Health Check issue 7 by Ravi Nair

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ISSUE 7

Wednesday, August 27, 2014

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Nation•Business•Sports•Chill Out

MANY YOUNG ADULTS MISINFORMED ABOUT HOOKAHS’ HARMS

NATIONAL MENTAL HEALTH STRATEGY CHANGING MINDS, CHANGING LIVES (2013-2018) PART OF

MANY YOUNG ADULTS DON’T REALISE THAT USING HOOKAHS CAN HARM THEIR HEALTH, A NEW STUDY REVEALS

ookah smoking can be just as dangerous as cigarettes, according to the U.S. Centres for Disease Control and Prevention. However, this study found that many young adults believe the water pipes are a safe alternative to cigarettes. Researchers asked patrons, aged 18 to 30, at three Southern California hookah lounges if they thought that hookah use could be harmful. More than half said they did not believe that it would harm their health. When asked why they believed hookahs were not a health threat, 47 percent said they thought the smoke gets filtered through the water. More than one-third thought the fruit used to flavour the tobacco detoxifies harmful chemicals, and 16 percent said the tobacco used in hookahs doesn’t contain nicotine and isn’t addictive. None of those beliefs is true, said the authors of the study in the July/August is-

sue of the journal Nursing Research. “With hookah smoking on the rise, particularly among young adults, our goal was to identify factors influencing perceptions, attitudes and preferences toward hookah smoking,” lead researcher Mary Rezk-Hanna, a nursing doctoral student at the University of California, Los Angeles, said in a university news release. Previous research has shown that while cigarette use continues to fall, hookah smoking is on the rise, especially among college students. Sixty percent of the participants in the UCLA study said hookah smoking is a trendy way of socialising. “This study underscores the urgent importance of more research and campaigns to increase public knowledge on the dangers of hookah smoking, especially among young adults,” Rezk-Hanna said. Understanding the basis of these perceptions and beliefs can help health care professionals design effective prevention and intervention strategies, she added.

TARGETS FOR IMMUNOTHERAPY IN EARLY-STAGE BREAST CANCER

he National Mental Health Strategy was launched in 9 December 2013. It sets out Qatar’s vision to provide the best possible mental health services for its citizens, while changing attitudes towards mental illness.

Vision for Mental Health in Qatar: Good mental health and wellbeing for the people of Qatar, supported by integrated mental health services with access to:

The Right Care

At the Right Time

In the Right Place

(Continued on page 2...)

ale Cancer Centre researchers used a new molecular analysis tool to accurately detect the level of an important target for immunotherapy in early-stage breast cancers. The diagnostic test, using RNAScope, measures the amount of PD-L1 (programmed death ligand 1) mRNA in routine formalin-fixed cancer tissues and is devoid of many of the technical issues that plague antibody-based detection methods that have yielded conflicting results in the past. PD-L1 is the target of several novel immune stimulatory therapies in clinical trials. PD-L1 is a protein that plays an important role in suppressing immune response, and in cancer, it may allow tumours to evade immune attack. The study demonstrated that about 60 percent of early-stage breast cancers have PD-L1

expression, and a subset of these cancers also have large numbers of tumour infiltrating lymphocytes. High levels of lymphocytes and PD-L1 predicted for better survival, suggesting a beneficial role for the immune system in at least partially controlling these cancers. “This is exciting because these findings provide the rationale to test PD-L1 targeted therapies in breast cancer with the hope of further improving cure rates in early stage breast cancer,” said Lajos Pusztai, MD, DPhil, professor of Medical Oncology and chief of Breast Medical Oncology at Smilow Cancer Hospital, Yale Cancer Center, and an author on the study. “Patients with many tumour infiltrating lymphocytes and high PD-L1 expression may be the ideal candidates for these therapies.”

The in situ mRNA detection method used in the study, eliminates many of the technical problems that older immunohistochemistry assays had, Pusztai added.

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Wednesday, August 27, 2014

... REPORT ...

NATIONAL MENTAL HEALTH STRATEGY • Mental health issues are often misunderstood and frequently surrounded by negative attitudes. • Changes to mental health service delivery and increasing awareness about mental illness can improve the lives of many in Qatar. • The strategy sets out a plan to promote good mental health and wellbeing, to prevent mental illnesses and to develop tailored, quality services that can be accessed when mental health issues occur.

The Future Mental Health System in Qatar: • • • • • •

People seek help without fear of stigma A range of information and supports are available People who need services can access them A high quality, well-resourced workforce Services in a range of settings Comprehensive standards and guidelines

Building the Future Mental Health System

(Continued from page 1)

atar’s first National Mental Health Strategy is a critical part of the National Health Strategy (201116) and demonstrates progress in transforming the health sector and developing integrated health services. The National Mental Health Strategy contributes to the human development pillar of the Qatar National Vision 2030, which recognises that a healthy mind is as important as a healthy body. The National Mental Health Strategy outlines a 5 year plan to design and build a comprehensive and integrated mental health system, including education, services, leadership and research. The strategy includes a new model of care that will change the way mental health services are delivered in Qatar, giving people a range of choices on how and where they receive care when they need it. Qatar’s public and private health service providers are united behind this integrated plan. The Supreme Council of Health, Hamad Medical Corporation and Primary Health Care Corporation are the key healthcare partners in delivery of the strategy. The Strategy includes 10 pledges which describe the benefits for the people as it delivers the system wide changes for mental health. A key outcome of implementing the Mental Health Strategy is to increase the number of people who have access to the care they need. This can be achieved by reducing stigma, offering treatment in a range of settings, building a mental health trained workforce, improving facilities and increasing financial investment over the next 5 years. The Supreme Council of Health has set a clear vision to create a high-quality mental health system for Qatar and will take a leading role in monitoring the successful implementation of the strategy.

