of part of the intestine limits surface area available to absorb nutrients, including calcium.

Test And Diagnosis The most common test to measure bone density is dual energy X-ray absorptiometry (DXA). This procedure is quick, simple and gives accurate results. It painlessly measures the density of bones in your spine, hip and wrist â&#x20AC;&#x201D; the areas most likely to be affected by osteoporosis.

Treatment Treating osteoporosis involves reducing bone resorption using bisphosphonate drugs, which are either taken orally weekly or monthly. However, a new medication, which is given via an infusion, only needs to be administered once a year, so helping to improve medication compliance.

Prevention Spending 10 minutes per day, exposing 40 percent of the body area such as the back, arms and legs to the sun as well as eating sufficient foods containing vitamin D, are both recommended actions for helping to maintain vitamin D levels within the normal range that prevents osteoporosis. The Medical Supplement 2013

SPORTS SUPPLEMENTS

Sports Supplements Farah Al Rifai

Dietetics Manager at the Diet Care. MBA, Bsc Nutrition, Licensed Registered Dietitian, ISSA Sports Nutrition Certified.

Sports nutrition is the study and practice of nutrition and diet as it relates to athletic performance. It is concerned with the type and quantity of fluid and food taken by an athlete, and deals with nutrients such as vitamins, minerals, supplements and organic substances such as carbohydrates, proteins and fats. From the time when the ancient Greeks and Romans started the Olympic games, the athletes had their own special water and nutrition regimen for great performance. Nowadays, research shows that the coupling of exercise and proper diet is what produces a healthy lifestyle that can prevent chronic diseases such as type II diabetes, hypertension, coronary heart disease, osteoporosis, obesity, mental health, colon cancers, stroke and back injury. In this article I will be discussing Nutritional Supplements. When you have a proper nutrition, you do not – I repeat- do not need ANY supplement.

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1.Vitamins/Minerals and Antioxidants: Recent Research shows that excess, non needed Vitamins and Minerals increase oxidation in the cells and have a negative effect on health/ disease and aging rather than a positive one. As we all know, the best way of getting your adequate intake of vitamins and minerals is through a balanced diet full of fruits, vegetables, grains, complex carbohydrates and lean low fat meat and dairy. 2.Protein: YOU ARE HAVING ENOUGH PROTEIN! It’s a phrase I repeat to all athletes since they always underestimate their protein intake from food. To build muscle you need 1g/kg body weight of protein. For an athlete who weighs 89kg, this is 89g of protein i.e 2 chicken breasts. We can go up to 2.5g/kg body weight which for the same athlete is 222g protein. This is : a. 3 eggs (make sure you get at least 1 yolk for biotin)+1 cup Skim milk in the morning b. 60g raw nuts snack c. 300g chicken+ 1cup boiled rice + a bowl of salad lunch d. 1 cup yogurt + fruit snack e. 300g grilled fish + sautéed vegetables and sweet potato for dinner.

SPORTS SUPPLEMENTS

We consume more than this/day, athletes or non athletes.

Steroids to begin with and those have even worse outcomes.

Whey protein (a scoop after training) can be beneficial in case of a low calorie diet for weight loss or for convenience, if the person will 7.Anabolic Androgenic Steroids are dose dependent. The more not be able to prepare an adequate meal after training. you use the worse the side effects. These include: Needless to say- higher protein requirements (.5g/kg body weight) a. Elevated blood pressure are given for body builders not for an average Joe biking around b. Harmful changes in cholesterol levels the block. c. Increase fasting blood sugar and changes in glucose tolerance 3.Amino Acids: Since they are decomposed protein, the body will tests d. Increase the risk of cardiovascular disease make use of them faster- Right? Wrong! Recent Research all leans towards the body’s need to e. Acne decompose meals by digestion to make use of the nutrients rather f. Premature baldness than have them as pills and powders. g. Liver damage 4.Fat Burners: Keep away. Most of them are very high in caffeine and will affect the central nervous system, the body’s hydration system, heart beats and sleep to say the least. Those which contain high doses of caffeine are 20% effective. You can get caffeine from coffee, tea and small amounts of dark chocolate - all natural ingredients, all rich in antioxidants with NO additives and chemicals.

h. Development of breast tissue in male (gynecomastia) i. Infertility j. Enlargement of body organs (heart-liver-kineys…) k. Dilation of the veins l.Psychiatric disorders(mania-rage- psychosis leading to suicide)

5.Electrolyte Replenishers: Like Gatorade, to be taken after an Also, it is strictly illegal. hour of HARD cardio training and in hot environment. If this is not your case, go for plain old water, 1 liter for each hour of training. To conclude, there’s nothing like the real thing. The body’s intake Electrolyte replenishers are high in sugar and calories, not a safe bet of vitamins, minerals and macro elements is best when taken from if they’re not needed. food and food alone. This is why, focus on a proper and varied nutritional regimen, follow the food guide pyramid and don’t 6. Growth Hormones. Side effects: omit any segment. By variety, good quality and adequate quantity, a. nerve, muscle, or joint pain your diet will be the major boost in your day to day or even highly competitive activities. b. swelling due to fluid in the body's tissues (edema) c. carpal tunnel syndrome d. numbness and tingling of the skin e. high cholesterol levels f. increased risk of diabetes g. increased risk of cancerous tumors Most Growth Hormones in the market are duped with Anabolic

The Medical Supplement 2013

ORAL HEALTH

7 Ways to Keep Your Mouth Healthy Brushing, flossing, and rinsing are the ABCs of oral health, but they're only the beginning. A marvelous mouth takes more than squeezing paste out of a tube - think improving your tooth brushing technique, ditching the daily soda habit, and saying good-bye to cigarettes. 1.Brush regularly. Brushing is the cornerstone of dental hygiene. It removes food particles that bacteria feed on, cleans teeth, and freshens breath. A toothpaste with fluoride helps strengthen teeth, but you must brush for at least two minutes to allow it to do its work. 2.Floss daily. Flossing removes the bacteria from in between your teeth that your toothbrush does not reach, which helps prevent gum disease. Dentists recommend flossing twice a day, but if you only do it once daily, make sure to floss before bedtime. When you sleep, you produce less saliva, which leaves teeth and gums particularly vulnerable to bacteria. 3.Visit your dentist. Visit your dentist at least twice a year for thorough dental cleanings. Your dentist can spot the early signs of gum disease, which is more easily treated when caught in the beginning stages. If you are prone to gum disease and cavities, consider visiting your dentist every four months. Similarly, if you have other health conditions that put you at higher risk for dental problems (such as diabetes, or a depressed immune system from HIV, cancer, or chemotherapy), ask your dentist how often you should have an exam. A special dental-hygiene

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regimen should be considered for pregnant women, people with diabetes, and anyone undergoing chemotherapy treatment or using medications that can affect the gums (such as antiepileptic medicines) or dry out the mouth (including some psychiatric medications). It's wise to examine your own mouth regularly for signs of trouble, such as a non healing sore on the lip or inside of your cheek, swollen gums, or sensitive or bleeding gums. If you notice any of these conditions, make an extra dental appointment to have them checked out.

