Health check issue 10

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ISSUE 10

Wednesday, November 26, 2014

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GYTS

GLOBAL YOUTH TOBACCO SURVEY QATAR 2013

Objectives The Global Youth Tobacco Survey (GYTS), a component of the Global Tobacco Surveillance System (GTSS), is a global standard for systematically monitoring youth tobacco use (smoking and smokeless) and tracking key tobacco control indicators.

GYTS is a nationally representative school-based survey of students in grades associated with age 13 to 15 years and is designed to produce cross-sectional estimates for each country. GYTS uses a standard core questionnaire, sample design, and data collection protocol. It assists countries in fulfilling their obligations under the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) to generate comparable data within and across countries. WHO has developed MPOWER, a package of selected demand reduction measures contained in the WHO FCTC: (Continued on page 2...)

MEASURING QUALITY IMPROVEMENTS IN MENTAL HEALTH

P

rogressing the delivery of key pledges in the Qatar National Mental Health Strategy , recently the Supreme Council of Health (SCH) hosted a stakeholder workshop to agree on performance measures for mental health care.

The measures will be collectively known as the Mental Health Minimum Data Set (MHMDS), and enable the SCH to understand and compare health outcomes from multiple providers across the whole health system and monitor the successful delivery of mental health priorities.

The workshop was led by Kevin Smith, Clinical Projects Manager from South London & Maudsley NHS Foundation Trust and associate of Maudsley International, to generate consensus on the clinical data set for mental health with Qatar’s key healthcare organisations, including Primary Health Care Corporation, Hamad Medical Corporation and the National Health Insurance Company.

Speaking at the opening of the event, Kevin Smith said: “The MHMDS will support the delivery of Qatar’s National Mental Health Strategy by providing comprehensive national activity data at a patient level, which is anonymised. The MHMDS allows a better understanding of the population’s need for mental health services by generating high grade health intelligence. This in turn will inform research, service planning, service improvement and performance management.”

The MHMDS will contain record-lev-

el data about the care of children, adults and older people using mental health services and will help determine the level of mental health care needed in the community. The data set brings together key information from mental health care pathways that have been captured on clinical systems as part of patient care.

Critically the data will enable the SCH to understand the outcomes of treatment by people in contact with mental health services and enable Qatar to benchmark those patient outcomes against similar services internationally.

As part of a quality information system, the data will provide a necessary foundation for clinical research and practice by providing access to robust, comprehensive, nationally consistent and comparable information. The MHMDS will promote reflective practice, giving local clinicians and Managers better quality information to facilitate clinical auditing and improve their services. The data will also help ensure evidence collected from mental health research translates into improvements in clinical practice and patient outcomes.

SCH has enhanced the alertness for winter season

W

hile surveillance of acute respiratory conditions and influenza-like illnesses persists, Public Health Department (PHD) at the Supreme Council of Health (SCH) has enhanced the alertness for winter season where respiratory diseases usually escalate. Surveillance reports, however, did not register any new confirmed case with Middle East Respiratory Syndrome Corona Virus (MERS-CoV), apart from the

two Qatari cases reported in last October, where one case has completely recovered and discharged home, while the other is still kept under intensified medical care due to his critical condition.

Yet, the two cases have tested negative for the serological investigation during the first week of supportive treatment and isolation, as monitoring of potential contacts of the two patients was actively implemented and recommendations of preventive practices were communicated with the close contacts at the community level as well as the healthcare institutions. Additionally, monitoring of persons arriving from Ebola-affected regions has not revealed any confirmed case of Ebola Virus Disease in Qatar so far.

The Health Protection and Communicable Diseases Control Department early preparedness and response package includes

surveillance coupled with monitoring of suspected cases and contacts; laboratory confirmation; case management and isolation of infected cases with ensuring availability of supportive medications and seasonal flu vaccine; infection prevention and control measures, in addition to health education for vulnerable population groups.

To this end, SCH emphasises that the seasonal flu vaccine is readily available at the primary healthcare centres for all public and in particular for those at greater risk of severe respiratory illnesses: persons with chronic morbidities like Diabetes Mellitus, heart diseases, renal diseases, or low immunity, in addition to elderly. Further, several training activities are underway to maintain the national alertness and reinforce capacities of leaders and healthcare staff of the institutions involved in early preparedness and response.

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Wednesday, November 26, 2014

... REPORT ...