The pledges to deliver an ‘Improved Mental Health System’ in Qatar include: • Increased public awareness about mental health and reduced stigma associated with mental illness

• Mental health information resources being widely available • Most people accessing their treatment in primary care and community settings • Specialist services that meet the differing needs of individuals and groups • Care individually tailored and based on treatments that work • A sustainable, high-quality mental health workforce for Qatar • A coordinated multi-sectoral approach to mental health policy development and planning • Enacted Mental Health Law in Qatar • Reported improvements in patient care • Mental health research translated into improvements in clinical practice and patient outcomes

The Importance of Mental Health Mental health affects everyone: all countries, all societies, the rich and the poor, the urban and the rural, and individuals of all cultures, races, genders and ages. Good mental health is central to quality of life for individuals and their families, and to the social and economic success of societies and nations.

Why does Qatar need a Mental Health Strategy? • Good mental health is central to quality of life for individuals and their families, and to the social and economic success of societies and nations. • Mental Health is as important as physical health to the overall wellbeing. • Mental illness is common across the world and research undertaken in Qatar estimates that 1 in 5 people experience a mental illness at any one time.

The development of the system is underpinned by four key strategic objectives. Each strategic objective and plans for the future are described below. Objective 1: Effective strategies for mental health promotion and prevention • Develop a mental health promotion and prevention strategy for Qatar • Identify mental health promotion opportunities within public health • Scope needs for the development of mental health information resources and public awareness campaigns Objective 2: Comprehensive, integrated and responsive mental health services • Agree infrastructure specifications for community and inpatient services • Establish specialist community services • Deliver age-specific inpatient services • Develop the workforce to increase clinical capacity • Develop care pathways across the mental health system, including clinical guidelines • Create a mental health service directory Objective 3: Leadership and governance for mental health • Launch the Qatar National Mental Health Strategy • Enact Mental Health Law • Deliver a policy framework for mental health Objective 4: Information systems, research and evidence based practice • Develop key performance indicators, including a comprehensive mental health minimum data set, to measure improvement in services • Develop a national mental health research strategy

Implementation of the Strategy To support delivery of the National Mental Health Strategy and realise the vision for mental health in Qatar, a Strategy Implementation Framework has been developed. The Framework provides a detailed description of how the strategy will be implemented and covers the following elements:

Implementation Plan Schedules Implementation Plan Schedules provide a high level overview of the actions, lead organisations and partners who supports the delivery of the strategy. Key program mile-

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Key Risks A detailed Program Risk Register has been developed as part of the monitoring and reporting mechanisms of the strategy’s implementation. Identified risks have been articulated with a comprehensive plan of mitigating actions and these will be monitored and reviewed on a regular basis to reflect the current status of implementation.

Mental Health Program Governance The diagram below outlines the current governance arrangements for the Mental Health Strategy.

stones and performance indicators have been identified that will measure the successful implementation of the strategy.

Resourcing the Implementation Plan Indicative costs associated with implementing a strategy of this complexity have been disaggregated from an initial investment analysis. Further refinements of costs will be undertaken as implementation and business planning progresses.

Working in Partnership It is recognised that support from a range of internal and external partners is needed to deliver the strategy for Qatar. A stakeholder analysis has been undertaken as well as a review of potential partnerships. This process has enabled the identification of a number of key organisations who could potentially provide different expertise across every part of the strategy as implementation progresses. Detail on partners involved the delivery of the strategy are also outlined in the Implementation Plan Schedules.

SCH Executive Committee

HE The Minister of Health

NHS Ministerial Program Board

Assistant Secretary General

NHS Steering Committee

National Mental Health Strategy Implementation Committee

NHS Program Management Office

National Mental Health Implementation Team

Taskforce Groups

National Mental Health Implementation Team (NMHIT) on behalf of the National Mental Health Strategy Implementation Committee (NMHSIC).

Impact Evaluation Impact evaluations will provide a systematic means of appraisal to assess the effectiveness of the whole National Mental Health Strategy. The evaluations will be conducted on a yearly basis and will complement the monitoring and reporting mechanisms, which track progress against key actions in the implementation plan.

Outcome of the National Mental Health Strategy: • Increased awareness of mental health and reduced prevalence of mental illness • Access to tailored services, with a focus on early intervention and recovery • A high quality service system which is regulated and monitored • Improved patient outcomes through evidence based policy and service provision

· Hamad Mental Health Workstream · Primary Care Strategy Steering Committee

NHS Program Governance Project Governance

Measuring Strategy Implementation Progress To monitor progress against the national implementation plan for mental health there will be a number of monitoring and reporting mechanisms established via the governance structure described above. At a national level the implementation of the strategy will be monitored by the

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Wednesday, August 27, 2014

... DOCTOR’S DESK ...

DON’T COMBINE YOUR PRESCRIPTION WITH THESE FOODS BACON AND CHOCOLATE. CHILI AND PEANUT BUTTER. SOME UNLIKELY COMBINATIONS END UP WORKING WELL TOGETHER. BUT WHEN IT COMES TO DIET AND DRUGS, THE WRONG PAIRING CAN UNWITTINGLY TURN INTO A RECIPE FOR DISASTER.

ou don’t need a prescription to face these risks— even some common over-the-counter treatments should warrant more careful attention to your menu, says Dr Jen Wolfe, a pharmacist and consultant with Comprehensive Pharmacy Consulting. Here are six dangerous duos to dodge.

