SCOPH
TIMES For the times we live in.
COL OR B L I N D N E A S S
lot of things don’t have meaning until there’s some basis of comparison. When you’re a kid, your world is just your world, and you don’t know it’s different from anyone else’s until that’s pointed out to you. When I was a kid, people pointed to red and called it red, so I called it red; but what I
was seeing wasn’t the red they saw at all. It took me a long time to understand what it meant to be color-blind. All I knew then was it felt like a dark shadow following me around, and I just wanted it to go away. The eye is a sphere of 24mm in diameter which is formed of 3 layers:
Outer coat, Middle coat, Inner coat. The retina (Inner coat) is the neuro-sensitive layer which translates the photon energy of the light into electrical impulses , so that the brain can understand it and tell us what are we looking at.
The retina consists of 10 layers , one of them is the photoreceptor layer which contains the photoreceptors.
What is a photoreceptor ?
It’s a specialized type of neural cell which responds to light and is able of visual photo-transduction ( conversion of light into electrical signals ).There are two types of photoreceptors found in the eye. Read more page 8
Standing Committee on Public Health [SCOPH] is a forum for medical students who work together to improve public awareness concerning public health issues. By tackling unhealthy lifestyles and by creating knowledge about community diseases, we try to improve the Public Health in Egypt. We achieve this by organizing projects, awareness campaigns and conferences. Our mission is to offer Egypt’s future physicians a comprehensive introduction to public health issues, who will in turn improve public health awareness. We are dedicated to try to influence the public health status in Egypt.
SCOPH
NEWSPAPER TEAM 2018-2019
Hamdy Shaheen Local Public Health Officer
Esraa Malek Designer and Editor
Esraa Alaa LPO Assistant Ahmed Dorrah Newspaper Coordinator
Mohamed Nabhan Writing and Research
Nirmeen Sha'arawy Proofreading
Ahmed Hamdy writing and Research
Merna Awaad Writing and Research
Mohamed Osama Writing and Research
Abdelatif Nader Writing and Research
Spring Edition
April 2019
SCOPH Times
Get Your Blood Pressure Under Control !
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood, this is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls, this is called diastolic pressure.
How do I know if my blood pressure is high? High blood pressure usually has no symptoms. So the only way to find out if you have high blood pressure is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. For most adults, blood pressure readings will be in one of four categories: Normal blood pressure means •Your systolic pressure is less than 120 AND •Your diastolic pressure is less than 80 Prehypertension means •Your systolic pressure is between 120-139 OR •Your diastolic pressure is between 80-89 Stage 1 high blood pressure means
Most of the time, there are no symptoms. For most people, high blood pressure is found when they visit their health care provider or have it checked elsewhere.
“People with high blood pressure, diabetes - those are conditions brought about by life style. If you change the life style, those conditions will leave” Dick Gregory Stage 2 high blood pressure means • Your systolic pressure is 160 or higher OR •Your diastolic pressure is 100 or higher
For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and gender. People with diabetes or chronic kidney disease should keep their blood pressure below 130/80.
SO what caused your High BP ?!
Many factors can affect blood pressure, •Your systolic pressure including: is between 140-159 OR •The amount of •Your diastolic pressure water and salt you have in your body is between 90-99 -3-
•The condition of your kidneys, nervous system, or blood vessels •Your hormone levels You are more likely to be told your blood pressure is too high as you get older. This is because your blood vessels become stiffer as you age. When that happens, your blood pressure goes up. High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney disease, or Any early death.
symptoms to be aware of ?
Most of the time, there are no symptoms. For most people, high blood pressure is found when they visit their health care provider or have it checked elsewhere.
Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure. Malignant hypertension is a dangerous form of very high blood pressure. Symptoms may include: •Severe headache •Nausea and vomiting •Confusion •Vision changes •Nose bleeding
Why do I need to worry about prehypertension and high blood pressure?
prehypertension means you're likely to end up with high blood pressure, unless you take steps to prevent it.When your blood pressure stays high over time, it causes the heart to pump harder and work overtime, possibly leading to serious health problems such as heart attack, stroke, heart failure, and kidney failure.
Spring Edition
April 2019
Seasonal Allergies
Who is at risk for high blood pressure?
