Health Check issue 6 by Ravi Nair

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ISSUE 6

Wednesday, July 30, 2014

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LAUNCH OF THE HEALTHCARE FACILITIES MASTER PLAN FOR THE STATE OF QATAR A SIGNIFICANT MILESTONE IN ENABLING THE FUTURE OF HEALTHCARE REFORM

he completion of the much anticipated “Qatar Health Facilities Master Plan” (QHFMP) was announced recently at a Supreme Council of Health [SCH] press conference by Dr. Faleh Mohamed Hussain Ali, the Assistant Secretary General for Policy Affairs, SCH. “Investing in health infrastructure is a priority health and social issue as increasing access to services will improve the lives of many individuals and families now and in the future,” Dr. Faleh said. The comprehensive 20 year blue-print produced as part of the National Health Strategy 2011-2016, outlines how Qatar can support its vision for a world class health system, in new buildings and facilities, through ‘wise use of resources’. In highlighting the importance of the QHFMP, Dr. Faleh said: “Developing an infrastructure master plan is essential to guide increasing healthcare capacity, and is further evidence that we are 100% committed to making sure the health sector meets the rising demand for quality services and facilities across the state for the next 20 years.” Infrastructure is a major driver of annual healthcare costs in Qatar so the master plan will rationalise, integrate and coordinate all existing, planned and proposed facilities. “The QHFMP will ensure that infrastructure spending correlates directly to the needs of the population and the greater model of care,” added Dr. Faleh. (to be continued on page 2...)

NEW SELF-ASSEMBLING NANOPARTICLE HELPS DOCTORS DIAGNOSE CANCER EARLIER

cientists have designed a new self-assembling nanoparticle that targets tumours, to help doctors diagnose cancer earlier. The new nanoparticle, developed by researchers at Imperial College London, boosts the effectiveness of Magnetic Resonance Imaging (MRI) scanning by specifically seeking out receptors that are found in cancerous cells. The nanoparticle is coated with a special protein, which looks for specific signals given off by tumours, and when it finds a tumour it begins to interact with the cancerous cells. This interaction strips off the protein coating, causing the nanoparticle to self-assemble into a much larger particle so that it is more visible on the scan. A new study published in the journal Angewandte Chemie, used cancer cells and mouse models to compare the effects of the self-assembling nanoparticle in MRI scanning against commonly used imaging agents and found that the nanoparticle produced a more powerful signal and created a clearer MRI image of the tumour. The scientists say the nanoparticle increases the sensitivity of MRI scanning and will ultimately improve doctor’s ability to detect cancerous cells at much earlier stages of development. Professor Nicholas Long from the Department of Chemistry at Imperial College London said the results show real promise for improving cancer diagnosis. “By improving the sensitivity of an MRI examination, our aim is to help doctors spot something that might be cancerous much more quickly. This would enable patients to receive effective treatment sooner, which would hopefully improve survival rates from cancer.” (to be continued on page 4...)

YOUR GENES MAY HELP PICK YOUR FRIENDS

person’s DNA may play a big role in who they decide to hang with, a new study sug-

gests. “Looking across the whole genome, we find that, on average, we are genetically similar to our friends,” study co-author James Fowler, a professor of medical genetics and political science at the University of California, San Diego,

said in a university news release. “We have more DNA in common with the people we pick as friends than we do with strangers in the same population,” he said. In the study, Fowler’s team analysed the genes of more than 1,900 people who were either pairs of unrelated friends or unrelated strangers. He and his colleagues found that friends share about one percent of their genes and are as much “related” as fourth cousins or people who share greatgreat-great grandparents. “One per-

cent may not sound like much to the layperson, but to geneticists it is a significant number,” study co-author Nicholas Christakis, a professor of sociology, evolutionary biology and medicine at Yale University, said in the news release. “And how remarkable: Most people don’t even know who their fourth cousins are! Yet we are somehow, among a myriad of possibilities, managing to select as friends the people who resemble our kin,” he added. The researchers also developed what they call a “friendship score” that can be used to predict who will be friends. It’s about as accurate as genetic-based methods of predicting a person’s risk of obesity or schizophrenia. (Source: HealthDay News)

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LAUNCH OF THE HEALTHCARE FACILITIES MASTER PLAN FOR THE STATE OF QATAR

(Continued from page 1) Leading the development of the plan Eng. Awn Sharif, Manager of Health Care Facility Planning, Health Planning & Assessment Department at the SCH said the QHFMP is the final output from National Health Strategy 6.4 Health Infrastructure Master Plan, project and is an extensive body of work which delivers: • A blue print of the future healthcare facilities in Qatar until 2033; • A 5 year Action Plan 2013-2018; • A legal and financial framework dictating the implementation of this plan; • A set of public policies regarding growth and development of healthcare facilities. Eng. Sharif pointed to the QHFMP as being built on the model of care, outlined in the Clinical Services Framework (CSF)

and noted that is closely aligned to ‘30 of the 39 National Health Strategy Projects’ which are either influenced by or have informed the plan development. “Essentially the plan will provide the physical environment to enable the implementation of the NHS,” said Eng. Sharif when speaking at the launch ceremony. “Implicit in the plan is developing a structural backbone to support the NHS priority areas; universal access to healthcare by everyone in Qatar, shifting the balance of care back to primary health care, enabling a high degree of specialisation for secondary and tertiary hospital care within Qatar, supporting mental health service development and preventive public health, enhancing community care, continuity of care and rehabilitation -all of which are reflected and represented by the National Health Strategy 20112016. It may be a plan about buildings and equipment, but the outcomes are fo-

cused on enhancing the health of human beings.”