1. Apple juice and allergy meds Nix the nectar from apples, oranges, and grapefruits if you take Allegra (fexofenadine) for hay fever—at least within four hours of swallowing the pill. These juices inhibit a peptide that transports the drug from your gut to your bloodstream. The resulting lack of absorption makes Allegra up to 70 per cent less effective at stopping your sniffling and sneezing. Other medications also travel with the help of the same peptide; lay off these juices while taking the antibiotics Cipro or Levaquin, the thyroid medication Synthroid, or the allergy and asthma treatment Singulair.

2. Cassia Cinnamon and Warfarin People taking the blood-thinning medication warfarin—prescribed to prevent or treat clots— have long been warned to keep their intake of vitamin K steady, says Wolfe. This means you shouldn’t change your weekly intake of foods like leafy greens or broccoli; because vitamin K plays a key role in clotting, doing so could affect the thickness of your blood. But there’s another risk. Cassia cinnamon, the kind on most supermarket shelves, contains high levels of a compound called coumarin that can thin blood and potentially cause liver damage, says Dr Eric Newman, a resident at Mercy Medical Center in Baltimore. If you’re on warfarin, switch to Ceylon cinnamon instead, he advises.

3. Smoked meats and antidepressants Check the label on your happy pills. If they belong to a class called monoamine oxidase inhibitors or MAOIs brand names Marplan, Nardil, Emsam, or Parnate—combining them with foods rich in the amino acid tyramine can cause life-threatening spikes in blood pressure. Unfortunately, the list of no-no’s includes not only sausage and smoked salmon, but also red wine, sauerkraut, hot dogs, aged cheeses, soy sauce, and draft or home-brewed beer. The good news? Canned or bottled beer probably won’t hurt you—and MAOIs have largely been replaced by newer-generation antidepressants, which don’t have the same effect on tyramine levels, says Dr Nicole Gattas, assistant professor of pharmacy practice at St. Louis College of Pharmacy.

4. Dairy products and antibiotics Some antibiotics, including Cipro, bind to calcium, iron, and other minerals in milk-based foods. This prevents the absorption of the antibiotics, ultimately decreasing their ability to fight infections. When you get a new prescription for acne or an infection, ask if the drug falls into a class known as tetracyclines or flouroquinolones. If so, avoid milk, yogurt, and cheese two hours before and after taking the pills. And talk with your pharmacist about proper timing if you take multivitamins with minerals—they can have a similar effect. • Highly supported by scientific evidence that classic families of antibiotics such as tetracyclines and fluoroquinolones are to be properly spaced from dairy products intake for absorption and effectiveness. (Everyday Health).

5. Chocolate and ritalin Besides caffeine, chocolate also contains a stimulant called theobromine, says Dr Tom Wheeler, director of pharmacy and pulmonary services at Advocate Illinois Masonic Medical Center in Chicago. (It’s the reason chocolate harms dogs—canine bodies can’t break it down.) Combining all these stimulants in humans can potentially lead to erratic behaviour and seizures. As with caffeine alone, the risks are largely individual. Your best bet: take note of whether you feel more nervous, irritable, or wired when you combine Ritalin—especially the extended-release forms—with chocolate. If so, increase the amount of time between downing your pill and having dessert. Or, lighten up: “The darker the chocolate, the more caffeine and theobromine it contains,” Wheeler says.

6. Limes and cough medicine You may have heard not to drink grapefruit juice with some prescriptions, including cholesterol-lowering statins. But limes, pomelos, and Seville oranges—although not the more-common navel and Valencia varieties—also may block an enzyme that breaks down statins and other drugs, including the cough suppressant dextromethorphan. Because the medication then builds up in your bloodstream, the risk for side effects increases, says Dr Mary Ellen Gullickson, a pharmacist at Marshfield Clinic in Wisconsin. With dextromethorphan, this includes hallucinations and sleepiness; in statins, you may sustain severe muscle damage. These fruits’ effects can linger for a day or longer, so it’s best to avoid them and their juices altogether while taking these drugs. And if you’re a citrus fiend? Check in with your pharmacist about potential drug interactions, Gullickson recommends. Australian Men’s Health magazine

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POTASSIUM GROCERY LIST

Healthy Appetisers While the heat is firing up, these starters will keep guests finger-licking happy & healthy!

Grilled Peaches and Tomatoes

FEELING LIKE YOUR BRAIN IS IN A FOG, YOUR HEART IS SKIPPING BEATS OR YOUR MUSCLES ARE CRAMPING COULD BE SIGNS THAT YOU’RE NOT GETTING ENOUGH POTASSIUM. BUT NEVER FEAR – THIS IMPORTANT MINERAL CAN BE FOUND IN SOME OF NATURE’S MOST DELICIOUS FOODS. THE NEXT TIME YOU VISIT THE STORE, KEEP THIS POTASSIUMPACKED GROCERY LIST IN MIND TO HELP GET YOUR BRAIN, HEART AND MUSCLES WORKING SMOOTHLY AGAIN IN SHORT ORDER.

Bananas

Peaches have 19% of your vitamin C for the day, 11% of your vitamin A, and 10% of your potassium. They are great as an appetiser or served alongside lean grilled meats and a salad. By simply grilling them up with a little bit of oil, tangy blue cheese and sweet tomatoes, you can have a tasty, easy and, most importantly, healthy side dish! Ingredients (Makes 4 servings) • 2 peaches, cut in half, pit removed • 2 tomatoes, cut in half

• 4 tsp extra virgin olive oil • 3 tbsp. crumbled blue cheese • 4 tsp maple syrup, honey, or good balsamic vinegar Directions • Drizzle the cut side of the peaches and tomatoes with a little olive oil and place cut side down for about 2 minutes on a hot grill. Flip them over, top with the blue cheese and grill them for an additional 2 minutes. Drizzle with maple syrup, honey or balsamic vinegar.

