A Simple Guide to Varicose Veins

A Simple Guide to Varicose Veins
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What are Varicose Veins?
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Varicose Veins are swollen veins in the legs which has ballooned up over time.
They are more common in women than in men.

What are the causes of Varicose Veins?
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The cause of the Varicose Vein is due to the accumulation and stagnation of blood in the veins over time.
From the heart blood flows easily downwards to the legs into the capillaries to supply nutrient and oxygen to the foot.
From the foot the blood is then pushed up though the veins right up to the heart.
Movement of the blood in the veins is assisted by the contraction of muscles pushing the blood upwards.
When the muscle relaxes, the blood in the veins gravitates downwards but is prevented from going down by valves in the veins.
If the valve in the vein fails, blood begins to accumulates and stagnate in the veins causing ballooning and dilation of the veins.
The distended veins are then called Varicose Veins.

Causes for the failure of the valves in the veins are:
1.Hereditary - some people are born with inherent weakness of the valve of the veins.

2.Prolonged standing -causes gravitation of the blood down the veins

3.Pregnancy - the veins may be partially blocked by weight of the foetus causing stagnation of blood

4.Obesity - the weight of the body causes the blood to slow down and gravitates down wards in the veins.

5.pelvic tumours like ovarian cysts can partially block the blood flow up the veins.

6.Tight stockings- constricts the blood vessels mechanically

7.Smoking- constricts the blood vessel through its chemicals

What are the complications of Varicose Veins?
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Varicose Veins reduces the blood flow in the legs and can give rise to
complications:

1.Phlebitis-
inflmmation of the varicose vein is due to a blood clot stucked in the vein forming a thrombosis.
The skin over the inflammed vein becomes hot, red, swollen and tender.
A thrombosis in the superficial veins are usually not dangerous but a deep vein thrombosis can become detached and lodged in the lungs causing pulmonary embolism.

2.Haemorrhage-
bleeding may occur when a swollen varicose vein with thinned walls burst.
Blood will then flow out.
Trauma or injury of the swollen varicose vein can also cause bleeding.

3.varicose ulcers may occur when the swollen venous wall gradually stretched and breaks without bleeding.
The break may slowly develop into a ulcer becoming larger unless treated.

4.varicose pigmentation results from skin discoloration from an iron containing pigment called hemosiderin from broken down red blood cells stucked in the varicose veins.

What are the symptoms of Varicose Veins?
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1. Swollen blood vessels in the legs
2. Varicose pigmentation
3. Varicose ulcers
4. Phlebitis

What are the investigations needed in assessment of varicose veins?
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The type, size, location and depth of the varicose vein problem can be determined by various non-invasive diagnostic tests:

1.venous doppler,

2.PPG, and

3.color duplex ultrasound.

What is the treatment for Varicose Veins?
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1. No treatment if condition is mild

2. Elastic stocking- support stockings and pressure bandaging compress the valves of the veins together to prevent backflow and prevent dilation of the veins.
Once the stockings are in place, you should exercise by walking as much as possible. When sitting raise the legs.
While sleeping do not use the stockings.
Raise the bottom of bed or put legs on pillows to elevate the legs.
While stockings can slow down the natural course of the disease and reduce the painful symptoms. they WILL NOT CURE the disease.

3. Medical treatment:

Injection of veins-

a.Traditional Sclerotherapy
Here the veins are injected with a small amount of a solution causing them to collapse and disappear.

b.Ultrasound Guided Sclerotheraphy
By using a Doppler/Duplex Ultrasound system the doctor can get a x-ray-like picture of the deeper vein and inject at strategic locations of the vein.

c.Foam Sclerotherapy
Similar to traditional sclerotherapy, but using a foaming agent, making it more suitable for larger veins.

d.IPL Laser Therapy used mostly for the smallest spider veins.
In this method a light beam is pulsed onto the veins to seal them.