4.Eat a healthy diet. Include plenty of dairy and other calcium-rich foods, like sardines and kale, in your diet. Calcium helps maintain strong bones and teeth, and the vitamin C in citrus fruits boosts gum health.

Two ingredients -- phosphoric acid and citric acid -- give soda its "bite" but also eat away at the surface of your teeth. Although the occasional soda won't hurt, a can or more a day makes your tooth enamel softer and more susceptible to cavities. Switch to water instead, adding flavor with sliced citrus or crushed berries or mint leaves.

6.Don't sugarcoat it: Sugar is a major culprit in tooth decay. It fuels bacteria and acidity in your mouth, causing plaque to form and eat away at your enamel and gums. Your pearly whites are hit with up to 20 minutes of acid production for every sugar fest you indulge in, from sweetened coffee in the morning to ice cream at night. To avoid tooth decay try to cut down on sugary treats, and aim to brush and floss after every meal or snack.

7.Stop smoking: The nicotine and tar in 5.Can the soda. Fizzy is fun but also part cigarettes not only turn your teeth an

of the reason soda is so bad for your teeth.

unsightly shade of yellow, they eat away at your gums. Smoking creates a ripe environment for bacteria and plaque on your teeth and along the gum line. That harms tissue, degrades the bone that supports teeth, and, eventually, increases your risk of tooth loss. Even worse, tobacco chemicals can lead to oral cancer.

PHARMACOLOGY

Over the Counter Medicines (OTCs) Abrar Alzoubi MSc.Cancer Pharmacology. Bradford University, UK. Bachelor of Pharmacy. Kuwait University

Over-The-Counter (OTC) drugs is a term used to describe any drug that could be sold without the need of a medical prescription. OTCs are usually safe and effective when used properly, however, one must not ignore the fact that side effects and overdosing on OTCs are still possible. Keeping this fact in mind, we will discuss a couple of very common OTC drugs used

by both adults and children, especially with the flu season coming up. The first one will be Panadol. Panadol is an all time favourite of most of us. The good news is that it is relatively safe and very effective in managing headaches, pains and fever. The recommended dose of Panadol for adults and children over 12 years is 2 tablets every 4-6 hours. Make sure not to exceed 8 tablets of Panadol within 24 hours. Panadol can be taken with or without food. It does not have any significant adverse effect on the stomach or the digestive system. Panadol is relatively safe during pregnancy (given that the pregnancy is not a complicated one, otherwise, please seek your doctor's advise). As for children, panadol offers two types of liquid forms, the first one is for babies and infant from 2 months to 5 years and the second one is for children from 5 years to 12 years. Please make sure you pick up the best one that suits your child. As for the dosing, it all depends on the child's weight. Please refer to the body weight to dosing chart found in every leaflet that comes with the drug. Suppositories are also available for children with nausea, vomiting or children who would spit their medication. The second drug we will be discussing

today is Brufen 400mg tablet. Brufen is also used to manage pain especially ones accompanied by inflammation and/ or swelling (e.g. Muscle/bone/dental injuries). Brufen dosage for adults is 1 tablet 3 times a day. However in cases of severe pain, the dose may be increased to 2 tablet 3 times a day. 6 tablets/day is the maximum Brufen 400mg tablet dose. This drug must be taken after a meal. Patients with stomach ulcers must not be taking Brufen, other alternatives are available. Brufen for children is available in a liquid form. It usually comes in a 100mg/5ml suspension. The dosage of Brufen also depends on the child's body weight. The recommended dose is 20-30mg/kg divided into 3 doses. For example, if your child weighs 15kg, the dose would be calculated as follow: 15*20=300mg/3=100mg. So the dose would be 100mg 3 times a day, i.e. 5ml 3 times a day. Although OTCs are convenient to most of us, please do not use any of them without a physician's prescription when it comes to ears or eyes infections no matter how tempted you are to do so. When taking any drug orally and vomiting occurs within the first 15 minutes of ingesting the drug, the dose should be retaken. Pregnant women and patients with chronic diseases (e.g. asthma, diabetes, kidney diseases, hypertension, heart diseases) should always consult their physicians before taking any drug what so ever. One must also notice any unusual rash that may occur after using any form of drug and consult you physician or pharmacist on changing the drug. Finally, hope you all have a healthy, disease free winter and enjoy the beautiful weather! The Medical Supplement 2013

INTERVIEW

ALI SALEH AL-HADDAD Meet ALI SALEH AL-HADDAD, Manager and creator of Get2fit Clinic and Company, and a Dietitian of the Modern Nutrition Ali is on a mission to put the brakes on obesity without compromising on your love for food in Kuwait. Sure, a lot of nutrition authorities talk about reversing obesity. But when Ali speaks about it, you truly believe it’s possible. After all, he has spent nearly 4 years taking on the biggest challenge in modern healthcare. Today CityPages sat down with Ali to discover his perspective on tackling obesity with a new phenomenon called ‘Modern Nutrition’ during a special Q & A, wherein he revealed how it is possible.

Hi, Please introduce yourself to our readers: In a nut shell, what does GET2FIT Offer? My name is ALI SALEH AL-HADDAD, Manager and creator of Get2fit Clinic and Company, and a Dietitian of the Modern It offers a system for life that makes you eat whatever you Nutrition. want according to your weight, height, age, level of activity and gender. It is very important to us to make you eat everything you like, Can you tell us a little about your education? I graduated from the Ohio State University in 2006 – again it’s a must to love what you eat and eat what you love. COLUMBUS, OHIO, USA. It is ranked as one of the top 10 universities worldwide in terms of nutrition and diet You call your approach as "MODERN NUTRITION" how education. does it differ from the traditional approach? Modern Nutrition: Tell me what you want to eat and tell me what you love to eat everyday, then we organize it for you and How and when did the idea of GET2FIT come up? The idea of Get2fit is revolutionary, where you can eat tell you when to eat it and the quantity you need from the anything you want and still lose weight, and when I say things you love (we can make it in your everyday diet plan). Traditional Nutrition: The dietitian will give you food without anything I mean it literally! The idea started when I saw so many people from all over the taking into consideration whether you love to eat it or not world are willing to lose weight, but are bored from the fad and add to that there are so many thing that you must not diets and are facing so many conflict information about food eat or ‘forget about’ list. and diet, thanks to us ‘the dietitians’ who seems to agree on nothing else but eat less and do more sport and guess what if How has the response been so far? you continue to do so, then you are going in deep depression It is astonishing! People are being more aware day by day of because you think you had done the right thing but your the importance of the modern nutrition, people are starting weight still doesn’t change. to realize that if they did not eat what they like, the system 52