(http://blog.doctoroz.com/recipe-rehab/grilled-peaches-and-tomatoes

Cucumber-Tomato Salad

This tasty fruit is famous for its high potassium content. One medium banana contains about 11% of your daily potassium requirement, in addition to plenty of vitamin C and vitamin B6.

Cantaloupe

Not only is it sweet and refreshing, but cantaloupe is also packed with potassium. One cup of cubed cantaloupe contains almost 10% of your daily potassium requirement.

Sweet Potato

One cup of cubed sweet potatoes contains even more potassium than a banana. Load up on your daily potassium with this fibre-full food that also contains 377% of your daily vitamin A.

Salmon

Cucumbers are essential to healthy skin and nails due to its high amount of the mineral silica. What else does silica do? It helps to increase bone mineral density, making us less prone to osteoporosis. In addition to helping us with strong bones and nails, cucumbers are low in calories and high in fibre, making it one of the best foods around if you’re looking to lose a few pounds! Ingredients • 6 tbsp. lemon juice • 1 tbsp. fresh garlic, fine chopped • 1 1/2 tsp salt • 1/4 teaspoon pepper

Wednesday, August 27, 2014

... NUTRITION ...

• 2/3 cup extra-virgin olive oil • 1 tbsp. fresh cilantro, chopped • 2 tbsp. fresh jalapeño pepper, minced, skinless & seedless • 2 cups cucumber, small dice, peeled and deseeded • 2 cups fresh tomatoes, small dice • 1 cup sweet onion, small dice Directions • In a large mixing bowl, combine the lemon juice, garlic, salt and pepper. Slowly whisk in extra-virgin olive oil. Add cilantro, jalapeño, and mix until blended. Add cucumbers, tomato and onion, mix well and serve.

(http://blog.doctoroz.com/food-doc/the-unsung-benefits-of-a-cucumber-salad)

You might associate salmon with its heart-friendly omega 3s, but did you know that just half a fillet of Atlantic salmon has more than 15% of your daily potassium needs?

Lentils

This filling, savoury legume is a great addition to any meal. Just one cup of lentils has 731 mg of potassium, or over 15% of your potassium needs.

(http://www.doctoroz.com/slideshow/potassium-grocery-list)

Dried Apricots

These tasty snacks are chockfull of potassium. One cup of dried apricots contains a third of your daily potassium. But don’t overdo it – they are also high in sugar.

Broccoli

This healthy green is packed with antioxidants and potassium. Just one stalk has 10% of your daily potassium needs, and a bunch contains about 40%. Plus, you’ll get tons of immune-boosting vitamin C and fibre in the bargain.

Avocado

Avocados are a true superfood. Packed with heart-healthy fats and the ability to lower the stress-hormone cortisol, one avocado alone also contains 975 mg of potassium, or 20% of your daily requirement.

Milk & Yogurt

If you’re a dairy fan, opt for milk and yogurt, which each come with a healthy dose of potassium, as well as bone-building calcium and plenty of vitamin B12.

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... HEALTH QUIZ ...

HEALTH IQ: VEGGIES VEGGIES ARE A VITAL PART OF A HEALTHY DIET. BUT HOW DO YOU GET THE BEST OUT OF YOUR VEG?

Quiz Answers Question 1 = c

Are fresh veggies always better than frozen?

Which is better for your health: raw or cooked veg?

a. Raw, because it’s always more nutritious. b. Raw, because cooking lowers the fibre content. c. A mix of raw and cooked is considered the ideal. d. Cooked, because raw vegetables pose a significant choking risk

a. Yes, freezing destroys important nutrients. b. Yes, frozen vegetables always contain added salt. c. No, freezing preserves important nutrients. d. No, nutrients are more readily absorbed from frozen vegetable.

If you’ve been worrying you need to eat a certain quota of raw veggies to meet your nutritional needs, you can breathe easy. It doesn’t really matter how we consume our veg, just as long as we get enough, says Sonya Stanley, of the Dietician’s Association of Australia. (Adults should eat up to five serves a day with a serve being half a cup of cooked veg or one cup of salad.) While some veggies may lose a little of their nutritional content when cooked, it’s not enough to worry about and cooking does not diminish the fibre content, Stanley says. In some cases, cooked veggies are actually more nutritious because the cooking process makes certain nutrients more readily absorbed by the body. So eating a mix of raw and cooked is probably a good goal to increase nutrient variety.

Question 2= a

When it comes to cooking your veg, which of the following is the best advice? a. Try to avoid cooking vegetables in the microwave. b. Try to always steam vegetables. c. Try to avoid char-grilled vegetables altogether. d. Try to use a variety of cooking methods for your vegetables.

Eating a variety of different coloured vegetables is recommended because?

a. Different colours tend to represent different nutrients and so you get broader health benefits. b. Different colours represent different types of fibre and your body needs all the types. c. Substances in vegetables of one colour may be harmful if they are not balanced out by substances in vegetables of other colours. d. You need to eat a variety of colours to prevent the disease scurvy.

http://www.abc.net.au/health/quizzestools/quizzes/2012/05/23/3509148.htm

The colours of fruits and vegetables are a small clue as to what vitamins and nutrients are included. Since different vitamins and nutrients are helpful for different aspects of your health, getting a variety means you’re getting the broadest possible range of health benefits. But there’s no evidence eating vegetables of only one colour is actually harmful. It’s just not as good as eating a variety of colours. Nor is their evidence colour variety is important for obtaining enough fibre. While eating vegetables is helpful for preventing scurvy, a disease caused by lack of vitamin C, varied colours is not essential for meeting your vitamin C needs. Some vegetables that are a good source of vitamin C include broccoli, spinach, cabbage and capsicum and an average serve of any one of these will supply more than a day’s vitamin C needs.

