Monday, September 8, 2008

Avoid 'More Slim' Weight Loss Products

Health Canada is advising consumers not to use More Slim due to concerns about possible side-effects.

Product Description: More Slim is promoted for weight loss.

Reason for Warning: The Hong Kong Department of Health has warned against the use of More Slim because it was found to contain the undeclared pharmaceutical ingredient sibutramine.

Sibutramine is a prescription drug used in the treatment of obesity and should only be used under the supervision of a health care professional.

Possible Side-Effects: Unsupervised use of sibutramine may cause headaches, increased heart rate and blood pressure, chest pain and stroke.

The Common Cold:Treatment

Only symptomatic treatment is available for uncomplicated cases of the common cold: bed rest, plenty of fluids, gargling with warm salt water, petroleum jelly for a raw nose, and aspirin or acetaminophen to relieve headache or fever.

A word of caution: several studies have linked the use of aspirin to the development of Reye's syndrome in children recovering from influenza or chickenpox. Reye's syndrome is a rare but serious illness that usually occurs in children between the ages of three and 12 years. It can affect all organs of the body, but most often injures the brain and liver. While most children who survive an episode of Reye's syndrome do not suffer any lasting consequences, the illness can lead to permanent brain damage or death. The American Academy of Pediatrics recommends children and teenagers not be given aspirin or any medications containing aspirin when they have any viral illness, particularly chickenpox or influenza. Many doctors recommend these medications be used for colds in adults only when headache or fever is present. Researchers, however, have found that aspirin and acetaminophen can suppress certain immune responses and increase nasal stuffiness in adults.

Nonprescription cold remedies, including decongestants and cough suppressants, may relieve some cold symptoms but will not prevent, cure, or even shorten the duration of illness. Moreover, most have some side effects, such as drowsiness, dizziness, insomnia, or upset stomach, and should be taken with care.

Nonprescription antihistamines may have some effect in relieving inflammatory responses such as runny nose and watery eyes that are commonly associated with colds.

Antibiotics do not kill viruses. These prescription drugs should be used only for rare bacterial complications, such as sinusitis or ear infections, that can develop as secondary infections. The use of antibiotics "just in case" will not prevent secondary bacterial infections.

Does vitamin C have a role? Many people are convinced that taking large quantities of vitamin C will prevent colds or relieve symptoms. To test this theory, several large-scale, controlled studies involving children and adults have been conducted. To date, no conclusive data has shown that large doses of vitamin C prevent colds. The vitamin may reduce the severity or duration of symptoms, but there is no definitive evidence.

Taking vitamin C over long periods of time in large amounts may be harmful. Too much vitamin C can cause severe diarrhea, a particular danger for elderly people and small children. In addition, too much vitamin C distorts results of tests commonly used to measure the amount of glucose in urine and blood. Combining oral anticoagulant drugs and excessive amounts of vitamin C can produce abnormal results in blood-clotting tests.

Inhaling steam also has been proposed as a treatment of colds on the assumption that increasing the temperature inside the nose inhibits rhinovirus replication. Recent studies found that this approach had no effect on the symptoms or amount of viral shedding in individuals with rhinovirus colds. But steam may temporarily relieve symptoms of congestion associated with colds.

Interferon-alpha has been studied extensively for the treatment of the common cold. Investigators have shown interferon, given in daily doses by nasal spray, can prevent infection and illness. Interferon, however, causes unacceptable side effects such as nosebleeds and does not appear useful in treating established colds. Most cold researchers are concentrating on other approaches to combatting cold viruses.

Keep Your Holidays Happy, Healthy and Headache-Free

As the holidays approach, people across the country are looking forward to the twinkling lights, festive music, sweet treats and an extra dose of family visits. But for many, these favorite holiday traditions can also bring on an unwelcome threat of headaches and for some, even a debilitating migraine headache attack.

Most people suffer from the occasional headache and an estimated 25 million Americans -- 75 percent of whom are women -- experience much more severe migraine headaches. No matter what the type, however, experts now know that headaches can be triggered by foods, beverages and other lifestyle factors. According to Donnica Moore, MD, founder of the Sapphire Women's Health Group, each headache sufferer has his or her own combination of personal headache triggers, which can be increasingly difficult to avoid during the holiday season.

"No doubt, the holidays can be a difficult time for headache sufferers," says Dr. Moore. "Not only are many headache triggers more prevalent, but also people may not want to feel excluded at the office parties or family gatherings by avoiding some of the more 'festive' headache triggers.