4. Surgical treatment:

a.tying of veins-
The simplest treatment consist of tying the superficial vein in the upper thigh preventing the flow of blood in the superficial vein and deflecting it into the deeper vein.

b.stripping of veins
this consist of removal of the long superficial vein using a instrument called the stripper.
After the removal of the vein, firm pressure is applied to the leg.

c.Ambulatory Phlebectomy
Parts of the vein is removed through tiny incisions leaving only small puncture marks and requires no stitches.

d.Closure(Radiofrequency Occlusion)
A super-thin catheter is inserted in the vein and when removed it closes the vein behind it by the use of radio frequency waves.

e.Endovenous Laser Treatment -same as the Closure Procedure, except the catheter emits laser rays instead of radio frequency waves

How can Varicose Veins be prevented?
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1.Reduce weight

2.Exercise

3.Aviod prolonged standing

4.Put your feet up

A Simple Guide to Obesity

A Simple Guide to Obesity
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What is obesity?
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Obesity is defined as having a weight 20% above the desirable weight which is having a BMI (Body Mass Index) of 22 or less.
It is a chronic medical condition where fat accumulates in the body due to excess calories.
Obesity is harmful to the person's health and well being.

What causes obesity?
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Many factors contributes to obesity:

Genetic factors
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Obesity runs in the family and is hereditary.
Family members who share the same diet and lifestyle may have the same overweight condition.

Environmental factors
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The environment is an important factor in determining obesity.
1.Overeating -
many people have an increased craving for food.
It has found that these people lack a hormone called serotonin in the brain which acts to decreased appetite.

2.low metabolism -
some people has a lower metabolic rate tends to accumulate the excess energy from food as fats in the body.
Classic example is hypothyroidism where the low thyroid hormone reduce the capacity of the body to burn off energy so they become lethargic and fat.

3.lack of exercise -
Exercise helps to burn up calories.
People who tend to have a sedentary life without exercise tends to be overweight

4.Certain medications:
some medications like corticosteroids, female hormones aand antidepressants tends to cause increased appetite and water retention and contributes to weight gain.

Psychological factors
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Psychological factors may be the cause of tendency to overindulge in food.
Some people eats more out of boredom, sadness, or anger.
Others overeat as a way of dealing with stress or depression.

Rare illnesses:
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Some rare illnesses like hypothyroidism, Cushing's syndrome, depression, and certain neurological problems can lead to overeating.
These conditions are believed to be responsible for only about one percent of all obesity cases.

What is the criteria for diagnosis of Obesity?
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The most widely used method is the body mass index (BMI).
BMI is the gauge of the amount of body fat in adults.

BMI = Your Weight (kg)
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Height (metres) x Height (metres)

The risk of developing heart disease and diabetes begins at BMI values of 23 kg/m2 and above.
BMI (kg/m2) (for adults):
Risk of Heart Disease and Diabetes

27.5 and above
High Risk

23.0 - 27.4
Moderate Risk

18.5 - 22.9
Low Risk (healthy range)

Less than 18.5
Risk of nutritional deficiency diseases and osteoporosis

Knowing your BMI will motivate you to lower your weight.

What are the Complications from obesity?
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Health hazards
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Obesity is not just a cosmetic problem.
Many serious medical conditions are associated with it:
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1.High blood pressure

2.High blood cholesterol

3.Diabetes

4.Coronary heart disease

5.Stroke

6.Gallbladder disease

7.Liver disease

8.Degenerative joint disease

9.Cancer (colon, uterine, breast and other cancers).

10.Gout,caused by high levels of uric acid in the blood from the high purine
proteins consumed.

11.Sleep apnoea

Emotional effects:
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1.Feelings of rejection, shame, or depression

2.Feeling undesirable compared with a slim person.

3.Some face prejudice or discrimination.

4.Some may be seen as lazy or lacking in self-control.

Treatment of Obesity will follow in A Simple Guide to Obesity Part 2

A Simple Guide to Depression

A Simple Guide to Depression
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What is Depression?
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Depression is a very common mental ilness with an alteration of mood which exceeds normal sadness.

How common is Depression?
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Everyone has felt sad at one time or another.
It may be due to a disappointment, frustration or losing someone.
But time heals, the mood lifts and people continue to get on with their lives.
In some people, depression can be so severe that it dominates their lives, preventing them from living their lives as they used to.
Depression of this degree is a medical illness and needs treatment.

What Are The Types Of Depression?
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1.Major depression is manifested by a combination of symptoms that affect our work, interests and feelings towards family and friends.
These disabling episodes can occur twice or several times in a lifetime.

2.Dysthymia is a less severe type of depression.
People with dysthymia have long-term depressive symptoms and it prevents them from functioning at an optimal level.