GYTS | GLOBAL YOUTH TOBACCO SURVEY (Continued from page 1)

QATAR 2013

Highlights TOBACCO USE •

15.7% overall, 22.8% of boys, and 8.8% of girls currently used any tobacco products.

•

12.3% overall, 18.4% of boys, and 6.2% of girls currently smoked tobacco.

•

9.8% overall, 14.9% of boys, and 4.7% of girls currently smoked cigarettes.

•

6.1% overall, 9.4% of boys, and 3.2% of girls currently used smokeless tobacco.

CESSATION 6 in 10 current smokers tried to stop smoking in the past 12 months.

6 in 10 current smokers want to stop smoking.

SECONDHAND SMOKE •

24.2% of students were exposed to tobacco smoke at home.

•

47.9% of students were exposed to tobacco smoke inside enclosed public places.

ACCESS & AVAILABILITY • Monitor tobacco use & prevention policies • Protect people from tobacco smoke • Offer help to quit tobacco use • Warn about the dangers of tobacco • Enforce bans on tobacco advertising, promotion & sponsorship • Raise taxes on tobacco

GYTS Methodology GYTS uses a global standardised methodology that includes a two-stage sample design with schools selected proportional to enrollment size. The classrooms within selected schools are chosen randomly and all students in selected classes are invited to participate in the survey. The survey uses a standard global core questionnaire with a set of optional questions that permits adaptation to meet the needs of the country on tobacco use and key tobacco control indicators. The questionnaire consists of the following topics: tobacco use (smoking and smoke-

less), cessation, secondhand smoke (SHS), pro- and anti-tobacco media and advertising, access and availability to obtain tobacco products, and knowledge and attitudes regarding tobacco. The questionnaire is self-administered; using scannable, paper-based bubble sheets, it is anonymous to ensure confidentiality.

In Qatar, GYTS was conducted in 2013 by SCH & SCE. A total of 2,109 eligible students in grades 7-9 completed the survey, of which 1,716 were aged 1315 years. The overall response rate of all students surveyed was 89.3%.

•

54.6% of current cigarette smokers obtained cigarettes by buying them from a store, shop, street vendor, kiosk, or cafeteria.

•

Among current cigarette smokers who bought cigarettes, 56.0% were not prevented from buying them because of their age.

MEDIA •

5 in 10 students noticed anti-tobacco messages in the media.

•

4 in 10 students noticed tobacco advertisements or promotions when visiting points of sale.

•

2 in 10 students own something with a tobacco brand logo on it.

KNOWLEDGE & ATTITUDES •

53.8% of students definitely thought other people’s tobacco smoking is harmful to them.

•

60.6% of students favor banning smoking inside enclosed public places.

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EDITORIAL TEAM

TASNIM AHMED TAHER ABU ZAID ............................................

DESIGNER RAVINDRANATH KOONATH ............................................

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Wednesday, November 26, 2014

... REPORT ...

GYTS│ YOUTH TOBACCO SURVEY GYTS GLOBAL | GLOBAL YOUTH TOBACCO SURVEY TOBACCO USE SMOKED TOBACCO Current tobacco smokers1

Current cigarette smokers2

Frequent cigarette smokers3

Current smokers of other tobacco4

Ever tobacco smokers5

Ever cigarette smokers6

Ever smokers of other tobacco7

OVERALL (%)

BOYS (%)

GIRLS (%)

12.3

18.4

6.2

9.8 2.7 7.0

29.7 24.8

SMOKELESS TOBACCO

Current smokeless tobacco users8

6.1

14.9 5.1

11.0

3.2

19.3

TOBACCO USE (smoked and/or smokeless) Current tobacco users10

15.7

22.8

Never tobacco users susceptible to tobacco use in the future12

23.1

Never smokers who thought they might enjoy smoking a cigarette13

12.1

3.0

9.4

31.0

15.2

SUSCEPTIBILITY

0.2

23.7

10.7 32.8

4.7

36.1

Ever smokeless tobacco users9 Ever tobacco

19.2 9.8 6.5 8.8

39.6

26.4

29.3

18.8

14.4

10.4

Current cigarette smokers who obtained cigarettes by buying them from a store, shop, street vendor, kiosk, or cafeteria14

Current cigarette smokers who were not prevented from buying cigarettes because of their age15 Current cigarette smokers who bought cigarettes as individual sticks16

MEDIA

TOBACCO INDUSTRY ADVERTISING

Current smokers who thought they would be able to stop smoking if they wanted to

Current smokers who have ever received help/advice from a program or professional to stop smoking