Managing Obesity and Cholesterol in Kids

If you are concerned about your child's weight, you are in good company. According to Samuel S. Gidding, MD, pediatric cardiologist at Virtua-duPont, "Childhood obesity is a serious problem. Over the past 20 years, the number of children who are overweight has increased by more than 50 percent and the number of extremely overweight children has nearly doubled. About 25 to 30 percent of school-age children in the United States are overweight or obese, which puts them at a high risk for heart disease, diabetes, high cholesterol, sleep apnea, asthma, orthopedic problems, hypertension and other health problems."

Obesity is a condition of excess weight, which puts a person at health risk. Defined as an excess of body fat, obesity is the result of a body's inability to balance calorie intake and energy expenditure. (Weight is evaluated by body mass index (BMI), waist circumference and a patient's risk factors for disease and conditions associated with obesity.)

According to Dr. Gidding, poor eating habits and inactivity are the root causes of childhood obesity. A family history of obesity may also increase a child's risk of becoming obese, especially if both the parents are overweight. In addition, the high level of fat and calories in the average United States diet combined with the inactive lifestyle of many children is contributing to the dramatic increase in the prevalence of childhood obesity. "In today's fast-paced society, foods with higher fat are easier to access as many families tend to eat out or eat on the run, often eating foods in larger portions with a higher caloric intake," says Dr. Gidding.

"Many parents worry about whether their children are at an unhealthy weight," says Dr. Gidding. "One way to know for sure is to check with your child's doctor, who will determine if your child is above the ideal weight for their height and age. A child usually is obese when they are significantly over ideal body weight for their height. In general, if a child's weight is 20 percent or more in excess of the expected weight for a given height, a child is mildly obese. More than 30 percent above ideal weight is severe obesity. Additional ways to determine childhood obesity include the measurement of skinfold thickness, bioelectrical impedance and whole-body densitometry."

Dr. Gidding recommends that if a child is more than 40 percent overweight, a physician or registered dietitian guided weight loss program may be suggested to modify the child's eating behaviors, rather than just restricting calories. "During the course of the program, the emphasis should be on adopting a healthier lifestyle for the long term, not just on losing weight now, explains Dr. Gidding. "Children are developing physically and mentally, and they need adequate nutrition as they grow. Combining a healthy well-balanced diet with exercise is the best way to achieve healthy levels of body fat. By setting reasonable goals, weight maintenance should be achieved before weight loss is contemplated."

Although rapid growth and weight gain are part of puberty and adolescence, Dr. Gidding explains that many children and teens become overweight because of too many calories and too little exercise. "If your child or teen tends to sit around and watch television or play video games, try gently introducing more physical activities into your family life whether in an organized sport or individual pursuit," suggests Dr. Gidding. "Take a walk together or go for a bike ride. Make good nutrition and exercise a family affair by planning lower fat meals, nutritious snacks and family activities."

One of the most important strategies of preventing childhood obesity is to provide adequate nutrition for growth and development. Dr. Gidding reminds parents to take a look at their own eating habits to see if they are setting a good example. "Family involvement is encouraged in identifying eating habits, exercise and lifestyle patterns that can be modified through nutrition counseling and behavior techniques," says Dr. Gidding. "Eliminate unhealthy foods from your household rather than singling out your child and prohibiting her from eating them; keep healthy snacks in a place where your child can easily get to them; limit television and computer time and make time to exercise with your child. Exercise is the simple thing that you can do to lower your cholesterol and blood pressure and make you feel better."

Thyroid disease and eye

What is Graves' disease?

Graves' disease is a disorder of the immune system that affects thyroid, skin and eye in the body. Though it may occur in any age in both the sexes, it is generally more common in females in the age group 20 to 60 years.

Normally the immune system in the body makes antibodies, which have a role in protecting the body from viruses, bacteria and other foreign substances. In graves' disease the immune system mistakenly attacks the thyroid gland, eyes and skin of the lower limb, causing the symptoms.

What are the manifestations of graves' disease?

As explained above, this disease affects thyroid gland, skin and eyes. Thyroid is a gland located in the neck region and is responsible for secreting a hormone that controls the metabolism and growth of the body. In graves' disease the secretion of thyroid gland is generally increased by the antibodies, leading to a condition known as hyperthyroidism. The symptoms of this condition are:
  • Increase in appetite
  • Loss of weight
  • Poor heat tolerance
  • Irregular heart beat, pounding of heart
  • Changes in menstrual pattern
Some people with Graves' disease suffer from an irritating skin condition. Skin over the shins appears red and swollen. The top of the feet also may be affected in this way.

How can this disease affect the eyes?
Thyroid and Eye
Graves' disease also affects the eye and leads to a condition known as Graves' ophthalmopathy. Eye symptoms and hyperthyroidism symptoms usually appear within 18 months of each other. It generally involves both eyes, though even one eye may be involved.