What Are The Causes Of Depression?
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1.hereditary or genetic factors in the transmission of depressive disorders.
In some families, major depression seems to occur generation after generation.

2.biological component in depression.
It may be associated with having too little or too much chemicals in the brain.

3. medications have mood altering properties.
Some medication act by altering the biochemical imbalances in the brain causing depression.

4. Life events such as loss of a job, retirement, divorce, death of a loved one or moving to a new house can precipitate a depressive illness.

5.Social circumstances also play a part.
If we are alone, have few or no friends, suffer from a chronic illness, then we may be more vulnerable to depression.

6. People with life threatening or long-term physical illness such as cancer, stroke, arthritis or heart disease are also more vulnerable to depression.

7. Personality may also play a part in depression. Some of us are more vulnerable than others because of the individual make-up or early life experiences.

Very often, a combination of genetic, psychological and environmental factors is involved in the onset of depression.

The good news is that whatever the cause, depression is treatable.

What are the Symptoms Of Depression?
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Certain characteristic symptoms can give you or your family a clue that you are depressed:

1.Depressed mood

2.lethargy and fatigue

3.loss of interest and enjoyment in life

4.lack of drive or motivation that makes even simple tasks or decisions difficult or impossible

5.loss of concentration

6.Loss of self confidence, avoiding people

7.Sleeplessness or excessive sleeping

8.Agitation or restlessness

9.ideas of being useless, inadequate, helpless or hopeless

10.Feeling guilty or worthless

11.Loss or gain in appetite, libido with loss or gain in weight

12.Thoughts of suicide;

These symptoms are very common in depression.
It is much better admitted to friends or relatives than to keep them hidden.

How is Depression Treated?
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Reassurance and support is most important in treatment of depression.

Recognition of suicide risk must be remembered when treating a depressed person.

Treatment for depression is well established.
Majority up to 90% of people with major depression have fairly good treatment outcome.

Treatment consists of
drug (antidepressant medication) and
non-drug therapy.
Usually, a combined treatment is best:
1.medication to gain relatively quick relief and
2.psychotherapy to learn more effective ways to deal with life stresses.

Antidepressant Medication
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All antidepressant medications are equally effective but they have different side effects.
The most often used antidepressants include tricyclics, monoamine oxidase inhibitors, lithium and selective serotonin inhibitors (SSRI).

Antidepressant medications do not begin working the day you take them but your mood will improve after one to two weeks.
However, you may notice some improvement on the first day, especially in your sleep and feeling less tense and anxious.

The medications are compatible with painkillers, antibiotics and contraceptives. However, you should avoid alcohol as the medication and alcohol combined can make you too drowsy.
Do not stop the medication once you start to feel better as you may relapse into depression again.
You should discuss this with your doctor and let him advise you when to stop.
Antidepressants like all drugs have some side effects, though these are usually mild and tend to wear off as treatment goes on.

The common side effects and their remedies are:
Dry mouth - drink more water
Constipation - eat more fruits, cereals, prunes and vegetables
Drowsiness - this will pass soon; do not drive or operate heavy machinery if feeling sedated Dizziness - rise from bed or chair slowly

Some side effects with the newer medications:
Headache - this will usually go away
Nausea and stomach discomfort - transient; take medication with food
Nervousness and insomnia - these may occur during the first few weeks, reducing the dose will usually resolve them.

Non Drug Therapy
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Psychotherapy
Psychotherapy involves talking things through with a trained counselor or therapist.
Talking to someone who can really listen and understand you without passing judgement can be a tremendous relief.
You learn how to solve problems and cope with life stresses better.

Exercise
Exercise not only improves your health but it also gives you a sense of accomplishment. Endorphins ('feel good' hormones) are released during exercise and this can elevate your mood.

Relaxation Therapy
This involves deep breathing exercises and progressive muscle relaxation.

Support Groups
Support groups offer fellowship and you get to hear first hand accounts of how others with depression, like you, have learnt to cope.
There is also a psychoeducation group which help you learn about the depressive illness and methods of coping.

Electroconvulsive Theraphy (ECT)
ECT is only indicated for those with severe depression who have not responded to treatment or are highly suicidal.
It involves giving a light general anaesthetic and an electric current is passed through the brain for a few seconds. The whole procedure takes only about 15 minutes and the patient is only aware of having gone to sleep.