SECONDHAND SMOKE Exposure to tobacco smoke at home††

Exposure to tobacco smoke inside any enclosed public place†† Exposure to tobacco smoke at any outdoor public place††

Students who saw anyone smoking inside the school building or outside on school property†

61.6

60.6

--

68.9

67.0

--

57.6

60.4

--

25.8

25.8

24.8

OVERALL (%)

BOYS (%)

GIRLS (%)

24.2

24.8

23.3

47.9 48.5 27.4

46.4 48.9 38.7

48.9 47.9 16.8

61.3

35.5

56.0

52.5

--

15.0

10.2

--

36.9

38.0

Students who were ever offered a free tobacco product from a tobacco company representative

11.0

14.2

7.9

Students who saw anyone using tobacco on television, videos, or movies18

Students who own something with a tobacco brand logo on it

63.5

58.0

67.8

ANTI-TOBACCO ADVERTISING

16.2

Noticing anti-tobacco messages in the media†

52.9

51.5

53.9

Current smokers who thought about quitting because of a warning label20

31.7

36.3

19.3

Noticing anti-tobacco messages at sporting or community events19

Students who favor banning smoking inside enclosed public places GIRLS (%)

54.6

37.7

Students who definitely thought other people’s tobacco smoking is harmful to them

BOYS (%)

GIRLS (%)

GIRLS (%)

Students who thought smoking tobacco helps people feel more comfortable at celebrations, parties, and social gatherings

OVERALL (%)

BOYS (%)

BOYS (%)

Students who definitely thought it is difficult to quit once someone starts smoking tobacco

CESSATION

OVERALL (%)

OVERALL (%)

KNOWLEDGE & ATTITUDES

Current smokers who want to stop smoking now

QATAR 2013 QATAR 2013

Noticing tobacco advertisements or promotions at points of sale17

Students who were taught in school about the dangers of tobacco use in the past 12 months

Current smokers who tried to stop smoking in the past 12 months

FACT SHEET

ACCESS & AVAILABILITY

14.5

users11

3

Students who favor banning smoking at outdoor public places

45.2 47.2

19.6

13.0

48.2 48.1

42.0 46.4

OVERALL (%)

BOYS (%)

GIRLS (%)

19.1

17.1

20.8

22.0

24.6

19.3

60.6

61.4

60.2

53.8 55.5

51.2 54.1

56.3 56.5

Smoked tobacco anytime during the past 30 days. 2 Smoked cigarettes anytime during the past 30 days.

Smoked cigarettes on 20 or more days of the past 30 days. 4 Smoked tobacco other than cigarettes anytime during the past 30 days. 5 Ever smoked any tobacco, even one or two puffs. 6 Ever smoked cigarettes, even one or two puffs. 7 Ever smoked tobacco other than cigarettes, even one or two puffs. 8 Used smokeless tobacco anytime during the past 30 days. 9 Ever used smokeless tobacco. 10 Smoked tobacco and/or used smokeless tobacco anytime during the past 30 days. 11 Ever smoked tobacco and/or used smokeless tobacco.

12 Susceptible to future tobacco use includes those who answered “definitely yes”, “probably yes”, or “probably not” to using tobacco if one of their best friends offered it to them, or “definitely yes”, “probably yes”, or “probably not” to using tobacco during the next 12 months. 13 Those who answered “Agree” or “Strongly Agree” to the statement: “I think I might enjoy smoking a cigarette”. 14 How cigarettes were obtained the last time respondents smoked cigarettes in the past 30 days. 15 Of those who tried to buy cigarettes during the past 30 days. 16 Based on the last purchase, of those who bought cigarettes during the past 30 days. 17 Among those who visited a point of sale in the past 30 days. 18 Among those who watched television, videos, or movies in the past 30 days. 19 Among those who attended sporting or community events in the past 30 days. 20 Among those who noticed warning labels on cigarette packages in the past 30 days. † During the past 30 days. †† During the past 7 days.

1 3

NOTE: Students refer to persons aged 13-15 years who are enrolled in school. Data have been weighted to be nationally representative of all students aged 13-15 years. Percentages reflect the prevalence of each indicator in each group, not the distribution across groups.

--Indicates estimate based on less than 35 unweighted cases and has been suppressed.

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... DOCTOR’S DESK ...