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INTERVIEW

The Medical Supplement 2013

THE HOT LIST IFTARS INTERVIEW

will not work for life, It will be temporary. Nothing will last forever unless it’s a system that could be part of your life and nothing can last unless it is something you are convinced by and you are happy to be a part of. We don’t want people to lose weight with a pain or headache. The main target for us is to make you lose weight while you are enjoying the experience, and having fun in every step in this long journey, we want people to lose weight and have fun, not to lose weight and feel bad for themselves. Please explain who is an ideal patient to benefit from your approach? Imagine if you have a diet plan that provides you with all the food from every single restaurant, you will never be lost for life , think about it as you enter a new city with a 3D Map, not only it will be easier but also more clear than ever before, having said that, every patient in our clinic understand and realize that we provide him/ her with a list of every single restaurant in the world and tell them what to eat in everyone of them, and yes it is a very long list almost as long as the great wall of china but it is worth it and I can see that from their eyes they feel they have just got back to life, they feel they are alive, they feel that nothing is impossible, they feel the power, and they feel the happiness. In short, every person who is willing to know what is the right amount of food for him to eat is an ideal customer

for us. How long does it take to start losing weight and how much weight loss is possible using your program? It varies from person to person and depends upon his/her weight – height - level of activity - male/female – age - family history of obesity – and metabolism rate. You can get to your ideal weight using modern diet system but it’s a must to allow some time, there is no approved diet system in the world that will get you to your ideal weight as fast as a jet airplane, even if it did so it won't be scientifically proven that you are going in the right direction. Share an experience you had in dealing with a difficult client and how you handled the situation? In Kuwait we have very educated people in all aspects of life but when it comes to nutrition, people are lost all at the sudden, they want to lose weight so fast without thinking about the side effect of the losing weight too fast, it is catastrophic. How often does the patient have to visit you? and what do you monitor during each visit? The best time to see every patient to monitor their success is once every month, but some patients insist on visiting every 2 weeks, it makes them feel more comfortable and that’s fine with me. Do any patients from outside Kuwait approach you? Yes, we conduct lectures all over the world, add to that we receive cases everyday through online program and I am happy with the results. Having people from all over the world following a system that no other has done ever before and it is a success like no other program has ever achieved, is something that made me proud of myself. Tell me how you organize and manage your busy work schedule and personal life? Thanks to my lovely & understanding wife, that I rarely see nowadays because of my busy life, my time is not mine anymore, the reason is because our work is not systematic, it keeps on changing so we have to continue to follow the latest every day, everything must be updated every day, what we are serving today is totally different than what will be serving tomorrow because we are updating ourselves daily and I mean it literally. Your message for us at CityPages magazine? I am proud of CityPages magazine mainly because they are so up-to-date, which is the most important thing that we share together, we are the most updated in food and diet systems and CityPages magazine is up-to-date in selecting topics that are important to people everywhere.

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STRESS MANAGEMENT

manage everyday stress Most of us think stress is caused by things that happen, but it's actually in our minds. It comes from how we perceive events, rather than the events themselves. Mindfulness is a technique that teaches us to recognise those thoughts and feelings, so we're no longer controlled by them. Here's how to apply some mindfulness to your day. More haste, less speed

powerful exercise in workplace awareness and acceptance.

When things go awry it's often because they were started in the wrong frame of mind. Begin tasks with a moment of stillness for a Focus fully calm and focused result. Putting all your fully focused attention into a task connects us with what we're doing. It even helps with those parts of our work we don't Press pause like. As an experiment, try fully focusing on a disagreeable job, like Create stillness throughout the day with little pauses, like stopping washing a very dirty dog. Really feel the dog, smell it and listen to it. for a cup of tea, for example. In the same way that punctuation helps You'll soon see there's nothing second-rate about the experience. make sense of written words, pauses help us make sense of our days.

Work until the job is done

Love what you do

Focus on the idea that you're working because you enjoy what you're It may seem obvious but many of us have drawers full of tasks to be doing, not for results or rewards. They will come naturally, when we completed 'another time'. Avoid the easy option. The final part of any aren't wasting time and energy worrying about them. task is often the hardest, but it's also the most vital and rewarding.

Let your tools do the job You shouldn't need to strain with a chisel for it to do its job. Likewise, if you're in an office, for example, it's best if everyone is able to do their jobs without interference. Allow the natural results of everyone's efforts to blossom without forcing them. This is a

Less can be more If you're working mindfully you should be aware enough to stop and think about what you really need to be doing in your job. You could end up doing less as you're working more efficiently, productively and enjoyably. The Medical Supplement 2013

LASER HAIR REMOVAL How many types of Laser are used in Yiaco Apollo for hair removal? Mainly two types of Laser are used Nd YAG and Alexandrite. ND Yag laser works more efficiently on strong hair and all types of skin. Alexandrite works better on fair skin and light hair. Is there any difference in your hair removal techniques which makes you different from another clinic? We have the latest cooling technique which makes the hair removal laser virtually painless apart from this, we have the shortest pulse duration which gives better and faster results without any side effects . How many laser sessions for hair removal I will require for reducing my hair growth? Depending on the area, texture, distribution and growth of your hair, you may require multiple sessions. Is it necessary that I should do my laser session frequently? Yes it is important for you to schedule your laser session every 6-8 weeks period in order to reduce your hair growth. Are there any side effects of laser? Usually the Dermatologist will take a detailed history and prescribe medications and precautions in order to determine your skin sensitivity. To avoid and reduce the incidents of burns, post laser pigmentation, acne farm eruptions or rashes after the laser. These may occur immediately after laser or within 24-48 hours after the laser session. How can I avoid any side effects after the laser? • Avoid any direct sun exposure before and after 2 weeks of your laser session. • Shave the area to be treated 1 day before your laser session. • Avoid applying any cosmetic cream or lotion before laser session. • Inform your doctor if you are on any medicine like antibiotics. If there is hair growth, after 1 week of my laser session, what should I do? The hair will start growing after few days after the

laser. Some of the hairs will fall and some of them will remain .shave those hairs if you are uncomfortable with it. Do not do waxing, plucking, tweezing, bleaching after laser. What measures may be done after laser session? Do not use hot water or scrub for 48-72 hrs over the laser area, avoid rubbing, scratching that are. Apply a post laser cream or antibiotic cream after laser as advised by your doctor.

LASER TREATMENTS FOR AESTHETIC Which other aesthetic and cosmetic treatment you have in your clinic? Apart from laser, we have many skin remodeling and rejuvenation programmes for face and body. One of them is the Oxygen treatment and 3 Face skin rejuvenation programme What is new about this oxygen & 3 Face programme? The Oxysystem is a new oxygen therapy that combines a jet of oxygen with dermabrasion and massaging of connective tissues. The 3 face also includes dermabrasion with massage, but it also provides photherapy to the skin. What are the benefits of these programmes? The Oxygen treatment increases the blood supply to the tissue, improves cell metabolism and stimulates the production of collagen by fibroblasts. The 3 Face treatment is mainly useful for fine lines around eyes and mouth, sun damaged skin, acne scars and uneven texture of skin. Do you have any treatment for stretch marks? Yes, recently we have added a new device name Derma Pod which is very useful for the stretch marks. Do you have any laser treatment for pores or skin rejuvenation We have a new aesthetic laser treatment known as spectra peel for open pores, inflammatory acne, pigmented lesions and skin rejuvenation.

