Health check Qatar

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ISSUE 16

Wednesday, July 29, 2015

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EXTINGUISHING THE THE WILL TO FLAME FOR TOBACCO USE

Antitobacco law in Qatar currently prohibits smoking in closed public places such as buses, shops and commercial centers.

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obacco dependency is a serious issue in Qatar, with more than two-fifths (41.5 percent) of smokers interviewed for GATS having their first puff within half an hour of waking. This is particularly high among the female population with 59.2 percent lighting up within 30 minutes of waking, compared with 39.9 percent of men.

Women smokers do, however, smoke fewer cigarettes per day, with average consumption at 10.9 percent in contrast to 17.6 percent among male smokers.

More than half (55.4 percent) of daily cigarette smokers consume 16 or more cigarettes per day.

Despite the high figures indicating daily cigarette use and numbers of cigarettes smoked, GATS Qatar revealed that there is a wish among the country’s tobacco users to give up.

Overall, 66.8 percent of current tobacco smokers were interested in quitting. Motivations possibly include an increasing awareness of the health risks associated with tobacco use.

The Qatar study shows that two thirds of smokers who visited a health care provider in the last 12 months were advised to quit smoking. Many of those attempting to give up smoking, however, did so without support. Figures show that 21.9 percent of men and 19.6 percent of women attempted to quit smoking while supported by nicotine replacement therapies, and 16.1 percent of men and 13.9 percent of women attempted to give up their habit with the support of counseling or advice.

Studies show that cessation support is vital in helping many of those wanting to give up tobacco use in breaking their dependency.

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n internationally recognized survey commissioned by the Supreme Council of Health highlights attitudes towards tobacco in the country, as well as the increasing desire among smokers to quit their habit.

Giving up smoking tobacco is a positive step toward better health for any individual. Smoking has been directly linked to increased risk of heart disease, diabetes, respiratory diseases and cancers, but according to the World Health Organization (WHO): “very few people will successfully quit the habit in their first attempt.” Tobacco users need support to help break their habit.

Governments clearly have a vested interest in helping individuals who want to reduce their tobacco use, but how is it possible to plan ahead and prepare resources to assist those ready to quit their smoking habit without first understanding the scale of the challenge?

In its efforts to verify the level of tobacco consumption, smoking cessation services and public perceptions surrounding tobacco, the Supreme Council of Health (SCH) and the Ministry of Development Planning and Statistics in Qatar, partnered in conducting the country’s first Global Adult Tobacco Survey (GATS).

In launching the study, Dr Kholood al Mutawa, Head of Non-Communicable Diseases at the SCH, said: “The survey methods are based on a global standard methodology for collecting data. The study will follow a global

protocol that has been reviewed and revised to be culturally appropriate for the Qatari community.”

The final report, also the first to be conducted in the region, was published in November 2014. This landmark study is recognized internationally as a tool to monitor adult tobacco use, enabling future planning implementation, and evaluation of tobacco control programs.

The National Health Strategy 2011-2016 (NHS) encompasses tobacco cessation with a commitment to reduce tobacco consumption and the GATS study fulfills the country’s obligation under WHO’s Framework Convention on Tobacco Control, signed by 178 countries which aims to generate comparable, open-access data.

This means that the success, or otherwise, of tobacco cessation programs can be compared on a wider scale.

GATS Qatar data was gathered from 8,398 male and female residents (both Qataris and ex-pats), aged 15 years and above, between March 6 and May 6, 2014. The study does not include laborers or domestic workers.

Standout GATS Qatar results showed that 12.1 percent of Qatar’s adult population is made up of smokers, who embark on their habit daily or less frequently. However, 38.2 percent of those had attempted to quit in the past 12 months, with 91.3 percent acknowledging that smoking causes serious illness. The will to stop is clearly strong.

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Wednesday, July 29, 2015

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Creating a smoke-free society

Targeting shisha use The figures regarding shisha smoking do not reveal the same wish to reduce tobacco usage, with 1.7 percent fewer of Qatar’s adult smokers believing this form of tobacco consumption is damaging to health.