TYPE 2 DIABETES: LEARN THE WARNING SIGNS sulin in the proper amount. Insulin allows the uptake of glucose by body cells for use as energy.

Type 2 Diabetes: Insulin Resistance What Is Type 2 Diabetes?

Type 2 diabetes can affect all people, regardless of age. Early symptoms of type 2 diabetes may be missed, so those affected may not even know they have the condition. An estimated one out of every three people with type 2 diabetes are not aware they have it. Diabetes interferes with the body’s ability to metabolise carbohydrates for energy, leading to high levels of blood sugar. These chronically high blood sugar levels increase a person’s risk of developing nerve problems, vision loss, cardiovascular disease, and other conditions.

Warning Sign of Diabetes: • Thirst

type 2 diabetes. Since diabetes can damage the blood vessels and nerves in the sex organs, decreased sensation can develop, potentially leading to difficulties with orgasm. Vaginal dryness in women and impotence in men are other complications of diabetes. Estimates suggest that between 35% and 70% of men with diabetes will eventually suffer from impotence. Statistics for women show that about one-third of women with diabetes will have some kind of sexual dysfunction.

In type 2 diabetes, the body’s cells cannot take up glucose properly, leading to high levels of glucose in the blood. Insulin resistance means that although the body can produce insulin, the body’s cells do not respond properly to the insulin that is made. Over time, the pancreas reduces the amount of insulin that it produces.

How Type 2 Diabetes is Diagnosed The hemoglobin A1c test measures the amount of glycosylated hemoglobin (hemoglobin bound to glucose) in your blood and provides information about your average blood glucose levels over the previous 2 to 3 months. Hemoglobin A1c levels over 6.5% are suggestive of diabetes. Another diagnostic test is the fasting blood glucose test. If your fasting blood glucose level is over 126, this establishes that diabetes is present. Random blood glucose levels over 200 are also consistent with diabetes.

Risks You Can Prevent Certain risk factors related to both lifestyle choices and medical conditions can increase your risk of developing type 2 diabetes. These include: • Cigarette smoking • Being overweight or obese, especially around the waist • Lack of exercise • Consuming a diet that is high in processed meat, fat, sweets, and red meats • Triglyceride levels over 250 mg/dL • Low levels of “good” HDL cholesterol (below 35 mg/dL)

Risks You Can’t Prevent Although people with type 2 diabetes may not have specific symptoms, an increase in thirst is one symptom that is characteristic of the condition. The increased thirst can accompany other symptoms like frequent urination, feelings of unusual hunger, dry mouth, and weight gain or loss.

• Headaches Other symptoms that can occur if high blood sugar levels persist are fatigue, blurred vision, and headaches.

• Infections Often, type 2 diabetes is only identified after its negative health consequences are apparent. Certain infections and sores that take a long time to heal are a warning sign.

Other possible signs include frequent yeast infections or urinary tract infections and itchy skin.

• Sexual Dysfunction Sexual problems can occur as a result of

Some risk factors for diabetes can’t be controlled. Hispanics, Native Americans, Asians, and African Americans have a higher than average risk for getting diabetes. Having a family history (parent or sibling) with diabetes increases your risk.

Those over 45 have a higher risk of type 2 diabetes than younger people.

Women’s Risk Factors Women who developed gestational diabetes in pregnancy have a higher risk for developing type 2 diabetes later in life. The same goes for women who have babies larger than 9 pounds. The insulin resistance associated with polycystic ovary syndrome also places women with this condition at a higher risk for diabetes.

How Does Insulin Work?

Insulin is a hormone that allows the body to efficiently use glucose as fuel. After carbohydrates are broken down into sugars in the stomach, glucose enters the circulation and stimulates the pancreas to release in-

(Source: medicinenet.com)

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... DOCTOR’S DESK ...

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Long-Term Damages: • Arteries Around two out of every three people with diabetes die of heart disease. Over time, elevated blood sugar levels damage the blood vessels, leading to an increased risk of clots. This increases the risk of heart attack. People with diabetes are also at an increased risk for stroke because of the damage to blood vessels.

• Kidneys

DIABETES

The risk for developing chronic kidney disease increases with time in people with diabetes. Diabetes is the most common cause of renal failure, making up about 44% of cases. Keeping your diabetes under control can reduce the risk of kidney failure. Medications are also used to reduce the risk of kidney disease in people with diabetes.

MANAGEMENT

• Eyes Diabetic retinopathy is damage to the tiny blood vessels within the retina of the eye due to high blood sugar levels over time.

