Whitecoats July 2014 by Sameer Kermalli

Tanzania 1000Tshs | Kenya 50Kshs| Uganda 2000Ushs WHITE COATS | A JAMSA PUBLICATION | JULY 2014

WHITE COATS

July 2014 | Ramadhan 1437 AH | Issue 15 - Medicine Yesterday, Today And Tomorrow

TANZANIA ROAD HAULAGE (1980) LTD & Group of Companies

COPPER HANDLING

TRANSPORT

INLAND CONTAINER DEPOT

OCEANAIR FREIGHT

ICD

Nelson Mandela Express Way, P. O. Box 21493, Dar es Salaam, Tanzania Telephone: +255 22 213 3666, +255 22 211 8327, +255 22 2850 980 +255 22 2851 980, +255 22 2850 298, +255 22 2850 973 Fax: +255 22 2113 358, +255 22 2112 585 Email: info@trhtz.com Website: www.trhtz.com

Editorial

Standing from left: Maisam Dossa, Mohamedhussein Rashid Sitting from left: Zainab Alimohamed, Naheeda Nasser, Sakina Nagri

“It always seems impossible until it’s done”. ~ Nelson Mandela. We proudly put forward to you yet another Whitecoats edition. Editing this magazine was no doubt a thrilling ride, it had its ups and downs ofcourse. We have so much to write about after this experience, but the most essential would be to highlight our aims, this edition we wanted to offer something new to our readers which we tried to do by adding various new exciting sections thus trying to make it more “youth friendly”. Our theme “medicine yesterday, today and tomorrow”, aims to shade light on how dynamic medicine is, how it has progressed over the years and will keep doing so. Penning down, we would fall short if we didn’t thank the people who worked tirelessly behind the scenes making this magazine a reality, first and foremost, the dedicated editorial team members under the JAMSA flag, our dear sponsors who have been constantly giving us their support, Central Medical Board, Sheikh Saqlain, Patron Dr.Kamal and Dr.Amira Baliram for their extremely valued time towards this magazine. Brother Sameer Kermalli for his brilliant work with designing and lastly Jamana for turning our hardwork into this hardcopy.

never have the confidence and strength to take up this project. Your constant support was invaluable to drive us to do better and more. Our hope is that if you have learnt just one new thing and implement that into making your and lives of others around you better, then we will consider our job well done. Happy reading! CO-EDITORS, Mohamedhussein Rashid Naheeda Nasser. Issue No. 15 Ramadhan 1437 A.H | July 2014 A publication of JAMSA Editorial Team Editors: Mohamedhussein Rashid Naheeda Nasser Members Maisam Dossa Sakina Nagri Zainab Z. Alimohamed

Our parents, without your encouraging words, we would

Design and Layout Sameer Kermalli

For Letters to the Editor, Comments, Article References, Suggestions and Reviews, please send us an email on jamsaawhitecoats@gmail.com

White Coats is a non-profit magazine and printing costs are financed through advertising.

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

What is inside

Contents 4

Editors Note

........................................................................ 1

JAMSA Presidents Note ........................................................................ 3

The Mighty Mind

Lujaina Hasanali............................................4

The Power of Sleep

Aliasgar Khaki................................................6

The Silent Killer

Shaneabbas Jaffer.........................................7

Stroke Happens

Zohra Damji....................................................9

Interviews YTT

......................................................................12

Golden Har Syndrome

Sharmeen Merali..........................................14

FAQs

Dr. Imran Hassam........................................17

Mental Health

Arzoo Khalfan...............................................19

OT Experiences

Sakina Bhimani and Fatema Somji.............20

Depression

Sayyada Versi..............................................22

Rumination

Sayyeda Sachedina.....................................24

Self Esteem

Sakina Moloo...............................................25

Healthy Living

Zainab Alimohamed.....................................26

Swimming

......................................................................27

Dental Caries

Ahmed Chagani............................................28

Oral Health

Sukaina Khimji.............................................30

Self Medicating

Abbas Sachedina.........................................31

Did you know?

Sanjida Rashid.............................................32

JAMSA Presidents Note

From the bigger desk

By Aliasgar Bashir Khaki

from left: Zohra Khalfan, Sanjida Rashid, Fatma Alloo, Abbas Sachedina, Alihussein Molloo, Aliasgar Bashir Khaki.

Asalaam Alaykum Ramadhan Kareem, It’s an absolute Honor to be designated as the Chairperson for the 2014 term of Jaffery Medical Students Association (JAMSA). I’m currently a third year medical student at the Hubert Kairuki Memorial University. JAMSA is a student-led organization and it’s been successively running for the past 14 years where it commenced with a few medical students having a vision to serve our community and today we are about 70 plus members from distinctive Medical Universities of Tanzania. The feeling of being able to give back to your community is virtuous and pleasing. Our activities run from educational seminars, annually Ramadhan screenings, team building activities and trainings into becoming better health practitioners. I was once told; “Your not judged by the amount of steps you take, but rather the footprint you leave behind”. Our vision is to create a platform in which medical students are united for the purpose of global health and are fully equipped with the knowledge, values and skills required into creating this world a healthier and safer place. A new initiative we have started to work on this year is termed Distant JAMSA, this will allow students from the Dar es Salaam Jamaat that are pursuing health science courses in different parts of the world to also

be active members and contribute to this network of ours. Some other plans for this year are:

• First aid training by professionals from the Tanzania Red Cross Society

• Educative seminars to primary and secondary • • •

schools students on various topics e.g. teen depression and drug abuse. Diabetes and hypertension research and screening in rural areas of Tanzania Fiqh sessions on various medical rulings pertaining to ISLAM Day out and team building activities to enhance communication between our members.

We would like to thank Dr. Kamaal Sheriff for his continuing support as our patron and the Dar es Salaam Jamaat for its support. We hope that we are able to achieve our long and short-term goals for this year’s term. On behalf of the entire JAMSA’s 2014 Executive Board, I would like to portray our gratitude towards the White Coats magazine team in putting their time and energy into making it a success, Asanteni Sana. It’s my hope that the support continues.

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

The Power House

THE MIGHTY MIND By Lujaina Hasanali

“One needs a mind, to mind, what’s in the mind” The mind is a treasure of wonders. It is a vast source of energy and power. It is a world of its own. A world of possibilities.

Meditate. Meditation is easier said than done. But if you could include it in your daily routine and practice it diligently, it would go a long way in giving you a better memory and – overall – a better brain

Scientists continue to invest the powers of their minds to decipher the capabilities of “the mind”, yet to fully acknowledge and realise it, is a goal surreal. However they made a few documented discoveries. Beyond the 5th sense In the 1930’s, J.B. Rhine a researcher at Duke’s university, configured several lab tests to evaluate the existence of ESP (Extrasensory perception) and deciphered the ability to detect the thoughts and feelings of others to be “THE 6TH SENSE”. What are you waiting for, unleash the psyche within YOU Opt for optimism “Worry is a misuse of the imagination”-Dan Zadra. Always try being in your positive light, for worrying solves no problems, but is a stepping stone for many more adversities. Latest analysis of various studies concluded that a rosy view of yourself boosts healing processes, hampers your cardiovascular responses to stress and lowers your baseline cortisol levels. So, is your head charging up, with those plus signs? (Journal of Personality and Social Psychology, vol 85, p 605) Make your TO-DO list, your secret Derek Sivers explains that psychological tests have

proven that “telling your goals” draws away the motivation to realise that goal. Social gratification, tricks the mind to believe that the goal has already been accomplished. So next time, walk your thought; don’t talk it!

Smile your troubles away The facial feedback hypothesis states that: The brain can’t distinguish between facial expressions representative of a true emotion or that which is conceptualized. Yup, that right! Enlighten your mood. Divorce those frown lines and embrace the crow feat on your eyes-sides. Allow the sparkle! Invert your pain A recent study at the oxford university demonstrated that when subjects looked at their wounds through the wrong end of the “inverted binoculars”, experienced less pain and decreased swelling as their wounds appeared less significant. The next time you get a paper cut, tell yourself, it’s too small to hurt. Believe “If you believe, a dream that you wish, will come true” ~ Walt Disney, Cinderella The key to driving your dreams to their destination is BELIEF. Believe so deeply that the gravity of your dream becomes the obsession of your mind. Believe to the point that you can deal with any distraction and obstruction. Your intense thoughts and belief when focused in this manner will create in the physical world exactly what you desire. Unleash the powers of your “wonder treasure” just BELIEVE!