Question 3 = c While it might seem intuitive good sense to opt for fresh vegetables whenever you can, health experts say frozen veg are nonetheless a valid inclusion in a healthy diet. That’s because frozen veg are almost always frozen very soon after picking and modern freezing technology preserves the nutrients (although it might change the texture in a negative way). Unless you can eat veg freshly picked from your garden, the fresh veg available in shops is usually at least a few days old and over this time, can lose a varying degree of nutrients. While some frozen vegetables are packaged with a sauce which may contain added salt, most frozen vegetables do not contain extra salt. But fresh veg is still a good choice and often has a better taste than its frozen counterpart.

Question 4 = d Cooking can have both positive and negative nutritional effects on veggies. And while steaming is considered a good cooking method because it retains a lot of nutrients you don’t need to eat steamed veg every night. That’s because variety, taste and texture are what motivate us to fill our plates with vegetables in the first place, and the biggest challenge for most people is actually eating enough veg to meet our health needs. While char-grilling may create chemicals that have been linked with some negative health outcomes, the findings are still somewhat preliminary and not considered proven. So experts recommends limiting char-grilled veg to once a week rather than cutting them out altogether – as again, variety is likely to increase intake. As for microwave cooking, it is perfectly safe and considered one of the better cooking methods.

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Wednesday, August 27, 2014

... PAEDIATRICS & CHILD HEALTH ...

TAKING CARE OF YOUR CHILD’S FEVER YOUNG KIDS OFTEN GET FEVERS. THEY’RE A NORMAL PART OF CHILDHOOD AND USUALLY AREN’T SERIOUS. IN MOST CASES, THEY GO AWAY ON THEIR OWN. FEVER IS THE BODY’S WAY OF KILLING OFF INFECTIONS BY RAISING THE HEAT ON GERMS. IT CAN BE CAUSED BY BACTERIA, LIKE STREP THROAT, OR A VIRUS, LIKE THE FLU. THE KEY IS LEARNING HOW AND WHEN TO TREAT THEM SO YOU CAN KEEP YOUR CHILD COMFORTABLE UNTIL SHE’S FEELING BETTER.

When should I treat fever? You can treat a fever when your child seems uncomfortable. It won’t make his infection go away, but it can help him feel better. Sometimes a fever can make your child sleepy. If you don’t treat a low fever, your child may be able to get more rest.

How should I treat fever? Give him a child’s dosage of ibuprofen or acetaminophen to safely bring his fever down. You can use ibuprofen for kids 6 months and older or acetaminophen for children 2 years and up. Ask your doctor for the correct dose if your child is under 2.

How can I keep my child comfortable when she has a fever? • A 15-minute bath in lukewarm water may help bring your child’s fever down. Make sure the water doesn’t get cold, and take her out if she starts to shiver. • Dress your child lightly. Use a sheet in-

stead of a blanket to cover her in bed. • Breastfeed or give your baby formula often. You may want to consider an oral rehydration drink like Pedialyte for babies. If your child is weaned, encourage him to drink extra water. Skip soda and caffeinated drinks, which can be dehydrating.

What’s the best kind of thermometer for children? • Digital thermometers are inexpensive, fast, and accurate. Depending on the model, they can be used to take temperature by mouth, under the arm, or in the bottom. There’s a temperature sensor at one end and a digital display at the other. Clear the screen before inserting the thermometer and remove it when it beeps. Clean the thermometer according to directions before storing it. • Electronic ear thermometers are fast and easy to use in children 12 weeks and older, but they’re expensive and aren’t as accurate for newborns and infants. • Plastic strip thermometers that are pressed against the forehead and pacifier

IS YOUR BABY A “HAPPY SPITTER?” Every baby spits up or vomits occasionally, and some do quite often or even with every feeding. If, despite the spitting, your baby is: • Content • In no discomfort • Growing • Experiencing no breathing problems from the vomiting She is what paediatricians call “a happy spitter” and no treatment is needed. Typically, the lower oesophagus valve tightens up sometime in the first year, usually around 4 to 5 months of age, at which time the spitting up may go away.

thermometers are convenient, but they’re not very accurate either -- especially for infants. Don’t use glass mercury thermometers. There’s a risk of being exposed to mercury, which is toxic.

When should I call the doctor? Call your doctor right away if you have a baby 12 weeks of age or younger with a temperature above 100.3. For a child of any age, call your doctor right away if his temperature rises above 104, if he won’t stop crying, or has any of the following: • Stiff neck • Severe headache • Severe sore throat • Ear pain • Repeated vomiting or diarrhoea • A seizure • Rash You should also call your doctor if the fever has dropped but your child is still acting sick or if he seems to be getting worse. Call if the fever lasts more than 24 hours in a child younger than 2, or more than three days in a child 2 and up.

WARNING SIGNS OF STRESS IN KIDS

A recent survey by the American Psychological Association found that 20% of children have ongoing stress. Is your kid among them? Ask yourself: 1. Does your child have more meltdowns than usual? 2. Do you notice a rise in fatigue, irritability, headaches, and stomachaches? 3. Is your child sleeping poorly or waking up from night terrors? 4. Is your child acting angry?

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Wednesday, August 27, 2014

... WOMEN’S HEALTH ...