Anyone can develop high blood pressure, but there are certain factors that can increase your risk: •Age - Blood pressure tends to rise with age. •Race/Ethnicity - High blood pressure is more common in African American adults. •Weight - People who are overweight or have obesity are more likely to develop prehypertension or high blood pressure. •Gender - Before age 55, men are more likely than women to develop high blood pressure. After age 55, women are more likely than men to develop it. •Lifestyle - Certain lifestyle habits can raise your risk for high blood pressure, such as eating too much sodium or not enough potassium, lack of exercise, drinking too much alcohol, and smoking. •Family history - A family history of high blood pressure raises the risk of developing prehypertension or high blood pressure.
How can I prevent high blood pressure?
You can help prevent high blood pressure by having a healthy lifestyle, This means: •Eating a healthy diet - Limit the amount of sodium (salt) that you eat, and increase the amount of potassium in your diet. It is also important to eat foods that are lower in fat, as well as plenty of fruits, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure. •Getting regular exercise - Exercise can help you maintain a healthy weight and lower your blood pressure. You should try to get moderate-intensity aerobic exercise at least 2 and a half hours per week, or vigorous-intensity aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats harder and you use more oxygen than usual. •Being at a healthy weight - Being overweight or having obesity increases your risk for high blood pressure. •Not smoking - Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, talk to your health care provider for help in finding the best way for you to quit. •Managing stress - Learning how to relax and manage stress can improve your emotional and physical health and lower high blood pressure. Stress management techniques include exercising, listening to music, focusing on something calm or peaceful, and meditating.
references
-https://medlineplus.gov/highbloodpressure.html
Don’t miss the chance to Visit our Facebook Page to learn more about MMSA and Our Activities and Campaigns! MUST Medical Students' Association (MMSA)
The Butter Fly effect
Our most watched video on Facebook Credit to SCORA Presented by Miss. Arwa Elbagdady Under the supervision of Miss. Rawan Elbagdady
SCOPH Times
Allergic reactions occur when the body wrongly defends itself against something that is not dangerous. A healthy immune system defends against invading bacteria and viruses. During allergic reactions, however, the immune system fights harmless materials, such as pollen or mold, by producing a special class of antibody called immunoglobulin E (IgE).
Protecting yourself •Keep windows in your home and car closed to lower exposure to pollen. •Keep cool with air conditioners. •Don't use window or attic fans. •Dry your clothes and avoid collecting pollen on them. •Have someone else mow your lawn.If you mow, wear a mask.
Weed Pollen
Tree Pollen
You’ll be most affected by weed pollen on dry, hot, windy days when these airborne particles are at their worst.Weed pollen is abundant from late summer to early fall. Mid-September, when pollen levels peak, is particularly bad.Ragweed is the biggest troublemaker of all weeds. A single plant can produce a million grains of pollen every day.
Trees produce pollen earliest, as soon as January in the South, and as late as May and June in the Northeast. They release huge amounts that can be distributed miles away. Fewer than 100 kinds of trees cause allergies. The most common tree allergy is against oak, but others include elm, hickory, sycamore, and walnut.
Protecting yourself •Remove brush and weeds from your property. •Learn when pollen counts are highest in your area. •Keep windows in your home and car closed to lower exposure to pollen. •Keep cool with air conditioners. Don't use window or attic fans. •Dry your clothes and avoid collecting pollen on them.
Protecting yourself •Follow the same protective strategies relatedto time of day, closed windows, and clothes dryers noted in "Protecting yourself" under Grass Pollen, above. •Plant species that do not aggravate allergies, include cottonwood, maple, palm, poplar, or willow trees.
Grass Pollen Grass pollens are regional as well as seasonal. Their levels also are affected by temperature,time of day. Lots of people are allergic to the pollen that comes from grasses. It brings on symptoms like a runny or stuffy nose, itchy eyes, and a cough.There are hundreds of types of grasses. The kinds that often trigger allergies include: Grasses tend to start growing in the early spring.In the late spring and early summer, they releasepollen into the air. The wind can carry it for miles. You may not see it in the air. But if you're allergic, your body may react even to small amounts.
Be Smart Treat respiratory allergy with antihistamines, topical nasal steroids, cromolyn sodium, decongestants, or immunotherapy. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
references
-Webmd -Zyrtec -NIH Medline -Dannemiller Healthcare Education
Miss Rawan Elbagdady, Your dedication to giving MMSA a Visual Print has been invaluable. We want to express our appreciation for all you have done in our behalf. Your efforts in organizing SCORA committee is impressive. Also we value your willingness to participate in SCOPH workshops and Campaigns. We hope you will accept these words of gratitude and that you will continue to bevoice for good in MMSA.