THE GUIDELINES ARE NOW CLEARLY LAID OUT FOR HOW FUTURE DEVELOPMENT CAN OCCUR “With the completion of the QHFMP now behind us, co-ordination and implementation of projects is underway. The ‘Capital Expenditure Committee’ and ‘Qatar’s Certificate of Needs’, or ‘QCoN’, the committee and implementation tool respectively, which sit alongside the QHFMP, will advise on and approve future infrastructure,” Eng. Sharif said. Public and private sector Healthcare providers will need to apply to the Supreme Council of Health for approval to proceed with the development of a new facility based on financial and service thresholds. By following the QCoN policies and

procedure, the QCoN team will assess whether the proposed facility meets population healthcare as reflected in the Healthcare QHFMP. This will then determine whether it will be granted approval and/or funding through the Capital Expenditure Committee. So the principle question in any consideration will be, does the population of Qatar need this facility, or is the demand already being met? As a result of Qatar Health Facilities Master Planning process, the Supreme Council of Health can proceed with due confidence knowing that health facilities will be located in the right place, developed at the right scale and will provide the right services to deliver a comprehensive world-class healthcare system whose services are accessible to the whole population of Qatar. (Continued on page 3)

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ABOUT THE NATIONAL HEALTH STRATEGY 2011-2016 [NHS]

The aim of the NHS is to provide a practical, implementable strategy to be used by the health sector as a means for reform and improvement toward reaching the ultimate goal of a healthy population. The National Health Strategy comprises of 40 projects (two of which are closed) and associated implementation plans, (as

“QATAR HEALTH FACILITIES MASTER PLAN” (QHFMP) LAUNCH ADDITIONAL BACKGROUND: 5 Year Action Plan The QHFMP long range road map also includes an immediate 5 year Action Plan which identifies the core “build” requirements that need to either be completed or initiated in the 2013-2018 time period. Included will be linking patient activity data collected by the National Health Insurance Company (Seha) into the QHFMP demand and capacity model, to produce a dynamic, adaptive tool. The 5 year Action Plan is scheduled to be updated five-yearly to sequence with other National master plans and sustain unified thinking. Vision “The QHFMP 2013-2033 will be the roadmap for the next generation’s health-

care infrastructure quality standards, requirements, investment priorities, service distribution and delivery alignments, guiding the entire continuum of healthcare capital allocation and advancing the health vision of the Nation.” The development of the QHFMP has required extensive consultation with the SCH, Hamad Medical Corporation (HMC), Primary Healthcare Corporation (PHCC), and collaboration with more than 107 stakeholders over 14 months of continuous work. The QHFMP takes the Qatar National Master Plan (QNMP) into full consideration and the development team has worked hand-in-hand with more than 26 organisations and local authorities including: Qatari Diar, General Secretariat for Development Planning, Ministry of Municipality and Urban Planning (MMUP), Ministry of Interior (MOI), Ashghal, Qatar Rail Company, Statistical Authority, Qatar Tourism, Qatar Foundation, Red Crescent, Sidra Medical and Research Centre and private healthcare providers; Al Ahli Hospital, Aspetar, Doha Clinic and many others.

at 2014), to achieve the goals of the Qatar National Vision 2030. The NHS is one of 14 sector strategies integrated into Qatar’s National Development Strategy. It is a strategy for reform with far-reaching and fundamental changes across Qatar’s entire healthcare system. The NHS program management office at the SCH is responsible for guiding, monitoring and reporting on the progress of the NHS.

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Wednesday, July 30, 2014

... MEDICAL SCIENCE ...

HEALTHY DIET AND EXERCISE CAN REVERSE AGING IN OUR CELLS

he study followed 35 men over the course of 5 years, all of whom had been diagnosed with low-risk prostate cancer. Ten of the men were assigned to undertake healthy lifestyle changes: a vegetarian whole-food diet, regular exercise and sessions of stress-reducing meditation or yoga. The others served as controls.

Aging Cells At the end of five years, researchers found the men who had adopted healthy habits had significantly “younger” DNA than when they began, in terms of telomere length. Telomeres are protective regions at the ends of chromosomes that help keep DNA intact. And shortening of telomeres is closely linked to aging and diseases of old age, explained study author Dean Ornish: “A number of studies have shown that as telomeres get shorter, the risk of premature death and most chronic disease, from heart disease to cancer, even dementia goes up,” said study researcher Dr. Dean Ornish, clinical professor of medicine at the University of California, San Francisco. “So as our telomeres get shorter, in a

sense, our lives get shorter,” Ornish said. “This is the first study showing that lifestyle changes may actually increase the length of telomeres.”