HEALING AFTER CHILDBIRTH YOU PROBABLY HAD A LONG LIST OF PROJECTS YOU PLANNED TO GET DONE DURING YOUR MATERNITY LEAVE. HOWEVER, YOU NOW REALISE THAT YOU FORGOT ONE THING: THIS IS NOT A VACATION. INSTEAD, IT IS A TIME TO HEAL, TO GET TO KNOW YOUR NEW BABY AND TO LEARN HOW TO BE A MOTHER. SO FORGET EVERYTHING EXCEPT THESE THREE THINGS.

he healing part is very important. Your body has been through a massive change over the past nine months; don’t expect to return to normal for a while. While our society considers women “healed” at six weeks—when many women get the green light to get intimate and return to work—it will really take the next nine months to return to normal. So relax. And follow this advice:

think that laundry, cooking or shopping is boring, especially if you talk to them.

• Sleep when Baby sleeps

Now is not the time to become a gourmet cook. If your partner can’t take over the cooking during the week, show him how to make large batches of food like pasta sauce, chicken casseroles, lasagna, etc., and freeze for during the week.

You will probably never be as tired again as during the first few months of motherhood. Forget about “getting things done” while the baby sleeps. As soon as she starts snoring, you need to hit the sack, too. Gradually, as you regain your strength, you’ll be able to stay awake longer.

• Do your chores with Baby Babies love to watch you. They don’t

• Get out of the house every day Even if it’s only for a walk around the block. The sunshine and fresh air will do you a world of good.

• Give in to take-out

morning—at least one room will look neat.

• Take care of your perineal area If you tore during delivery or had an episiotomy, sitting in a few inches of water several times a day not only keeps the area clean, but can soothe any pain. You can reduce swelling with ice packs or chilled witch hazel pads.

• Eat right That means following the same healthy diet you followed during pregnancy and abstaining from alcohol if you’re breastfeeding.

• Lower your standards

• Watch out for problem signs

Your house doesn’t have to be spotless. If you can afford it, hire a cleaning service. If not, just focus on the clutter control. And make your bed in the

If you suddenly start bleeding heavily again, develop a breast infection, or feel pain in your pelvic region, call your health care professional.

Feeling Down T he “baby blues” are not a myth. After the giddiness of the birth wears off and the reality of motherhood—complete with little sleep—sets in (helped along by plummeting hormone levels), you may feel down, weepy, depressed. This is completely normal and usually disappears within about 10 days. If those “blue” feelings persist, however, or become more intense, you may have a condition called postpartum depression. Other symptoms include: • Feeling restless, irritable or anxious • Loss of interest or pleasure in life • Loss of appetite • Less energy and motivation • Problems falling asleep or staying asleep or waking up too early in the morning • Feeling worthless, hopeless or guilty • Feeling like life isn’t worth living • Showing little interest in the baby • Unexplained weight loss or gain If you have several of these symptoms for more than a week or two, call your health care professional or ask someone to call for you to make an appointment. Support, therapy and, if necessary, medication can restore you to your old self. Postpartum depression is not a normal phase. Please get help, if you need it.

Got Insomnia? Gulp a Kiwi! W hen shut-eye is hard to come by—and women are more likely than men to toss and turn all night—this fuzzy fruit may help you conk out faster. Researchers at a Taiwanese university found that women who ate two kiwis one hour before bedtime for a month fell asleep 14 minutes faster and had better sleep duration and quality than those who didn’t eat the fruit. One possible explanation: Noshing on the sweet green flesh before hitting the sack may boost levels of serotonin, a sleep-inducing neurotransmitter that delivers an express ticket to dreamland.

Other Ways to Dose Yourself: Chop and add to fruit salads and salsas; puree and mix into smoothies and fruit drinks; slice for a tart topping. Pub Med: Numerous studies have revealed that kiwifruit contains many medicinally useful compounds, among which antioxidants and serotonin may be beneficial in the treatment of the sleep disorders. Kiwifruit consumption may improve sleep onset, duration, and efficiency in adults with self-reported sleep disturbances. Further investigation of the sleep-promoting properties of kiwifruit may be warranted. http://lovehealth.co.za/eat-this-cure-that/

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... MEN’S HEALTH ...

HIGH CHOLESTEROL IN MEN H

igh cholesterol tends to run in families, so obviously genes play a role. But a variety of lifestyle choices -- including diet, activity, and body weight -- also affect cholesterol levels. The only way to know how high your cholesterol levels are is to get a simple blood test. Everyone over 20 should get a cholesterol test at least once every 5 years. If your numbers are high, your doctor may recommend the test more often. Q: What are the risk factors for having high cholesterol? A: Your risk of having high cholesterol increases if: • Your diet is high in saturated fat. These fats, found in meat and fullfat dairy products, raise LDL cholesterol. Dietary cholesterol, found in eggs and organ meats, can also raise blood cholesterol levels, but not as much as saturated fat does. • You eat foods containing trans fats. These are artificially made fats found in partially hydrogenated oils. They raise LDL cholesterol and lower HDL cholesterol -- exactly the wrong combination.

• You eat processed foods or foods high in carbohydrates. These types of foods have also been shown to increase LDL cholesterol. • You are overweight or obese. Excess weight increases LDL and lowers HDL. • You don’t get much exercise. Studies show that frequent exercise can boost HDL, the good cholesterol. Lack of exercise can lead to weight gain. Q: What are the treatments for high cholesterol? A: The first treatment of choice for high cholesterol is adopting a healthier lifestyle. In many people who have cholesterol in the borderline high category, healthier habits can bring the numbers down to normal. If lifestyle changes are not enough, a variety of cholesterol-lowering medications are available. The leading choice -- statin drugs -- are very effective at lowering LDL. Recent studies have confirmed that, by lowering cholesterol levels, these drugs reduce the risk of heart disease.

HIGH CHOLESTEROL, ALSO CALLED HYPERCHOLESTEREMIA, PUTS MEN AT GREATER RISK FOR HEART ATTACKS, STROKES, AND PERIPHERAL ARTERY DISEASE. FOR MANY MEN, THE RISK FROM HIGH CHOLESTEROL STARTS IN THEIR 20s AND INCREASES WITH AGE.