This can cause progressive and permanent vision loss. Diabetic retinopathy is the most common cause of new blindness in people between 20 and 74. This image shows pools of blood, or haemorrhages, in the retina.

Type 2 Diabetes Prevention

• Nerve Pain

Type 2 diabetes is preventable in many cases. At the least, it is possible to reduce the incidence of complications of diabetes by eating a healthy diet, getting moderate exercise, and maintaining a healthy weight. It’s also helpful for people at risk to be screened for diabetes and prediabetes, so that management can begin early in the course of the disease. This reduces the risk of long-term problems.

• Diet Keeping good control over blood sugar levels can help reduce the risk of getting complications from diabetes. Your doctor can refer you to a registered dietician or diabetes counsellor to help you formulate a healthy eating plan. Many people with type 2 diabetes will need to monitor intake of carbohydrates and reduce calories. Watching total fat and protein consumption is also recommended.

• Exercise Regular exercise, including walking, can help people with type 2 diabetes lower their blood glucose levels. Physical activity also reduces body fat, lowers blood pressure, and helps prevent cardiovascular disease. It’s recommended that people with type 2 diabetes get 30 minutes of moderate exercise on most days.

• Reduce Stress Stress is particularly worrisome for people with diabetes. Stress not only increases blood pressure, but it can also increase blood glucose levels. Many people with

Tingling, numbness, and a sensation of “pins and needles” are all symptoms of diabetic neuropathy, or nerve damage related to diabetes. This is most common in the hands, feet, fingers, or toes. Controlling diabetes can help prevent this complication.

• Feet Damage to nerves caused by diabetes can make it hard to feel injuries to the feet. At the same time, damage to the blood vessels can reduce circulation in the feet of people with diabetes. Sores that heal poorly and even gangrene are complications of diabetes that can occur in the feet. Amputation may be the result in severe cases.

diabetes find that relaxation techniques can help manage their condition. Examples are visualisation, meditation, or breathing exercises. Taking advantage of social support networks is also helpful, like talking with a relative or friend, member of the clergy, or counsellor.

• Oral Medications Oral medication is recommended for people with type 2 diabetes who cannot adequately control their blood sugar with diet and exercise. Many types of oral diabetes medications are available, and these may be used in combination for the best results. Some increase insulin production, others improve the body’s use of insulin, while still others partially block the digestion of starches.

• Insulin Some people with type 2 diabetes also take insulin, sometimes in combination with oral medications. Insulin is also used in “beta-cell failure,” a condition in which the pancreas no longer produces insulin in response to elevated blood glucose. This can occur in people with type

2 diabetes. If insulin is not produced, insulin treatment is necessary.

• Non-Insulin Injections There are other non-insulin drugs given in injection form that are used to treat type 2 diabetes. Examples are pramlintide (Symlin), exenatide (Byetta), and liraglutide (Victoza). These drugs stimulate the release of insulin.

• Testing Blood Glucose Your doctor can suggest how often you should test your blood glucose. Testing can give a good idea of the extent to which your diabetes is under control and can tell you if your management plan needs to be altered. Some common times to test blood sugars are upon awakening, before and after meals, before and after exercise or physical activity, and at night.

(Source: medicinenet.com)

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Wednesday, November 26, 2014

... WOMEN’S HEALTH ...

OVARIAN CYSTS AND TUMOURS What causes ovarian cysts?

Cysts are fluid-filled sacs that can form in the ovaries.

They are very common. They are particularly common during the childbearing years.

There are several different types of ovarian cysts. The most common is a functional cyst. It forms during ovulation. That formation happens when either the egg is not released or the sac -- follicle -- in which the egg forms, does not dissolve after the egg is released.

Other types of cysts include: • Polycystic ovaries. In polycystic ovary syn-

What causes ovarian tumours?

THE OVARIES ARE TWO SMALL ORGANS LOCATED ON EITHER SIDE OF THE UTERUS IN A WOMAN’S BODY. THEY MAKE HORMONES, INCLUDING OESTROGEN, WHICH TRIGGER MENSTRUATION. EVERY MONTH, THE OVARIES RELEASE A TINY EGG. THE EGG MAKES ITS WAY DOWN THE FALLOPIAN TUBE TO POTENTIALLY BE FERTILISED. THIS CYCLE OF EGG RELEASE IS CALLED OVULATION.