How Can You Prevent Depression ?
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1.try to talk to close friends about bad news

2. Be realistic about your goals. Do not aim too high. Set priorities and do what you can.

3. Do something - get out of the house for a walk or some exercise.
While you may not be able to work, it is always good to try to keep up with some light activities such as housework.
This will help take your mind off those painful feelings.

4. Eat a good balanced diet, even though you may not feel like eating.

5. Resist the temptation to drown your sorrows with alcohol.
Alcohol can depresses the mood, so while it may give you immediate relief by making you forget your problems, this is very temporary and you may end up more depressed.
It is also bad for your liver and general physical health.

6. Remind yourself that you are suffering from depression, something that many other people have gone through, and that you will eventually come out of it, as they do

7.Remember your appointments to see the doctor , take your medicine regularly and do not be afraid to ask for help from your friends and support groups.

A Simple Guide to Gastritis

A Simple Guide to Gastritis
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What is Gastritis?
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Gastritis is a disease which is caused by inflammation of the stomach lining.
It may presents as gastritis ,peptic gastric ulcer or if it extends to the duodenum(first part of small intestine) duodenal ulcers.

What are the causes of Gastritis?
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Two main causes are

1.helicobacter pylori infection - this bacteria damages the protective lining of the stomach making the underlying stomach tissue more vulnerable to the acidic gastric juice.

2.excessive production of acidic gastric juice
Excessive production of acidic gastric juice burns into the protective lining of the stomach and cause inflammation of the underlying stomach tissue.
The causes of excessive production of acidic gastric juice are:
1. Most common is stress and anxiety which automatically increase the production of the acid as a result of sympathetic nervous reaction
2.hereditary- some gastric patient has family history of gastric problem. Blood group O tends to have more gastritis while Blood group A has a tendency towards stomach cancer.
3.irregular meals tend to cause more acidic gastric juice to form at regular meal time.
4.alcohol and smoking has been associated with increased acid formation
5.Drugs: prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen,
6. diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.

What are the Symptoms of Gastritis?
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The most common symptoms are
1.upper abdominal upset or pain.
Other symptoms are
2.belching, abdominal bloating,
3.nausea, and vomiting
4.indigestion or of burning in the upper abdomen or in the chest(heart burn).
5.Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention.

How do you diagnose Gastritis?
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Gastritis is diagnosed through one or more medical tests:
Medical history - past and family history of gastritis
Physical examination- epigastric bloating or tenderness
Upper gastrointestinal endoscopy.
The doctor eases an gastroscope, a thin tube containing a tiny camera, through your mouth and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests(biopsy).
The biopsy will detect how bad is the inflammation or whether there are underlying cancer cells. In additional if any polyps (benign swelling of the lining of the stomach) are detected, they are removed at the same time and sent for biopsy.
Blood test. The doctor may check your blood for any evidence of H.pylori infection and your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
Urea breath test can also determine whether you have H.pylori infection
Stool test. This test checks for the presence of blood in your stool, a sign of bleeding. Stool test may also be used to detect the presence of H. pylori in the digestive tract.

What is the Treatment of Gastritis?
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The main treatment is usually
1.reduce stress
2.reorganisation of work in such a way as to be able to handle the pressure of work better as well as to have regular meals
3.Control of diet - avoid hard foods such as peanuts , tough meat, spicy food, cold food, black coffee, strong tea,citrus fruits and their juices,carbonated beverages, deep fried or oily food.
4. Take more frequent and smaller meals.
5. Avoid alcohol and smoking
6. Avoid drugs such as aspirin, painkillers,steroids which may irritate your stomach and cause increase in acid production
Medical treatment:
Treatment usually involves taking drugs
1.Antacids:to reduce stomach acid and thereby help relieve symptoms and promote healing. (Stomach acid irritates the inflamed tissue in the stomach.)
2.H2 Antagonist: to reduce to production of acidic gastric juice.(cimetidine, ranididine,omeprazole, Nexium etc)
3. Antispasmodics: anticholinergic drugs like buscopan, librax reduce the spasm in the stomach and duodenum
4. Antiflatulents - to reduce gas in the abdomen
5.If your gastritis is caused by an infection, that problem may be treated as well. For example, the doctor might prescribe antibiotics to clear up H. pylori infection.