RAC 3050 Designed for more powerful cooling

Double Virus Care

Eliminates the virus twice by Filter and Virus Doctor

Visualized Performance

More Wider, Faster and Stronger wind by Triangle shape

Smart Inverter

Reduce electricity bills by High Efficiency

Freedom Electronics | P. O. Box 20091, Harbour View Tower | Samora Avenue, Dar es Salaam | T: +255 22 2124760 / 2135713 | F: +255 22 2124759

POWER of SLEEP

Awake Time

By Aliasgar Bashir Khaki

The first most infuriating noise of the day we hear is ringing at 5am and, “What, its morning already? I just went to sleep” It intrudes us from the single most imperative behavioural experience. We spend 36% of life simply sleeping. Sleep is considered a very significant experience, however many of us take sleep very frivolously. In the past, people were always early to bed and early to rise, however as time went on, sleeping early became for the workless and a behaviour we rather tolerate. “Sleep is useless, it just takes up our time and we do absolutely nothing”. However its actually not, although we deem we are doing absolutely nothing, there are a lot of processes that take place, the brain is functioning and there are three main processes that take place. Firstly we begin to restore what we have lost during the day, it gives the opportunity for repair and growth. Tissue repair, protein synthesis, growth hormone released and muscle growth take place while we are asleep. Secondly it’s an opportunity for conservation of energy. Whilst asleep, our body’s energy requirement is reduced which allows for it to be stored and used during the day. Thirdly learning and memory go alongside with sleep. It is believed that after leaning a task you should sleep well and this will enhance your memory to recall better. If you’re sleep deprived then the ability to concentrate

optimally is decreased and therefore learning something new wont be an easy task. EDITOR’S TIP for students, staying up the entire night before an exam isn’t the best thing to do! “Sleep is casual, just get to bed and you’re asleep”. That’s a very good postulation, but we all know it’s not that easy. There are many reasons that make sleep an obstacle. Stressful life conditions, millions of deadlines, work, night shifts and Jet Lag, we end up sacrificing our night sleep to compensate for our time and whilst we’re awake consumption of caffeine, nicotine, and other drugs to prevent the eyelids from tumbling. How can we adopt better sleeping habits? Primarily learning efficient ways to manage stress and time will save us time working last minute. If stress is not managed then not only is sleep affected, but lower immunity, hypertension and diabetes are also part of the package. A study has shown that when you dim the lights and switch of your electronic gadgets at least half an hour before you want to go to sleep, it reduces alertness and allows you to fall asleep easier. “Am I getting enough sleep?” 8 hours of sleep may be too much for some or too little. It merely depends on you and how your body responds to it. Try judging your self; do you take long to get up? Are you told you look sleepy? Are you grumpy? Do you need coffee? If you answered No to all the questions then congratulations you passed the test and your not sleep deprived. Research is insinuating that mental disorders and sleep patterns have a strong link. Depression, schizophrenia and bipolar there is sleep disruption observed. In schizophrenia there are genes that are mutated and cause sleep disruption. Lack of sleep is the first alarming sign in mental illnesses. Its been proven that if sleep is improved upon for such patients then it will succour them with the disorders and live a healthier life. Some remarkable advantages of sleeping well are increase in creativity, social skills, healthier skin, better life style, better focus on work and longer life. Early to bed early to rise makes a man health, wealthy and wise.

Stick to the same bedtime and wake up time, even on the weekends. This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night

THE SILENT KILLER CAUGHT

Planning to Stroke

By Shaneabbas Jaffer

Salts Vs Blood pressure. Even if you don’t add salt to your food, you may still be eating too much. About three-quarters of the salt we eat is already in the food we buy, such as breakfast cereals, soups, breads and sauces. Eating too much salt can raise your blood pressure

Imagine a disease that works in the shadows. It creeps up inside of you, without giving you a tiny clue. It slowly progresses in the body then gradually destroys it. Before you know it you’re one of those already hit. A long dark road it slowly paves, it’s an assassin that puts many in their graves. The fact is: it’s misunderstood. Many times it’s just over looked. A Thriller that needs no mention. The silent Killer – Hypertension.

It was not until over four thousand years after that when one of the first direct measurements of blood pressure was made. As one of his backyard experiments, Stephen Hales used a measuring tube almost 10 feet long to measure how high the blood from a horse’s artery rose.

Hypertension or high blood pressure refers to the condition in which blood is pumped around the body at a very high a pressure.

Seeing that this method was not really practical for measuring blood pressure in humans, many scientists tried to find alternate ways of accomplishing the task. In 1896 Riva-Rocci developed a primitive tool which was a wrap-around cuff that occluded the artery of the upper arm. What made it easy to use was that it was noninvasive and made using commonly available objects such as a bicycle inner tubing, a copper pipe, some mercury and an ink well. This was the first portable device used to determine the systolic pressure in humans. The pressure was measured as the point at which the pulse reappeared as the cuff was slowly deflated.

Hypertension has been known to exist as early as 2600 B.C. when it was suspected to be the cause behind the thudding pulse of people. At that time a pounding pulse that could not be stopped by applying pressure was often treated with leeches or by making the person bleed.

The introduction of the Riva-Rocci Cuff into clinical medicine was accepted by some practitioners as a valuable aid to diagnosis. However, many were initially sceptical and held the view that by using the device they would only weaken their clinical judgment. The landmark breakthrough was made by Korotkoff

High blood pressure is often known as “the silent killer” among diseases. You may not realize that you have it until you are already very sick. In fact, one in three people who have it don’t know it. This is because in most cases it does not have any symptoms and the few times that it does, they are commonly attributed to a hectic day at work.

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

only a century ago when he described the sounds heard when a stethoscope was placed just below the point where Riva-Rocci felt for the pulse using the deflatable cuff. Korotkoff’s findings were the ones that initiated the clinical recording of blood pressure throughout the world. At that time, high blood pressure was considered to be an adaptive mechanism to provide blood supply to the vital organs when there was a problem in the kidney (White Hypertension) or the blood vessels (Red Hypertension) but the actual cause of hypertension was not known. In fact, specialists thought that if this blood pressure was lowered, it would do more damage than benefit.

including smoking, obesity, lack of physical activity, too much salt in the diet, stress, male gender and a family history of high blood pressure. On the other side, the harmful effects of hypertension are well known and we have various studies that link hypertension to conditions like stroke, heart attack, aortic aneurysm, kidney failure and damage to the eyes. Research has also shown that the lowering of blood pressure in hypertensive patients is indeed beneficial and defensive. We already have several drugs that are used in lowering blood pressure and research continues to excel in finding even better agents day by day.

In 1931, Dr. Paul Dudley White, an eminent Boston cardiologist wrote: “Hypertension may be an important compensatory mechanism which should not be tampered with, even if we were it certain that we could control it.”

To catch hypertension early in its course, the routine measurement of blood pressure was introduced in clinics. This helps physicians to try and protect the patient from developing the adverse sequelae of the disease.

Even today, the exact causes of high blood pressure are still not identified, but several risk factors and conditions are known to play a role in its development,

So, the next time when you have to wait to measure your BP before you get to see the doc, know that it is only beneficial for you!

• Globally, nearly one billion people have high blood pressure (hypertension); of these, twothirds are in developing countries.

• Hypertension is one of the most important causes of premature death worldwide and • • •

the problem is growing; in 2025, an estimated 1.56 billion adults will be living with hypertension. Hypertension is the leading cause of CVD worldwide. People with hypertension are more likely to develop complications of diabetes. High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people do not realize they have it; that is why it’s important to get blood pressure checked regularly.

Prevention is Key

BE STROKE SMART By Zohra Damji

Many people think stroke usually happens in elderly, but that is not true. This trend is changing, and the number of stroke cases is rising among young people. At Kilimanjaro Christian Medical Center (KCMC), stroke remains one of the top ten diseases in the internal medicine ward. Understanding stroke and its warning signs can save permanent brain damage, disability, and death.

down? S – Speech : Ask the person to repeat a simple sentence. Is the speech unintelligible or slurred? T – Time : In stroke, every second counts! The faster you treat a stroke, the less the risk of brain injury and disability. Other symptoms of stroke, that may occur, and are not in the FAST rule include: headache, vomiting, dizziness, sudden visual problems, loss of balance / coordination, sudden weakness and numbness, and sudden confusion. Symptoms of a stroke depend on which area of the brain is affected, and what functions in the body it controls.

A stroke is a ‘brain attack,’ like a heart attack. The blood in our body carries oxygen. Arteries are like pipes that carry blood to different parts of the body, including the brain. A stroke occurs when there is not enough blood and Stop smoking. Smoking doubles the oxygen supply to part of a brain, Anybody can have a stroke, but risk of stroke. It damages blood vessel therefore affecting the brain certain risk factors place you at walls, speeds up artery clogging, raises tissue involved. a higher risk. Non-modifiable blood pressure and makes the heart risk factors, which we cannot do work harder There are two types of stroke: much with, are age, gender, family ischemic and haemorrhagic. history, and ethnicity. Modifiable Ischemic strokes are more risk factors that we can control common, and they happen in approximately 80% of are smoking, poor diet, dehydration, obesity, and not the cases. Ischemic stroke occurs when there is a clot exercising enough. Treatable conditions that increase in the artery, blocking blood and oxygen supply to the your risk of stroke are hypertension (high blood brain. On the other hand, haemorrhagic stroke happens pressure), chronic stress, heart disease (including atrial when one of the arteries in the brain burst, spilling fibrillation and PFO – Patent Foramen Ovale), diabetes, blood around and / or in the brain tissue, leaving the and high blood cholesterol. All of these can be brain deprived of oxygen. If you suspect a stroke, it controlled by lifestyle changes and medication. There is important to have the person evaluated immediately by a CT scan and other tests. A CT scan will help confirm and identify the type of stroke. Since different strokes require different treatments, it is important to identify it. A stroke is treatable if detected early. When it comes to getting treatment for stroke, every minute counts. For every 15 minutes saved in starting treatment, the patient gains a month of healthy life. The warning signs of a stroke can begin anywhere from a few minutes to days before a stroke actually occurs. Everyone in the house should know the symptoms of a stroke, and think FAST. The FAST rule, according to the National Stroke Association, is: F – Face : Does one side of the face droop? Ask the person to smile. Is the smile even? A – Arms : Ask the person to lift both arms. Does one arm drift WHITE COATS | A JAMSA PUBLICATION | JULY 2014

are several risk factors that are unique to women: using birth control pills, using hormone replacement therapy (HRT), and being a migraine headache sufferer. As a stroke survivor, it is important to find out the cause of your stroke, and treat the underlying cause or change your lifestyle accordingly, in order to reduce the chance of a second stroke happening. Stroke-friendly foods include green leafy vegetables, fish, whole grains, nuts (especially walnuts), as well as monitoring salt intake. As always, prevention is better than cure! There are several myths regarding stroke:

• Women are protected from strokes.