How does this Spectrapeel differs from ordinary laser treatment? Spectra peel is a two step rejuvenation treatment that dramatically reduces acne, improves your general skin tone and texture and even reduces large pores and some acne scars. Unlike other laser treatment, spectrapeel is virtually painless. You can return to your normal life, immediately after treatment without any risk of side effects. Do you have any treatment for wrinkles, skin rejuvenation, apart from spectra peel? We do have procedures like Botox, Derma fillers, Mesotherapy to meet the demand of enhancing facial contour by removing wrinkles & rejuvenating the skin without any surgery. What is this no needle Mesotherapy? This is a new concept in mesotherapy whereby aesthetic medicines for improving the skin elasticity & glow are infused with machine. It is totally painless, so patients prefer this procedure to enhance their looks. What is PRP? PRP is blood plasma enriched with platelets. It contains various growth factors and cytokines required for tissue regeneration. It is an excellent way to reduce the signs of ageing. Where is it used? PRP has been used to treat nerve injury, tendonitis, osteoarthritis, bone injury and in cardiac muscle regeneration. In aesthetic medicine it has a variety of applications which include treatment of wrinkles and skin aging, scars, pigmentation and hair regeneration . How it is done? The procedure includes drawing a small amount of blood from the patient. The blood is centrifuged to concentrate the platelets which are activated and reinjected in the treatment area by small needles where requires for example face, neck, scalp (hair roots) or hands. Three sessions are done at monthly intervals followed by a fourth session at 6 months and fifth session at one year. Results appear gradually and continue to improve over a long period of time. Is it safe? PRP is absolutely safe as patients own blood is used and is the natural way of skin regeneration.

Thank you for Reading ..

“ If you have any Laser, Dermatology or Beauty concerns .. if you love to take care of yourself and shine .. if you want answers to all your beauty concerns. We have them for you now! Ask and get interacted with our Doctors!

YIACO APOLLO ... Reveal your beauty ...

TECHNOLOGY

HELPFUL GADGETS Nowadays, there's an app for almost everything and health is no exception. New breakthrough in medicine continue to be reported almost daily. Scientists are exploring a pill which will monitor the body's change and can email results to your doctor, all from inside your intestine! And news recently emerged of a non-invasive technique which could replace painful chemotherapy treatments for cancer. While you may have to wait a few years before these technologies become available, here are a few useful gadgets you can purchase to help monitor yourhealth.

WITHINGS SMART BLOOD PRESSURE MONITOR

ZEO SLEEP MANAGER PRO

Connect the stylish white blood pressure cup to an Apple iOS device, wrap the cuff around the arm and see your systole, diastole and heart rate information, all of which can be saved directly to the device. The free app also includes a feature that lets users e-mail their results to a doctor or to personal health record sites.

BASIS B1

If you feel like you're still not getting a restful sleep, the Zeo headband system will tell you if you were sleeping in the wrong position last night. The device measures brain waves to track how well you sleep and then offers a daily score and sleep graph. An online dashboard, accessible through a mobile app, looks at your diet and work schedule and offers tips on how to improve your patterns.

The Basis is a digital watch with an array of sensors on the back, allowing it to gather more information than competitors can -- not just sleep but also heart rate, skin temperature and perspiration. This provides deeper, more sophisticated data analysis. It's also water-resistant for anything short of dunking in the swimming pool. And yes, it also tells the time. 58

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TECHNOLOGY

FOR YOUR HEALTH FITBIT ONE The 24-hour activity tracker is simple, unobtrusive and slips into a pocket or clips onto clothing. It counts steps, distance, calories burned and stairs climbed during the day. At night it measures your sleep cycles and figures out the best time to wake you with a gentle vibration so you'll feel most refreshed.

WITHINGS WI-FI BODY SCALE The Wi-Fi Body Scale sends a signal through the body to measure a user's body weight as well as lean and fat mass. The wireless feature lets you sync. and monitor your information on an iPhone, Google Android device or secure website, and can support use by up to eight people.

TINKE Think of it as a thumb-drive sized doctor's checkup. Using optical sensors, Tinke monitors the thickness of your blood to determine oxygen levels, while also measuring your heart and respiratory rates. You can view the data on iOS-compatible phones and tablets, or share your daily score on Facebook and with friends who join the Tinkle network.

The Medical Supplement 2013

CHILD HEALTH

Kids Health Guide for Parents You've heard the expression "An apple a day keeps the doctor away." That certainly has some truth in it as you will find out later. Of course it is very important to see a doctor, but the point of this article is to give you tips for preventative health care as you know prevention is better than cure. These preventative health care tips for kids will be useful, beneficial, and most importantly give you and your children peace of mind.

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CHILD HEALTH

1) Proper hygiene for kids - Make protect them from the sun at its peak bath time fun for infants and toddlers by adding toys and games. When they are over the age 3 a kid-safe shower head, with a gentler spray and adjusted for their height, makes the older kids feel more grown-up. An absolute must, all kids need to wash their hands after they've been outside, before every meal, and when they've played around with pets. Hand washing helps prevent the spread of germs and illness.

between the hours of 10:00am till 4 :00pm. Take frequent breaks indoors or in the shade.

Managing Fever

8) Child-proof the home - Protect

children from getting into prescription medications, household cleaning supplies, power shed tools, kitchen knives, or anything else that could be a danger to children. Have them learn the correct procedures to call 112 for emergencies.

2) Eat plenty of fruits, vegetables, and grains - Drink natural fruit juices, 9) Swimming in the pool - Strict

milk, and water. Also include meat, adult supervision at all times when fish, beans, and nuts for well-rounded children are playing or swimming in the nutrition at breakfast, lunch, and dinner. pool, either in their own home or at a friend's. Get a pool safety fence and 3) A good night's sleep - Kids cover when the pool is not in use. Have between the ages of 5 to 12 need 10 to your children take swimming lessons at 11 hours of sleep each night. This helps an early age. them pay better attention in school, be in a better mood, and to fight off 10) Vision and Hearing Tests - It is sickness in order to stay healthy. still important to go for vision exams and hearing tests so that any interventions 4) Practice Dental Prevention can begin early if necessary. By regularly brushing your teeth in the morning and before bedtime you can 11) Yearly physical examinations prevent cavities and reduce plaque - Besides going to the doctor every year build-up on your teeth. With flossing, for a physical, be sure to have your your gums will stay healthy. doctor check for the kids' BMI (Body 5) Exercise regularly - Instead of Mass Index) to help prevent getting kids sitting in front of the computer or their young bodies with having too the TV all day begin with daily physical much fat.

activities such as household chores, 12) Go to the Dentist for Checkwalking the dog, wash the car, or even yard work. These are things that must ups twice a year - This is for an be done on a daily basis and getting overall examination of your teeth and the kids involved makes them more gums by a professional, in addition to a thorough teeth cleaning and x-rays. If productive. cavities are found on dental x-rays then 6) Eliminate snacks as much as a filling is necessary at a later visit. possible - Candies, cakes, fast food, sodas, and junk food are a growing 13) Get vaccinated - Keep current concern due to the epidemic of obesity with all vaccinations to ensure in children. Over the decades many protection from serious diseases. were raised on a steady diet of fast foods, carbonated drinks, and junk food 14) Children going Green - Learn such as potato chips, donuts, and other the benefits of a clean environment, which is the land, the water, and the high calorie foods. air we breathe. The word "Green" 7) Protection from the summer comes from the color of the plants that sun - Children always need sunscreen provide the earth's nourishment. Learn lotion while outdoors during the hot to reduce, recycle, reuse, and enjoy the summer months. It is also important to earth for you and your kids