While shisha users are far outnumbered by cigarette smokers – with just 3.4 percent of the adult population consuming tobacco in this way – it is a communal activity, particularly among the male population, which therefore presents its own challenges in any cessation initiative.

Nearly 74 percent of users recorded that their last shisha-smoking session occurred in a café, with 85.2 percent of those being male smokers.

Women are more likely to use a waterpipe at home with 62.8 percent indicating that this was the environment of their last shisha-smoking session in the survey. Even taking into account cultural precedence for female Qataris, 60.1 percent of non-Qatari women stated that their last shisha-smoking session occurred at home.

GATS data from other countries also supports the misconception that using a waterpipe is a less harmful way to use tobacco.

There is a belief that this is a safer method of consuming tobacco due to the smoke’s passage through water, which is thought to filter out toxins. Studies show, however, that this is not the case as harmful polycyclic aromatic hydrocarbons (PAHs), nicotine, tar, and particles remain in the inhaled smoke. Just like smoking cigarettes, using a waterpipe has been linked to lung cancer, periodontal diseases and low birth weight.

When compared with cigarettes, research suggests shisha use exposes smokers and those around them to lower quantities of toxic substances in a single puff. This is, however, counterbalanced with the duration of each smoking session, typically lasting 45 to 60 minutes and the depth of each inhaled breath.

In addition, studies show that a single waterpipe session can increase blood nicotine and carbon monoxide exposure to

higher levels than those observed after a single cigarette.

More research is required and a study ‘Effect of Shisha Smoking on the Biology of the Airway Epithelium in Qatar’, led by Dr Ronald Crystal of Weill Cornell Medical College is currently underway. The research team will be joined by colleagues from Weill Cornell Medical College in Qatar and a Hamad Medical Corporation (HMC) team is due shortly.

Qatar’s smokers are not alone in believing that shisha offers a less harmful method of consuming tobacco. A study entitled ‘Cross-country comparison of waterpipe use: nationally representative data from 13 low to middle-income countries from GATS’ was published on 11 June 2013.

While the data is not directly comparable with Qatar, since this is ranked as a high-income country, the results are interesting for healthcare professionals planning to tackle the issue.

Of the 13 countries surveyed, waterpipe use among men was highest in Vietnam (13.0 percent) with Egypt ranked second (6.2 percent). Alarmingly, more than 90 percent of adult smokers in Ukraine thought smoking tobacco caused serious illness but only 31.4 percent believed smoking tobacco using a waterpipe was seriously damaging to health.

Some 22 countries have published GATS data (at time of writing). More are scheduled to publish their results in the near future which will allow direct comparison of higher income countries, such as Qatar, and a truer assessment of attitudes towards shisha.

As expected, GATS Qatar revealed that attitudes towards the harmful effects of tobacco are strongest among the non-smoking adult population. According to the Qatar survey 96.7 percent of non-smokers believed smoking caused serious illness, while 90.9 percent of adults believed shisha is harmful.

The health risks posed by passive smoking are well documented. WHO’s Tobacco Free Initiative records that more than 600,000 people die each year from exposure to secondhand smoke. According to WHO there is no safe level of exposure to smoke.

GATS Qatar data shows that smokers recognize the risks of breathing other people’s smoke as 91.7 percent of adult smokers in the study indicated that they believe that this causes serious illness.

Anti-tobacco law in Qatar currently prohibits smoking in closed public places such as buses, shops and commercial centers.

Of those working indoors, 12 percent indicated that they were exposed to tobacco smoke in the workplace with 16.8 percent exposed to tobacco smoke at home.

Under current legislation, which is under review, individuals caught smoking within confined areas in public places can be fined.

Discouraging youth tobacco use Preventing initiation of tobacco use among the young is an important element of any anti-smoking campaign, since it is easier to prevent people smoking than it is to break the habit of dependency.