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special thanks to SCORA TRIO : Miss. Arwa El Boghdady Miss. Naira waheeb Miss. Nadia Khalid
Spring Edition
April 2019
SCOPH Times
Getting a Kidney Transplant
According to the latest WHO data published in 2017 Kidney Disease Deaths in Egypt reached 20,433 or 3.98% of total deaths. The age adjusted Death Rate is 32.88 per 100,000 of population ranks Egypt #20 in the world. A study included 1109 patients, that is, 71% of the total number of end-stage renal disease (ESRD) patient in Assiut governorate during the year 2014 indicated that the prevalence rate of ESRD was 366 per million populations. Unknown etiology and hypertension are the major known causes of ESRD. The majority of patients underwent dialysis three times per week. Your kidneys are two bean-shaped organs that filter out waste and extra water, make hormones, and do other important things to keep you healthy. They are located on either side of your spine and are each about the size of your fist.
their ability to function—less than 15 percent of normal kidney function.
Can a transplant help?
What causes kidney failure?
Diabetes and high blood pressure are the main causes of chronic kidney disease, which is the gradual loss of kidney function. Other conditions that affect the kidneys include autoimmune diseases like lupus and inherited diseases like polycystic kidney disease. Some people live with kidney disease for years, others quickly progress to kidney failure. Kidney failure means that your kidneys have lost most of their ability to function—less than 15 percent of normal kidney function. Medication and other methods of managing kidney disease help some people maintain kidney function for years. Others progress quickly to kidney failure. Dialysis and kidney transplants are two treatments used to replace failing kidneys. Dialysis takes the place of your kidneys by helping remove waste and water from your blood, but doesn’t fully replace everything your kidneys normally do. Kidney failure means that your kidneys have lost most of -5-
When your kidneys have failed, a transplant may also be a good option. Compared to dialysis, a working transplanted kidney does a better job of filtering waste, replacing your failed kidneys, and keeping you healthy. However, a kidney transplant isn’t for everyone. Anyone interested in a kidney transplant should be evaluated by a transplant center, as some people may not be healthy enough for transplant surgery. While a transplant is a good treatment for kidney failure, it’s not a cure. You need to take medicines daily so your body doesn’t reject the new kidney. You also need to see your health care professional regularly. Getting a transplant Your health care professional will refer you to a transplant center for tests to see if you’re healthy enough to receive a transplant. Living donors, such as family or friends, need to be tested to make sure they’re healthy enough to donate a kidney. If you have a living donor, don’t worry about being a perfect “match.” Today, innovations such as kidney exchanges allow transplant surgeons to get around incompatibilities and make many living donor transplants possible. If you don’t have a living donor, you’ll be placed on a waiting list to receive a kidney. You’ll have regular blood tests while you wait for a kidney. The center must have a recent sample of your blood to match with any kidney that becomes available. As soon as a kidney is available, you must go to the hospital to have your transplant. Donated organs need to be used in a specific amount of time or they may not be usable.
Spring Edition
Ever thought how the Surgery is done ! Dear
April 2019 After surgery
Many people report feeling better right after having transplant surgery. For others, it takes a few days for the new kidney to start working. You will probably need to stay in the hospital for several days to recover from surgery maybe longer if you have any problems. You’ll have regular follow-up visits after leaving the hospital. If you have a living donor, the donor will probably also stay in the hospital for a couple of days, although probably less time than you will.
medical students, BUCKLE UP!
How do I prepare for a kidney transplant?