Reality: Women actually suffer strokes more than men. According to the National Stroke Association, stroke kills twice as many women than breast cancer every year.

• There are warning signs to a stroke.

Reality: You can have a stroke with no warning signs or symptoms. It happens quickly within seconds to minutes.

• Strokes are not preventable.

Reality: Strokes are preventable to a large extent. In fact, 80% - 90% of strokes are preventable.

• Strokes can’t be treated.

Reality: The majority of strokes are ischemic

(caused by a clot), and can be treated with tPA.

• Strokes aren’t hereditary.

•

Reality: Strokes do run in families. Some risk factors for stroke (obesity, hypertension) are genetic. Stroke recovery happens only in the first few months after a stroke. Reality: Stroke recovery is life-long, though most of the healing takes place in the first few months.

• If stroke symptoms pass, you don’t need treatment. Reality: If a person has temporary symptoms of a stroke, it is called transient ischemic attack (TIA) also known as a ‘mini stroke’ – which is a medical emergency. Those who have had a TIA have a high risk of getting a stroke within a week. It is important to seek medical attention for any stroke like symptoms, even if they pass.

Don’t say: “Oh it is late, I’ll go see the doctor tomorrow” or “Nothing can be done – it can’t be managed” or “I’ll wait and see if it goes away.” With stroke, and other health conditions, time and medical intervention is crucial. Health is not merely the absence of disease, but complete physical, mental, and social well-being. Let us be health-smart, be our own advocate, be responsible for our own health and the health of our community, and live our lives to the fullest.

MEDICINE Yesterday, Today and Tomorrow

Looking Behind while ...

“Some people say the Golden age of medicine has passed, but in reality, The Golden Age of medicine is yet to come.” The objective of this page is to give an insight to our readers on how vastly the medical field has changed through the decades. Who better to describe this change than those who have experienced it themselves?

PAST

Mohamed “PAAN” Ismail. (His granddaughter Mehjabeen Ismail) WhiteCoats: Your grandfather was well known for his expertise in the field of traditional medicine. Please give us a brief insight on that? Mehjabeen: His job entailed mainly of prescribing and compounding herbal medicines using natural herbs only, and when medicines weren’t necessary he would teach his patients exercises which in modern medical terms would be described as physiotherapy. Majority of people preferred traditional medicines to modern ones because of its rare availability, the number of side effects that came about with any artificial product and the stigma towards modern medicines. My Grandfather was trusted by many because of his very reliable and effective prescriptions. WhiteCoats: Being so trusted he must have treated a lot of patients. What were the most common problems people came with? Mehjabeen: That would be diabetic issues and menstrual disorders. He treated a lot of paediatric issues as well. Issues related to diabetes are still prevalent in our community and this comes with the eating habits we have grown up with. My grandfather kept singing to my family and his patients, “prevention is better than cure”, he wouldn’t prescribe any medicine before advising the patient to change his habits or lifestyle. WhiteCoats: Seems like your grandfather was very particular and precise when treating his patients. What was his most memorable case? Mehjabeen: One of the very interesting cases would be about the time when my grandfather was presented an infant who was diagnosed with pneumonia and my grandfather immediately compounded a few herbs to cure the pneumonia, unfortunately the brew presented some unpleasant side effects when the child had it and therefore worsening his state. When this came to my grandfather’s attention, he compounded another medicine that cured not only the pneumonia but the side effects as well. WhiteCoats: That’s so impressive. Was there any particular factor that inspired him into this field? Mehjabeen: I wouldn’t say it was an inspiration that got him to do it, rather curiosity. He loved his books, his addiction to reading is what made him who he was. He came across books about self-healing and

experimented it on himself and each of the trials showed a positive result. He was so happy with the outcome he decided to share it with others suffering from similar problems starting off with family, friends and eventually resulting into a career. I guess the inspiration came later when he felt the fulfilment in being able to better some one’s health. WhiteCoats: Curiosity is definitely the key to discovery. Was there any specific advice he might have given to you or by chance the youths in your family? Mehjabeen: Yes definitely. He said; “To be happy and successful in life, do something you are passionate about and when doing it show enthusiasm, it does not only make you believe, but also the people around you.” And Once again, “Prevention is better than cure”.

PRESENT DR.KAZIM DHALLA

WhiteCoats: What do you do for a living and what does your job entail? Dr. Kazim: I work as a Senior Consultant Ophthalmologist with sub specialization in Vitreo Retinal surgery. I see patients with a wide range of eye pathologies but concentrate more in Vitreo retinal diseases and surgery. WhiteCoats: You must be having excellent qualifications for this job then, brief us on your extremely dynamic background. Dr. Kazim: I completed my basic medical degree (MD) at University of Dar Es Salaam in 1993 and worked at Ebrahim Haji Ithnasheri CH as a general practitioner for 2 years. I then proceeded to Zimbabwe for a post graduate training in Ophthalmology in 1997. After two and a half years I decided to transfer my studies to Moshi and completed my M.Med ( Master of Medicine) at Tumaini University ( Moshi) in 2001 after which I did a two year fellowship training in Vitreo Retinal surgery at the same university. I am currently pursuing on line Master’s degree in Clinical research. WhiteCoats: What inspired you into this field? Dr. Kazim: My father’s vision, my mother’s sacrifices, my wife’s support, my children’s patience and my extended family’s backing. WhiteCoats: You have been part of the medical field for quite a long time, what would you say has been the most drastic or the most advantageous change in the field?

... Forging Ahead

Dr. Kazim: Medical science is a very dynamic field. A lot of new discoveries, inventions and innovations have taken place in the past 20 years that I have been in medical practice. LASERs, Gamma knives, stereotactic and radio surgery, femto second and nano technology are some of them. However, in my opinion, the deciphering of the human genome and the advent of targeted gene therapy is perhaps the greatest achievement so far. In Ophthalmology we are seeing an era of microchip implantation in patients with retinal blindness unfolding. The horizon for medical students and young medical graduates has never been so wide . I therefore urge the younger colleagues to expand their vision beyond the traditional practice. WhiteCoats:Besides work, is there anything else that interests you? Any hobbies? Dr. Kazim: In fact I am not doing much compared to my role models like Shk. Dr. Murtadha Alidina and Prof. Karim Manji who are institutions by themselves. Martial arts is great for all because of the discipline and endurance it instills in you. It gives me the physical workout that I think we all need on regular basis. Flying has always been my passion and I thank the Almighty SWT to have given me the opportunity to fulfill this desire through the kind heart of Capt. Hasnain Kassam. WhiteCoats: Your enthusiasm is exemplary; usually Doctors complain they don’t have enough time. I am sure a lot of people will learn how to manage their time from this. Dr. Kazim: Life is like swimming. The moment you stop your strokes you start to sink. Time is short and there is a lot to achieve. We can only achieve higher goals in life if we stop concentrating in petty things which consume a lot of our time. Ameerul Mumineen (AS) said “ Ah ! The journey is long and the provision is scanty” If we only realize these golden words of our master we will reach beyond the horizon. WhiteCoats: I am sure you would want more youths to have a determination like yours, what’s the best piece of advice you have for our youths, especially those who are already part of the medical field either studying, freshmen working or those who one day aspire to join the medical field. Dr. Kazim: All I can say is if you are satisfied with yourself you stop to progress. Self appraisal and especially self criticism is one of the keys to success. Finally, thank you very much for giving me this honor.