GATS Qatar revealed that 45.5 percent of smokers, currently aged 20-34 years started smoking before they reached 18 years, with 8.6 percent starting before the age of 15.

Current legislation (Law No. 20 of 2002) prohibits the sale of tobacco products within 500 meters of schools and other educational and training institutions. It is also illegal to sell tobacco products to people below the age of 18 years.

New regulations backed by the Supreme Council of Health under NHS 20112016 requiring tobacco manufacturers to place health warnings on cigarette packets came into force in November 2012. The labels warn graphically of the potential dangers including cancers, breathing problems and gum disease.

GATS Qatar indicates that these may be encouraging smoking cessation with 51.4 percent of current smokers considering quitting because of warning labels on cigarette packets. Only 23.8 percent of current shisha smokers considered quitting because of warning labels on shisha products, although 45.9 percent did notice anti-shisha smoking information in local media.

New laws are expected to discourage tobacco use – particularly in respect to the exposure young people have to products.

International solidarity World No Tobacco Day is marked by WHO each year on 31 May, when smokers are encouraged to reduce their tobacco

consumption over the course of the day.

SCH undertook a media campaign to highlight the event within the community and the health benefits associated with tobacco cessation. HMC hosted a series of educational events and activities, aimed at the public and healthcare professionals, offering support in quitting smoking.

Support to quit Tobacco cessation support clinics can help those wanting to quit smoking. Alongside willpower alone, cessation clinics can give individuals an understanding of the techniques necessary to break their habit.

Clinics can provide psychological counselling, nicotine replacement therapies, and other medications. Many private health care providers run such clinics as do selected HMC and PHCC facilities.

(Source: sch.gov.qa)

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Wednesday, July 29, 2015

... HEALTH QUIZ ...

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MYTHS AND FACTS ABOUT YOUR MOOD s r e w s n A Quiz Question 1 = D A recent study found that people who consume a lot of olive oil are less likely to be depressed. Salmon and walnuts are good sources of omega-3 fatty acids, and some studies have suggested that these essential fatty acids could have mood-boosting properties. Some research also indicates that eating high-calorie comfort foods, which we typically reach for during times of stress or anxiety, may be a type of “natural reward” that reduces stress responses.

Question 2= B

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Which of the following foods is thought to have positive effects on mood? a. Olive oil b. Salmon c. Walnuts d. All of the above You’re more likely to catch someone in a lie if you’re in which of the following moods a. Good b. Bad c. Neutral Moods are contagious. a. True b. False Exercise can improve your mood by a. Creating new neurons b. Boosting brain blood flow c. Increasing dopamine levels d. All of the above As people get older, they’re more likely to be in bad moods. a. True b. False

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When smokers quit smoking, they suffer from darker moods?

a. True b. False If you’re in a good mood, you’re more likely to be? a. Rational b. Superstitious c. Risk-averse d. None of the above A change in weather can change your mood a. True b. False Seasonal affective disorder is a weather-related mood disorder that: a. Occurs in winter b. Occurs in summer c. Occurs in spring d. All of the above Depression can be distinguished from normal feelings of sadness or pessimism by a. Symptoms b. Severity c. Duration d. All of the above

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Australian researchers studying the effect of mood on scepticism and trust found that people in a good mood are more trusting and people in a bad mood are more sceptical. People in a bad mood were more likely to detect when someone was being deceptive, while people in a good mood were more easily fooled.

Question 3 = A A recent study found that people can “catch” happiness from happy people around them or become more depressed if they’re around people who are depressed. “People’s happiness depends on the happiness of others with whom they are connected,” the authors concluded.

Question 4 = D Studies have shown that exercise can help create new neurons in the brain, boost blood flow to the brain, and increase levels of key moodregulating chemicals in the brain, such as dopamine and serotonin.

Question 5 = B A number of studies have shown that as people grow older, they generally tend to accentuate the positive.

Researchers speculate that as people begin to realize that they have a limited number of years left, they make a conscious or subconscious decision to focus more on positive thoughts.