Tumours can form in the ovaries, just as they form in other parts of the body. If tumours are non-cancerous, they are said to be benign. If they are cancerous, they are called malignant. The three types of ovarian tumours are: • Epithelial cell tumours start from the cells on the surface of the ovaries. These are the most common type of ovarian tumours.

• Germ cell tumours start in the cells that produce the eggs. They can either be benign or cancerous. Most are benign.

• Stromal tumours originate in the cells that produce female hormones.

What are the symptoms of ovarian cysts and tumours?

Often, ovarian cysts don’t cause any symptoms. You may not realise you have one until you visit your health care provider for a routine pelvic exam. Ovarian cysts can, however, cause problems if they twist, bleed, or rupture.

If you have any of the symptoms below, it’s important to have them checked out. That’s because they can also be symptoms of ovarian tumours. Some of these ovarian tumors can be cancerous especially in

•

• •

Ovary with cyst

drome (PCOS), the follicles in which the eggs normally mature fail to open and cysts form.

Endometriosis. In women with endometriosis, tissue from the lining of the uterus grows in other areas of the body. This includes the ovaries. It can be very painful and can affect fertility.

Cystadenomas. These cysts form out of cells on the surface of the ovary. They are often fluid-filled.

Dermoid cysts. This type of cyst contains tissue similar to that in other parts of the body. That includes skin, hair, and teeth.

Doctors aren’t sure what causes ovarian cancer. They have identified, though, several risk factors, including: • Age - specifically women who have gone through menopause • Smoking • Obesity • Not having children or not breastfeeding (however, using birth control pills seems to lower the risk) • Taking fertility drugs (such as Clomid) • Hormone replacement therapy • Family or personal history of ovarian, breast, or colorectal cancer (having the BRCA gene can increase the risk)

older women. Ovarian cancer often spreads before it is detected.

Symptoms of ovarian cysts and tumours include: • Pain or bloating in the abdomen • Difficulty urinating, or frequent need to urinate • Dull ache in the lower back • Pain during sexual intercourse • Painful menstruation and abnormal bleeding • Weight gain • Nausea or vomiting • Loss of appetite, feeling full quickly

How are ovarian cysts and tumours treated?

Most ovarian cysts will go away on their own. If you don’t have any bothersome symptoms, especially if you haven’t yet gone through menopause, your doctor may advocate ‘’watchful waiting.’’ The doctor won’t treat you.

But the doctor will check you every one to three months to see if there has been any change in the cyst.

Birth control pills may relieve the pain from ovarian cysts. They prevent ovulation, which reduces the odds that new cysts will form.

Surgery is an option if the cyst doesn’t go away, grows, or causes you pain. There are two types of surgery: • Laparoscopy uses a very small incision and a tiny, lighted telescope-like instrument. The instrument is inserted into the abdomen to remove the cyst. This technique works for smaller cysts.

•

Laparotomy involves a bigger incision in the stomach. Doctors prefer this technique for larger cysts and ovarian tumours. If the growth is cancerous, the surgeon will remove as much of the tumour as possible. This is called debulking. Depending on how far the cancer has spread, the surgeon may also remove the ovaries, uterus, fallopian tubes, omentum -- fatty tissue covering the intestines -- and nearby lymph nodes.

Other treatments for cancerous ovarian tumours include: • Chemotherapy - drugs given through a vein (IV), by mouth, or directly into the abdomen to kill cancer cells. Because they kill normal cells as well as cancerous ones, chemotherapy medications can have side effects, including nausea and vomiting,

hair loss, kidney damage, and increased risk of infection. These side effects should go away after the treatment is done.

•

Radiation - high-energy X-rays that kill or shrink cancer cells. Radiation is either delivered from outside the body, or placed inside the body near the site of the tumour. This treatment also can cause side effects, including red skin, nausea, diarrhoea, and fatigue. Radiation is not often used for ovarian cancer.

Surgery, chemotherapy, and radiation may be given individually or together. It is possible for cancerous ovarian tumours to return. If that happens, you may need surgery, chemotherapy or radiation depending upon the type of tumor and the site where it has relapsed.

(Source: webmd.com)

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... PAEDIATRICS & CHILD HEALTH ...