Once the underlying problem disappears, the gastritis usually does too.
Talk to your doctor before stopping any medicine or starting any gastritis treatment on your own.
What are the Complications of untreated Gastritis?
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Any untreated gastritis can cause complications such as:
1. peptic ulcers
2. bleeding ulcers
3.perforated stomach and peritonitis

Gastritis or ulcer is not healed overnight. The chances of satisfactory gastric recovery are excellent. However recurrences are always possible so do not stop your medications, good food habits and healthy lifestyle too soon.

A Simple Guide to Scoliosis

A Simple Guide to Scoliosis
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What is Scoliosis?
----------------------

Scoliosis literally means a crooked spine, a lateral curve or angular deviation of one or more of the vertebral segments.
3% of the population have some form of scoliosis.
For many people it's not much of a problem.
For a small number of people, the curve gets worse as they grow.

What is the cause of Scoliosis?
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1.The most common type of scoliosis is called idiopathic(or unknown cause.) scoliosis.
2.Scoliosis can run in families, that is , it may be hereditary.

Who is affected by Scoliosis?
---------------------------------

Scoliosis usually begins at the age of 9-18 years when the bone starts growing during puberty. After this age, the curve usually become permanent as the bone stopped growing.
Scoliosis is more common in girls than boys.

How Do You check for Scoliosis?
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Scoliosis may be easily noticeable.
A curved spine can cause someone's body to tilt to the left or right.
Many children with scoliosis have one shoulder blade that's higher than the other or an uneven waist with a tendency to lean to one side.

During a doctor visit in school, cases of scoliosis are easily detected during examination.
It's an easy test called the forward-bending test.
It involves bending over, with straight knees, and reaching your fingertips toward your feet or the floor. Then the doctor will look at your back to see if your spine curves.

Someone with scoliosis may have a back that curves like an "S" or a "C."
This type of curve may be noticeable to others and can be uncomfortable.

How to decide whether your Scoliosis require Treatment?

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If you have confirmed scoliosis, then the doctor will decide whether treatment is necessary. He may order X-rays of your spine. This will determine the angle of curvature and the severity.
If the curve is mild, you may not need much treatment except for exercises to straighten your back and consistent monitoring of your spine.

If the curve is severe ,an orthopedic surgeon will check on how severe your spine's curve is.

He will looks at your X-rays and measures the spine's curve in degrees.

Someone who has a mild curve may just need regular checkups to make sure the curve isn't getting worse.

Someone with a more severe curve may need to wear a brace or have an operation.

What is the treatment of Scoliosis?
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There are 3 main methods of treatments:

1.Exercises for back and monitoring:
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For mild cases, you may need to do some exercises to help straighten the back such as doing pull ups.

2.Treating With Braces
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The brace for scoliosis is meant to hold the spine in place so the curve doesn't get any worse.
Some braces are made to be worn only at night.
Others are designed to be worn for much of the day.
Most children need to wear their braces at least 20 hours a day, so that means wearing them to school.
As he or she gets older and the spine curvature improve, braces are worn for a shorter peroid daily.

Braces now are lighter, more comfortable, and easier to wear.
There are many different types of braces.
Where the scoliosis is in the lower part of the back, the child often wear a brace called a thoracolumbosacral orthosis or TLSO for short.
This kind of brace comes up under the arms and is more comfortable than the bigger braces.
The two most popular TLSOs are the Boston brace and the Wilmington brace.

3.Treating With Surgery
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Braces often are able to control the curvature.
Some children who have scoliosis eventually need an operation because of the increasing severity of the scoliosis or if a severe scoliosis is detected late.

During the operation, the orthopedic surgeon fuses the bones in the spine together to correct the curve using metal rods, hooks, screws, and wires to hold everything in line until the bones heal.

The operation takes several hours, depending on how big the curve is and how many bones need to be fused.
After the operation,the child can usually go back to school about a month later.
He or she need not wear a brace and can return to some activities in 3 or 4 months, and most normal activities after a year.
Each patient's surgery and recovery might be different, depending on the type of surgery and the patient's age.

With improved treatment, more children with scoliosis can live normal lives.

A Simple Guide to Asthma

A Simple Guide to Asthma
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What is asthma?
-------------------

Asthma is a common long-lasting (chronic) inflammatory disease of the lungs and airways (bronchi) that affects 5 % adults and 20% children and causes narrowing of the airtubes.