Another possibility is physiological: As people age, a part of the brain

associated with emotion is more likely to be activated in response to positive images and less activated in response to negative images.

Question 6 = B Although it’s true that smokers can feel irritable while they’re trying to quit, a Brown University study found that smokers reported being in much better moods after they had successfully quit smoking. However, if they had been trying to quit but were unable to do so, they reported being in much darker moods.

Question 7 = B According to a study in the Journal of Personality and Social Psychology, people in a good mood are more likely to be superstitious than people in a bad mood. Researchers speculate that happy people are more inclined to “follow their gut” -- even if it’s not rational – since what they’ve been doing so far has been making them happy.

Question 8 = A Numerous studies confirm that people’s moods can be significantly affected by the weather. Sunshine is associated with good moods, and “spring fever” appears to be a real phenomenon brought on by warmer temperatures at the end of winter.

Question 9 = D Seasonal affective disorder (SAD) is a mood disorder that most often occurs in winter but can occur any time of year. It appears to be related to the body’s response to varying amounts of sunlight, so it tends to occur when days are shorter in the winter or in other parts of the year when it’s unusually cloudy.

Question 10 = D Depression is differentiated from normal mood changes by the extent of its severity, the symptoms, and the duration of the disorder. Consult a doctor if symptoms persist for more than two weeks or if they significantly impair your normal activities

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... MENTAL HEALTH ...

TOP CONCENTRATION KILLERS

WHETHER YOU’RE LIVING WITH ADHD OR JUST HAVE TROUBLE FOCUSING FROM TIME TO TIME, TODAY’S WORLD IS FULL OF CONCENTRATION KILLERS. PSYCHOLOGIST LUCY JO PALLADINO, PHD OFFERS A FEW TIPS TO MANAGE DISTRACTIONS, STARTING WITH SOCIAL MEDIA

Culprit: Social Media It’s easy to connect with friends -- and disconnect from work -- many times an hour. Every status update zaps your train of thought, forcing you to backtrack when you resume work.

Fix: Avoid logging in to social media sites while you’re working. If you feel compelled to check in every now and then, do it during breaks, when the steady stream of posts won’t interrupt your concentration. If you can’t resist logging in more frequently, take your laptop someplace where you won’t have Internet access for a few hours

Culprit: Email Overload There’s something about an email -- it shoots into your inbox and itches to be answered immediately. Although many emails are work-related, they still count as distractions from your current project. You won’t make much progress if you constantly stop what you’re doing to reply to every message.

Instead of checking email continuously, set aside specific times for that purpose.

During the rest of the day, you can actually shut down your email program. This allows you to carve out blocks of time when you can work uninterrupted.

Culprit: Your Cell Phone Perhaps even more disruptive than the ping of an email is the ringtone on your cell phone. It’s a sound few of us can ignore.

But taking a call not only costs you the time Fix: If you suspect the call is not urgent, answer it later. If you’re working on a par-

ticularly intense project, consider silencing your phone so you’re not tempted to answer.

Culprit: Stress When you feel like you have too much on your plate, it can be hard to focus on individual tasks. To make matters worse, stress takes a noticeable toll on the body.

You may develop tight shoulders, headaches, or a racing heart, all of which can chip away at your ability to concentrate.

Fix: Learn stress reduction techniques, such as meditation. This can help you rein in stressful thoughts, so they don’t demand so much of your attention. In one study, researchers found that people who took an eight-week meditation course improved their ability to focus. If you can’t find a meditation class locally, look for one online.

Culprit: Multitasking If you’ve mastered the art of multitasking, you probably feel you’re getting more done in less time. Think again, experts say.

Research suggests you lose time whenever you shift your attention from one task to another. The end result is that doing three projects simultaneously usually takes longer than doing them one after the other.

Fix: Whenever possible, devote your attention to one project at a time, particularly if you’re working on an intense or high-priority task. Save your multitasking skills for chores that are not urgent or demanding –it probably won’t hurt to tidy up your desk while talking on the phone.