Extensive testing must be done before you can be placed on the transplant list. A transplant team carries out the evaluation process for a kidney. The team includes a transplant surgeon, a transplant nephrologist (healthcare provider specializing in the treatment of the kidneys), one or more transplant nurses, a social worker, and a psychiatrist or psychologist. Other team members may include a dietitian, a chaplain, and/or an anesthesiologist. The evaluation includes: •Mental health evaluation. Psychological and social issues involved in organ transplantation, such as stress, financial issues, and support by family and/or significant others are assessed. These issues can greatly affect the outcome of a transplant. The same kind of evaluation is done for a living donor. •Blood tests. Blood tests are done to help find a good donor match, to check your priority on the donor list, and to help the chances that the donor organ will not be rejected. •Diagnostic tests. Diagnostic tests may be done to check your kidneys as well as your overall health status. These tests may include X-rays, ultrasound, kidney biopsy, and dental exams. Women may get a Pap test, gynecology evaluation, and a mammogram. The transplant team will weigh all the facts from interviews, your medical history, physical exam, and tests to determine your eligibility for kidney transplantation. Once you have been accepted as a transplant candidate, you will be placed on the list. When a donor organ becomes available, you will be notified and told to come to the hospital right away. If you are to get a kidney from a living family member (living-related transplant), the transplant may be done at a planned time. The donor must have a compatible blood type and be in good health. A mental health check will be done to be sure the donor is comfortable with the decision. These steps will happen before the transplant: •Your transplant team will explain the procedure to you and you can ask questions. •You will be asked to sign a consent form that gives your permission to do the surgery. Read the form carefully and ask questions if something is not clear. •If you have been on routine dialysis before the procedure, you will get dialysis before the procedure. •For a planned living transplant, you should fast for 8 hours before the operation, generally after midnight. In the case of a cadaver organ transplant, you should start to fast once you are told a kidney has become available. •You may get a sedative before the procedure to help you relax. •Based on your medical condition, your transplant team may ask for other specific preparation.
SCOPH Times
Transplant rejection
Transplant rejection often begins before you feel any symptoms. Rejection occurs when the immune system attacks the “foreign” transplanted kidney. The routine blood tests that you have at the transplant center will reveal early signs of rejection. You may develop high blood pressure or notice swelling because your kidney isn’t getting rid of extra salt and fluid in your body. If you think you may have transplant rejection, contact your health care professional immediately. Rejection can often be treated, but only if it is detected early. Your health care professional will treat early signs of rejection by adjusting your medicines to help keep your body from rejecting your new kidney. Rejection does not necessarily mean you will lose your transplant. Additionally, when you’re taking anti-rejection medicines, you’re at a greater risk for infection. Anti-rejection medicines can dull symptoms of problems such as infection. Call your transplant center right away if you aren’t feeling well or have: a fever of more than 100 degrees, drainage from your surgical scar, burning when you pass urine, a cold or cough that won’t go away.
What happens during a kidney transplant?
A kidney transplant requires a stay in a hospital. Procedures may vary depending on your condition and your healthcare provider's practices. Generally, a kidney transplant follows this process: •You will remove your clothing and put on a hospital gown. •An intravenous (IV) line will be started in your arm or hand. More catheters may be put in your neck and wrist to monitor the status of your heart and blood pressure, and to take blood samples. Other sites for catheters include under the collarbone area and the groin blood vessels. •If there is too much hair at the surgical site, it may be shaved off. •A urinary catheter will be inserted into your bladder. •You will be positioned on the operating table, lying on your back. -6-
•Kidney transplant surgery will be done while you are asleep under general anesthesia. A tube will be inserted through your mouth into your lungs. The tube will be attached to a ventilator that will breathe for you during the procedure. •The anesthesiologist will closely watch your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. •The skin over the surgical site will be cleansed with an antiseptic solution. •The healthcare provider will make a long incision into the lower abdomen on one side. The healthcare provider will visually inspect the donor kidney before implanting it. •The donor kidney will be placed into the belly. A left donor kidney will be implanted on your right side; a right donor kidney will be implanted on your left side. This allows the ureter to be accessed easily for connection to your bladder.
Reference:
-World life expectancy series of Education. .Study of prevalence of end-stage renal disease in Assiut governorate, upper Egypt. .Menoufia Medical Journal. -The Egyptian Journal of Internal Medicine. -National institution of medical health. .Johns Hopkins Medicine.
Spring Edition
April 2019
SCOPH Times
Research Highlights of 2018 Testing an Artificial Pancreas for Type 1 Diabetes: A new artificial pancreas system can control blood sugar in adults with type 1 diabetes better than conventional insulin pump therapy. The artificial pancreas system uses a continuous blood glucose monitor (CGM) and a smartphone app that wirelessly connects to a pump delivering insulin or glucagon based on input from the CGM.The app regulates the pump, which pushes the insulin or glucagon into the body through a thin tube. Currently, people with type 1 diabetes adjust their insulin based on carbohydrate counting and careful monitoring of blood sugar.