What happens during an asthma attack?
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When your airtubes are exposed to trigger factors, inflammation of the airway results.
The breathing tubes become narrowed and clogged up with mucus making breathing difficult. Inflammation may continue even though there is minimal or no symptom of asthma.

What are the symptoms of Asthma?
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Asthma is characterised by attacks of

1. breathlessness,

2.tight chest,

3.wheezing sounds and

4.coughing

These symptoms are caused by the airways becoming narrowed and inflamed.
Some people may have these symptoms all of the time.

Others may be normal between attacks.

Who is at risk of developing asthma?
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Anybody can get it at any age but it tends to run in families.
They also have an inherited tendency to develop other allergic conditions such as eczema and allergic rhinitis.
Most children, particularly those with mild asthma will be attack free by adolescence.
A small number continue to have symptoms as adults.
Yet others have their asthma symptoms reappearing only when they reach adulthood.

What causes asthma attacks?
-------------------------------------

Asthma results from sensitive airways that react to certain trigger factors.
These triggers may be different for different people.
Avoidance of trigger factors is important.

Some common triggers are:
1.Allergens such as house-dust mites, cockroaches, animal danders, pollen, indoor moulds and foods particularly those containing sulphite.
2.Infections such as the common cold and sinus infection

3.Weather changes due to change in temperature or humidity
4.Air pollution e.g. from tobacco smoke and haze
5.Strong odours or sprays e.g. paints, varnishes, cleaning solvent fumes, perfumes, cooking fumes
6.cold air,
7.vigorous exercise
8.stress.

Attacks may be more frequent or severe in people who have a chest infection.

Avoidance of trigger factors
1.Animal dander (fur, skin of cats or dogs) Give away pet if possible. If not, prevent pet from entering the bedroom. Bathe pet weekly.
2.House-dust mites Use protective air-tight mattress covers and pillow cases. Wash bedsheets and pillow cases weekly in hot water
3.Cockroaches Do not leave garbage uncovered. Use poison baits. Use pesticide spray only when the asthmatic is out of the house.
4.Indoor moulds Reduce dampness in the house.
5.Outdoor pollens Close doors and windows and stay indoors when pollen count is highest in the afternoon.
6.Tobacco smoke and haze Avoid tobacco smoke and haze as far as possible.
7.Medication Aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and beta-blockers should be avoided.
8.Food Certain foods containing sulphites should be avoided such as shellfish and preserved foods.

What to do during an asthma attack?
--------------------------------------------

1.Stay calm. Family members or caregivers should be calm, positive and encouraging.
2.Use 2 puffs of your reliever inhaler immediately as previously instructed by your doctor.
If asthma symptoms are not relieved or wheezing returns within 4 hours, give another 2 puffs of the reliever.

3. take your asthma medications with warm water.

4. consult your family doctor if there is no improvement.
If necessary, go to the nearest hospital for help.

How serious is Asthma?
----------------------------

Asthma is not generally considered by doctors to be a serious illness in most people who have it, mainly due to the mildness of symptoms and the range of very effective medicines that control these symptoms and stop asthma worsening.
Asthma does, however, have an effect on quality of life because attacks can be unpleasant and distressing and can restrict activity. Whilst most sufferers learn to live with and manage their condition, for some it can be disabling.
In exceptional cases, asthma can be life-threatening, particularly if it is not treated adequately or promptly. For some of these, an attack is so severe that it results in death.

How long does Asthma last?
-----------------------------------

Asthma attacks come and go, with wide variation in the symptoms at different times.
Many people with asthma have problems only occasionally but others struggle with it every day. Modern medicines control and relieve symptoms and so attacks may only last a few hours or minutes, but without treatment this may go on for several days.
Some children grow out of asthma and some people are only affected at different times of the year.
However, the period of time during which people may have asthma attacks can last for many years or throughout life.