FUTURE SAYYEDA ISMAIL

WhiteCoats: Tell us something about yourself and what you want to do. Sayyeda: I am currently doing my A levels at Almuntazir

Islamic Seminary, I had applied for medical imaging at Manipal University and Alhamdulillah I have received my acceptance letter. WhiteCoats: What does your course entail and why did you choose Medical Imaging? Sayyeda: Medical imaging is a 4 year course including internship. I’ll be concentrating more on diagnostic imaging which means more of using machines to make patients’ reports. This way it gives practitioners a deeper insight on what they are dealing with thus preventing errors and effectively saving more lives. What medical imaging deals with is extremely important because it enables us to identify a broad range of injuries and diseases including cancer. Medical Imaging in other words is a technical approach to medicine. WhiteCoats:You sound very passionate about your career, what was your inspiration? Sayyeda: I’ll fall short if I don’t mention my mother being my major inspiration, to make a difference is what she taught me. She has always encouraged me to get into the medical field because it deals directly with helping people in need and Medical Imaging being the heart of health care advancement, gives me the opportunity to do exactly this. WhiteCoats: Being a girl, what challenges do you expect to encounter and how will you overcome them? Sayyeda: My biggest fear would be the side effects that come along working with radiations, the scariest being cancer. I have also heard of cases where ladies who come in contact with radiations then deliver deformed babies or develop complications with their pregnancies. Every career has its own risks and challenges and so definitely there are precautions that I’ll need to take. Apart from that, there are always phobias that come with moving away from home, adjusting in a new environment and making new friends especially when there are so many terrifying stories about people in India. Thus to overcome these type of challenges I shall be careful with who I interact with and InshAllah, the almighty will guide me. WhiteCoats:You said you want to make a difference, how do you plan on doing that? Sayyeda: Being one of the very few youths in our community, considering radiography as a career, I hope to come back and put my skills into practice, helping this community which has brought me to where I am today. Along with that I intend to be there for other youths who aspire to get involved in the medical field.

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

GOLDEN HEART

Being Different

By Sharmeen Merali

My name is Sharmeen Merali. My heart is on the reverse side, I have 11 deformities, I have had more than 15 surgeries at 3 different hospitals and I have one story to tell. When I was a little girl, I knew I looked different physically but didn’t quite understand why, so growing up my family used to tell me that I had a Golden Heart and that I was unique. I felt special at times, despite the many tantrums and negative chants towards God. Medically I have ‘Golden Har’ syndrome, till today it is not known whether the cause is genetic or environmental. However 27 years ago, this syndrome was so rare that it was almost untreatable and there was no hope for me to live beyond six months and if I did I would be in a coma. By the grace of God, I passed the ‘deadline’ and proved to become more of a challenge to the many doctors and surgeons. The Golden Har Syndrome is gradually becoming well known amongst the medical field. Unfortunately this is only the case in UK and USA. Let me tell you a little about it. Golden Har disease is a condition that is present at birth and mainly affects the development of the eye, ear and spine. Affected individuals commonly have a partially formed ear, or totally absent ear, noncancerous (benign) growths of the eye, and spinal abnormalities. Golden har disease may also affect the facial structure, heart, lungs, kidneys, and central nervous system. The underlying cause of the condition remains unknown, though it is thought to be due to multiple factors including a genetic component and familial patterns. The major signs and symptoms of Golden har disease are usually only seen on one side of the body, but it has been known for defects to occur bilaterally. Treatment is age-dependent, with timesensitive interventions at appropriate stages of growth (craniofacial) and development

I have spent my entire childhood visiting hospitals and undergoing several surgeries, I think going under the needle and other treatments made me a stronger person. I used to love going to the hospitals especially Great Ormond Street Hospital in London. There was a very positive and vibrant feel to it. Living in a country that is oblivious to this can be quite challenging as I felt alienated in a huge community, most people would feel sorry for my family. This was years ago, nowadays people are more accommodating to ‘unique’ people like us and it has been easier to lead a normal life. It gets even better when I get complimented on the progress I have made from the time I was that little girl. These life-changing events have made me realize that the Almighty Lord knows what is best for us so we so we just have to live for ourselves and not be too worried about what others believe. In fact my only true best friend is God, I have had endless conversations with him, I have also been very mean too as naturally I blamed him for my situation. But with time and patience am fully accepting the way I am. Today I am 27 years old, I work as a TV presenter, editor, researcher and writer for IBNTV; an Islamic TV station based in Dar es Salaam. I work with children that is the biggest achievement for me as growing up I used to get the odd stares and children would generally be afraid of the way I looked. I have now come to understand that almost everyone has some sort of a setback be it physically, mentally or spiritually. I strongly feel that God knows what he is doing as despite all this medical trauma, I am blessed with two sets of amazing parents, hilarious siblings and my huge extended family who have been a great support till today.

GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAG FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET CALL 0785 678 907 for DETAILS GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS - GET GREATER MILEAGE FOR LESS -

ADVERTISE WITH WHITE COATS.

http://www.carrotmuseum.co.uk/nutrition.html

Points of Awareness

Qs TO THE DOCTOR By Dr. Imran Hassam

JOCK

or severe allergic reactions called anaphylaxis reaction.

This is a bit embarrassing. I have been having an itch in my inner upper thighs for quite a long while now. Somedays it is very itchy and on other days I don’t even realize it. I can’t go to my doctor as I feel a bit embarrassed about it. Please help. What you have is popularly called “Jock itch” or Tinea cruris. This is actually a fungal infection and can be caused by a number of fungus which infects the superficial layer of the skin usually around the groin and inner thighs. These are the areas of the body which are mostly moist and warm, exactly the kind of environment fungus thrives in. Jock itch are usually annoying and not serious. Itching and slight pain are common, an easily recognizable rash is seen with a distinct edge which maybe reddish in color or have bumps on them and the centre of the rash is usually a slightly brownish color. The good news is that it is easily treated at home with over the counter anti-fungal powders or creams which contain clotrimazole or miconazole. After washing the area with soap and water and drying it. Apply the medication beyond the edge of the rash usually twice a day for up till 2 weeks. How to prevent it from coming back? Well generally keep the groin area clean and dry. Dry off thoroughly after bathing or swimming. Take showers as soon as possible after sporting activities, wear cotton underwear and avoid tight clothes. And of course avoid sharing towels.

So how do we test for allergic rhinitis? There are a number of tests available (even some here in Tanzania) the most popular being Skin Allergy test where allergens are introduced in to your skin to see what you are allergic to. So coming to the million dollar question, how do we control allergic rhinitis? There are three major methods that can be employed.

• Environmental control and avoiding what causes •

•

your allergies. So things like vacuuming your carpets, avoiding heavy drapes in your room, etc. Drugs, drugs and more drugs!. You could most probably control your allergies with oral antihistamines (like loratidine or cetirizine) or decongestions and even both. You could even consider using intra-nasal steroids sprays. Immunotherapy. This has yet to make a lading in Tanzania and is usually quite expensive but it is still an option for those whose allergies are severe.

ANCHOR CLEARING & FORWARDING

A small heads up though, if after two weeks the rash has not gone away or comes back – best to get it seen by a dermatologist who might want to take a scraping of the skin to analyze under a microscope.

ALLERGIC I wake up in the morning and just sneeze and sneeze and sneeze. My nose is usually runny and sometimes my eyes are itchy and a bit puffy. It has gotten to a point that some days I can’t even smell my food or perfumes properly. This is very, very annoying! Anything I can do? Sounds like you got a case of the allergies. This is quite common and it is called Allergic Rhinitis. It can be triggered by allergens in the environment that you are in. Allergens like Dust, pollens, moulds, dust mite droppings to name a few. Allergic Rhinitis is usually not life threatening unless accompanied by severe asthma

Zanaki Street, P.O. Box 2951 Dar es Salaam, Tanzania Tel: +255 22 2111808 | +255 713 465 046 Email: anchorcf@gmail.com

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

It’s a State

MENTAL WELLBEING By Arzoo-e-zainab Khalfan

Why Mental Health?? The tragic event of the building collapsing in Dar Es Salaam in April last year highlighted lack of capacity in the community, despite good intentions, to know how best to support those suffering mental and emotional distress. The situation showed that people want to be compassionate but lacked the skills and knowledge to do so in a way that provides the best support for the persons who are suffering and their families. What is Mental Health?? This is the level of psychological well being or it’s the absence of mental disorder. This is the emotional and spiritual resilience which allows us to enjoy life and survive disappointment and sadness. It is a positive sense of well being and self esteem. Mental health Influences how we think and feel about ourselves and others, how you look at yourself, your life and People in your life and how can you evaluate your options and make decision. What you think? Thinking is the basic key component of Mental Health. It is essentially important to know your thoughts and determine if they are reasonable and most importantly, on how you respond to them (negatively OR positively) as thoughts produce feelings and emotions within us. The thoughts and feelings result in Action which can either be healthy as in, the individual talks to someone about their feelings OR unhealthy were the individual starts smoking, drinking, yelling, staying alone/hiding in the room etc.

Mental illness occurs when the brain is not working well or is working in a wrong way, this will disrupt one or more of the 6 functions: -Thinking, Perception, Emotions, Signaling, Physical, and Behavior. Mental health problems are disturbances in the way the individuals emotionally feel, think and also behave. It can disrupt individuals ability to function e.g. to work, or maintain personal relationship. Mental Health Problems and Age -People of all ages can experience poor mental health, although the way in which it is experienced and the things that may cause or contribute to it may be age specific. Some mental health problems are more common than others at different stages in life. For example, Schizophrenia commonly develops from early adolescence through young adulthood. Depression can be a particular problem in older people, whereas selfharming behavior is on increase among young people. Mental health and Gender Men and women can differ in the way they experience mental distress. Women are likely to experience depression and eating disorders while men are more likely to abuse alcohol and drugs, however they both have equal chances of suffering from psychosis (condition in which a person experiences changes in thinking, perception, mood and behavior which can severely disrupt their life).