Although it can be frightening when a child’s temperature rises, fever itself causes no harm and can actually be a good thing – it’s often the body’s way of fighting infections. SIGNS AND SYMPTOMS A child may have a fever if he or she is: •Fussy •Uncomfortable •Warm to the touch •Flushed •Sweaty WHAT TO DO It’s best to keep a child with a fever home from school or child care. If your child is uncomfortable due to fever, here are some ways to relieve symptoms: •Give the child a sponge bath in lukewarm water to help bring the fever down •Offer plenty of fluids to avoid dehydration •Ask your doctor about fever-reducing medicines •Never use rubbing alcohol to bring the fever down •Do not give aspirin to an infant or child Seek Medical Care Right Away if: •An infant is younger than 3 months and has a temperature of 100.40F (380C) or higher Call the doctor if an older child has a fever and also: •Appears sick •Has a skin rash •Has persistent diarrhea or repeated vomiting •Has signs of dehydration (urinating less than usual, not having tears when crying, less alert and less active than usual) •Has recurring fever for 5 days •Has a chronic medical problem like sickle cell disease, heart problems, cancer, or lupus Think Prevention! Fevers are virtually unavoidable. The key is to make the child as comfortable as possible until the fever passes and seek medical treatment when necessary.

The Medical Supplement 2013

PROFILES

YIACO Apollo Medical Center was established in year 2005 in the heart of Salmiya Kuwait. Is being run by the prestigious YIACO Medical Company which considers to be one of the best medical services company in the state of Kuwait. Yiaco Apollo now dominated the market as a result of efficient patient care services provided to its patient delivered by its well trained team of doctors, paramedical and very efficient customer service staffs. YIACO-APOLLO Medical Center had made a big leap during the last quarter of 2010 in renovating the center facility which comes along with its new branding design giving the Center a more sophisticated image. Yiaco Apollo Medical Center is a perfect blend of functionality, elegance and excellent services to patients. A team of highly qualified and experienced doctors in their specialty, trained paramedical staffs with the latest medical equipments ensure a complete comprehensive care for you and your entire family. Efficient and well trained customer service staff ensures you the comfort of your family from the moment you walk in. The center has emerged as a leading healthcare provider in Kuwait due to its commitment for quality healthcare at the most affordable rates in the market. The aim of the center is to serve the healthcare needs of the region by giving comprehensive and compassionate patient care to prevent and treat illness and to provide advanced medical procedures using modern technology combined with the traditions of caring and compassion.

These aims are achieved through: - Patient Care as Top Priority - Confidentiality of Patient Information - Proper Patient handling with compassion - Teamwork and clinical excellence - Continuous professional improvement - Accountability, responsibility, honesty and integrity - Patient Safety and Security - Operational efficiency - Respect for Patient Rights and Privacy - Having fully renovated facility combined with the latest medical equipments and dedicated team made Yiaco Apollo achieve its vision of being the leading Medical Center in the State Of Kuwait. Yiaco Apollo Vision: “Leading the way of being the best Medical center in Kuwait.”

Yiaco Apollo Mission: To provide advance medical procedures with its modern and its latest technology combined with traditional method of compassion and care. Serving YAMC’s patients is a team of dedicated, highly qualified and experienced doctors who are specialists in their respective fields of medicine. The medical team, with the support of modern and sophisticated equipment and technology, ensures the delivery of a comprehensive medical care for the entire family. YAMC’s medical professionals are always ready and bound to serve from the moment the patients walk into its premises. Among the services provided by YAMC are the following: Dermatology, Laser and Cosmetology Center – “Reveal Your Beauty” The Laser, Dermatology and Cosmetology department is a serious investment from YIACO Apollo Medical Center. This provides full-fledged and transformational services focusing on shaping the new age of patient care. The goal is to deliver world class, high quality and affordable services to women and men through the hands of professional doctors in a committed and compassionate manner. Kuwait’s rising needs for top-notch beauty, laser, skin care and cosmetology services match the facilities provided by YIACO Apollo, which help patients re-evaluate their treatment options to maintain skin and Beauty quality by using our doctors’ expertise combined with the region’s best medical equipment. The Dermatology and Laser Department, located on the first and second floor is consider to be the largest Laser Unit in the state of Kuwait, supervised by a highly qualified team of doctors. The department is well equipped with modern and computerized facilities for hair laser removal, frox peel, Mesotherapy treatment, botox, fillers

and oxygen treatment. In addition to above, the newly revamped YIACO Apollo Beauty and Cosmetology Department, located on the third floor, offers an exhilarating sensory experience in its soothing ambience that by far exceeds guests’ expectations and helps patients forget the daily hustle and bustle from the moment they walk through the doors. The entire floor offers a vast array of spa-like services with personal and detailed attention given to every individual. Some of the medically enhanced beauty services offered at the cosmetology and beauty department include facials, crystal peeling, facial oxygen therapy, chemical peeling, face whitening, acne treatments, Fat reduction, eye contour treatment, the latest PRB treatment, skin tightening and body scrubbing with more yet to come. Women can enjoy the leisure of a medical spa ambiance within the guidance of qualified doctors that select individually suitable beauty treatments to help enhance and revitalize beauty. Some of the other departments based at the clinic include: ENT, Gynecology, Internal Medicine, Dental, Pediatrics & Neonatology, Laboratory, Radiology, Pharmacy and General Practice. The center is located in Salmiya, Block 10, at the corner of the Amman Street and Al Mughira Street intersection.

“ONLY THE BEST HEALTH CARE FOR YOU & YOUR FAMILY”, IS WHAT THE CENTER PROMISES”

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‫‪PROFILES‬‬

‫عندما جتتمع اخلدمات الطبيه و الفن في األداء هذا (( إحنا ))‬ ‫مستوصف بوشهري التخصصي‬ ‫نشعر بحرارة املنافسه فنتسابق و هدفنا إرضاء املراجع و املريض و السمعة الطيبه ‪.‬‬ ‫خدماتنا طبية مميزه ‪ ،‬أطباء نخبه بتخصصات متعددة وطاقم متريض و فنني و سكرتاريه‬ ‫و إداره بطابع عائلي ‪.‬‬ ‫حياكم اهلل هدفنا إرضائكم‬ ‫املدير العام‬ ‫زينب بوشهري‬

‫‪Baghdad Street – Building 38 same as Boushahri Seema Pharmacy,‬‬ ‫‪Opposite Suleiman Al-Luhaib Mosque - Tel : 1888877‬‬ ‫‪Boushahri_clinic‬‬ ‫‪63‬‬

‫‪The Medical Supplement 2013‬‬

‫‪www.boushahricp.com‬‬

LAB TESTS

Understanding Your Laboratory Report If you’ve had laboratory tests performed, you may have been given a copy of the report by the laboratory or your health care provider. Once you get your report, however, it may not be easy for you to read or understand, leaving you with more questions than answers. This article points out some of the different sections that may be found on a typical lab report and explains some of the information that may be found in those sections. Abnormal test results are fairly common, especially among older adults. Fiftyplus folks tend to take more medications, and that can throw off test results. For example, diuretics can alter sodium and potassium levels; heparin can decrease your platelet count. (These are real abnormalities that may need further treatment.) Plus, many older adults have chronic conditions that require more frequent testing — and the more you’re tested, the greater the likelihood of error. Finally, normal ranges are based on population averages, so normal for you might be slightly out of that range and of no significance. For instance, if you have Gilbert’s syndrome, a common, mild liver condition, you’d show elevated Bilirubin, which could otherwise signal a serious liver dysfunction. If you have known abnormalities, be sure to remind your doctor each time you get tested.