Opposite Effects The 10 men who made lifestyle changes grew their telomeres by an average of 10% over the course of the study, and the more positive changes they made the more growth they saw. In contrast, telomeres of men in the control group shrunk by an average of 3%. The small size of the study means that conclusions should be taken with a grain of salt. Tom Vulliamy, senior lecturer in Molecular Biology at Queen Mary University of London, said: “It is really important to highlight that this is a small pilot study… Given this, I’m definitely going to wait to see whether this can be replicated on a larger scale and with more sizeable effects before I get excited.” But if you’re looking for that extra bit of motivation to go for a jog, well—do it for your telomeres. (Lisa Raffenspergerdiscovermagazine)

LIFESTYLE CHANGES MAY, IN FACT, BE ABLE TO TURN BACK THE CLOCK ON AGING. A SMALL PILOT STUDY HAS PROVIDED THE FIRST EVIDENCE THAT LIFESTYLE CHANGES CAN LENGTHEN PROTECTIVE REGIONS OF OUR DNA CALLED TELOMERES.

New self-assembling nanoparticle HELPS DOCTORS DIAGNOSE CANCER EARLIER

(Continued from page 1) “MRI scanners are found in nearly every hospital up and down the country and they are vital machines used every day to scan patients’ bodies and get to the bottom of what might be wrong. But we are aware that some doctors feel that even though MRI scanners are effective at spotting large tumours, they are perhaps not as good at detecting smaller tumours in the early stages”, added Professor Long. The newly designed nanoparticle provides a tool to improve the sensitivity of MRI scanning, and the scientists are now working to enhance its effectiveness. Profes-

sor Long said: “We would like to improve the design to make it even easier for doctors to spot a tumour and for surgeons to then operate on it. We’re now trying to add an extra optical signal so that the nanoparticle would light up with a luminescent probe once it had found its target, so combined with the better MRI signal it will make it even easier to identify tumours.” Before testing and injecting the non-toxic nanoparticle into mice, the scientists had to make sure that it would not become so big when it self-assembled that it would cause damage. They injected the nanoparticle into a saline solution inside a petri dish and monitored its growth over a four hour period. The nanoparticle grew from 100

to 800 nanometres - still small enough to not cause any harm. The scientists are now improving the nanoparticle and hope to test their design in a human trial within the next three to five years. Dr Juan Gallo from the Department of Surgery and Cancer at Imperial College London said: “We’re now looking at fine tuning the size of the final nanoparticle so that it is even smaller but still gives an enhanced MRI image. If it is too small the body will just secrete it out before imaging, but too big and it could be harmful to the body. Getting it just right is really important before moving to a human trial.” (Source: Imperial College London)

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Wednesday, July 30, 2014

... NUTRITION ...

Healthy Recipes Butt-Busting Brownie

If you think brownies are off-limits when you’re trying to get fit, think again! This no-bake brownie is not your typical dessert. Cayenne is rich in capsaicin, vitamin C, vitamin B6, vitamin E, potassium, manganese, and flavonoids (which give the chili its antioxidant properties).

HEALTHY FROZEN FOOD GUIDELINES GET ALL THE CONVENIENCE OF FROZEN FOODS AND BOOST YOUR HEALTH AT THE SAME TIME BY STICKING TO THESE EASY GUIDELINES.

Ingredients • 1 cup raw cacao powder • 1/4 tsp cayenne • 2 tsp cinnamon • 1/2 cup low fat milk • 1 cup organic raisins • 1 cup oats Directions • In a food processor purée the cacao, cayenne, cinnamon, milk and raisins until a smooth paste forms. Add the oats to the food processor and quickly pulse to incorporate them. Transfer the mix into a square or rectangular container lined cross wise with wax paper. Press down to form the ‘brownie’ base. Refrigerate until firm. Cut into squares before serving. Enjoy!

Revved Up Red Juice

The allure of the frozen food aisle can have a strong pull, with pre-packaged meals that proclaim to be fast, easy and healthy. But many frozen foods contain hidden ingredients and calories that could be sabotaging your health. Fortunately, if you know how to make smart choices, you can give your diet a boost and cash in on convenience at the same time – just stick to these easy frozen food guidelines.

allows you diversify your diet by adding in veggies that aren’t in season. Vegetables are great for weight loss because they’re low in calories and packed with filling fibre. Just be wary that you’re not picking up vegetables that have been preserved or packed with a lot of sodium – this can cause you to retain water and feel bloated. Make sure the label says it has less than 200 mg of sodium.

Proteins Looking for natural ways to satisfy your sweet tooth? Try this Red Juice recipe and rev up your day. Ingredients • 1/2 cup chopped peeled red beets • 1/2 red pepper, seed and stem removed, chopped

• 2 cups watermelon cubes • 1 cup hulled strawberries • 1 cup peeled cucumber cubes • 1 tsp grated ginger • Juice of 1/2 lime • 1/2 cup ice Directions • Combine all in blender, serve and enjoy!