Culprit: Boredom Some of the tasks we have to do each day are more interesting than others. The boring ones may burn through your attention span in minutes, making you extremely vulnerable to distractions. Your phone, the Internet, even the prospect of dusting your workspace can seem tempting if you’re bored.

Fix: Make a deal with yourself: If you stay on task for a certain period of time, you earn a 10-minute break. Reward yourself with coffee, a favourite snack, or a walk outside. Boring tasks are easier to accomplish when you have something to look forward to. This is also one case where multitasking may work well. Listening to the radio while filing receipts could help you stay put long enough to finish the job.

Culprit: Fatigue Fatigue can make it tough to concentrate, even when you have few distractions.

Studies suggest too little sleep can sap your attention span and short-term memory.

Fix: Most adults need 7-9 hours of sleep per night. Instead of burning the midnight oil, make sleep a priority. This will help you get more done during your waking hours.

Also, pay attention to which times of day you feel most alert. Then you’ll know when to schedule your most intense tasks.

Culprit: Hunger The brain can’t focus without fuel, so skipping meals, especially breakfast, is a top concentration killer. Research indicates short-term memory and attention suffer when you don’t eat breakfast.

Fix: Keep hunger at bay and give your brain a steady source of fuel with these habits: • Always eat breakfast.

• Eat high-protein snacks (cheese, nuts) • Skip simple carbs (sweets, white pasta) • Choose complex carbs (whole grains)

Culprit: Depression Most people tend to think of sadness as the hallmark of depression. But the National Institute of Mental Health says difficulty concentrating is one of the most common symptoms. If you’re having trouble focusing and you also feel empty, hopeless, or indifferent, you may be experiencing depression.

Fix: If you think you might be depressed, the first step is to talk with a doctor or counsellor. Depression is highly treatable. Many studies have shown the effectiveness of antidepressant medications and certain types of talk therapy.

Culprit: Medication Unfortunately, some of the medications used to treat depression can interfere with concentration. The same is true of many other drugs. Talk to your doctor or pharmacist to check if a medication or supplement you are taking may be affecting your concentration.

Fix: If you suspect your meds are clouding your concentration, don’t assume there are no other options. Talk to your doctor about adjusting your dosage or switching to a different class of medication. Do not stop taking your medicine unless your doctor tells you to.

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... NUTRITION ...

OVE R P N IM ES OF A C THY C L U N A O E A Y CH AH R G U YO ININ ADD A T N YOU S AND MAI F I D IN BRA RT” FOO UR DIET A O “SM S TO Y K DRIN

BRAIN FOOD THAT IMPROVE YOUR CONCENTRATION I

t may sound trite but it’s true: If your diet lacks essential nutrients, it can hurt your ability to concentrate.

Eating too much or too little can also interfere with your focus. A heavy meal may make you feel tired, while too few calories can result in distracting hunger pangs.

Benefit your brain: Strive for a well-balanced diet full of a wide variety of healthy foods and they will do everything from sharpen focus to enhance memory, attention span, and brain function.

But do they really work? There’s no denying that as we age, our body ages right along with us. The good news is that you can improve your chances of maintaining a healthy brain if you add “smart” foods and drinks to your diet.

Caffeine Can Make You More Alert There’s no magic bullet to boost IQ or make you smarter -- but certain substances, like caffeine, can energize you and help you concentrate. Found in coffee, chocolate, energy drinks, and some medications, caffeine gives you that unmistakable wake-up buzz, though the effects are short-term. And more is often less: Don’t overdo it by drinking too caffeine otherwise it’ll make you jittery and uncomfortable.

Sugar Can Enhance Alertness Sugar is your brain’s preferred fuel source – not table sugar, but glucose, which your body processes from the sugars and carbs you eat. That’s why a glass of something sweet to drink can offer a short-term boost to memory, thinking, and mental ability.

Don’t have too much, though, or your memory can be impaired -- along with the rest of you. Go easy on the sugar so it can enhance memory without packing on the kilograms.