The antibodies act on the tissues behind the eyeball. These get inflamed and attract and hold water. This leads to swelling of tissues and muscles, causing the eyeball to protrude forwards and also leads to some decrease in mobility of the eyeball. The symptoms of this condition therefore are:
  • Proptosis (protrusion of the eyeball forwards)
  • Widening of the space between the eyelids
  • Redness of the eyes
  • Excess tearing and discomfort
  • Blurring or double vision
  • Decreased movements of eyes
Can it cause serious damage to the eyes?

Besides causing inconvenience in form of decreased movement and double vision, graves' ophthalmopathy may also lead to serious vision threatening complications. These are:
  • Damage to the cornea (the transparent portion of the eye): Protrusion of the eyeball and the widening of the opening of the eyelids leads to inadequate closure of the eyes during blinking and sleep. This leads to drying up and opacification of the cornea.
  • Damage to the optic nerve: The swelling in the tissues behind the eyeball may compress the optic nerve as it passes through it. This may lead to a serious loss of vision if not treated promptly.
Therefore whenever one has a symptom of irritation, excess tearing or decrease in vision, an ophthalmologist must be consulted. These two conditions may warrant an urgent treatment with medicines, radiation therapy or even orbital decompression surgery.

What is the treatment?

First of all the thyroid status is determined and is treated accordingly, based on whether the thyroid hormone levels are high or normal or even low. The treatment for the eye condition depends upon the severity of the disease as well as the stage of the disease. The patient may need one or a combination of the following treatment options:
  • Cool compresses, sunglasses, lubricating eyedrops, or raising your head at night
  • Medications or radiation to shrink tissues
  • Orbital decompression surgery
  • Prisms for your glasses
  • Eye muscle surgery, eyelid surgery, or both
Is surgery also required?

Depending upon the condition of the eyes, the ophthalmologist may advise a surgery. The following surgeries are done for this condition:
  • Orbital decompression surgery: In this surgery, the bone between the orbit (the cavity holding the eyeball) and the surrounding sinuses (air spaces next to the orbit) is removed. This provides more space to the swollen tissues behind the eye and thus decreases the protrusion of eyeballs and also the pressure on the optic nerve.
  • Eye muscle surgery: The involvement of the muscles of the eyes may lead to misalignment of the eyes and thus lead to double vision. If the prisms in the glasses can not relieve the symptoms, surgery may be required. This surgery aims to correct the misalignment by operating on the muscles of the eye. The aim is to give single vision in the straight-ahead gaze and the downgaze (as for reading). It may require more than one surgery to properly align the eyes. This surgery is undertaken only after the misalignment has been constant and is not changing.
  • Eyelid surgery: In Graves' ophthalmopathy the eyelids open more widely. The surgery on eyelids is undertaken to correct this defect.
If the eye requires all these three surgeries, the sequence is orbital decompression, eye muscle surgery and then eyelid surgery.