Anti-Bloat Elixir

Beat bloating with this drink, which is designed to cleanse your digestive tract. Ingredients • 1 cup coconut water • 1 tbsp. psyllium husks • 1 tbsp. acacia fibre

• 1 cup chopped pineapple or papaya or a mix of the two • A handful of spinach • 4 to 6 ice cubes Directions • Blend ingredients together and serve cold. (Source: The Dr.Oz show website)

Avoid “pre-seasoned” meat: If you’re tired of having fresh meats go bad before you use them, opt for frozen meats (or freeze your own). While a fresh steak only lasts three to five days before it goes bad, a frozen steak can be stored from six months to a year! Plus, high-protein foods take more work to digest and metabolise, which means they help you burn more calories and keep you fuller, which is great for weight loss. However, avoid any packaging that says the meat is pre-seasoned – this could mean that it’s packed full of sodium and unhealthy processed ingredients. Instead, season your meat yourself using herbs and spices like cayenne, turmeric and ginger, which may help you with weight loss.

Vegetables Keep sodium under 200: Surprisingly, frozen vegetables may be more nutritious than fresh ones. This is because frozen vegetables are usually picked at their peak and then immediately frozen, saving them from days to weeks sitting on trucks and in stores. Plus, buying frozen veggies

Carbohydrates Watch the serving size: Preparing healthy carbohydrates can be time-consuming, so it’s no wonder that frozen carbs can be a tempting option. To maximise your nutrition benefit while minimising your waistline, look for healthy frozen carbohydrates like brown rice, quinoa or beans. Avoid carbs that are creamy or cheese-based. And, be sure to check the serving size. You may think you’ve found the perfect meal only to find that you’re consuming way more than a serving.

Fruit Check for sweeteners: Frozen fruit can be a healthy and delicious snack or dessert, especially if you blend them together to make your own sorbet or smoothie. Plus, it’s a great way to get some of your favourite fruits out of season. Just be sure to check the fine print on the label for the sugar content and to see if it contains artificial sweeteners or syrup. These hidden sweeteners could add inches to your waistline and slow your metabolism. And since fruit is so sweet on its own, you don’t even need them. (Source: The Dr.Oz show website)

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... HEALTH QUIZ ...

FIBRE, FLATULENCE & A HEALTHY GUT:

HOW MUCH DO YOU KNOW? FIBRE AND STARCH ARE VITAL FOR A HEALTHY GUT BUT MANY PEOPLE ARE PUT OFF BY THEIR AFTER EFFECTS. HOW MUCH DO YOU KNOW ABOUT FIBRE AND FLATULENCE?

Quiz Answers

Is there any way to reduce the gas produced after eating vegetables like cabbage, cauliflower and broccoli?

Question 1 = a

a. Yes, cook them for as short a time as possible e.g. by stir frying. b. Yes, cook them as long as possible e.g. in a stew or casserole. c. No, but take heart not everyone eating these will produce gas that smells like rotten eggs. d. No, and unfortunately everyone eating these can expect gas that smells like rotten eggs.

Are you more likely to get intestinal gas when you eat hot potatoes or cold (as in say, a potato salad)?

a. b. c. d.

It makes no difference. Hot. Cold. Neither. Potatoes don’t give you gas.

Which of the following is the best way to increase your fibre intake?

a. b. c. d.

Eat a lot of processed foods. Eat a lot of bran. Eat lots of green salads. Eat a wide variety of unprocessed high-fibre foods

Is a high-fibre diet a good idea for everyone?

a. Yes always, just increase your fibre gradually as this results in less gas. b. Yes always, just increase your fibre gradually as this helps your body learn to tolerate gas. c. No, a high fibre diet can stop you digesting food properly. d. No, a minority of people may not be able to tolerate a high fibre diet.

Can drinking peppermint tea help if you have a problem with excess gas in your gut?

a. Yes b. No.

Cabbage and related vegetables including cauliflower, broccoli, Brussels sprouts, and turnips have chemicals containing sulphur in them that produce more gas, the longer they are cooked. So brief cooking for less than five minutes, such as in a stir fry, is likely to reduce the amount of gas produced. But the gas will only smell like rotten eggs if you have certain bacteria present in your gut.

Question 2= c It is not just fibre but certain types of starch (as well as sugars) in food that result in intestinal gas (most of which is produced by bacteria in the colon, part of the large intestine). Eating a potato hot or cold may change the amount of gas you get because different temperatures change the potato starch. Hot potatoes will give you the least gas because more of the starch will be digested in the small intestine. But when potatoes are left to cool, some of the starch in them changes shape so it can no longer be digested in the small intestine. Instead it passes through to the colon, where it is broken down by bacteria, resulting in gas. If you want less gas, eat your potatoes while they’re hot.

Question 3 = d Eating at least 30 grams of fibre a day helps prevent constipation and diseases like bowel cancer. Getting this much fibre is difficult if you eat a lot of processed foods such as cakes, biscuits, white bread or cornflakes, which are low in fibre. But it’s not simply a matter of eating fibre; you need different types and should aim to meet your fibre needs from a variety of unprocessed sources. Some foods like bran contain mostly

insoluble fibre, which is more easily fermented in the gut than another fibre type, soluble fibre (present in foods like oats) that’s also important to gut health. “Relying too much on bran is bad. Also people tend to use too much bran and it produces too much gas,” says experts. Nor should you rely mainly on green salads to get your fibre hit. Vegetables like peas, beans, broccoli, corn and spinach are better sources. But you should also eat a variety of fruit, seeds, cereals, nuts, and legumes.