How is Asthma treated?
----------------------------

There is no cure for asthma, but there are different types of medicines that will help to keep it under control and relieve symptoms.
1.Most sufferers must be given a type of medicine called a preventer, which is usually an anti-inflammatory steroid (of the glucocorticosteroid type) that treats the underlying causes of the asthma. These are usually given from an inhaler.
Even if symptoms are not present, sufferers should keep taking the preventer medicines, as this will greatly decrease the risk of suffering asthma attacks. This will help many asthmatics to live a normal active life.
Steroids can also be taken as tablets but have many side effects.
2.Another sort of medicine is called a reliever that is used during an asthma attack and may be contained in an inhaler. This contains a bronchodilator medicine that opens up the bronchial tubes of the lungs and works in a few minutes. It can also be taken as tablets. Side effects may be rapid heart beats and tremors of hands.

Can asthma be cured?
---------------------------

No, there is currently no known cure for asthma.

The good news is that modern medicine is extremely effective in controlling symptoms.

You can lead a relatively normal life if you seek to understand how to control your asthma and prevent attacks from occurring.

Asthma attacks may be prevented at a reasonable cost.
It usually requires long term treatment with 'preventer medication'.

What you can do to control asthma?
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ASTHMA MANAGEMENT PLAN
Asthma is a chronic disease requiring continuous management and appropriate treatment.
If you follow your prescribed asthma management plan, you can expect to live an active, normal lifestyle.

Successful treatment of asthma is a partnership between you and your doctor.

You and your doctor should work out an asthma management plan.
This should include:
1.understanding what asthma is all about
2. having clear goals of management
3. knowing the severity of your asthma;
patients with mild asthma can do with just reliever medications to stop the attacks.
On the other hand, patients with severe asthma or those with frequent attacks should go on regular medications to prevent attacks
4.being able to recognise symptoms suggesting worsening of asthma
5.knowing your medicines (preventers and relievers) and how to use them correctly
6.using the right inhaler technique and practicing it until you get it right
7..recognising and avoiding trigger factors
8.knowing what to do during an asthma attack
9..arranging regular follow-up visits with your doctor

A Simple Guide To Gout

What is Gout?
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Gout is a disease caused by the excessive uric acid in the blood.

Who get Gout?
-----------------
Gout is often hereditary so even young adults are affected.
It occurs more commonly in men than in women.

How does it cause problems?
----------------------------------
The uric acid in the blood is usually discharged from the body dissolved in the urine and the intestinal tract and sometimes as perspiration through the skin.

1. Gouty Arthritis
high concentration of uric acid in the blood caused the formation of needle shaped urate crystals which are deposited in and around joints thus causing pain and swelling.

2.Kidney stones
Deposits can also form in the kidney and urinary tract as urate crystals or stones.

3.Skin urate trophi
Some urate crystals are also deposited in the skin, mostly commonly at the earlobe and joints.

What are the symptoms of Gouty Arthritis?
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The symptoms of gouty arthritis are usually of sudden onset.
They are:
1.pain
2.swelling
3.pain
4.joint feels hot

Where does gouty arthritis attack?
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These are the most common joints affected by Gout:

1. Big toe 76%
2. Ankle 50%
3. Knee 32%
4. Fingers 25%
5.Elbow 10%
6. Other Joints 2%

How do I prevent Gout?
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1.Drinks lots of fluids(at least 8 glasses of water a day).
This will help to excrete the uric acid through the urine and dilute the uric acid
concentration in the blood.

2.Avoid food which can produce high levels of uric acid. These are high protein foods such as:

Animal organs -liver,kidneys, intestines,brain
Seafood - especially prawns, crabmeat, lobsters, cockleshells, fish roes
Bean products- beancurds, soya beans,bean sprouts, peanuts
Alcohol - cause dehydration in the blood raising the concentration of uric acid.

3.Avoid fasting and starvation - again this raises the concentration of uric acid in the blood.
Obesity should be slowly reduced. The over-weight body affects the joints.

4.Avoid certain drugs like diuretic which reduces the volume of water in the blood and
raises the concentration of uric acid.

5.Take medications like allopurinol which help to reduce the production of uric acid.

How to treat an acute attack of Gouty arthritis?
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1.Take medicine like probenecid or cochicine which helps to flush the uric acid out through the urinary tract.

2.Drinks lots of water (eg. 3 glasses of water) immediately during an acute attack.

3.Rest the joint. If the the big toe is affected, raise it above the heart level to help the blood flow.

What are the Complications of Gout?
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1.Kidney stones may develop in the kidneys or urinary tract causing pain and damage to the kidneys.
2.Recurrent attacks of gout may erode the surfaces of the joint resulting in permanent damage.