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LAB TESTS

Complete Blood Count (CBC) What it does: Measures essential components of the blood

WHITE BLOOD CELL COUNT (WBC)

HEMOGLOBIN

PLATELET COUNT WHAT IT IS

Measures number of platelets â&#x20AC;&#x201D; colorless blood cells integral to clotting

NORMAL RESULTS

150 - 400 Thous/mcL

WHAT A LOW NUMBER MAY MEAN

Viral infections, lupus, leukemia, chemotherapy, pernicious anemia (due to vitamin B12 deficiency)

WHAT A HIGH NUMBER MAY MEAN

Leukemia, myeloproliferative disorders (which cause blood cells to grow abnormally in bone marrow), inflammatory conditions

WHAT IT IS

White blood cells defend the body against infection

WHAT IT IS

Oxyrgen-carrying pigment in red blood cells

NORMAL RESULTS

4,500 - 10,000 cells/mcL

NORMAL RESULTS

WHAT A LOW NUMBER MAY MEAN

Autoimmune illness, bone marrow failure, chemotherapy, viral infections

Male: 13.8 - 17.2 g/dL Female: 12.1 - 15.1 g/dL

MEAN CORPUSCULAR VOLUME (MCV)

WHAT A LOW NUMBER MAY MEAN

Iron, vitamin B12, or folate deficiency; bone marrow damage

WHAT IT IS

Average size of red blood cells

WHAT A HIGH NUMBER MAY MEAN

Dehydration, renal problems, pulmonary or congenital heart disease

NORMAL RESULTS

80 - 95 fL

WHAT A LOW NUMBER MAY MEAN

Iron deficiency

WHAT A HIGH NUMBER MAY MEAN

Vitamin B12 or folate deficiency

WHAT A HIGH NUMBER MAY MEAN

Infection, inflammation, cancer, leukemia, intense exercise, stress, corticosteroids

RED BLOOD CELL COUNT (RBC) WHAT IT IS

Red blood cells pick up oxygen from the blood and deliver it to tissues throughout the body

NORMAL RESULTS

Male: 4.32 - 5.72mill cells/mcL Female: 33.90 - 5.03mill cells/mcL

WHAT A LOW NUMBER MAY MEAN

Iron, vitamin B12, or folate deficiency; bone marrow damage

WHAT A HIGH NUMBER MAY MEAN

Dehydration, renal problems, pulmonary or congenital heart disease

HEMATOCRIT WHAT IT IS

The percentage of red blood cells in the blood

NORMAL RESULTS

Male: 40.7% - 50.3% Female: 36.1% - 44.3%

WHAT A LOW NUMBER MAY MEAN

Iron, vitamin B12, or folate deficiency; bone marrow damage

WHAT A HIGH NUMBER MAY MEAN

Dehydration, renal problems, pulmonary or congenital heart disease

Comprehensive Metabolic Panel What it does: Measures kidney and liver function, electrolyte levels

GLUCOSE (FASTING)

POTASSIUM

WHAT IT IS

Sugar in the blood

WHAT IT IS

An electrolyte and mineral

NORMAL RESULTS

70 - 99 mg/dL

NORMAL RESULTS

3.7 - 5.2 mEq/L

WHAT A LOW NUMBER MAY MEAN

Hypoglycemia, liver disease, adrenal insufficiency, excess insulin

WHAT A LOW NUMBER MAY MEAN

Chronic diarrhea, vomiting, use of diuretics or corticosteroids (such as prednisone or cortisone)

WHAT A HIGH NUMBER MAY MEAN

Hyperglycemia, certain types of diabetes, prediabetes, pancreatitis, hyperthyroidism

WHAT A HIGH NUMBER MAY MEAN

Acute or chronic kidney failure, Addison's disease, diabetes, dehydration

BUN: BLOOD UREA NITROGEN

SODIUM WHAT IT IS

An electrolyte, which keeps your body in balance

NORMAL RESULTS

136 - 144 mEq/L

WHAT A LOW NUMBER MAY MEAN

Dehydration, vomiting, diarrhea, use of diuretics, adrenal insufficiency

WHAT A HIGH NUMBER MAY MEAN

Kidney dysfunction, dehydration, Cushing's syndrome

WHAT IT IS

A waste product formed in liver and carried to kidneys, filtered out of blood, excreted through urine

MEAN CORPUSCULAR HEMOGLOBIN (MCH) WHAT IT IS

The amount of hemoglobin in red blood cells

NORMAL RESULTS

27 - 31 pg

WHAT A LOW NUMBER MAY MEAN

Iron deficiency

WHAT A HIGH NUMBER MAY MEAN

Vitamin B12 or folate deficiency

CHLORIDE WHAT IT IS

An electrolyte

NORMAL RESULTS

96 - 106 mmol/L

WHAT A LOW NUMBER MAY MEAN

Emphysema, chronic lung diseases

WHAT A HIGH NUMBER MAY MEAN

Dehydration, Cushing's syndrome, kidney disease

CARBON DIOXIDE WHAT IT IS

Gaseous waste product from metabolism

NORMAL RESULTS

20 - 29 mmol/L

WHAT A LOW NUMBER MAY MEAN

Kidney disease, certain toxic exposures, severe infection

WHAT A HIGH NUMBER MAY MEAN

Lung diseases, including COPD

CREATININE WHAT IT IS

A chemical waste produced by muscle metabolism

NORMAL RESULTS

7 - 29 mg/dL

NORMAL RESULTS

0.8 - 1.4 mg/dL

WHAT A LOW NUMBER MAY MEAN

Malnutrition

WHAT A LOW NUMBER MAY MEAN

Low muscle mass, malnutrition

WHAT A HIGH NUMBER MAY MEAN

Liver or kidney disease, heart failure

WHAT A HIGH NUMBER MAY MEAN

Chronic or temporary decrease in kidney function

The Medical Supplement 2013

THE HOT LAB TESTS LIST IFTARS

BILIRUBIN

ALKALINE PHOSPHATASE (ALP)