Question 4 = d While there’s no disputing the benefits of a high fibre diet, some people can’t tolerate it without gut pain and discomfort. Introducing fibre into your diet can lead to you having more intestinal gas, but gradually increasing your fibre intake over weeks or months, to a level where you are eating at least 30 grams a day, can help to reduce any discomfort. This approach gives your bowel a chance to develop tolerance so you don’t feel as uncomfortable. But according to experts, a minority of people, usually young women, have a persistent problem with bloating that may be made worse by fibre. The problem is caused by a disturbance in the part of the nervous system that senses the amount of distension in the gut and controls gut contractions. Those affected need to speak to a doctor about how to manage their symptoms.

Question 5 = a Some studies have found that peppermint can reduce bloating and gas. It is an ingredient in many medications aimed at this result. Simply drinking peppermint tea may also help. However, many remedies for gas work for some people and not others so it is worth experimenting to see what works for you. (Courtesy: abc.net.au/health)

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Wednesday, July 30, 2014

... PAEDIATRICS & CHILD HEALTH ...

5 COMMON SYMPTOMS IN INFANTS AND YOUNG TODDLERS DIARRHOEA Diarrhoea is one of the most common childhood illnesses. Causes can include infection, food intolerance, or drinking too much fruit juice. Until diarrhoea stops, keep your child at home and hydrated. If she’s on solids, avoid dairy, high-fibre, and greasy foods. Call your paediatrician if she isn’t better in 24 hours, is under 6 months old, or has other symptoms, including a fever of 101.4 or higher, vomiting, bloody or black stool, or abdominal pain.

FEVER THERE’S NOTHING MORE DISTRESSING TO A NEW PARENT THAN A SICK BABY. TRY NOT TO LOSE YOUR COOL. TRUST YOUR INSTINCTS, BUT STAY ALERT FOR SIGNS THAT YOU NEED TO CALL YOUR HEALTH CARE PROVIDER OR SEEK EMERGENCY CARE.

In newborns, a low-grade fever can signal serious infection. Call the doctor immediately if a baby under 3 months has a rectal temperature of 100.4 or higher, or a baby 3 to 6 months old has a temperature of 101 or higher. Look for ear pain, cough, lethargy, rash, vomiting,

or diarrhoea. Soothe baby with fluids, a lukewarm bath, and by dressing him in lightweight clothes. Ask your doctor about safe fever reliever use.

CONSTIPATION Some babies poop several times a day; others go a few days between bowel movements. Don’t worry if your baby or toddler doesn’t go as often as you’d expect. True constipation is when stools are hard and painful to pass. Your doctor may suggest adding a few extra ounces of water or a little bit of prune juice to your child’s bottle or sippy cup. If constipation continues or your baby has other symptoms, such as abdominal pain or vomiting, call the doctor.

RASHES Babies have sensitive skin. Rashes can range from pimples

to little white bumps (milia) to red, dry, itchy patches (eczema). To avoid diaper rash, change diapers often, and apply an ointment for protection. For eczema, avoid harsh soaps and keep skin moisturised. Most rashes aren’t serious, but call the doctor if your baby’s rash is painful or severe, or if he also has a fever or blisters.

STOMACH ACHE Uncontrollable crying, back arching, and spitting up are all symptoms of an upset tummy. It could be caused by colic, gastroesophageal reflux, food intolerance, virus, or other reasons. Toddlers can also have problems as they try different foods. Most stomach aches aren’t dangerous and will go away. If it doesn’t improve, or your child vomits, has diarrhoea, becomes lethargic, or runs a fever, call the doctor. (Source: WebMD)

PREVENTING DEHYDRATION IN KIDS WHY IS VITAMIN K IMPORTANT FOR MY BABY?

ll babies are born with low levels of vitamin K in their bodies. Vitamin K is made naturally in the intestine but as newborn babies have very little bacteria in their intestine they do not make enough. As your baby grows they will start to make enough vitamin K. Breastmilk does contain vitamin K but in too small an amount to provide protection. Too little vitamin K puts your baby at risk of a rare disease called VKDB (vitamin K deficiency bleeding).

HOW TO GIVE VITAMIN K TO BABIES: The most reliable way to give babies vitamin K is by one injection into the muscle in the leg (intramuscular injection). One injection given just after birth will protect your baby for many months. It is possible to give babies vitamin K by mouth (orally). However, this is not recommended because: • Vitamin k is not absorbed as well when given by mouth. • The protection does not last as long and so 3 doses are required (at birth, at 5 to 7 days and at 6 weeks). • There may be doubt as to whether the dose has been swallowed. • There is a risk that the later dose may be forgotten. • Some babies may have conditions that prevent absorption of vitamin k from the gut.

o prevent dehydration in your child, make sure they drink cool water and sports drinks early and often. Send your child out to practice or play fully hydrated. Then, during play, make sure your child takes regular breaks to drink fluid, even if your child isn’t thirsty. A good size drink for a child, according to the American Academy of Paediatrics is 5 ounces of cold tap water or sports drink for a child weighing 88 pounds, and nine ounces for a teen weighing 132 pounds. One ounce is about two kid-size gulps. Get them acclimatised before summer practice. “If you’re going to send your kid off to tennis camp, they shouldn’t be sitting around doing nothing in May and then going out to play tennis eight hours a day in June,” says experts. “They should be outdoors jogging, riding a bike, and otherwise slowly building up their fitness and ability to handle the heat.” The fitter children are, the sooner their bodies will start to sweat after beginning to exercise -- and that’s a good thing!