Eat Breakfast to Fuel Your Brain Tempted to skip breakfast? Studies have found that eating breakfast may improve short-term memory and attention. Students who eat it tend to perform better than those who don’t. Foods at the top of researchers’ brain-fuel list include high-fiber whole grains, dairy, and fruits. Just don’t overeat; researchers also found high-calorie breakfasts appear to hinder concentration.

Fish Really is Brain Food A protein source linked to a great brain boost is fish -- rich in omega-3 fatty acids that are key for brain health. These healthy fats have amazing brain power: A diet with higher levels of them has been linked to lower dementia and stroke risks and slower mental decline; plus, they may play a vital role in enhancing memory, especially as we get older. For brain and heart health, eat two servings of fish weekly.

Add a Daily Dose of Nuts and Chocolate Nuts and seeds are good sources of the antioxidant vitamin E, which is linked to less cognitive decline as you age. Dark chocolate also has other powerful antioxidant properties, and it contains natural stimulants like caffeine, which can enhance focus.

Enjoy up to 30 grams a day of nuts and dark chocolate to get all the benefits you need without excess calories, fat, or sugar.

Add Avocados and Whole Grains Every organ in the body depends on blood flow, especially the heart and brain. A diet high in whole grains and fruits like avocados can cut the risk of heart disease and lower bad cholesterol. This reduces your risk of plaque build-up and enhances blood flow, of-

fering a simple, tasty way to fire up brain cells.

Whole grains, like popcorn and whole wheat, also contribute dietary fiber and vitamin E. Though avocados have fat, it’s the good-for-you, monounsaturated fat that helps with healthy blood flow Blueberries Are Super Nutritious Research in animals shows that blueberries may help protect the brain from the damage caused by free radicals and may reduce the effects of age-related conditions such as Alzheimer’s disease or dementia. Studies also show that diets rich in blueberries improved both the learning and muscle function of aging rats, making them mentally equal to much younger rats Vitamins, Minerals, and Supplements?

Store shelves groan with supplements claiming to boost health. Although many of the reports on the brain-boosting power of supplements like vitamins B, C, E, beta-carotene, and magnesium are promising, a supplement is only useful to people whose diets are lacking in that specific nutrient.

Get Ready for a Big Day Want to power up your ability to concentrate? Start with a meal of 100% fruit juice, a whole-grain bagel with salmon, and a cup of coffee. In addition to eating a well-balanced meal, experts also offer this advice: • Get a good night’s sleep.

• Stay hydrated.

• Exercise to help sharpen thinking.

• Meditate to clear thinking and relax.

Always remember, eating in moderation is key

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Wednesday, July 29, 2015

... FITNESS ...

EXERCISES TO

YO UR

STRENGTHEN KN EES to a chair. If this becomes easy, you can add ankle weights, slowly increasing the weight from 1 to 3 to 5 pounds.

Prone Straight Leg Raises

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f you have a knee injury, you may worry that exercising could cause more damage or pain. But the opposite is true: Strengthening the muscles that support your knee, and keeping them flexible, is the best way to prevent further injuries. Start slowly, and build your strength over time. Some muscle soreness is normal when you exercise.

But you shouldn’t feel more pain, especially in your knee. If you do, stop and contact your doctor.

Warm Up Your Knee Stretching can help your leg muscles perform better. Warm up before you stretch, though. You can ride a stationary bike for about 5 minutes, take a brisk 2-minute walk

while pumping your arms, or do 15-20 wall push-ups followed by the same number of calf raises. It will help you get more out of your workout and lower your risk of injury.

Lie on your stomach with your legs straight. Tighten the muscles in your bottom and the hamstring of one leg, and lift toward the ceiling. Hold 3-5 seconds, lower, and repeat. Do 10-15 lifts and switch sides.

You can add ankle weights as you gain strength. You should not feel back pain. If you do, limit how high you lift up. If it’s still painful, stop and talk to your doctor.