WHAT IT IS

A pigment in the bile, a digestive fluid produced by the liver

WHAT IT IS

Enzyme found in the liver and bones

NORMAL RESULTS

0.2 - 1.9 mg/dL

NORMAL RESULTS

44 - 147 IU/L

WHAT A LOW NUMBER MAY MEAN

Generally not a concern

WHAT A LOW NUMBER MAY MEAN

Malnutrition

WHAT A HIGH NUMBER MAY MEAN

Liver disease, bile duct disorder or red cell destruction

WHAT A HIGH NUMBER MAY MEAN

Paget's disease or certain cancers that spread to bone, bile duct obstruction, liver disease

BUN/CREATININE RATIO

PROTEIN WHAT IT IS

Chains of amino acids essential for the growth and repair of cells

10:1 to 20:1

NORMAL RESULTS

6.3 - 7.9 g/dL

WHAT A LOW NUMBER MAY MEAN

Malnutrition

WHAT A LOW NUMBER MAY MEAN

Malnutrition, liver or kidney disease

WHAT A HIGH NUMBER MAY MEAN

Blood in bowels, kidney obstruction, dehydration

WHAT A HIGH NUMBER MAY MEAN

Liver or kidney disease, dehydration, multiple myeloma

WHAT IT IS

Its a ratio

NORMAL RESULTS

CALCIUM

WHAT IT IS

Enzyme found mostly in the liver

NORMAL RESULTS

8 - 37 IU/L

WHAT A LOW NUMBER MAY MEAN

Generally not a concern

WHAT A HIGH NUMBER MAY MEAN

Certain toxins such as excess acetaminophen or alcohol, hepatitis, and liver disease

ALBUMIN

WHAT IT IS

A mineral stored in the hard part of bones

NORMAL RESULTS

8.5 - 10.9 mg/dL

WHAT A LOW NUMBER MAY MEAN

Calcium, magnesium, or Vitamin D deficiency, malnutrition, pancreatitis, neurological disorders

WHAT A HIGH NUMBER MAY MEAN

ALANINE AMINOTRANSFERASE (ALT)

Kidney disease, hyperparathyroidism, cancer, excess vitamin D intake

Protein that keeps fluid from leaking out of blood vessels and that nourishes tissues and transports nutrients through the body

ASPARTATE AMINOTRANSFERASE (AST) WHAT IT IS

Enzyme found in liver, muscle, and other tissues

NORMAL RESULTS

3.9 - 5.0 g/dL

NORMAL RESULTS

10 - 34 IU/L

WHAT A LOW NUMBER MAY MEAN

Liver or kidney disease, malnutrition

WHAT A LOW NUMBER MAY MEAN

Generally not a concern

WHAT A HIGH NUMBER MAY MEAN

Dehydration

WHAT A HIGH NUMBER MAY MEAN

Excess acetaminophen, hepatitis, muscle injury

WHAT IT IS

DESIRED LEVELS

Lipid Panel

What it does: Measures coronary artery disease risk

TOTAL CHOLESTEROL

less than 200 mg/dL (lower numbers are desired)

HDL

greater than 40 - 60 mg/dL (higher numbers are desired)

LDL

lower than 130 mg/dL (lower numbers are desired)

TRIGLYCERIDES

10 - 150 mg/dL (lower numbers are desired)

VLDL

2 - 30 mg/dL

Urine Analysis Urine tests are typically evaluated with a reagent strip that is briefly dipped into your urine sample. The technician reads the colors of each test and compares them with a reference chart. These tests are semiquantitative; there can be some variation from one sample to another on how the tests are scored. PH

SPECIFIC GRAVITY (SG)

WHAT IT IS

This is a measure of acidity for your urine.

WHAT IT IS

This measures how dilute your urine is. Water would have a SG of 1.000. Most urine is around 1.010, but it can vary greatly depending on when you drank fluids last, or if you are dehydrated.

NORMAL RESULTS

4.6 â&#x20AC;&#x201C; 8

NORMAL RESULTS

1.0 - 1.030

WHAT A LOW NUMBER MAY MEAN

Diabetic ketoacidosis, diarrhea, starvation

WHAT A LOW NUMBER MAY MEAN

Excessive fluid intake, diabetes insipidus, kidney failure, renal tubular necrosis, severe kidney infection (pyelonephritis), aldosteronism (very rare)

WHAT A HIGH NUMBER MAY MEAN

Gastric suction, kidney failure, kidney tubular acidosis, urinary tract infection, vomiting

WHAT A HIGH NUMBER MAY MEAN

Dehydration, Diarrhea that causes dehydration, Glucosuria, Heart failure (related to decreased blood flow to the kidneys), Renal arterial stenosis, Shock, Syndrome of inappropriate antidiuretic hormone secretion (SIADH), Addison's disease (rare)

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LAB TESTS

GLUCOSE

PROTEIN

WHAT IT IS

The glucose urine test measures the amount of sugar (glucose) in a urine sample. The presence of glucose in the urine is called glycosuria or glucosuria.

WHAT IT IS

It measures the amount of proteins, such as albumin, found in a urine sample. Normally there is no protein detectable on a urinalysis strip. Protein can indicate kidney damage, blood in the urine, or an infection. Up to 10% of children can have protein in their urine. Certain diseases require the use of a special, more sensitive (and more expensive) test for protein called a microalbumin test. A microalbumin test is very useful in screening for early damage to the kidneys from diabetes, for instance.

NORMAL RESULTS

0 - 0.8 mmol/l (0 - 15 mg/dL)

NORMAL RESULTS

For a random urine sample, the normal values are approximately 0 to 8 mg/dL. For a 24-hour urine collection, the normal value is less than 80 mg per 24 hours.

WHAT A LOW NUMBER MAY MEAN

Glucose is not usually found in urine. If it is, further testing is needed.

WHAT A LOW NUMBER MAY MEAN

WHAT A HIGH NUMBER MAY MEAN

Diabetes, renal glycosuria, gestational diabetes

WHAT A HIGH NUMBER MAY MEAN

Small increases in urine protein levels are usually not a cause for concern. However, larger amounts of protein in the urine may be due to: Amyloidosis, bladder tumor, congestive heart failure, dehydration, diabetic nephropathy, glomerulonephritis, goodpasture syndrome, heavy metal poisoning, kidney-damaging drugs (nephrotoxic drugs), polycystic kidney disease, preeclampsia, systemic lupus erythematosus, urinary tract infection.

BLOOD WHAT IT IS

Normally there is no blood in the urine. Blood can indicate an infection, kidney stones, trauma, or bleeding from a bladder or kidney tumor. The technician may indicate whether it is hemolyzed (dissolved blood) or non-hemolyzed (intact red blood cells). Rarely, muscle injury can cause myoglobin to appear in the urine which also causes the reagent pad to falsely indicate blood.

BILIRUBIN WHAT IT IS

Normally there is no bilirubin or urobilinogen in the urine. These are pigments that are cleared by the liver. In liver or gallbladder disease they may appear in the urine as well.

NITRATE WHAT IT IS

Normally negative, this usually indicates a urinary tract infection.