WHAT IS HIGH CHOLESTEROL? Cholesterol is a waxy, fat-like substance made in the liver and other cells. It’s also found in certain foods, such as dairy products, eggs, and meat. Your body needs some cholesterol to function properly. Its cell walls, also known as membranes, need cholesterol to produce hormones, vitamin D, and the bile acids that help you digest fat. But the body only needs a limited amount of cholesterol. When there’s too much, health problems, such as heart disease, may develop. There are different kinds of cholesterol, and if there’s too much of certain kinds in your blood, a fatty deposit called plaque can build up on the walls of your arteries. This plaque build-up can block blood flow to the heart muscle, reduc-

ing its oxygen supply. A heart attack happens when the plaque completely blocks a blood vessel feeding a section of the heart muscle. If the plaque blocks a blood vessel going to your brain, you can have a stroke. The cholesterol that blocks arteries is called low-density lipoprotein, or LDL. Another kind of cholesterol called high-density lipoprotein or HDL is known as good cholesterol because it helps remove LDL from the blood and eventually from the body. For good health, you ideally want to keep the LDL levels down and the HDL levels up. If this balance isn’t maintained, especially if it’s reversed, you are said to have high cholesterol.

(Source : Webmd.com)

How to benefit from stress A LITTLE PRESSURE WON’T KILL YOU. TAKE THE STRAIN AND USE IT TO MAKE YOU STRONGER

tress doesn’t affect your lifespan – but how you feel about it does. Not what you’re used to hearing? Here’s proof: researchers in Michigan asked 30,000 people to rate their stress level and also rate how much they believed it impaired their health. Those who felt it was harmful were 43% more likely to die in the study period. Cheer up and it might never happen. If you need help ‘reframing’ stress try this: moderate doses help you

recover faster from illness, according to Stanford University. Sure, you might sweat it when the boss dumps a new project on you. But you’ll also feel excited. That’s the pleasure chemical dopamine flowing in your brain; you won’t get your dopamine from doing the same old thing. So don’t be put off by pop psychologists who call stress a killer. Otherwise you’ll miss out on all its benefits – and a chance to climb the ladder. Man up and move up.

Make stress a strength • Think of your pounding heart as your body tapping resources in preparation: it’ll widen your arteries and boost attention, says The Journal of Experimental Psychology. • Rebrand ‘stress hormone’ cortisol as the ‘get up and go’ one. Concordia Uni found that optimists display less of a stress response. • Give your time to family or charity: do-gooders live longer, says a University of Buffalo study, even if stressed. It’s not like you’re busy or anything.

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... FITNESS ...

A WORKOUT FOR EVERY DISEASE WORKING OUT IS FAR MORE THAN JUST SIXPACKS AND SHOWING OFF; IT SHOULD LEAVE YOU HEALTHIER, PROTECT YOU FROM DISEASE AND GENERALLY MAKE YOU HAPPIER. IT SHOULD, IN SHORT, GET YOU FIT FOR LIFE. AND WE MEAN FOR YOUR LIFE TODAY, AS WELL AS INVESTING IN YOUR PHYSICAL STATE FOR THE FUTURE

esearch from the Harvard School of Public Health discovered that increasing your energy expenditure by just 4 000kJ per week can lower your risk of death from major illnesses by 20%. Which is a lot.

the blood to the liver, where it’s expelled from the body. Brandeis University found that weightlifting circuits performed with a heavy load (60% of your one-rep max and above) were the most effective exercise for boosting memory function.

But there’s more. By tailoring the style, structure, intensity and duration of your workouts, you can specifically strengthen your body’s resistance to five of the biggest threats to your health and improve your overall well-being every time you hit the gym.

2. Run Off Your Risk Of… PROSTATE CANCER

1. Lift Big To Avoid… ALZHEIMER’S Smart men go heavy. The Alzheimer’s Society reports a six-fold rise in the risk of developing the disease if you have high blood pressure and high cholesterol, while recent studies suggest regular exercise helps move LDL (bad cholesterol) from

Regular vigorous aerobic activity cuts your chance of developing prostate cancer by 61%, according to a study by Harvard University. The research found that activities which multiply your resting metabolic rate by six, such as running, swimming, cycling, racket sports, rowing or high-intensity circuits, create an inhospitable environment for tumour growth. As an added bonus, they’re not bad for shrinking your waistline, either.

3. Push Yourself To Dodge…DIABETES Work hard against one of the fastest growing health concerns in the developed world. Research from the American Diabetes Association found a 46.3% increase in insulin efficiency when men lifted weights to the point of muscular exhaustion. That’s because more fibres are recruited than during basic aerobic activity, allowing your body to better access and release glycogen stores. You should use 50-80% of your one-rep max weight and perform until failure.

4. Start Slow To Outsmart… ARTHRITIS Warming up before working out is an investment in the future of your joints. A

Nottingham University study found that you are 4.2 times more likely to develop osteoarthritis if you’ve had even a moderate injury to one of your joints. Warm-ups that include joint awareness, coordination and high-intensity upper and lower-body moves result in the greatest reduction in injury risk.

5. Work More Muscles To Beat… HEART DISEASE Exercising multiple muscle groups in one session maximises the oxygenated blood your heart needs. “The rhythmic contraction and expansion of arteries allows better dilation and more oxygen to get to the heart,” says Professor Jonathan Myers of the Palo Alto Veterans Affairs Health System in California.

How Can I Keep Knots from Forming in My Neck and Shoulders?