Straight Leg Raises

Close the Chain

If your knee’s not at its best, start with an easy strengthening exercise for your quadriceps, the muscles in the front of the thigh. This move puts little to no strain on the knee: Lie on your back on the floor or another flat surface. Bend one knee and place your foot flat on the floor. Keeping the other leg straight, raise it to the height of the opposite knee. Repeat 10-15 times for three sets.

Hamstring Curls Your hamstrings are the muscles along the back of your thigh. Lie flat on your stomach. Slowly bring your heels as close to your buttocks as you can, and hold that position. Do three sets of 15. You can also do this exercise standing while holding on

Wall squats are “closed chain” exercises, advanced strengthening moves that keep your feet on the floor. Stand with your back against a wall, your feet about shoulder-width apart. Slowly bend your knees, keeping your back and pelvis against the wall. Hold for 5-10 seconds. Don’t bend too deeply or you could injure your knee.

If you feel pressure or discomfort in your knees, adjust your position. Repeat the exercise, and try to hold the sit position a few seconds longer each time.

Calf Raises Stand facing the back of a sturdy chair, other support such as the back of a couch, or a wall bar at the gym. You can also do this on the stairs, holding on to the banister with your heels hanging off the edge of the step. Slowly raise the heels as high as you can, then lower. Do three sets of 10-15. If this move becomes easy, lift one foot slightly off the floor, placing all your weight on the other foot.

Step-Ups Place one foot on a step bench, platform, or the lowest step on a staircase.

Keeping your pelvis level, bend your knee and slowly lower the opposite foot to the floor. Lightly touch your toe to the floor, then rise back up. Repeat 10-15 times, then switch legs. If this exercise becomes easy, use a higher step, or touch your heel instead of your toe.

Hip Abduction Lie on one side with legs stacked. Bend the bottom leg for support. Straighten the top leg (without locking the knee), and raise it to 45 degrees. Hold for 5 seconds, lower

and relax briefly, then repeat 10-15 times.

Switch sides and repeat. Vary the exercise by pointing the toe of your upper leg slightly toward the floor as you raise it.

Leg Presses Sit on a leg-press machine with your back and head against the support and your feet flat on the foot plate. Adjust the seat back until you feel comfortable. Slowly push the plate away from you until your legs are extended (but do not lock your knees). Bend your knees and return to your starting position. Do three sets of 10-15 reps. (Ask a member of the gym staff for assistance the first time you do this.)

Aerobic Exercise That Works for Your Knee If you have knee pain, avoid exercises that aggravate it. This may include high-impact activities such as running or intense aerobics. Use a common-sense approach and notice what feels right for you. For example, some people find that elliptical machines hurt, while others do not. A great activity for people with sore knees is swimming: Your body in water weighs 1/6 of what it does on land.

Always Remember that No exercise should ever cause or increase pain. Muscle soreness after a vigorous workout is normal, but any kind of sharp, shooting, or sudden pain in the muscles or joints is a sign that something is wrong. If you feel pain while exercising, stop right away and check with your doctor.

(Source: webMD.com)

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... PAEDIATRICS & CHILD HEALTH ...

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COMMON CHILDHOOD SKIN PROBLEMS What’s That?

Wondering about that rash, welt, or bump on your child’s skin? Sickness, allergies, and heat or cold are often behind kids’ skin changes. Most aren’t a big deal and are easy to treat.

You can learn to tell what many of them look like. Of course, always check with your child’s doctor to know for sure and get the right treatment.

Ringworm Worms don’t cause ringworm. It’s caused by a fungus that lives off dead skin, hair, and nail tissue. It starts as a red, scaly patch or bump. Then comes the telltale itchy red ring. The ring has raised, blistery, or scaly borders. Ringworm is passed on by skin-to-skin contact with a person or animal. Kids can also get it by sharing things like towels or sports gear. Your doctor may treat it with antifungal creams.