Wednesday, September 3, 2008

Further Reading

Further reading

  • Bausell, R. Barker (2007), Snake Oil Science: The Truth About Complementary and Alternative Medicine, Oxford University Press, ISBN 978-0-19-531368-0
  • Benedetti F, Maggi G, Lopiano L. "Open Versus Hidden Medical Treatments: The Patient's Knowledge About a Therapy Affects the Therapy Outcome." Prevention & Treatment, 2003; 6(1), APA online
  • Diamond, J. Snake Oil and Other Preoccupations, 2001, ISBN 0-09-942833-4 , foreword by Richard Dawkins reprinted in Dawkins, R., A Devil's Chaplain, 2003, ISBN 0-7538-1750-0 .
  • Downing AM, Hunter DG. "Validating clinical reasoning: a question of perspective, but whose perspective?" Man Ther, 2003; 8(2): 117-9. PMID 12890440 Manual Therapy Online
  • Eisenberg DM. "Advising patients who seek alternative medical therapies." Ann Intern Med 1997; 127:61-69. PMID 9214254
  • Goldberg, Burton. Anderson, John & Trivieri, Larry “Alternative Medicine: The Definitive Guide”, Ten Speed Press, 2002 ISBN 978-1587611414
  • Gunn IP. "A critique of Michael L. Millenson's book, Demanding medical excellence: doctors and accountability in the information age, and its relevance to CRNAs and nursing." AANA J, 1998 66(6):575-82. Review. PMID 10488264
  • Hand, Wayland D. 1980 "Folk Magical Medicine and Symbolism in the West", in Magical Medicine, Berkeley: University of California Press, pp. 305-319.
  • Illich, Ivan. Limits to Medicine. Medical Nemesis: The expropriation of Health. Penguin Books, 1976.
  • Feinstein, D., & Eden D. Six Pillars of Energy Medicine: Clinical Strengths of a Complementary Paradigm, Alternative Therapies in Health and Medicine 2008, 14(1), 44-54.
  • Lazarou, J. Pomeranz, BH. Corey, PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies, J of the American Medical Association 1998, 279, 1200-1205.
  • Mayo Clinic. Mayo Clinic Book of Alternative Medicine: The New Approach to Using the Best of Natural Therapies and Conventional Medicine, Parsippany, NJ: Time Inc Home Entertainment, 2007, ISBN 978-1933405926.
  • Murray, Michael, & Joseph Pizzorno. Encyclopedia of Natural Medicine, New York: Three Rivers Press, 1997 (second edition), ISBN 978-0761511571.
  • Ninivaggi, F. J., An Elementary Textbook of Ayurveda: Medicine with a Six Thousand Year Old Tradition, International Universities/Psychosocial Press, Madison, CT, 2001.
  • Ninivaggi, F. J., "Ayurveda: A Comprehensive Guide to Traditional Indian Medidine for the West", Praeger Press/Greenwood, Westport, CT, 2008.
  • Pert, Candace B., Molecules of Emotion: Why You Feel the Way You Feel, Scribners, 1997, ISBN 0-684-84634-9
  • Phillips Stevens Jr. Nov./Dec. 2001 "Magical Thinking in Complementary and Alternative Medicine", Skeptical Inquirer Magazine, Nov.Dec 2001
  • Planer, Felix E. 1988 Superstition, Revised ed. Buffalo, New York: Prometheus Books
  • Rosenfeld, Anna, Where Do Americans Go for Healthcare?, Case Western Reserve University, Cleveland, Ohio, USA.
  • Tonelli MR. "The limits of evidence-based medicine." Respir Care, 2001; 46(12): 1435-40; discussion 1440-1. Review. PMID 11728302 PMID: 11863470
  • Trudeau, Kevin, Natural Cures "They" Don't Want You to Know About, Alliance Publishing Group, ISBN 0-9755995-9-3; Mass Market Edition, 2007.
  • Trudeau, Kevin, More Natural "Cures" Revealed, Alliance Publishing Group, 2006, ISBN 0-9755995-4-2.
  • Wisneski, Leonard A. and Lucy Anderson, The Scientific Basis of Integrative Medicine, CRC Press, 2005. ISBN 0-8493-2081-X.
  • Zalewski Z. "Importance of Philosophy of Science to the History of Medical Thinking." CMJ 1999; 40: 8-13. CMJ online

Public Health

Public health is the study and practice of managing threats to the health of a community. The field pays special attention to the social context of disease and health, and focuses on improving health through society-wide measures like vaccinations, the fluoridation of drinking water, or through policies like seatbelt and non-smoking laws.

The goal of public health is to improve lives through the prevention and treatment of disease. The United Nations' World Health Organization defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." In 1920, C.E.A. Winslow defined public health as "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals."

The public-health approach can be applied to a population of just a handful of people or to the whole human population. Public health is typically divided into epidemiology, biostatistics and health services. Environmental, social, behavioral, and occupational health are also important subfields.


Objectives

The focus of a public health intervention is to prevent rather than treat a disease through surveillance of cases and the promotion of healthy behaviors. In addition to these activities, in many cases treating a disease can be vital to preventing its spread to others, such as during an outbreak of infectious disease or contamination of food or water supplies. Vaccination programs and distribution of condoms are examples of public health measures.

Most countries have their own government public health agencies, sometimes known as ministries of health, to respond to domestic health issues. In the United States, the frontline of public health initiatives are state and local health departments. The United States Public Health Service (PHS), led by the Surgeon General of the United States, and the Centers for Disease Control and Prevention, headquartered in Atlanta and a part of the PHS, are involved with several international health activities, in addition to their national duties.

There is a vast discrepancy in access to healthcare and public health intiatives between developed nations and developing nations. In the developing world, public health infrastructures are still forming. There may not be enough trained health workers or monetary resources to provide even a basic level of medical care and disease prevention. As a result, a large majority of disease and mortality in the developing world results from and contributes to extreme poverty. For example, many African governments spend less than USD$10 per person per year on healthcare, while, in the United States, the federal government spent approximately USD$4,500 per capita in 2000.

Many diseases are preventable through simple, non-medical methods. For example, research has shown that the simple act of hand washing can prevent many contagious diseases.

Public health plays an important role in disease prevention efforts in both the developing world and in developed countries, through local health systems and through international non-governmental organizations, like the International Public Health Forum (IPHF)

The two major postgraduate professional degrees related to this field are the Master of Public Health (MPH) or the (much rarer) Doctor of Public Health (DrPH). Many public health researchers hold PhDs in their fields of speciality, while some public health programs confer the equivalent Doctor of Science degree instead. The United States medical residency specialty is General Preventive Medicine and Public Health.