Recovery This is the way of living a satisfying, hopeful and contributing life even with the limitations caused by illness. It involves the development of new meaning and purpose in one’s life as one grows beyond the Maintaining of Mental Health involves: severe effects of mental illness. Eating fish once • Eating healthy People can recover from even the most a week could • Exercise severe mental health problems. A wide lower your risk of • Managing Stress variety of factors can influence recovery, depression by 30%. • Always think POSITIVE including supportive social networks, • Make time for yourself access to education, employment • Have people around you, who you can opportunities, and the availability of Trust and Share your feelings with. (Social Contact) treatments. Recovery provides an empowering message of Hope, What are Mental Health Problems? which says that, regardless of symptoms, people with This is also referred to as mental illness, psychiatric serious mental health problems should have every illness or mental disorder. opportunity to lead fulfilling and satisfying lives.

PROFESSIONAL CREATIVE

FREE GRAPHIC DESIGN *

Call: +255 787 212 256 or e-mail : sameer.kermalli@gmail.com

* 45 minutes Product Photoshoot with Sameer Kermalli [$150US] will get a Free Design of a flier

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

SO MUCH MORE TO

Fixing the Sapling

MEDICINE

When a youth wants to pursue into the medical field, the first things that crosses his mind is DOCTOR, DENTIST and PHARMACIST. The idea of this section is to give the youths an insight into various other medical fields apart from the conventional ones and for this issue we went with Occupational therapy. Who better to narrate these experiences than those who are directly involved in the field. Occupational therapy (OT) is a professional treatment which focuses on helping people mainly kids with a physical, sensory or cognitive disability to be as independent as possible in all areas of their lives and with that to enhance their self-esteem and sense of accomplishment.

By Sakina Bhimani My journey to Occupational Therapy (OT) began with a conversation with a Tanzanian. While doing my undergraduate degree in Health Promotion in the UK, I met a student OT from Tanzania. To be perfectly honest I didn’t really know what I wanted to do but I have always had the desire to help people in some way. Up until that conversation I had not heard of the OT profession, and asked the common question OT’s and OT students get, ‘what’s that about?’ This question sparked my journey to OT. It sounded interesting, full of potential to make a difference. Despite this, at that point I didn’t inquire further to consider transferring. My aim in life at that time was to get out of university and find a job and settle down. The idea of an extra year of studying just didn’t fit in with my life plan. I completed my degree in Health Promotion in 2009, and found that the jobs I was chasing were very niche, and graduate opportunities were scarce… I did however try and keep up volunteering, learn sign language as I recognised the value of experience not just a degree. After graduation I decided I wanted to widen my experience and went to stay with my uncle in Tanzania. While here I had the opportunity to work, observe and learn a lot in a diabetic Foot clinic. I still remember my initial week there in shock at the effects of what I knew to be a preventable disease. Never in the UK, had I seen people seek help so late. A special thanks goes out to the doctor at the clinic who told me that I would never see cases like this in the UK and to make the most of the unique experience. Little did I know this experience would help me get my place on my pre-reg master’s course in occupational therapy. In this clinic I was able to see the effects of Diabetes leading to limb loss and gangrene, but also the positive attitude of the African people and how they dealt with adversity. I also saw a lot of problem solving, some compensatory methods of assisting people in mobility as well as treatment, and limb care. This experience and along with the conversation with the OT student ignited my passion for OT. I began to explore the option of pursuing it as a career which led

me to applying for a course at Brunel University and was elated but terrified when I got an interview for a place to study. So, I returned to university, even after swearing I would never again, as the dissertation killed me the first time round, and it was very hard, but very interesting. I have gained an insight into the vast array of practice settings that OT’s work in, with opportunities to work with different client groups and conditions, from mental health, to physical, working with old and young. My first placement experience, was at amputee prosthetic rehab centre, and was amazing to see the possible recovery after the severity of the situation I saw in Africa. This experience taught me the possibility of hope, and life after trauma and helping people live there life their way. Looking through a new lens of helping people to do what they want and need to do, that drive towards independence and gaining control again. So as I near the end of my course, after all the stress the challenges, the difficulties the highs and lows.. I would like to take this opportunity to thank the people who helped me on my journey and highlight the problem-solving potential of occupational therapy, as helping people to live their lives their way.

PUMA TANZANIA SERVICE STATION JAFF’S UNITED Wholesale and Retail Agents for Chai ya Amani Agents for Chai Jaba

Rungu Products Anjari Healtho

P.O.Box 721 Moshi Tanzania Tel :02752434

By Fatema Somji My occupational therapy journey began a year and an experience ago. I took one year to decide my career, having fleeting thoughts from physiotherapy to speech therapy. I had never heard of this unique field – occupational therapy. Some you who are reading this sentence are thinking to yourself, what is this field? After being asked the same question a million times throughout my first year not only from people I met during my fresher’s week but also from my friends, I was not surprised at the amount of people who had not heard of this subject area. Indeed it is a very recent field which is still developing. The role of an occupational therapist is to use activities that a person enjoys doing to improve their functions. The one experience that sparked my interest was when I worked with an eight year old boy, Fadhili, who was unable to distinguish between colours and holding a paint brush correctly. During art sessions, I tried multiple times to help him by getting him to talk about his goals and aspirations. This distracted him from his inability to paint. It took a while for Fadhili to gain the confidence to use a brush but with a lot of encouragement and patience, he finally stepped out of his comfort zone. It was very inspiring to experience his eagerness in trying to carry out a task that was unfamiliar to him. This teaching opportunity gave me a massive wave of satisfaction. We both reaped from this journey but little did he know that he became my teacher. He taught me to look at the world through his lens. He helped me to recognize my dream, a dream to help children like him. And most importantly, he taught me to never give up. The satisfaction level I attained from this encounter was unbelievable. The journey wasn’t as straightforward as it looked, but this is what grasped my attention. Who are we to deprive people with so much enthusiasm from discovering the world?

This is when I realized I wanted to spend my time helping people work to the best of their abilities, no matter how long it took. Before embarking on my first placement I was extremely nervous as I had no previous clinical experience. After finding out it was going to be a mental health setting, my anxiety levels shot up even higher. I started my first day at the hospital thinking ‘any minute I am going to hear someone shout or hurt me’, and constantly expecting something terrible to happen, I was on high alert the entire time on the ward. After spending a few days on the ward, engaging and listening to the service user’s stories, I had a guilty realization. I understood how wrong I was to judge them so quickly and they, the mental health patients, are just like normal people. Sure there would be these rare incidents on the ward where service users would set fire to a newspaper or abscond a staff member but I also understood that was the result of an outrage. We’re all in a bad mood once in a while and don’t want to talk to anyone; similarly these patients didn’t want to be forced to do activities. A mental health setting might not be the field I want to further pursue, however there was lots I took away from my placement which will inform my future expectations of placements. By the end of my four weeks in the mental health setting, all my stereotypes and schemas about mental health patients had changed. I do not only attribute this to the portal of mental health in the media but also my lack of knowledge of it. This is because, coming from a society where mental illness is either looked down upon or neglected or the correct help is not provided, I believe the lack of awareness in our society about mental health needs to change with time and it’s our duty to start this change. ‘The most blessed is the one who helps others.’ – Prophet Muhammed

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

DEPRESSION The Silent Assassin

Things that Sneak

By Sayyeda Versi

Face your fears. Don’t avoid the things in daily activities, difficult The world feels like a murkier you find difficult. When people feel low with relationships, sleep place; hopelessness, isolation or anxious, they sometimes avoid talking disturbances, change in and suicide are the only to other people. If this starts to happen, appetite, weight loss, difficult words left, Why me? Is the facing up to these situations will help in concentration, inability to only question and black and them become easier. make decisions and worst of all white are the only colors suicidal thoughts or attempts. sensed. You’re walking through life and you feel you want to cry, but you Did you know that women are twice as likely to don’t know why. The basic needs have become a burden and all your hoping for is “when will all suffer from depression as men? Depression can be due to many factors and it has been classified in of this end”. It gets to the point where you feel different approaches; you’re too much of a burden. Well the truth is that • Genetics- in which risk of mood disorders is depression will affect YOU at some stage in your increased in first degree relatives. life… no one is immune. • Childhood experiences-(early environment) As a medical student, I find it sad that even this involves parental deprivation as well as within the community of physicians and mental poor relationships with parents. Psychoanalysts health professionals, we often fail to recognize the have suggested that childhood deprivation of condition or provide accurate treatment. Despite maternal affection through separation or loss the increasing cases of depression disorder, little is predispose to depressive disorders. On the known about it in our society. contrary there is more support for the proposal that depressive disorders in the later teenage Depression is a persistent feeling of sadness, life is associated with parental separation hopeless or helplessness, having low self esteem, particularly DIVORCE! feeling inadequate excessive guilt, loss of interest

Physical or sexual abuse is a risk factor for major depression and this leads to gross disruption of prenatal child relationship • Current life difficulties and stress- can provoke mood disorders in predisposed individuals • Social economic status is also another factor. What can we do?