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Wednesday, July 30, 2014

... WOMEN’S HEALTH ...

11 NAIL SYMPTOMS

YOU SHOULDN’T IGNORE YOUR FINGERTIPS SAY MORE ABOUT YOUR HEALTH THAN YOUR REALISE

5. Brittle Nails If you have nails that are hard but break easily, this can be a sign of dryness or possibly hypothyroidism—especially if you also have thinning or unusually dry hair, says Krant.

6. Longitudinal (Vertical) Ridges

f you ever go for a dermatologist screening, they’ll request that you remove your nail polish. This is also true if you end up in surgery. Why all the hate for polish? Turns out, your nails can reveal serious concerns about your health. Check out these revealing signs.

1. Darkened Nails These can mean a few things, says Jessica Krant, M.D., a board-certified dermatologist in New York City and founder of Art of Dermatology. First, it could be just a natural, genetic pigmentary change, like a freckle. But if there’s a dark streak along the nail from cuticle to tip and there’s only one—or it’s changing fast—it may mean something more serious: melanoma of the nail, says Krant. This is a form of skin cancer and potentially deadly. Some nail fungus infections can also be dark grey or green.

2. Blue-ish Nails And by that, we mean blue-ish nail beds, which signify that your fingertips aren’t receiving enough oxygenated blood, says Krant. This can be a sign that your circulation is bad in your hands and feet or that your lungs aren’t properly oxygenatating the blood in your whole body—either due to lung disease or heart disease.

3. Whitened Nails These can mean several bad things, but the most serious thing to worry about is liver disease, says Krant. So if you notice this, make sure to bring it up with your doctor.

4. Thinning Nails Thin, peeling, or spoon-shaped nails (ones that are curved in a concave instead of convex way) are associated with iron-deficiency anaemia, says Krant.

These usually develop normally with age. “It’s a sign that the nail matrix (the root of the nail under the cuticle) is drying out,” says Krant. “Sometimes it’s possible to make it better by keeping extra-heavy moisturising emollients and ointments on the cuticles and nails.”

7. Horizontal Ridges A deep horizontal ridge with normal nail on either side usually means there was some specific trauma, stress, illness, or other metabolic disruption for a defined period before the nail went back to normal growth patterns, says Krant.

8. Separated from the Nail Bed A nail detached from the nail bed (onycholysis) can mean nail fungus or infection under the nail, but it may also be caused by certain medications. Either way, see your doctor, says Dr. Krant.

9. Flattened angle at cuticle Club-shaped fingertips with broad, flattened nails and cuticle zones are a sign of poor oxygenation of the blood. Clubbing is a common sign in cystic fibrosis in the young, but also in chronic lung disease in the elderly, says Dr. Krant.

10. Small Indentations or Pits Small dots or pits in the nail may indicate psoriasis. This can be confined solely to the nails and be relatively harmless, or it may indicate a likelihood of more extensive skin psoriasis or internal psoriatic arthritis. Since psoriasis is linked to a higher risk of heart disease due to chronic inflammation, the nail pits may be a valuable flag, says Dr. Krant.

11. Thickened

Not all thickened nails are caused by fungus, which is why it’s important to get a test before starting any risky medication or expensive treatment. Some thickened rough nails are actually caused by psoriasis in a different presentation than the previously mentioned nail pits. It’s important to keep in mind that even with temporary nail problems that may grow out, fingernails can take six months to fully grow out and toenails up to a year. Knowing this may help you judge how long you’ve had a certain condition and may help link it to an initiating cause. When in doubt, see your dermatologist. (Courtesy: Women’sHealth mag.)

WHY SCREENING TESTS ARE IMPORTANT? R

emember that old saying, “An ounce of prevention is worth a pound of cure”? Getting checked early can help you stop diseases like cancer, diabetes, and osteoporosis in the very beginning, when they’re easier to treat. Screening tests can spot illnesses even before you have symptoms. Which screening tests you need depends on your age, family history, your own health history, and other risk factors.

Cervical Cancer

With regular Pap smears, cervical cancer is easy to prevent. The cervix is a narrow passageway between the uterus (where a baby grows) and the vagina (the birth canal). Pap smears find abnormal cells on the

cervix, which can be removed before they ever turn into cancer. The main cause of cervical cancer is the human papillomavirus (HPV), a type of STD.

Screening for Cervical Cancer During a Pap smear, your doctor scrapes some cells off your cervix and sends them to a lab for analysis. A common recommendation is that you should get your first Pap smear by age 21, and every two years after that. If you’re 30 or older, you can get HPV tests, too, and wait a little longer between Pap smears. Both screenings are very effective in finding cervical cancer early enough to cure it.

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Wednesday, July 30, 2014

... MEN’S HEALTH ...