LEUKOCYTE ESTERASE WHAT IT IS

Normally negative. Leukocytes are the white blood cells (or pus cells). White blood cells in the urine suggest a urinary tract infection. SEDIMENT WHAT IT IS

Here the lab tech looks under a microscope at a portion of your urine that has been spun in a centrifuge. Items such as mucous and squamous cells are commonly seen. Abnormal findings would include more than 0-2 red blood cells, more than 0-2 white blood cells, crystals, casts, renal tubular cells, yeast or bacteria. (Bacteria can be present if there was contamination at the time of collection). Squamous cells may indicate contamination by skin cells if the specimen was not collected carefully.

The Medical Supplement 2013

HEALTH QUIZ

What's Your Potential Age? This quiz is based on the latest research done by a professor, who studies centenarians (people who've lived to 100 and beyond) at Boston University. You can now calculate your potential age in a fun way. Here's how it works: Start with the number 89, and add or subtract the values given to your corresponding answers. (Don't worry, some questions have more than one right answer). When you're finished, you'll be left with your prospective age. Long live a healthy, happy you!

Q1) When you are stressed, how do you handle it? 1) Very well 2) Pretty well 3) Not so well Chronic stress can shave years off your life, but your outlook matters, too. Hopefully you answered "Very well" OR "Pretty well." If you answered Very well: Do nothing If you answered Pretty well: Do nothing If you answered Not so well: Subtract 5

Q2) How often do you do things that keep your brain sharp, like learning a language, playing chess, or solving crosswords? 1) Couple times a week 2) Once a week / once a month 3) Rarely or never Doing challenging things lays down new pathways in your brain, which may help prevent cognitive problems. If you answered Couple times/week: Add 5 If you answered Once a week / once a month: Add 2 If you answered Rarely or never: Do nothing

Q3) Do you spend time with friends on a regular basis? 1) Yes, with many 2) Yes, with some 3) No 68

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An active social life is a key stress-reducing ingredient. And, remember, less stress means more years clocked for you. If you answered Yes; with many: Add 5 If you answered Yes; with some: Add 2 If you answered No: Do nothing

Q4) Have any of your parents, grandparents, aunts, or uncles lived to be 97 or older? 1) Yes 2) No 3) I don’t know Those with relatives who lived to a ripe old age are more likely to live longer. But a less-than-perfect family history doesn’t doom you to a short life. If you answered Yes: Add 10 If you answered No: Do nothing If you answered I don't know: Do nothing

Q5) Do you have a parent, brother, or sister with a history of heart attack or diabetes? 1) Yes 2) No 3) I don’t know Good health habits can lower your risk for conditions that can have a genetic component, such as heart disease, breast cancer, and more. If you answered Yes: Subtract 3 If you answered No: Do nothing If you answered I don't know: Do nothing

Q6) How much do you exercise? 1) 30min, 5 times a week 2) Some, about 2 times a week 3) Rarely or never Exercise strengthens your heart, builds bone, and helps preserve muscle mass and balance, all of which are important for staying well long-term. If you answered 30min, 5 times a week: Do nothing If you answered Some, about 2 times a week: Subtract 2 If you answered Rarely or never: Subtract 5

Q7) Are you at a healthy weight? 1) Yes 2) Pretty close 3) No Experts say not gaining weight is one of the most important factors in aging. Hopefully you answered "Yes" OR "Pretty close." If you answered Yes: Do nothing If you answered Pretty close: Do nothing If you answered No: Subtract 8

Q8) Do you smoke? 1) Yes 2) No This is a pretty obvious one. You've heard it all before: If you smoke, quit. If you answered Yes: Subtract 15 If you answered No: Do nothing

HEALTH QUIZ

Q9) Do you floss your teeth? 1) Everyday 2) Occasionally 3) No Bacteria that collects in your gums may also build up in the fatty deposits that can clog your coronary arteries. If you answered Every day: Do nothing If you answered Occasionally: Subtract 3 If you answered No: Subtract 3

Q10) How often do you eat red meat? 1) 4 times a week or more 2) 2 – 3 times a week 3) Once a week or never

Fat from animals (with the exception of fish) is mostly saturated, which contributes to heart disease. Choose omega-3-loaded salmon instead to help prevent hypertension and diabetes. If you answered 4 times a week or more: Subtract 5 If you answered 2 – 3 times a week: Subtract 5 If you answered Once a week or never: Do nothing

Q11) Do you have a primary care doctor you trust whom you've seen in the last year? 1) Yes 2) Only my gynecologist 3) No

Regular visits to your doctor's office could save your life, especially if it means catching a disease early. If you answered Yes: Do nothing If you answered only my gynecologist: Subtract 2 If you answered No: Subtract 2

Q12) How would you describe your sleep? 1) Great 2) Could be better 3)Not so great There’s no magic number for how many hours you should be sleeping, doctors say "The question is, do you feel well rested with the amount of sleep you get?" If you answered Great: Do nothing If you answered Could be better: Subtract 2 If you answered Not so great: Subtract 2

The Medical Supplement 2013

THE HOT LIST IFTARS DIRECTORY

Emergency Phone Number of Police, Ambulance and Fire Services 112 HOSPITALS Sabah Hospital Amiri Hospital Maternity Hospital Mubarak Al-Kabir Hospital Chest Hospital Farwaniya Hospital Adan Hospital Ibn Sina Hospital Al-Razi Hospital Physiotherapy Hospital

CLINCS 24812000 22450005 24843100 25312700 24849400 24892010 23940620 24840300 24846000 24874330/9

PHARMACIES 23915883 23726558 22436184 24734000 22625999 25340559 25721264 25726265

Sama Safwan Danat Al-Sultan Ahlam New Shifa Ikhlas Ghadeer Ibn Al-Nafis Tariq

CLINCS Rawda Adaliya Khaldiya Kaifan Shamiya Shuwaikh Abdullah Salem Nuzha Industrial Shuwaikh Qadsiya Dasmah Bneid Al-Gar Shaab Qibla 70

www.citypageskuwait.com

22517733 22517144 24848075 24849807 24848913 24814507 22549134 22526804 24814764 22515088 22532265 22531908 22518752 22459381

25746401 25316254 25623444 25388462 25381200 22630786 24770319 24575755 24772608 24775066 24775992 24311795 24884079 24892674 24719048 24710044 23900322

Salmiya Jabriya Maidan Hawally Bayan Mishref W Hawally Jahra New Jahra West Jahra South Jahra North Jahra North Jleeb Ardhiya Firdous Omariya N Khaitan Fintas

PRIVATE Asnan Tower (Dental Center) Dr. Adel Quttainah Clinic (Cosmetic Surgery Clinic) Noor Clinic Yiaco Apllo Medical Center Boushahri Specialized Polyclinic Taiba Hospital Diet Center Images Diagnostic Center Al Seef Hospital Beverly Hills Medical Center Dar Al Shifa Hospital New Mowasat Hospital Al Omooma Hospital

25736666 25625030 23845951/ 2 / 3 /4/5 22275916 / 22275910 1888877 1808088 24918901 - 02 22269300 1881122 22289999 1802555 25726666

THE HOT LIST DIRECTORY IFTARS