The role of the community in the prevention and care of the depressed has now been widely acknowledged and in the future may be regarded as the most appropriate for the basis of mental health programs. Several studies have shown that knowledge of public attitude to depression and its treatment is vitally important prerequisite to the realization of a successful community! The recognition of depression also depends on a careful evaluation of the norms, beliefs and customs within the individual’s cultural environment. Community attitude and beliefs play an important role in determining help seeking behavior and successful treatment of the depressed.

most importantly self-realization can help reduce the number of cases in the community. Every 30 seconds somewhere someone commits suicide because of depression! It may be two blocks away, two countries away but it happens every day. Teenagers are the most venerable to depression. This is because of the different stressors they are going through and the change into adolescence. It’s difficult to diagnose teenagers with depression, as they tend to hide it and confine it to themselves due to the fear of social stigma. Without seeking care and treatment the consequence of depression are suffered by both individual and the society as a whole. It can lead to unemployment, drug abuse, homelessness, and suicide! To all of you out there experiencing any of the above mentioned symptoms no matter how bad it is…there is a better day waiting!

Since depression is associated with loneliness; emotional support, socialization, consultation and

“Excellence in Hearing Care”

HEARWELL

Audiology Clinic

- Audiometry - Tympanometry - Speech Evaluation - Speech Therapy - Cochlear Implant Mapping - Diagnostic ABR Test

- ENT Consultation - Hearing Aid Programming/Fitting - Digital Hearing Aids - Tinnitus Therapy - Earwax Removal - Custom Earmoulds/Hearing Aids

SERVICE PARTNER

P.O.BOX 6509, Tel: 0774 446699, Email: info@hearwell-tz.com, MINDU STREET, CANAL RESIDENCE BLDG, GROUND FLOOR, DAR ES SALAAM. www.hearwell-tz.com WHITE COATS | A JAMSA PUBLICATION | JULY 2014

PSYCHOLOGICAL DISORDER By Sayyada Sachedina

RUMINATION

Procrastination

according to the Mental Health Foundation. Why Do We Ruminate? Susan Nolen-Hoeksema, a psychologist carried out a research and found that ruminators may simply have more stress in their lives which preoccupies them. She said “ When people ruminate in a depressed mood they remember more negative things in the past, they interpret situations in their current life negatively and are hopeless about the future. It paralyses your problem solving skills, you become so preoccupied with the problem that you are not able to push past the cycle of negative thoughts. Moreover, their dear ones may get frustrated and pull away their support and affection”

Rumination is one of the commonest psychological disorder affecting a greater percentage of the world’s population currently. Ruminating is like a record that How To Reduce/Stop Ruminating? is stuck and keeps repeating the same lyrics. It could Positive self reflection is the most be replaying an argument with a friend crucial step towards the treatment in your mind or retracing past mistakes. Exercise or walk. Moving for rumination. The society will not Within the process, people obsess your body can move value you if you are not confident themselves about situations or life the content in your about yourself . Practice adaptive events such as work and studies. head. Notice aspects self reflection there by focusing on the Symptoms Of Ruminating: of nature or humanity concrete parts of a situation and the • Your worrying is causing you to that are larger than your improvements to be made. For instance, have sleep problems (insomnia) conundrum. Try to focus if an error occurred in the examination • Physical symptoms of stress such on what is outside of you think of positive ways to overcome as headache, fatigue or stomach rather than inside of you. the same mistake in future instead of ache blaming yourself. In addition to that, • Your ruminating thoughts are one should engage in activities that foster positive interfering with your ability to function in the day to thoughts. It may include a favourite physical activity, day activities. hobby, meditation or prayer. The ultimate goal is to • In some extreme cases, ruminating can get the mind off the ruminations for some time so that be a symptom of Obsessive-Compulsive they lose their grip on the mind. In the final analysis, Disorder (OCD). In OCD one is troubled by a pattern this article acts as an eye opener to us portraying that of intrusive and distressing thoughts as well as there is an element of rumination in each one of us, the repetitive behaviour. degree however varies from one individual to another. It might just start as a worry and eventually end up into Is Ruminating healthy for us? the dangerous catastrophe of depression. Ruminating is not healthy. Research has shown that rumination is associated with a variety of negative consequences including anxiety and stress. The most hazardous effect that it can lead to is DEPRESSION. Repeated dwellings on feelings, problems and difficulties exacerbates negative mood and predicts an increase in depression. Referring to the BBC News Magazine of 17th October 2013, rumination and self blame have been accepted by health professionals as part of the problems that can lead to depression and anxiety- the two most common health problems

Positive thinking is the best solution as advised by Mahatma Gandhi . “Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behaviour. Keep your behaviour positive because your behaviour becomes your habits. Keep your habits positive because your habits become your values. And keep your values positive because your values become your destiny.”

Self Development

KNOW, UNDERSTAND AND CORRECT By Sakina Moloo

3. ACCEPT ALL COMPLIMENTS WITH A THANK YOU. A thank you may seem so small and many of us when thanked just say ‘’ummm, I don’t think you should thank me.. I didn’t do anything’’. No! this isn’t what it should be like. You are devaluing yourself. The action of turning Do something you enjoy. Doing down compliments by brushing something that you enjoy, and that it off sends a message to your you are good at, can help build your sub-conscious brain which in confidence and increase your selfturn lessens your confidence esteem. This could be anything from and feelings of self worth. You paid work, volunteering, caring or a are reinforcing the bad by not hobby embracing the good.

Have you wondered about what self-esteem is and how to get more of it? Do you think your self-esteem is low? Do you know how to tell? Do you know what to do about it? Self-esteem is a term in psychology to reflect a person’s overall evaluation or appraisal of his or her own worth. It is the way we feel about ourselves, be it negative or positive, is our selfesteem.

Why have a self esteem? • People with a healthy level of self-esteem: • Have the power to believe in themselves • Respect themselves. • Make good choices about their mind and body. • Have an integrated ability. • Adequately cope with difficult and stressful life situations • Stand up for what they believe in. • Learn from the past and plan for the future, but live in the present intensely

4. FIND YOURSELF WITH POSITIVITY Use the talents you possess. Engage yourself in activities that make you feel good. Read books that inspire you, watch movies that make you laugh. Challenge yourself with learning new languages or playing riddles and other math games. 5. ASSOCIATE WITH SUPPORTIVE PEOPLE. Hang out with people who love you unconditionally and who accept you for who you are. 6. LIST YOUR PAST SUCCESSES Listing down your accomplishments will make you appreciate what you have done in the past. It will make you realize you did it one day, why not again?

While those with a low self esteem basically are the opposite. 9 Priceless steps in building one’s self esteem. 1. STOP COMPARING YOURSELF Each one of us at one time or another has looked at our friend, relative or a co-worker with envious eyes. Be it a big salary or a pictorial family life, perfect looks or even having a sixth pack :P everyone on occasion falls in a victim of feeling inadequate as a result of someone’s accomplishment. Throw this habit out the window and be the person you are. 2. KEEP YOUR THOUGHTS POSITIVE Avoid talking down to yourself and try to self appreciate your true self. Many times we hear teens go like, ‘’I’m born a loser’’. Define your strengths on paper and congratulate yourself for your victory however small it may be. Use simple affirmations such as ‘’I AM AMAZING IN THE KITCHEN’’ –think like a proton, always positive!

7. DO GOOD FOR OTHERS In a day to day life try to do good to others, not because you will get something in return but it will make you feel happy. It can be as small as helping someone open the door or getting an old lady or a school child to the other side of the road. 8. FIND YOUR PASSION After strengths, find what you really like. Be it a volunteer, business or even something at school. Know yourself and follow your heart. 9. BE YOURSELF Life seems much more difficult and fake when you pretend to be someone else just to impress other people. This is totally wrong! It will stop you from knowing who you are. So, just be yourself and believe.