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HEALTH ISSUES OF PREMATURE BABIES BECAUSE PREMATURE BABIES ARE BORN BEFORE THEY ARE PHYSICALLY READY TO LEAVE THE WOMB, THEY OFTEN HAVE HEALTH PROBLEMS. THESE NEW-BORNS HAVE HIGHER RATES OF DISABILITIES (SUCH AS CEREBRAL PALSY) AND EVEN DEATH. BECAUSE OF THESE HEALTH CONCERNS, PREMATURE BABIES ARE GIVEN EXTRA MEDICAL ATTENTION AND ASSISTANCE IMMEDIATELY AFTER DELIVERY. DEPENDING ON HOW EARLY THE BABY HAS ARRIVED, YOUR PAEDIATRICIAN OR OBSTETRICIAN MAY CALL IN A NEONATOLOGIST (A PAEDIATRICIAN WHO SPECIALISES IN THE CARE OF PREMATURE OR VERY ILL BABIES) TO HELP DETERMINE WHAT, IF ANY, SPECIAL TREATMENT THE INFANT NEEDS.

HERE ARE SOME OF THE MOST COMMON CONDITIONS THAT OCCUR IN PREMATURE INFANTS: Respiratory Distress Syndrome (RDS) RDS is a breathing disorder related to the baby’s immature lungs. It occurs because the lungs of preterm babies often lack surfactant, a liquid substance that allows the lungs to remain expanded.

Treatment: Artificial surfactants can be used to treat these babies, along with a ventilator to help them breathe better and maintain adequate oxygen levels

in their blood. Sometimes, extremely preterm babies may need long term oxygen treatment and occasionally may go home on supportive oxygen therapy.

Chronic Lung Disease/ Bronchopulmonary Dysplasia (BPD) BPD, or chronic lung disease, is a term used to describe babies who require oxygen for several weeks or months. They tend to outgrow this uncommon condition, which varies in severity, as their lungs grow and mature.

Apnoea and Bradycardia Apnoea is a temporary pause (more than

fifteen seconds) in breathing that is common in preterm infants. It often is associated with a decline in the heart rate, called bradycardia. A drop in oxygen saturation as measured by a machine called pulse oximetry is called desaturation. Most infants outgrow the condition by the time they leave the hospital for home.

Retinopathy of Prematurity (ROP) ROP is an eye disease in which the retina is not fully developed.

Treatment: Most cases resolve without treatment, although serious cases may need treatment, including laser surgery in the most severe instances. Your infant may be examined by a paediatric oph-

thalmologist or retina specialist to diagnose and, if needed, recommend treatment for this condition.

Jaundice Jaundice happens when a chemical called bilirubin builds up in the baby’s blood. As a result, the skin may develop a yellowish colour. Jaundice can occur in babies of any race or colour.

Treatment: Treating it involves placing the undressed baby under special lights (while her eyes are covered to protect them).

Other Health Problems Other conditions sometimes seen in preterm babies include anaemia of prematurity (a low red blood cell count) and heart murmurs.

(Source: healthychildren.org)

Depression in Children and Young People: Information for Parents DEPRESSION CAN AND DOES OCCUR IN CHILDREN AND YOUNG PEOPLE. IN FACT A SIGNIFICANT PROPORTION OF MENTAL ILLNESSES DEVELOP IN ADOLESCENCE, OFTEN BEFORE THE AGE OF 14.

BEING AWARE OF THE SIGNS AND SYMPTOMS WILL ENABLE PARENTS TO SEEK HELP FOR THEIR CHILDREN AT AN EARLY STAGE, WHICH WILL BENEFIT THEIR RECOVERY. • Depression affects how people feel about themselves and may cause a young person to feel sad, moody or miserable most of the time. They may lose interest in things they normally enjoy, lack energy, have difficulty sleeping or sleep more than usual, feel irritable and find it hard to concentrate.

• Symptoms of depression in children and adolescents can present as functioning poorly at school, socially, or at home. It might even present as bad behaviour, particularly in boys.

• The duration and persistence of the symptoms is something that parents should be paying attention to. If they notice that symptoms are longer lasting (more than 2 weeks), it is advisable to seek advice from a health professional. The symptoms of depression are also common for other health conditions that are not mental health related and these should also be explored.

• A consultation with a mental health expert is advisable as depression needs treatment, just as any other

illness. A children’s mental health expert will be able to discuss the best possible treatment options which can include individual psychological therapy (which is based on talking therapy), family work and in some cases medication. Each individual child is assessed according to what they need in order to make a full recovery.

• Child and Adolescent Mental Health Services are available through Hamad Medical Corporation’s Psychiatry Department.

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Wednesday, November 26, 2014