Fifth Disease This contagious and usually mild illness passes in a couple of weeks. Fifth disease starts with flu-like symptoms. A bright face and body rash follow. It’s spread by coughing and sneezing and most contagious the week before the rash appears. It’s treated with rest, fluids, and pain relievers (do not give aspirin to children). If your child has fifth disease and you are pregnant, call your doctor.

Chickenpox This once-common rash isn’t seen as much in today’s kids thanks to the chickenpox vaccine. It’s very contagious, spreads easily, and leaves an itchy rash and red spots or blisters all over the body. The spots go through stages. They blister, burst, dry, and crust over. Chickenpox can be very serious. All young kids should get a chickenpox vaccine. So should teens and adults who never had the disease or the vaccine.

Impetigo Impetigo, caused by bacteria, creates red sores or blisters.

These can break open, ooze, and develop a yellow-brown crust. Sores can show up all over the body but mostly around the mouth and nose. Impetigo can be spread through close contact or by sharing things like towels and toys. Scratching can spread it to other parts of the body. It’s treated with antibiotic ointment or pills.

Warts A virus causes these funky but mostly harmless, painless skin growths. Warts can spread easily from person to person.

They also spread by touching an object used by a person with the virus. They’re most often found on fingers and hands. To prevent warts from spreading, tell your child not to pick them or bite nails. Cover warts with bandages. Most warts go away on their own.

Heat Rash (‘Prickly Heat’) Blame blocked sweat ducts. Heat rash looks like small red or pink pimples. You usually see it on the head, neck, and shoulders of babies. The rash often comes when well-meaning parents dress a baby too warmly. But it can happen to any child in very hot weather. Dress your baby in only one more layer than you’re wearing. It’s OK if his feet and hands feel cool to the touch.

Contact Dermatitis Some kids’ skin reacts after touching foods, soaps, or plants like poison ivy, sumac, or oak. The rash usually starts within 48 hours after skin contact. Minor cases may cause mild redness or a rash of small red bumps. In severe cases you may see swelling, redness, and larger blisters. This rash goes away after a week or two or after contact with the culprit ends.

Hand-Foot-Mouth sackie)

Disease

(Cox-

Despite its scary name, this is a common childhood illness. It starts with a fever, followed by painful mouth sores and a non-itchy rash. The rash blisters on hands, feet, and sometimes buttocks and legs. It spreads through coughing, sneezing, and used diapers. So wash hands often. Coxsackie isn’t serious and usually goes away on its own in about a week.

Eczema Kids prone to eczema may have other allergies and asthma. The exact cause isn’t clear. But kids who get it tend to have a sensitive immune system.

Watch for a raised rash with dry skin and intense itching. Atopic dermatitis is the most common type

of eczema. Some children outgrow it or have milder cases as they get older.

Hives Many things can trigger these itchy or burning welts. Medicines such as aspirin (which kids should never take) and penicillin can set off hives.

Food triggers include eggs, nuts, shellfish, and food additives. Heat or cold and strep throat can also cause hives. Welts can show up anywhere on the body and last minutes or days. Sometimes an antihistamine can help. Hives can be a sign of serious problems, especially when they come with breathing troubles or swelling in the face. In those cases or if hives don’t go away, see your doctor.

Scarlet Fever Scarlet fever is strep throat with a rash. Symptoms include sore throat, fever, headache, belly pain, and swollen neck glands. After 1-2 days, a red rash with a sandpaper texture shows up. After 7-14 days, the rash rubs off. Scarlet fever is very contagious, so wash hands often to keep it from spreading. Call your child’s doctor if you think your child has it. He’ll probably be treated with with antibiotics.

Roseola (Sixth Disease) Roseola, a mild illness, gets its nickname from a list of six common childhood rashes. Young kids 6 months to 2 years are most likely to get it. It’s rare after age 4. It starts with a cold, followed by a few days of high fever (which can trigger seizures).

Then the fevers end suddenly. They’re followed by a rash of small, pink, flat, or slightly raised bumps.

It shows up first on the chest and back, then hands and feet.

(Source: WebMD.com)

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Wednesday, July 29, 2015