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

HEALTH IN OUR HANDS

What We Can Do

By Zainab Z. Alimohamed

Are you always overwhelmed with lethargy? Can’t focus on your assignments/work? Worry not! Thousands, if not millions of individuals all over the globe today suffer from the “fatigue syndrome” as we call it! So, how do we tackle this problem? Sports, healthy diets, correct sleeping patterns… all matter in affecting our health and hence, outlook on life! “I just can’t find time to work out every single day!”... Sounds familiar, doesn’t it? Plugging in time for our physical fitness may seem impossible, but scientists have proven that dedicating at least half an hour each day to your personal health, will provide you with a better state of mind, a healthier body and a sense of great satisfaction! Your workout can be any sort of exercise such as walking, swimming, cycling and much more. But remember, along with all the hours of workout that you do, it’s extremely important to have a healthy and balanced diet. Seriously, there is no point cycling for an hour each day and then coming home and feasting on a dinner of oil-dripping foods. Along with that, sleeping hours and patterns also play an integral role in affecting our mental and physical well-being. The right amount of sleep allows the body systems to synchronize, thus rejuvenating our physical and mental health. As the common phrase goes, “Early to bed, early to rise, makes a man healthy, wealthy and wise”. It couldn’t have been put in a better way! In a nutshell, an active and healthy lifestyle involves care and attention to many dimensions of our lives, and this will allow us to achieve so much more. Several narrations from the Holy Prophet (SAW) and A’immah (AS) indicate to us the method and importance of living a healthy life. Being inactive and unhealthy affects our worship too, making all our actions seem like a burden rather than moments to be relished. Being inactive hinders our abilities and

enthusiasm to achieve our maximum potential. We need to focus on this vital issue now, how otherwise are we going to serve the Imam of our time (ATFS)? The power to change our attitude and our health lies within us. As it has been wisely stated, “Take care of your body, it’s the only place you have to live in”- Jim Rohn. We went a further step and asked a few people in our community who admit that giving time to some sports changed their life, and asked them to share their experience. Mohamed ‘Mo’ Khimji. I had a very active teenage life, soccer, swimming, cricket, you name it and I played it. I also played Cricket for the National under 19 Team and thereafter promoted to the Seniors Team. I was on top of my health. After High School came University and after University came Employment and after Employment came Wife and Kid. For good 8 to 9 years i didn’t do anything, no sports, no activities and I ate garbage. Couple of days after my son was born I weighed myself and at 175cm tall I weighed almost 100Kgs! Looked myself at the mirror took a snap and said to myself “I gotta get healthy” I played Squash like a monkey, swam like a fish, cycled like there was no end, ran like the whole world was after me, I cooked my own food, kept away from oil and after 12 good months I felt like a High School kid again. Today I weigh 67kgs and work out twice a day, 1 hour of Cardio and 1 hour of Weight resistance training, I also substitute my Cardio with Squash, Cycling and Swimming. I’ve never felt so healthy and more importantly HAPPY! Kaniz-e-fatema Gulam Sheriff. I am 46years of age, mother of 3 and a badminton player. After 3 kids I stopped playing, this was for about 10years, but a few years back when the opportunity presented I took it, remembering the good old days and I continue to play to this day. I don’t only play for the competition but for the love of the sport, it not only helped me build my stamina but the few hours away from my hectic schedule focusing on just the game helps me relieve my stress. I want to encourage more people especially the ladies out there to pursue sports, any kind and why not try everything. Age should not be a reason neither should time, because if you love and enjoy something you make time for it.

What We Are Doing

GOING BACK To Water

“You are only one swim away from a good mood” Speedo. DROWNING??? A real deal breaker but wait till you hear of the benefits to swimming. For the ladies who need to fit in their dress for a friend’s wedding in a week, did you know swimming for an hour can burn up to 650 calories which is way more than an hour of walking or biking? For the gym freaks, did you know you exercise all your major muscle groups? That means every day is in fact LEG DAY. Together with that swimming is a great cardiovascular work-out. And as for those who hate their jobs, swimming reduces your stress. It’s more refreshing than any other sport. It won’t change your job neither will it kill your boss but well, it will make your day less painful. NIZAR MOLOO(Professional swimmer). WhiteCoats : Tell us something about yourself and your experience with swimming. Nizar: I have spent nearly 35 years of my life enjoying the daily morning swim. Swimming has become part of my life so much as to missing it makes my day uncomfortable, I feel as if I have missed an essential part of my day. I prefer swimming in the ocean compared to the pool coincidently I grew up in a small island of the coast of Tanzania, namely Jangbar (Zanzibar), which is covered by the ocean from all four corners. The wind blowing, the sound of the waves, allows you to start of with a fresh feel. Swimming is what has been keeping me young and fit at age 62, and unlike other men at my age, a healthy appetite and digestion.

WhiteCoats : According to you, what are the benefits to swimming? Nizar: Swimming has countless benefits to the human body but to mention a few, it treats back and joint aches, arthritis and helps in maintaining blood pressure. Personally I believe swimming is better than any other exercise, and the most appropriate time is early in the morning. Besides the physical advantages, the effect swimming has on your mental wellbeing is beyond measure. WhiteCoats : You were very specific when mentioning the health benefits, any experience? Nizar: At the age of 30, due to the hectic business hours and the stress that came along with it, I was diagnosed with high blood pressure. I visited Dr. McLarti at the Muhimbilli hospital and he gave me an advice that I will be thankful for all my life, he told me take up active swimming. I started this exercise and kept track of my blood pressure for six months without any medication and Alhamdullilah I haven’t encountered any problem after that. WhiteCoats : Do you have any advice to give to the community. Nizar: Swimming, as I mentioned, is the best exercise for youths and elderly, and what keeps me going is that it never gets boring. The youths are always looking for something fun to do, and that goes for all sports, I am a very big soccer fan myself and have been playing it since I was a kid. It even serves as a distraction from other unhealthy habits. Sports are a good way of reliving stress, it allows the body, mind and soul to feel relieved and unloaded of the daily baggage we carry in the rat race we run, day in day out. Swimming is one of the many; it’s worth giving it a try.

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

DENTAL CARIES By the Ancients

Sensitive

By Ahmed Chagani

A visit to the dentist often seems like a dreadful event to most people nowadays but frankly speaking you are now far, FAR better off now than were patients who were treated several thousands years back. They also had teeth , naturally also had episodes of toothache. Back then there weren’t any dental colleges or degrees to hold , it was still the painful era of “trial and error” . Unfortunately for the patients, they had to put up with all forms of treatments that would be considered astronomically bizarre in today’s era of modern medicine !

Halitosis. Also known as bad breath, due to poor oral hygiene was a Consider fluoride common problem treatments. Fluoride helps concoction so a prevent tooth decay by of various ingredients making the tooth more were made, they resistant to acid attacks had their own version from plaque bacteria and fresheners of breath sugars in the mouth halitosisBreath Sweetener: Take frankincense, myrrh, cinnamon, bark and other fragrant plants, boil with honey and shape into pellet. Sometimes the patient would have their jaw bone drilled in order to drain an abscessed tooth or teeth. Teeth were filled using a type of mineral cement, and gum disease were also treated by using myrrh and other antiseptic herbs.

Ancient Egyptians have been documented to be one of the first civilizations to practice dental therapy. Excavations from ancient burial sites revealed mummies with jaw bones with different types of treatment done on them. Dental caries was almost an epidemic back then due to their diet and poor oral hygiene. Local infirmaries began finding ways to treat dental caries .Listed below are the various ways in which the Egyptians had dealt with the various dental situations that troubled them back then. DENTAL DRILL 9000 YEARS AGO Toothache. The ancients had amazing ways of treating toothache, they developed several theories on the causation of toothache and as many treatment methodologies as well. Only some are mentioned below.

Extractions. Probably the simplest way to solve someone’s dental problems . Of course they didn’t have the “advanced” technology that’s applied today, loose teeth were usually removed using fingers and, mind you , local anesthesia wasn’t discovered until the late 18th century ! (ouch )

Beliefs the ancients believed that PTAH a god for creation was responsible for causing toothache, this was a result of angering him and as a result he would send demons into the accursed tooth to cause pain (seems plausible ). Alongside therapy, religious invocations and also use of amulets were also practiced.

Fillings. Readings from ancient scriptures gave accounts of various medicinal preparations used as filling materials some of which included ..

One of the most farfetched methods to have been recorded from the Egyptians to treat tooth ache was, the applying of a body of a dead mouse on the affected tooth . They believed that a mouse was a creature protected from divine wrath and hence was considered it as a type of charm.

Resin of terebinth: “1; Nubian Clay: 1; green eye lotion: crush together and (or apply) to the tooth” (wonder whose eyes they crushed)

One recipe to treat toothache requires beans to be ground up with another substance. The word is missing but it is possible that it could be “willow” from which

aspirin was originally obtained. Other mixtures seem likely to have hardened after preparation and might have been used to splint loosening teeth. Honey, which is included in several recipes, has been shown to have an antibacterial effect. But much conjecture must remain. The terms used may make translation uncertain, the identification of herbs and substances may be inaccurate Teeth wired together by gold probably the worlds first set of braces So the next time you go to the dentists , be sure to appreciate the newer ,safer, and MUCH less painful methods available today.