HAVING SLEEP PROBLEMS? FOLLOW THESE TIPS BEAT STRESS, GET STRONGER, AND FEEL FULLER IN MINUTES

QUICK HEALTH TIPS THAT CAN CHANGE YOUR LIFE C

hanging your life sounds daunting. But sometimes, it’s the super-small steps you take—like chewing more to feel fuller and cut calories, or measuring your blood pressure in both arms to get a better reading and fight off heart disease—that leave the biggest impact. Check out these 2-second tips from some top advisors, and start living a healthier life immediately.

• Bare Both Arms • Slay Saturday Blues

Transitions can be a drag—like the Saturday night blues, which torment a large percent of the population. Take the edge off by doing 10 minutes of work before dinner on Saturday. Or spend a few minutes visualising Sunday’s tasks. This simple exercise may ease anxiety.

Don’t fight heart disease single-handedly. A new study from Boston University confirms that having a different blood pressure in each arm is associated with a higher risk of heart problems. Differences 10 points and up may indicate narrowing arteries. So always measure your BP in both arms.

ATTENTION DESK JOCKEYS! SPENDING ALL DAY IN A CHAIR CAN SHORTEN YOUR LIFE, EVEN IF YOU HIT THE GYM COME 5PM

• Get Real-World Strong We tend to exercise forward and back, up and down. Life’s not that simple. Fight back with the kettlebell side lunge and touch: Grab the kettlebell with both hands; let it hang in front of you. Step to the left and bend your left knee until the bell touches the floor. Power back to the start. Repeat on your right.

Keep your room quiet and dark. Use earplugs to cut noise. Keep out light with window blinds, heavy curtains, or an eye mask. Turn off any electronic devices in your bedroom. If you need to get up at night, use a small night-light instead of a bright one. Eat like a bird. Avoid large meals within 2 hours of bedtime. If you are hungry, try a glass of milk. The natural chemical L-tryptophan in it may help you sleep. Time your sleep right. Go to bed at about the same time every night. Try not to nap late in the afternoon. If you do nap, keep it short, just 10 to 15 minutes. Calm down before bedtime. Stop working on any task an hour before bedtime, especially those that include computers and devices. Try to keep your mind off worries or things that upset you once you’re in your bedroom. Keep your cool. A good temperature for sleep is above 54 degrees F but below 75 degrees. Practice relaxing. Flexing your muscles, imagining a calming scene, or meditating can help you unwind and get ready to sleep. Don’t smoke. Nicotine is a stimulant, which can keep you up. So reaching for a cigarette near bedtime or in the middle of the night can ruin sleep. Stop having caffeine 4-6 hours before bed. That includes coffee, cola, tea, and chocolate, and some over-the-counter medications, too. If you are still having trouble sleeping after putting these ideas to work, tell your doctor about it. (Source: WebMD)

• Chew More, Eat Less

Here’s further evidence that slow and steady wins the bellyoff race: Chewing more can lower your total meal intake by

nearly 15 percent without sacrificing satiety, reveals a new research. Double the number of times you chew food. This gives your brain time to register fullness. (Source: Men’sHealth mag.)

Desk jockeys, your attention please: if you work at a computer, you might want to stand up while you read this. Because sitting down all day is killing you. Men who regularly sit for more than six hours a day are 20% more likely to die over a given period, compared to those who sit for just three. Now consider that the average man spends 9.3 hours a day sitting down – far outweighing the 7.7 hours he spends asleep. If you have a desk job, you’re twice as likely to contract cardiovascular disease than people with standing jobs. You’re also more likely to develop colon cancer and obesity. Your risk of diabetes increases by a staggering 112%, according to one study. All because your default position is to park it. In order to stay healthy, you should never miss a chance to move around your workplace and explore new ways to stand and walk rather than being glued to your seat.

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Wednesday, July 30, 2014

... FITNESS ...

KNEE LIGAMENT INJURIES

EXERCISE FOR YOUR LOWER BACK & BUTTOCKS

igament injuries in the knee - such as an anterior cruciate ligament (ACL) -- are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change your lifestyle. But there’s good news. While an ACL injury or other ligament damage once ended the career of many an athlete, treatment is much more successful now. So what’s behind these feared injuries? Ligaments are tough bands of tissue that connect the bones in your body. Two important ligaments in the knee, the ACL and posterior cruciate ligament (PCL), connect the femur or thigh bone with the tibia, one of the bones of the lower leg. But too much stress on these ligaments can cause them to stretch too far -- or even snap.

ACL injury and other ligament injuries can be caused by: • Twisting your knee with the foot planted. • Getting hit on the knee. • Extending the knee too far.

• Jumping and landing on a flexed knee. • Stopping suddenly when running. • Suddenly shifting weight from one leg to the other.

These injuries are common in soccer players, football players, basketball players, skiers, gymnasts, and other athletes.

the shin bone in the knee. 3. The lateral collateral ligament (LCL) connects the thigh bone to the fibula, the smaller bone of the lower leg on the lateral or outer side of the knee. 4. The medial collateral ligament (MCL) also connects the thigh bone to the shin bone on the medial or in side of the knee.