Smart contact lenses can monitor blood glucose in people with diabetes: One of the frustrating components of living with diabetes is the finger pricking or burdensome monitors necessary to consistently track blood glucose levels. In an attempt to reduce the inconvenience for diabetes patients, a team of researchers at the Ulsan National Institute of Science and Technology in South Korea developed a new contact lens capable of detecting glucose levels in patients with diabetes. According to the press release, the smart lens has built-in pliable, transparent electronics that use tears to monitor glucose levels. "These smart contact lenses are made of transparent nanomaterials and therefore do not obstruct the wearer's view," said Jihun Park in the Combined M.S./Ph.D. of Materials Science and Engineering, the first author of the study. "Besides, because the system uses a wireless antenna to read sensor information, no separate power source, like battery is required for the smart contact lens sensors." So far, the lenses have only been tested on live rabbits, not humans.
Deep brain stimulation (DBS) presents a breakthrough for patients paralyzed from a stroke: A tragic component of strokes is their potential to leave their victims paralyzed. Cleveland Clinic researchers sought to address this problem using deep brain stimulation (DBS). Andre Machado, MD, Ph.D., and Kenneth Baker, Ph.D. tested DBS on a 59-year-old woman who experienced hemiparesis after having an ischemic stroke. The researchers saw significant improvement in her motor functions five months after she had a DBS electrode surgically implanted in her cerebellum. In May the team was awarded $2.2 million from the National Institutes of Health to further research the benefits of DBS in stroke patients. "If this research succeeds, it will offer new hope for patients who have suffered a stroke and remained paralyzed," said Machado. "It's an opportunity to allow patients to rehabilitate and gain function — and thereby gain independence."
Reference: -www.thisisinsider.com -www.sciencedaily.com -www.time.com
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Spring Edition
April 2019
SCOPH Times People with normal color vision are known as trichromats. People with ‘faulty’ trichromatic vision will be color blind to some extent and are known as anomalous trichromats. In people with this condition all of their three cone types are used to perceive light colors but one type of cone perceives light slightly out of alignment, so that there are three different types of effect produced depending upon which cone type is ‘faulty’. The different anomalous conditions are •protanomaly, which is a reduced sensitivity to red light •deuteranomaly which is a reduced sensitivity to green light and is the most common form of color blindness •tritanomaly which is a reduced sensitivity to blue light and is extremely rare. The effects of anomalous trichromatic vision can range from almost normal color perception to almost total absence of perception of the ‘faulty’ color.
Rods
•Their number in each eye is about 120 millions . •They are present mainly at the peripheral part of the retina •They contain a photo-pigment called “rhodopsin” , thus the rods are very sensitive to light even to a single photon of light •They are responsible of the Night vision.
Cones
•Their number in each eye is about 6 millions . •They are present mainly at the fovea ( central part of the retina ) •They have much less sensitivity to light than rods but they contain three types of pigments , each is sensitive to a primary color , thus the cones are responsible for the color vision •They are responsible for the Day vision. Color vision is the ability of the visual system to distinguish different wavelengths of light and interpret them as the usual colors we know. This is explained by Young-Helmholtz theory of color vision this theory depends on the
presence of three different types of cones each type contains a photopigment that is maximally sensitive to light of the wavelength of one of the three primary colors (red-green-blue) •Blue-sensitive Cones : contains a pigment that is sensitive to the blue – violet part of the spectrum ( maximally at 445 nm ) •Green-sensitive Cones : contains a pigment that is sensitive to the green part of the spectrum ( maximally at 535 nm ) •Red-sensitive Cones : contains a pigment that is sensitive to the yellow-orange part of the spectrum ( maximally at 565 nm ) So the ability to distinguish more than different 100 colors is based on the fact that each color has a certain wavelength and can stimulate the different types of Cones unequally, for example: light of wavelength 580 nm is orange . It stimulates the red cones by intensity 99% , green ones by 42% and blue ones by 0% So, the signal is interpreted as this is the orange color. -8-
People with deuteranomaly and protanomaly are collectively known as red-green color blind and they generally have difficulty distinguishing between reds, greens, browns and oranges. They also commonly confuse different types of blue and purple hues. People with reduced blue sensitivity have difficulty identifying differences between blue and yellow, violet and red and blue and green
Color Anopia :
It’s the complete loss of function of one or more types of cones . So the patient may be : •Dichromat : having only 2 types of cones , so patients might have -Protanopia -Deuteranopia -Tritanopia •Monochromat : having only one type of cones
References: -Guyton and Hall Textbook of Medical Physiology -www.colourblindawareness.org