WHITE COATS | A JAMSA PUBLICATION | JULY 2014

ORAL HEALTH

Prevention is Better

By Sukaina Khimji

A good mouth with white shining teeth and a perfect smile..... is what we all want, but do we all know how to achieve oral health. Good oral hygiene helps to prevent dental problems - mainly plaque which is the main causes of gum disease and dental caries (tooth decay). Risk factors for oral diseases include unhealthy diet, smoking, tobacco use, harmful alcohol use, and poor oral hygiene. There is some evidence to suggest that poor oral hygiene is associated with an increased risk of developing heart diseases such as heart attack and other cardiovascular disease. Ideally the first step towards oral health is brushing your teeth. It is recommended to brush your teeth either just before eating, or atleast an hour after eating. The reason for this is to help prevent tooth erosion. Many foods contain acids particularly, fizzy drinks and fruit juices. After your teeth are exposed to acid, the enamel is a little softened. Therefore, do not brush teeth immediately after eating when the enamel tends to be at its softest. It is best to wait at least an hour after eating or drinking anything before brushing. In addition to the benefits to your teeth, good mouth hygiene may have even further benefits. According to a past president of Academy of General Dentistry, Luke Matranga who says “Don’t Rush the Brush, Brush to the Beat! Since many people brush during the morning or at night with the radio on, I tell my patients to brush for one song, that’s about three minutes – the right amount of time to get the best results from brushing.” Furthermore, it has been observed that up to 39% people would not visit a dentist unless they suffer from painful dental cavities. Dentist are highly educated individuals in the society whom we often tend to neglect but have we ever realized how important they are? Regular dental visits are important because they help to keep your teeth and gums healthy. During the check-up, your dental professional will check your overall oral health for any trouble areas. While during the cleaning, your dental professional will remove any plaque or tartar buildup and may polish your teeth. Hence you should necessarily have a regular dental visit at least twice a year. On the other hand, The incidence of dental caries in children in most countries worldwide can be reduced. This would be largely attributed to exposure to fluoride, primarily from fluoride toothpaste, and improved oral hygiene. Where dental caries is largely under control by fluorides and regular dental care , moderate consumption of sugars is not a major risk factor except in individuals who are highly susceptible to dental caries or do not use fluoride toothpaste properly. Good

oral hygiene and the use of fluoride are considered the main factors responsible for preventing tooth decay and promoting good Rinse or chew sugarfree after oral health. meals. Rinsing your mouth with an antibacterial rinse can What does the help prevent decay and gum future hold for problems. Chewing sugar-free oral health? The gum after a meal can also investments we protect by increasing saliva make today will flow, which naturally washes create an exciting bacteria away and neutralizes tomorrow for oral acid health prevention. Six decades from now, dentistry should be integrated into the primary health care network of the nation. Dental drills will be a thing of the past. Specialized biomaterials such as rinses and biological implants will prevent plague formation on teeth, thus reversing tooth decay. Standard equipment in the dental offices will include imaging devices that can scan for and spot any unusual sores inside a patient’s mouth and even look for problems in other organs, through detection of saliva.

SELF MEDICATING Benefits and Problems

Being a Camel Doctor

By Abbas Naushad Sachedina

Pain relievers, cough remedies, antiallergics, laxatives, vitamins, tonics, antacids; these are the type of drugs most of us would self prescribe ourselves with after suffering from any minor symptoms like flu, fever, headache or acidity; not realizing the possibility of adverse effects that may result from this. Self-medication is defined as the selection and use of medicines by individuals Ciprofloxacin, a (or a member of the individualsâ&#x20AC;&#x2122; common new antibiotic family) to should not be taken treat selfrecognized with milk or other dairy diagnosed or selfconditions products for at least two or symptoms. hours.

of these antibiotics overtime may lead to bacterial resistance and therefore potential for future antibiotic resistant bacterial infections. We might think that weâ&#x20AC;&#x2122;re taking the correct measures in treating ourselves and getting rid of certain symptoms and this may provide relief to some extent and sometimes totally alleviate the symptoms, however in certain instances this may cause more harm than benefit. It is doubtful whether taking these drugs ever improves a personâ&#x20AC;&#x2122;s health, it may even make it worse, lead to dependency and poisoning. Only a qualified doctor is trained to decide when to treat symptoms only, and when to attack the cause.

Most of us when sick, tend to self prescribe ourselves with over the counter drugs thinking that the symptoms and signs we suffer from are minor and will get relieved on taking a pain killer or an antibiotic. This may have several benefits to some extent if used appropriately however it is not completely safe and may have a lot of risks, some of them being potentially life threatening. Some of them include incorrect selfdiagnosis, delays in seeking medical advice when needed, less frequent but severe adverse reactions (allergy), dangerous drug interactions, incorrect manner of administration, incorrect dosage, incorrect choice of therapy, poisoning, masking of a severe disease, risk of dependence and abuse. The psychology of such behavior is typically within the specific context of using recreational drugs, psychoactive drugs, alcohol, and other forms of behavior to alleviate symptoms of mental distress, stress and anxiety including mental illnesses and/or psychological trauma is particularly unique and can serve as a serious detriment to physical and mental health if motivated by addictive mechanisms. Another issue arising with self medication is treating oneself for infections using antibiotics without the prescription of a doctor, along with other drugs that are available dangerous drugs like antibiotics are also now freely available over the counter and therefore easily accessible to people who believe that the cause to their symptoms is a bacterial infection. The frequent misuse WHITE COATS | A JAMSA PUBLICATION | JULY 2014

DID YOU KNOW

Stuff to Know

By Sanjida Rashid

Mental Health Research has shown that lemon has a calming effect and therefore may be able to help remove fatigue, anxiety, exhaustion, nervousness and tension. It is also believed that inhaling lemon oil helps in increasing concentration and alertness. Hence, use it in your offices to increase the efficiency of the employees. Leave the fever Chills and fevers may be due to a variety of causes, but lemon is always a helpful remedy. Here’s a way to ease fever; add the juice of 1 lemon to a cup of hot water with honey and drink at once, then every 2 hours until the fever or chill subsides. Treating Arthritis and Rheumatism Lemon is a diuretic – assists in the production of urine which helps you to reduce inflammation by flushing out toxins and bacteria while also giving you relief from arthritis and rheumatism Respiratory Problems Lemon water can reduce phlegm (cough); and can also help you breathe properly in cases of asthmatic patients. Prevents Kidney Stones Regular consumption of the refreshing drink or even lemon juice mixed with water may increase the production of urinary citrate, a chemical in the urine that prevents the formation of crystals that may build up into kidney stones Keep Insects Out of the Kitchen You don’t need insecticides to keep your kitchen antiinsects free. All you need to do is squirt some lemon onto door thresholds, window sills, holes, cracks where insects enter through. Finally, scatter small slices of lemon peel around the outdoor entrance. The insects will get the message that they aren’t welcome. Anti-Aging Lemon water reduces the production of free radicals which are responsible for aging skin and skin damage. Lemon water is calorie free and an antioxidant. Making your skin look refreshed and clean. High Blood Pressure Lemon contains potassium which controls high blood pressure and reduces the effect of nausea and dizziness.

Oral Health I’m sure most of us have a sweet tooth, add some lemon to your daily life to reduce toothaches and reduce bleeding gums. Treat Infections Lemon water can fight throat infections, thanks to its antibacterial property. If salt water does not work for you, try lime and water for gargling. Lemons contain many substances notably citric acid, calcium, vitamin C and etc. that promote immunity and fight infection. Clean and Whiten Nails Pamper your hands without a manicurist. Add the juice of 1/2 lemon to 1 cup warm water and soak your finger in the mixture for 5 minutes. After pushing back the cuticles, rub some lemon peel back and forth against the nail. Deodorize Your Garbage If your garbage is beginning to smell yucky, here’s an easy way to deodorize it: Save leftover lemon and orange peels and toss them at the base under the bag. Abolish acne and lighten age spots Why buy expensive products when you’ve got lemon juice? Lemon contains citric acid, which can be effective in treating acne, to lighten liver spots and freckles. The vitamin C found in citrus fruits is vital for that healthy glowing skin while its alkaline nature kills some types of bacteria known to cause acne. Stomach Health With all the variety of foods we love to eat, lemon becomes an important ailment in treating majority of the digestive conditions such as consultation, reduces chances of indigestion, eliminates toxins from your body, purifies the blood. All you need to is to use warm water and lime juice.

Pl aza Limited

BOOK YOUR SPACE NOW Contact us at: Jangid Plaza Ltd. P.O.Box 22028, Dar Es Salaam, Tanzania. Sales Hotline: +255 784 737705, 0786 224822, 0776 786300 Email: shafiqali@jangidplaza.com

24 Hour Security

CCTV cameras and access control, monitored from central security room

Fully Controllable Air Conditioning in Each Floor

High Speed Internet access capability

Four (4) High Speed Lifts and Two (2) Escalators on Ground Floor for Shopping Center

Luxurious Interior Design of Ground Floor Lobby Using Marble and Granite

120 Covered Parking Spaces on Basement Levels

Designated visitors parking

Drop off Area at Building Entrance

Features: Electronic access cards for secured parking and tenants areas

Eight Floors of A-Class office Space, Offices ranging from 109mÂ˛ to over 1800mÂ˛

Retail outlets on the ground and mezzanine floor

Amenities: Location: Main Road Ally Hassan Mwinyi Road and Junction of Protea Apartments (Little Theater)

Jangid Plaza epitomizes the style and status of business in the most prestigious location in Dar Es Salaam with its elegant design and prominent position to the Oysterbay Area. Businesses gain maximum exposure through its strategic location on Ally Hassan Mwinyi Road and its close proximity to the commercial hub of Dar Es Salaam a prime location for world-class companies and brands.