There are four ligaments in the knee that are prone to injury: 1. Mentioned above, the anterior cruciate ligament (ACL) is one of the two major ligaments in the knee. It connects the thigh bone to the shin bone in the knee. ACL injuries are a common cause of disability in the knee. They are more common in women than men. 2. The posterior cruciate ligament (PCL) is the second major ligament in the knee connecting the thigh bone to

THIS EXERCISE IS GREAT FOR TARGETING THE HIP STABILISING MUSCLES. Equipment: Exercise Mat; Pilates ball, pillow, or towel Muscles: Back, Back: Lower, Buttocks, Core, Hamstrings, Hip Stabilisers Categories: Core, Strength Instructions: 1. Lie flat on a mat with your knees both bent at 90 degrees. If desired, place a small Pilates ball, pillow, or towel under your head. Your arms should be relaxed. 2. Lift your right leg leg off of the mat. Engage your core, exhale, and push into your left heel to lift your buttocks off of the mat. Inhale and slowly lower yourself back to the floor, keeping your core and glutes engaged the whole way down. Repeat this exercise 8-12 times on the left, then switch sides. Rest, then repeat the entire exercise sequence as desired. (Source: fitness.com)

(Source: WebMD)

ARE DUMBBELLS BETTER THAN A RESISTANCE BAND? Q: I use a resistance band at home because they don’t take up much space. Are they as effective as dumbbells?

A: Research suggests that they offer similar benefits to free weights, such as increased muscle tone and size, and decreased body fat. Plus, resistance bands come with advantages: they’re easy to travel with, affordable and provide constant resistance, which works the muscles in a different manner than weights would. Resistance bands are also popular in rehab settings because they’re safer than free weights. Regardless of what you’re using, it’s important to train according to sound exercise principles so you see improvements and gain maximum benefits. (Source: womenshealthsa.co.za)

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Wednesday, July 30, 2014

... MENTAL HEALTH ...

9 STRESS BUSTERS:

QUICK WAYS TO REDUCE YOUR TENSION to stress. It brings on anxiety when you can’t find your checkbook, your child’s homework, or the utility bill. So de-clutter to destress. Tackle a drawer, a shelf, or a tabletop at a time. An uncluttered space can feel satisfying and restorative. As an added plus, spring cleaning is good exercise, burning more than 250 calories an hour.

Laugh Out Loud

Chew Some Gum

Feeling stressed about work and family responsibilities? There are plenty of quick things you can do to reduce your tension. Throw a comedy into the DVD player, invite over some friends, and share a few good laughs. Every time you crack up, increased oxygen courses to your organs, blood flow increases, and stress evaporates. In fact, just thinking about having a good laugh is enough to lower your stress hormone levels.

Sing a Song

Mow the Lawn

Turn up the radio in the car or start crooning in the shower. No matter how out of tune you are, singing can make you feel happier. Choral members who were surveyed said singing put them in a better mood and made them feel less stressed. Singing also can be good for your breathing and posture, as well as your heart and immune system.

Cutting the lawn might sound like work, but the smell of freshly mown grass actually can make you feel more relaxed. Scientists say chemicals from newly cut grass help block the release of stress hormones in the brain. Just remember to wear earplugs to drown out the mower, because too much loud noise can send your stress rate soaring again.

Take a Deep Breath

Aromatherapy isn’t just for spas. No matter where you are, taking a deep whiff of lavender or rosemary can put you into a more relaxed state. Inhaling those aromas can lower your levels of the stress hormone cortisol. But just the act of breathing deeply is also a stress buster. Deep breathing sends oxygen surging through your bloodstream, helping to calm your entire body.

Pet Your Dog

Your pet not only gives you unconditional love, but he’s also good for your health. When you pet your dog even for just a few minutes, your body releases feel-good hormones like serotonin, prolactin, and oxytocin. At the same time, it decreases the amount of the damaging stress hormones that are released. That can mean lower blood pressure, less anxiety, and even a boost in immunity.

(Source: WebMD) PUBLISHED BY

Drink Some Orange Juice

Clean the Clutter Being surrounded by too much stuff can be overwhelming and contribute

Chewing gum can do more than freshen your breath. According to research, chewing a stick of gum also seems to reduce stress and anxiety, as well as improve mental performance during tasks. In one study, not only did gum chewers report they were less stressed, they were also less depressed and less likely to see a doctor for high blood pressure or high cholesterol.

The tart beverage that already may be a regular part of your morning routine could help you in surprising ways. Researchers say vitamin C may help people manage their stress more effectively, in part by lowering levels of stress hormones like cortisol. As an added bonus, vitamin C-rich foods such as orange juice, grapefruit juice, strawberries, or sweet red peppers can help boost your immune system.

Take a Walk

Exercise is a great way to ease stress. It helps your body produce endorphins -- the neurotransmitters in your brain that make you feel good. It also forces you to focus, helping you forget what’s making you anxious. Exercising in warm, sunny weather can boost your mood. And if you walk briskly for at least 30 minutes, you’ll meet daily exercise recommendations, and ramp up stress-busting benefits even more.

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TASNIM AHMED TAHER ABU ZAID ............................................ DESIGNER RAVINDRANATH KOONATH ............................................

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Wednesday, July 30, 2014