3 RID YOURSELF OF COMMON TIGHTNESS AND PAIN AT WORK BY TRYING THESE 3 FAST STRETCHES

f you want to keep creaks from forming all over your body, stop sitting like a caveman at work. Hunching in front of a screen keeps muscles contracted, restricting bloodflow and oxygen and forming knots. Use an adjustable chair with armrests “so you aren’t wearing your shoulders as earrings”. Also, keep your screen 15 to 24 inches away and adjust fonts so you won’t lean in to read. Then do these stretches three or four times a day. Hold each for 15 seconds.

1. Your Neck Tilt your head right, then left. Bring your chin to your chest

and hold; then gently look up at the ceiling. Rotate your head to the right, then the left.

2. Your Arms & Back Clasp your hands and push up. Hold, release, and repeat three to five times. Then stand, arms up. Bend at your waist to your right, hold, and repeat left.

3. Your Chest Interlace your fingers behind your back. Inhale and pull your arms back and up while sticking out your chest. Hold, and release. Do it three to five times.

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... MENTAL HEALTH ...

UNDERSTANDING BIPOLAR DISORDER BIPOLAR DISORDER, SOMETIMES CALLED MANIC DEPRESSION, IS A DISORIENTING CONDITION THAT CAUSES EXTREME SHIFTS IN MOOD

Bipolar Disorder: What Is It?

Causes of Bipolar Disorder

Talk Therapy for Bipolar Disorder

Bipolar disorder, sometimes called manic depression, is a disorienting condition that causes extreme shifts in mood. Like riding a slow-motion roller coaster, patients may spend weeks feeling like they’re on top of the world before plunging into a relentless depression. The length of each high and low varies greatly from person to person. Depressive Phase Symptoms: Without treatment, a person with bipolar disorder may experience intense episodes of depression. Symptoms include sadness, anxiety, loss of energy, hopelessness, and difficulty concentrating. Patients may lose interest in activities that were once pleasurable. They may gain or lose weight, sleep too much or too little, and contemplate suicide. Manic Phase Symptoms: During a manic phase, patients tend to feel euphoric and may believe they can accomplish anything. This can result in inflated self-esteem, agitation, reduced need for sleep, being more talkative, being easily distracted, and a sense of racing thoughts. Reckless behaviours, including spending sprees, sexual indiscretions, fast driving, and substance abuse, are common. Having three or more of these symptoms nearly every day for a week may indicate a manic episode. Bipolar I vs. Bipolar II: People with bipolar I disorder have manic episodes or mixed episodes and often have one or more depressive episodes. People with bipolar II have major depressive episodes with less severe mania; they experience hypomania, a condition that is less intense than mania or lasting less than a week. Patients may seem like the “life of the party” -- full of charm and humour. They may feel and function fine, even if family and friends can see the mood swing. However, hypomania can lead to mania or depression. Mixed Episode: People with mixed episode experience depression and mania at the same time. This leads to unpredictable behaviour, such as sadness while doing a favourite activity or feeling very energetic. It’s more common in people who develop bipolar disorder at a young age, particularly during adolescence. But some estimates suggest up to 70% of bipolar patients experience mixed episodes.

Doctors aren’t exactly sure what causes bipolar disorder. A leading theory is that brain chemicals fluctuate abnormally. When levels of certain chemicals become too high, the patient develops mania. When levels drop too low, depression may result.

Talk therapy can help patients stay on medication and cope with their disorder’s impact on work and family life. Cognitive behavioural therapy focuses on changing thoughts and behaviours that accompany mood swings. Interpersonal therapy aims to ease the strain bipolar disorder may place on personal relationships. Social rhythm therapy helps patients develop and maintain daily routines.

Diagnosing Bipolar Disorder Currently, bipolar disorder cannot be identified through a blood test or a brain scan, but these tests can help rule out other factors that may contribute to mood problems, such as a stroke, brain tumor, or thyroid condition. If the problems are not caused by other illnesses, the health care provider may conduct a mental health evaluation or provide a referral to a trained mental health professional, such as a psychiatrist. A psychiatrist usually makes the diagnosis based on a careful history and evaluation of the patient’s mood and other symptoms.

Medications for Bipolar Disorder Medications are key in helping people with bipolar disorder live stable, productive lives. Mood stabilisers can smooth out the cycle of ups and downs. Patients may also be prescribed antipsychotic drugs and anticonvulsant drugs. Between acute states of mania or depression, patients typically stay on maintenance medication to avoid a relapse.

Lifestyle Tips for Bipolar Disorder Establishing firm routines can help manage bipolar disorder. Routines should include sufficient sleep, regular meals, and exercise. Because alcohol and recreational drugs can worsen the symptoms, these should be avoided. Patients should also learn to identify their personal early warning signs of mania and depression. This will allow them to get help before an episode spins out of control.

Electroconvulsive Therapy (ECT) Electroconvulsive therapy can help some people with bipolar disorder. ECT uses an electric current to cause a seizure in the brain. It is one of the fastest ways to ease severe symptoms. ECT is usually a last resort when a patient does not improve with medication or psychotherapy.

Bipolar Disorder: Who’s at Risk?

Bipolar disorder affects males and females equally. In most cases, the onset of symptoms is between 15 and 30 years old. People are at higher risk if a family member has been diagnosed, especially if it’s a first degree relative, but doctors don’t think the disorder kicks in based on genetics alone. A stressful event, drug abuse, or other unknown factor may trigger the cycle of ups and downs.

Bipolar Disorder and Daily Life Bipolar disorder can disrupt your goals at work and at home. In one survey, 88% of patients said the illness took a toll on their careers. The unpredictable mood swings can drive a wedge between patients and their co-workers or loved ones. People with bipolar disorder also have a higher risk of developing anxiety disorders.

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EDITORIAL TEAM

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

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Wednesday, August 27, 2014